Stress, Burnout, and General Mental Health among Healthcare Workers in Poland during the Long-Lasting COVID-19 Pandemic
Functional and Psychosocial Profile of Older People Living in Nursing Homes in Europe
Enhancing Kidney Transplant Care through the Integration of Chatbot
Second Victims among Austrian Pediatricians (SeViD-A1 Study)

Journal Description

Healthcare

Healthcare is an international, scientific, peer-reviewed, open access journal on health care systems, industry, technology, policy, and regulation, and is published semimonthly online by MDPI. Ocular Wellness & Nutrition Society (OWNS) is affiliated with Healthcare and its members receive discounts on article processing charges.

Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
High Visibility: indexed within Scopus, SCIE and SSCI (Web of Science), PubMed, PMC, and other databases.
Journal Rank: JCR - Q2 (Health Policy & Services ) / CiteScore - Q2 (Leadership and Management)
Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 19.5 days after submission; acceptance to publication is undertaken in 2.4 days (median values for papers published in this journal in the second half of 2023).
Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Companion journals for Healthcare include: Trauma Care and European Burn Journal.

Impact Factor: 2.8 (2022); 5-Year Impact Factor: 3.0 (2022)

Imprint Information Journal Flyer Open Access ISSN: 2227-9032

Latest Articles

14 pages, 447 KiB

Open AccessArticle

Functional Fitness Norms of Community-Dwelling Older Adults in Southern Rural Taiwan: A Cross-Sectional Study

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Healthcare 2024, 12(2), 213; https://doi.org/10.3390/healthcare12020213 - 15 Jan 2024

Abstract

Background: Physical activity (PA) and functional fitness (FF) are crucial for promoting independent living and healthy aging in older adults. However, there is a lack of normative values for the Senior Fitness Test (SFT) among older adults (aged 55–90) living in southern rural Taiwan, particularly in the Chiayi region, which has been relatively underserved in terms of health-related resources compared to northern Taiwan. Purpose: This study aimed to determine the age- and gender-specific normative fitness scores for a large representative population of community-dwelling older adults in southern rural Taiwan. Methods: A cross-sectional descriptive study was conducted to obtain normative FF scores for 3332 community-dwelling elderly people (1057 men and 2275 women) in Chiayi, through the implementation of functional fitness tests across 72 Chiayi communities. The developed normative data served as a reference for exercise prescription for the elderly in southern Taiwan. Results: The study showed that the average normative values of all functional fitness tests declined significantly with increasing age (p < 0.05). Sex differences were also found in all measures of FF tests, with elderly women scoring significantly better than men on flexibility (scratch back: −1.34 ± 9.03 vs. −6.54 ± 11.07; chair sit and reach: 6.56 ± 9.44 vs. 0.56 ± 10.40) (p < 0.05), while men scored significantly higher than women on strength (grip strength: 30.83 ± 8.06 vs. 21.82 ± 5.32; bicep curl: 19.25 ± 5.44 vs. 17.64 ± 4.98) (p < 0.05). Furthermore, four FF normative scores in southern rural Taiwan were found to be significantly higher than their counterparts living in northern Taiwan. Conclusion: These findings contribute positively to the evaluation of fitness levels among older adults in southern rural Taiwan and provide a concrete reference for developing sound PA programs for this population. The results suggest that strategies aimed at promoting increased participation in PA among older adults need to consider age-, sex-, and region-specific factors. Full article

(This article belongs to the Topic Sport and Society)

14 pages, 423 KiB

Open AccessArticle

Evaluation of Telephone Visits in Primary Care: Satisfaction of Pediatricians and Family Physicians and Their Perceptions of Quality of Care and Safety

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Healthcare 2024, 12(2), 212; https://doi.org/10.3390/healthcare12020212 - 15 Jan 2024

Abstract

Telehealth has accelerated since the outbreak of the COVID-19 virus. As telephone visits become more common, it is important to examine the challenges involved in using this modality of care. In this study, we examined family physicians’ and pediatricians’ perceptions regarding three aspects of the use of telephone visits: quality of care, safety of care, and physicians’ satisfaction. A total of 342 family physicians and pediatricians responded to an online survey. Respondents were asked to rate their degree of agreement with 17 statements inquiring about quality, safety, and satisfaction with telephone visits on a Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). This was followed by in-depth interviews between January and April 2023 with 26 physicians. Participants expressed satisfaction (3.66 ± 0.80) with the use of telephone visits and lower assessments of safety (3.03 ± 0.76) and quality (2.27 ± 0.76) of care using the telephone modality. Eighty percent of the respondents think combining a face-to-face visit with a telephone visit is recommended, and 51% noted that the inability to examine patients closely affects and impedes a physician’s decision making. Most interviewees indicated that telephone visits are safe only with former patients they had already seen in the clinic. The findings shed light on the perceptions of family physicians and pediatricians regarding telephone visits. The lower assessments of quality and safety compared to the assessment of satisfaction underscore the need for careful use of telephone visits in healthcare. A proper and balanced selection of patients, implementing technological upgrades to the modality, and performing patient education practices are recommended. Full article

