Health Promotion Perspectives最新文献

Background: Critical thinking has emerged as a vital competency for effective decision-making in healthcare management, yet its conceptualization and application within culturally specific contexts remain insufficiently explored. In this qualitative study, we seek to conceptualize critical thinking within the context of Iranian healthcare management.

Methods: In 2023, through conventional content analysis of semi-structured individual interviews with 17 healthcare managers from diverse roles and institutions in Sanandaj, Iran, we tried to identify key components of critical thinking within the Iranian healthcare context. The interviews lasted from 45 to 60 minutes. MAXQDA 2020 was used to manage the data.

Results: From the viewpoints of our participants, the concept of critical thinking in healthcare settings means Strategic organizational awareness, Adaptive leadership & staff-centered management, Structured decision-making, Operational oversight and collaboration, and Learning and professional development.

Conclusion: Our study provided a contextually grounded understanding of critical thinking among Iranian healthcare managers. Findings may be contributed to both theoretical and practical discourse on managerial competence in healthcare, potentially offering transferable insights for comparable global contexts. The findings can inform policy formulation, enhance professional training programs, and shape leadership strategies specific to Iran's healthcare system.

Background: The optimal protein intake for critically ill patients remains uncertain. This systematic review and dose-response meta-analysis aimed to evaluate the effect of high-protein nutritional support on clinical outcomes in intensive care unit (ICU) patients.

Methods: Randomized controlled trials (RCTs) comparing high- versus low-protein nutrition in critically ill adults with similar energy intake were identified through PubMed, Web of Science, and Scopus (up to June 2023). A random-effects model was used to pool risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). Linear and non-linear trends were assessed using the one-stage cubic spline regression model.

Results: Twenty-three RCTs were included. The summary RR was 0.83 (95% CI: 0.64-1.08; I²=63.6%; n=17) for mortality and 1.05 (95% CI: 0.88-1.25; I²=0%; n=7) for infections. The summary MD was -0.23% (-0.76 to 0.29, I²=5.6%, n=14) for mechanical ventilation days, -0.40 (-1.11 to 0.32, I²=0%, n=17) for ICU days, 0.73 (-1.11 to 2.58, I²=6%, n=10) for hospital days, and -3.44 (-4.99 to -1.90; I²=16.4%; n=5) for muscle atrophy. There was no evidence of linear or nonlinear trends.

Conclusion: Although higher protein intake had no significant effect on mortality or length of stay, it was associated with reduced muscle wasting. This suggests a potential role in preserving lean mass and supporting long-term functional recovery.

Systematic review registration: PROSPERO CRD42024480303.

Background: Occupational health and safety (OHS) interventions predominantly target workplace ergonomic, psychosocial, and material risks. Workplace health promotion (WHP) interventions have a primary focus on health education-related activities and health behaviour change. The aim of this study was to assess the workers' needs of OHS-WHP integrated approaches in Australia.

Methods: A descriptive cross-sectional study was conducted in 2024 among 261 Australian workers across various industries (mainly including education, health, retail, recreation). Eligible participants were employed in Australian workplaces under any contract type and were aged≥18 years. Data were collected through an online survey via Qualtrics platform. This article focuses on the qualitative data generated from the main open-ended question of the survey. The data were analysed employing a thematic inductive approach.

Results: Thematic analysis identified seven key areas for integrating OHS and WHP, mainly including the need for more frequent breaks (49%), enhanced training and education (33%), mental health support (19%), and risk management (19%). The remaining three areas less frequently reported included ergonomic workstations (e.g. adjustable chair) (15%), recreational and physical activities (e.g. stretching exercises) (15%), and Personal Protective Equipment (e.g. visibility clothes) (6%).

Conclusion: Future integrated interventions should prioritise breaks, education, and mental health resources to improve workplace well-being. WHP educational activities could inform OHS information delivery process, possibly enhanced through recreational activities. The engagement of all stakeholders, mainly including employers and workers, when planning and implementing integrated approaches, requires attention and further investigation.

Background: This study examined the association between changes in diet quality-assessed using the healthy eating index-2015 (HEI-2015) and the dietary inflammatory index (DII)-and lipid profiles and glycemic control in adults with type 2 diabetes.

Methods: In this longitudinal study, data were collected from 103 adults with type 2 diabetes at two time points, six years apart (baseline and reassessment). The main predictors were changes in HEI-2015 and DII scores over time. The primary outcome measures were lipid profile components (LDL, HDL, total cholesterol, triglycerides) and glycemic control (FBS). Associations were examined using regression models adjusted for age, sex, body mass index (BMI), and energy intake.

