Journal of Multidisciplinary Healthcare最新文献

Background: Due to the growing demand for better health services by the population pressure, Saudi Arabia is facing challenges in providing the required coverage in primary health care over all regions.

Study objectives: The study aims to do a comparative analysis of the spatial distribution of the primary healthcare centers and health manpower across Saudi Arabia.

Study methods: This study deals with the analysis of the spatial distribution of the PHCCs and health manpower in Saudi Arabia regions during the period 2017-2021 by applying the Shapiro-Wilk test. This study relied on a dataset issued by the Ministry of Health (MoH). The variance of the spatial distribution of the dataset was also analyzed using the T-student and Binomial tests.

Results: This study found that PHCCs of 2020; the dentists of 2021; and Allied Health Personnel of 2017, 2020, and 2021 were normally distributed. However, the distribution of the population and all datasets of the other health indicators is a non-normal distribution. In addition, the correlation between the number of PHCCs and regions based on population is significant in all the regions. Moreover, The number of dentists showed a significant correlation with the population in most regions, except Riyadh, Makkah, and Jazan. However, the number of physicians, allied health personnel, nurses, and family medicine practitioners generally did not correlate significantly with the population, with exceptions for nurses in Tabuk and family medicine in the Northern Borders. Finally, the spatial distribution of the population shows the concentration in three major regions which are Riyadh, Makkah, and Eastern Province.

Conclusion: Despite the expansion in the number of PHCCs and health workers and spread in all regions of Saudi Arabia, their spatial distribution still requires the establishment of more of them to provide the basic health services necessary to cover the actual needs of the population.

Objective: To explore the research trends and hotspots of health economics evaluations of patients with chronic fatigue syndrome.

Methods: To explore the research trends and hotspots of health economics evaluations of chronic fatigue syndrome, 180 articles published between 1991 and 2024 were visualized and analyzed via CiteSpace 6.3 software. R3 and VOSviewer1.6.20 and R4.3.3. The content includes annual publication volume, journal distribution, author country, publishing organization, author collaboration, citation analysis, and keyword analysis in 7 aspects.

Results: Fewer studies have evaluated the health economics of individuals with chronic fatigue syndrome in China and abroad, Chinese studies are especially rare, and research results in the UK are mostly found in other countries. Moreover, cooperation and linkages between institutions, as well as between authors, are not yet strong.

Conclusion: The hotspot of health economics evaluation methods in this field is cost-effectiveness analysis, and the hotspot of diagnosis and treatment methods is cognitive‒behavioral therapy. We also found that chronic fatigue syndrome may also have a strong potential association with depression from the perspective of health economics. Health economic evaluations of multiple treatments should be conducted simultaneously to increase attention to this field and provide a reference basis for low-cost and high-quality diagnostic and treatment programs.

Pharmacogenetics is a promising approach in future personalized medicine. This field holds excellent prospects for healthcare quality acceleration. It promotes the transition to the precision medicine era, whereby a health treatment is driven by a deeper understanding of individual characteristics by interpreting the underlying genomic variation. Pharmacogenetics has been developing rapidly since the human genome project. Many pharmacogenetics studies have shown the association between genetic variants and therapy outcomes. Several pharmacogenetics working groups have recommended guidelines for the clinical application of pharmacogenetics. However, the development of pharmacogenetics in low- and middle-income countries (LMICs) is still retarded behind. The problems mainly include clinical evidence, technology, policy and regulation, and human resources. Currently, available genome and drug effect data in LMICs are scarce. Pharmacogenetics development should be escalated with evidence proof through research collaboration across countries. The challenges of pharmacogenetics implementation are discussed comprehensively in this article, along with the prospect of pharmacogenetics-guided personalized medicine in developed countries. Stepwise is expected to help the researchers and stakeholders define the problem that hindered the pharmacogenetics application.

Objective: To analyze research trends, frontiers, and hot topics in specialty nurse training over the past 20 years, and provide a reference for researchers to understand the current research landscape in this field.

Methods: Studies from the core collection of Web of Science were used. Furthermore, CiteSpace 6.3 R3 was utilized to analyze information on country, institution, authors, keywords and burst words.

Results: A total of 296 articles were included in the analysis. The United States had the highest number of articles, and there was limited cooperation between authors and institutions. The research hotspots in this field included "clinical education models for specialist nurses", "APN role training", and "interprofessional education".

Conclusion: The future research trend is to explore the effective integration of training models suitable for different regions and cultural backgrounds and cross-professional education models. It is suggested that researchers pay attention to the innovation and development of specialized nursing clinical practice under different cultural backgrounds, and strengthen international exchanges and cooperation.

Background and objectives: While extensive research has examined the rehabilitation challenges faced by stroke survivors, there is limited literature addressing the difficulties encountered by older adult stroke survivors and their caregivers in accessing rehabilitation and long-term care within the Chinese community. This study aimed to investigate the specific challenges related to access, quality, and coordination of rehabilitation and long-term care experienced by older adult stroke survivors and their caregivers within the Chinese community.

Methods: A qualitative phenomenological design was employed to explore the lived experiences of stroke survivors and their caregivers within the Chinese community. A purposive sampling method was used to recruit participants from June to August 2023. Participants engaged in face-to-face semi-structured interviews. The data were analyzed using an inductive thematic analysis approach to identify and understand key themes and sub-themes.