(This article belongs to the Special Issue The 10th Anniversary of Healthcare—TeleHealth and Digital Healthcare)

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10 pages, 238 KiB

Open AccessArticle

Translation and Cultural Adaptation into Arabic of Patient-Reported Outcome Measurement Information System^® Item Banks: Cognitive Function Abilities and Physical Function for Samples with Mobility Aid Users

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Healthcare 2024, 12(2), 211; https://doi.org/10.3390/healthcare12020211 - 15 Jan 2024

Abstract

Purpose: This study aimed to provide Arabic-speaking individuals with tools to assess their cognitive abilities and physical function and to contribute to a better understanding of these capabilities in this population. Thus, the specific objective was to translate into Arabic and culturally adapt two Patient-Reported Outcome Measurement Information System (PROMIS) item banks: the Adult Cognitive Function Abilities and the Physical Function for Samples with Mobility Aid Users item banks. This study employed the Functional Assessment of Chronic Illness Therapy (FACIT) multilingual translation methodology to ensure cultural and linguistic relevance. The translation process included forward and back translations, expert reviews, and finalisation by a language coordinator. Cognitive debriefing interviews were conducted with 30 native healthy Arabic speakers to assess the clarity and comprehension of translated items. Most items were well understood, but two items related to cognitive ability and four related to physical functions required revision to address participant confusion. The translations were refined based on the participants’ feedback and expert recommendations. This study followed a rigorous translation process and included cognitive debriefing interviews to ensure linguistic and cultural equivalence. The availability of these tools in Arabic enhances cross-cultural research and practice in healthcare and contributes to a global understanding of cognitive and physical functions. Full article

(This article belongs to the Special Issue Patient-Reported Measures)

2 pages, 290 KiB

Open AccessCorrection

Correction: Kanda et al. Body Compression Corrective Garment and Eating Behavioural Change for Weight Reduction: The Mutsu City Randomised Controlled Trial. Healthcare 2023, 11, 942

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Healthcare 2024, 12(2), 210; https://doi.org/10.3390/healthcare12020210 - 15 Jan 2024

Abstract

In the original publication [...] Full article

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14 pages, 743 KiB

Open AccessArticle

Identifying Witnessed Suicides in National Violent Death Reporting System Narratives

Alina Arseniev-Koehler

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Healthcare 2024, 12(2), 209; https://doi.org/10.3390/healthcare12020209 - 15 Jan 2024

Abstract

There is increasing attention to suicides that occur in view of others, as these deaths can cause significant psychological impact on witnesses. This study illuminates characteristics of witnessed suicides and compares characteristics of these deaths to non-witnessed suicides. We develop a codable definition of what constitutes witnessed (vs. non-witnessed) suicide. Our data include a sample of 1200 suicide descriptions from the 2003–2017 National Violent Death Reporting System (NVDRS). We first developed criteria to identify probable cases of witnessed suicide. The coding scheme achieved 94.5% agreement and identified approximately 10% (n = 125) of suicides as witnessed. Next, we examined differences between witnessed and non-witnessed suicides in demographics, manner of death, and social/environmental factors using bivariate Chi-squared tests, multivariate logistic regression, and ANOVA. Witnessed suicide decedents were significantly more likely than non-witnessed suicide decedents to be male, younger, and members of a sexual minority, and to have died in living spaces by means of a firearm. Two thirds of witnesses were strangers to the decedents, while 23.2% were romantic partners or ex-partners of the decedents. Our coding method offers a reliable approach to identify witnessed suicides. While witnessed suicides are relatively infrequent, these deaths have profound impact on witnesses. Articulating the features of witnessed suicides may contribute to identifying potential risk mitigation strategies. Full article

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11 pages, 414 KiB

Open AccessArticle

Unlicensed/Off-Label Drug Prescriptions at Hospital Discharge in Children: An Observational Study Using Routinely Collected Health Data

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Healthcare 2024, 12(2), 208; https://doi.org/10.3390/healthcare12020208 - 15 Jan 2024