Results: No statistically significant associations were observed between HEI-2015 or DII scores and lipid or glycemic outcomes in the overall sample. However, subgroup analyses based on adjusted models revealed reduced odds of LDL elevation among individuals aged>60 (OR: 0.14, 95% CI: 0.02-0.91) and those with BMI≥30 (OR: 0.15, 95% CI: 0.02-0.90) in the highest tertile of DII change. These effects were not observed consistently across other subgroups.

Conclusion: While no significant associations were found in the overall cohort, subgroup analyses revealed that individuals over 60 and those with BMI≥30 had reduced odds of LDL elevation with higher DII scores. These findings suggest potential population-specific effects of dietary inflammation on lipid metabolism. Despite limitations such as a small sample size and wide confidence intervals, this study provides valuable exploratory evidence and underscores the need for larger, targeted investigations to confirm whether anti-inflammatory diets can improve metabolic outcomes in high-risk subgroups.

Background: Health literacy (HL) plays a crucial role in how people make decisions in their daily living activities. Considering the critical role of HL among household health ambassadors (HAs) in promoting their health and that of their households, this study aimed to examine the HL of household HAs in Iran.

Methods: In this HL survey, a number of 2183 household HAs from 18 cities of East Azarbaijan province was recruited to participate in the study. The data were collected applying the Health Literacy for Iranian Adults (HELIA) Questionnaire via an online link, which were then analyzed applying multivariate linear regression with enter method by using SPSS version 19.

Results: The results revealed an average HL score of 14.96 (SD 3.21). Among the participants, approximately 8% [95% confidence interval (CI): 5.13-11.62] (n=174) exhibited poor HL, while 41.2% [95% CI: 37.45-51.32] (n=899) demonstrated moderate and 50.8% [95% CI: 42.87-59.23] (n=1109) achieved good levels of HL.

Conclusion: Our findings emphasized the urgent need to assess and enhance the HL of household HAs in a developing country, like Iran. Notably, about half of participants exhibited poor or moderate levels of HL. This trend underscores the vital role that HAs play in promoting HL and facilitating individual self-care within their communities. To empower these ambassadors, it is crucial to implement innovative and targeted strategies that effectively boost their HL.

Background: Chronic liver disease (CLD) influences the levels of diverse metabolites that may be related to its pathogenesis. The study aimed to indicate the relation between CLD and the levels of phospholipids.

Methods: In this systematic review, PRISMA guidelines were considered for reporting the results. Up to November 2024, the databases of MEDLINE (through PubMed), Scopus, Web of Science, and Google Scholar were searched. Case-control (CC) and cross-sectional (CS) studies explored the link between CLD and serum phospholipids. The Newcastle-Ottawa scale (NOS) for CC studies and the modified NOS scale for CS studies were applied to evaluate the quality of the included articles.

Results: A total of 11304 articles were included. Eleven thousand duplicates were removed, 9304 studies were excluded, and 343 full-text articles were reviewed. Fifteen CC studies and four CS studies were included in this study. Quality assessment using NOS revealed most studies had low to moderate risk of bias, with scores ranging from 4 to 8 out of 9.The included studies verified a significant association between the levels of total PL (TPL), phosphatidylcholine (PC), phosphatidylethanolamine (PE), phosphatidylserine (PS), phosphatidylinositol (PI), phosphatidic acid (PA), lysophosphatidylcholine (LPC), lysophosphatidylinositol (LPI) and lysophosphatidic acid (LPA) and liver diseases., with reported odds ratios ranging from 1.44 to 2.51 and correlation coefficients from -0.58 to 0.62.

Conclusion: Phospholipid levels are associated with liver diseases. It is important to identify noninvasive ways to diagnose biological risk factors in patients with liver damage so they can be targeted for early treatment. Most of the included studies revealed significant alteration of phospholipid levels in CLD. Thus, the lipidome can predict liver dysfunction and prevent its attributed complications.

Background: Social media has become integral to daily life among young adults, offering opportunities for connection and self-expression and raising concerns about its impact on mental health. While global studies have examined these effects, evidence from Cameroon remains limited. This study assessed the relationship between social media use and psychological well-being among young Cameroonian adults.

Methods: A cross-sectional online survey was conducted via Google Forms between September 2023 and April 2024 among Cameroonians aged 18-35. The questionnaire collected sociodemographic information, social media usage patterns, and self-reported mental health indicators. Descriptive statistics summarized platform use and engagement, while linear regression analysis examined associations between time spent on social media and mental health outcomes.