Results: The study involved 38 participants, consisting of 21 older adult stroke survivors (13 males, 8 females) and 17 family caregivers (7 males, 10 females), recruited from five Chinese community health service stations. The analysis identified four distinct themes and 11 sub-themes that encapsulated the challenges faced by participants. These themes include (1) Difficulties in accessing medical services (insufficient medical resources, lack of rehabilitation resources, and time-consuming processes), (2) Challenges in daily life (inconvenience in daily mobility, inadequate financial support, and difficulties in applying for home care services), (3) Psychosocial stress (loneliness, powerlessness, and worry about burdening others), (4) Insufficient information (lack of awareness of available community services, and limited public health education activities).

Conclusion: Older adult stroke survivors and their caregivers in Chinese communities face significant challenges. To improve their well-being and quality of life, it is crucial to address these challenges through enhanced access to healthcare, better support for daily living, and more effective information dissemination. Meeting these needs requires a coordinated effort from healthcare providers, community stakeholders, and policymakers to develop and implement effective, long-term care solutions.

Purpose: Flavonoids are naturally occurring compounds with diverse health-promoting properties. The purpose of this study was to explore the associations between dietary flavonoid intake and cardiovascular health in cancer survivors.

Patients and methods: We obtained data from the National Health and Nutrition Examination Survey (NHANES) 2007-2008, 2009-2010, and 2017-2018 cycles. Weighted linear regression and restricted cubic spline (RCS) were used to explore the correlation between dietary flavonoid intake and cardiovascular health (Life's Essential 8 (LE8) score) in cancer survivors. Then, weighted quantile sum (WQS) regression and quantile-based g-computation (qgcomp) models were performed to assess the mixed effects of the six flavonoid subclasses and to determine the major flavonoid types. Additionally, the protective effect of high flavonoid intake on cardiovascular health was further evaluated in different subgroups, and mediation analysis was used to explore mediating factors.

Results: After adjusting for all covariates, compared to those in the first quartile, participants in the fourth quartile of total flavonoids, anthocyanidins, flavonols, flavanones, and flavones intake exhibited increases in LE8 scores of 3.24% (95% CI: 0.45-6.03, P for trend=0.030), 6.25% (95% CI: 3.14-9.36, P for trend<0.001), 3.01% (95% CI: 1.33-4.69, P for trend= 0.003), 3.23% (95% CI: 0.18-6.27, P for trend=0.030), and 5.01% (95% CI: 2.42-7.61, P for trend<0.001), respectively. Meanwhile, significant non-linear relationships were supported by the RCS models. However, the weighted linear regression and RCS models did not reveal any clear correlations between isoflavone or flavan-3-ol intake and the LE8 score. Regarding mixed effects, anthocyanidin, flavonol, flavanone, and flavone intake were positively related to the LE8 score according to both the WQS and qgcomp models, and anthocyanidin intake was the major contributor.

Conclusion: Our study indicated that dietary flavonoid intake is positively associated with cardiovascular health in cancer survivors, among which anthocyanidin intake might provide the most benefit.

Study purpose: This study seeks to investigate the various dimensions contributing to the sustainable competitive advantage of the Saudi eHealthcare system.

Methods: A cross-sectional survey design was adopted in this study. Eleven factors were identified that may affect the sustainable competitive advantage, which were embedded in to the survey questionnaire. Participants included diverse healthcare workers (physicians, specialist physicians, nurses, managers) from Saudi public hospitals. A total of 382 healthcare workers participated in the study.

Results: User experience and accessibility emerged as the most significant factor with a high mean of 4.04 ± 0.69, followed by innovation and continuous improvement (mean 3.8 ± 0.89) and AI adoption (mean 3.91 ± 0.82). Notably, a statistically significant difference is observed in the domain of Data Security and Privacy (p = 0.0448), with specialist physicians exhibiting a lower mean score (2.44 ± 0.86) compared to other roles.

Conclusion: The need to strengthen overall competitiveness is emphasized by identified areas for improvement, including data security, interoperability, and integration, which highlight the necessity for specific initiatives.

Objective: To explore the effect of the Integrated Management Model of Doctor-Nurse-Pharmacist Collaboration on the Safety of Intravenous Therapy in Critically Ill Patients.

Methods: 1587 patients who were hospitalized in the Intensive Care Department of the Fourth Hospital of Hebei Medical University in China from January 2021 to December 2022 were selected. 768 patients before the implementation of the integrated medical, nursing, and drug management model were selected as the control group, and 819 patients who implemented the integrated medical, nursing, and drug management model were selected as the observation group.

Results: Compared with the control group, the incidence of drug compatibility contraindications in the observation group decreased from 3.5% to 1.5% (χ²=6.957 P=0.008), the central venous catheter (CVC) blockage rate decreased from 2.5% to 1.0% (χ²=5.249 P=0.022), the daily incidence of catheter related bloodstream infections decreased from (1.84 ± 2.17) to (0.91 ± 1.19)(t=6.988 P=0.015), and the incidence of peripheral venous treatment related complications decreased from 10.3% to 2.9% (χ²=16.663 P=0.000). Among them, the incidence of phlebitis decreased from 5% to 1.6% (χ²=4.817 P=0.028). The incidence of drug exudation decreased from 3.4% to 0.8% (χ2=0.031 P=0.019). The incidence of extravasation has decreased from 2.5% to 0.4% (χ²=0.044 P=0.027). The differences were statistically significant (P<0.05).

Conclusion: The Integrated Management Model of Doctor-Nurse-Pharmacist Collaboration significantly reduced the incidence of catheter-related bloodstream infections (CRBSI), drug incompatibility, and other intravenous therapy-related complications, thereby enhancing the safety of intravenous therapy in critically ill patients.