Results: Among 151 respondents, WhatsApp (97.7%, 95% CI: 93.7-99.5%), Facebook (66.9%, 95% CI: 58.3-74.7%), and TikTok (43.4%, 95% CI: 34.9-52.1%) were the most used platforms. More respondents (39.74%) reported using social media for over five hours daily. Greater daily usage was linked with poorer self-reported mental health scores. Over one-third (37.1%) reported feelings of inadequacy related to social media, and 21.9% perceived a decline in their mental health since using it. Regression analysis indicated that prolonged social media use and cultural factors were associated with poorer self-rated mental health, while other sociodemographic factors were not significant predictors.

Conclusion: Social media is deeply embedded in the lives of young Cameroonians, but it may negatively impact their mental well-being when usage is excessive. These findings highlight the urgent need for culturally tailored mental health interventions, digital literacy programs, and policies promoting healthier online engagement among youth.

Background: Drug addiction is a global social and health issue, with children being the most vulnerable group. This study aimed to validate the Addiction Potential Questionnaire for Iranian children aged 12 to 18 years using confirmatory factor analysis (CFA) and structural equation modeling (SEM).

Methods: This cross-sectional study was conducted in 2023 on 600 students from Shiraz, Iran, using multi-stage sampling (stratified-cluster-simple random sampling). The Addiction Potential Questionnaire used in this study was originally developed by the research team to assess addiction potential among Iranian children. Construct validity was assessed through CFA, along with convergent and discriminant validity, and SEM. The reliability of the tool was calculated using Cronbach's alpha, intra-class correlation coefficient, and composite reliability.

Results: Results from CFA indicated a χ²/df ratio of 2.80. Additional fit indices also confirmed a good fit for the final model, including goodness-of-fit index (GFI=0.9), parsimonious comparative fit index (PCFI=0.74), and comparative fit index (CFI=0.8). Assessing convergent and discriminant validity revealed that all dimensions met acceptable standards. SEM results showed strong positive relationships among latent variables, with correlations of 0.82 between environmental-social-spiritual (ESS) and physical-psychological, and 0.98 between ESS and Other (P<0.001). The reliability indices for each factor were as follows: Other: Cronbach's alpha (α)=0.46, Omega (composite reliability, CR)=0.43, Maximal reliability (Max(R))=0.44, intraclass correlation coefficient (ICC) [95% confidence interval (CI)]=0.74 (0.64-0.81), Akaike information criterion (AIC)=0.12. Family: α=0.70, CR=0.72, Max(R)=0.73, ICC [95% CI]=0.72 (0.61-0.79), AIC=0.24. Physical-psychological: α=0.80, CR=0.82, Max(R)=0.83, ICC [95% CI]=0.84 (0.78-0.88), AIC=0.35. ESS: α=0.61, CR=0.60, Max(R)=0.66, ICC [95% CI]=0.69 (0.58-0.78), AIC=0.13. Total Questionnaire: α=0.89, CR=0.85, Max(R)=0.86, ICC [95% CI]=0.88 (0.83-0.91), AIC=0.39.

Conclusion: The results indicated that the tool possesses good validity and reliability, making it a credible instrument for assessing addiction potential in Iranian children and for developing preventive programs.

Background: There is limited data on the association between dietary patterns and health outcomes in older adults. The aim of this study was to investigate the association of major dietary patterns with obesity, hypertension, and cognitive function in this population. The aim of this study was to investigate the association of major dietary patterns with obesity, hypertension, and cognitive function in older adults.

Methods: This cross-sectional study was performed on 337 participants aged 60 years or older. Dietary data were collected using a validated semi-quantitative food frequency questionnaire. Data regarding height, weight, waist circumference (WC), and blood pressure were collected using standard methods. Obesity was defined as body mass index (BMI)≥30 kg/m², and abdominal obesity was defined as WC≥95 cm for men and women. Hypertension was defined as blood pressure≥140/90 mm Hg or taking anti-hypertensive medications. Mini-Mental State Examination (MMSE) score validated for Iranians, was applied to assess cognitive function. Dietary patterns were identified using factor analysis procedure.

Results: Three major dietary patterns including mixed, healthy, and unhealthy were identified. There was an inverse association between the mixed dietary pattern and both abdominal obesity (odds ratio [OR]: 0.39, 95% confidence interval [CI]: 0.20-0.76) and general obesity (OR: 0.49, 95% CI: 0.24-0.99). A higher score of mixed pattern was also associated with lower odds of hypertension (OR: 0.39, 95% CI: 0.20-0.78). Moreover, a significant positive association was observed between unhealthy dietary pattern and hypertension (OR: 1.86, 95% CI: 1.01-3.43). A significant positive association was also observed between the unhealthy dietary pattern and abdominal obesity (OR: 1.90, 95% CI: 1.05-3.44).

Conclusion: Our findings underscore that higher consumption of certain types of healthy foods (loaded strongly in mixed dietary pattern) could be a viable strategy for prevention of obesity and hypertension.