Abstract

Background: Unlicensed and off-label (UL/OL) prescriptions have been associated with an increased risk of drug-related problems. Data of their prevalence at hospital discharge remain insufficient. We aimed to describe the prevalence of UL/OL drugs in outpatient prescriptions at discharge in children. Methods: We conducted a retrospective study using the routinely collected health data of children at discharge from 2014 to 2016. The primary reference source for determining licensed labelling was the summaries of product characteristics (SPCs) in a French industry-independent formulary named Thériaque. We described the characteristics of UL/OL prescriptions at discharge and looked for predictors of UL/OL prescriptions. Results: We included 2536 prescriptions of 479 children. Licensed, OL, and UL prescriptions accounted for 58.6% (95% CI: 56.7–60.5), 39.2% (95% CI: 37.3–41.1), and 2.3% (95% CI: 1.7–2.9), respectively. A total of 323 (74%) children received at least one UL/OL drug. Among the licensed drugs, bronchodilators (8.8%) and analgesics (8.6%), and among the OL drugs, antibiotics (2.8%), were the most prescribed. The younger age of the children and higher number of drugs they received increased the probability of UL/OL prescriptions (unadjusted p-value of ≤0.05). Conclusion: The prevalence of UL/OL prescriptions is about 40% at discharge from a pediatric university hospital in France. Full article

(This article belongs to the Special Issue Application of Electronic Health Records in Pharmacovigilance)

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12 pages, 242 KiB

Open AccessArticle

The Impact of Social Determinants of Health on Australian Women’s Capacity to Access and Understand Health Information: A Secondary Analysis of the 2022 National Women’s Health Survey

Neve Davison

Karin Stanzel

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Karin Hammarberg

Healthcare 2024, 12(2), 207; https://doi.org/10.3390/healthcare12020207 - 15 Jan 2024

Abstract

The ability to access, understand, judge, and use health information is crucial for making informed decisions about health and optimal health outcomes. This secondary data analysis investigated associations between social determinants of health and Australian women’s ability to access and understand health information using data from 10,652 women who responded to the 2022 National Women’s Health Survey. A score (0–5) was created based on five questions assessing the participants’ ability to access and understand health information, which was dichotomised into low (≤3) and high (≥4) scores. The data were analyzed using descriptive statistics, univariate comparisons, and multivariable binary logistic regression. Almost a quarter of the women had a low score. Non-native English speakers were approximately four times more likely to have low health literacy than native English speakers. Additionally, women without tertiary education, financially disadvantaged women, and First Nations women were almost twice as likely to have lower health literacy than other women. These findings suggest that social determinants of health decrease the capacity to access and understand health information. To reduce health inequalities, healthcare systems and health professionals must consider the factors that reduce women’s capacity to access and understand health information and address the health information needs of socioeconomically disadvantaged women. Full article

15 pages, 951 KiB

Open AccessArticle

Development and Evaluation of Nursing Clinical Practice Education Using M-Learning

Sungeun Kim

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Mihae Im

Healthcare 2024, 12(2), 206; https://doi.org/10.3390/healthcare12020206 - 15 Jan 2024

Abstract

This study aims to develop and evaluate the effectiveness of nursing practice education using mobile learning or m-learning for nursing students. A nonequivalent control group post-test design was used. Overall, 42 nursing students participated in the study. A three-week nursing practice education program was developed using the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model. The course was implemented on the basis of Gagne’s nine instructional situations. The findings demonstrated improvements in clinical competency (t = 7.44, p < 0.001) and problem solving (t = 2.29, p = 0.028). Accordingly, the study recommends introducing m-learning in nursing practice education using tablet PCs, as part of a newer nursing practicum training strategy that takes into account the factors identified in this study. It is also suggested that a continuous m-learning approach and development plan for nursing students be prepared to achieve technically advanced nursing practice education. Full article

(This article belongs to the Section Nursing)

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13 pages, 529 KiB

Open AccessArticle

Daily Moderate-to-Vigorous Activity of Native Hawaiians and Pacific Islanders and Seven Asian Subgroups by Types of Activities, American Time Use Survey, 2010–2019

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Healthcare 2024, 12(2), 205; https://doi.org/10.3390/healthcare12020205 - 15 Jan 2024

Abstract

The study used the American Time Use Survey data from 2010 to 2019 to compare the daily moderate-to-vigorous activity of Native Hawaiians and Pacific Islanders (NHPI) and seven Asian ethnic subgroups. Adults aged 24 years and older were included. The study analyzed activities from sports and recreation, household activities, and all activities carried out during the day. Outcomes were determined by the completion of 30 min or more of moderate-to-vigorous activity and the type of activity carried out in the day. Significant ethnic differences were observed for sports and recreation but not for household activities and not for all activities carried out during the day. Of the ethnic populations, NHPI were the least active, and Asian Indians and Chinese were the most active. A majority achieved 30 min or more of moderate-to-vigorous activity during the day from all their activities. Physical activity from household activities exceeded physical activity from sports and recreation. The most physically active group was adults over the age of 65 years, perhaps reflecting more time to exercise or greater concerns about their health. For sports and recreation, exercising with someone doubled the minutes of moderate-to-vigorous activity. The results emphasize the importance of activities performed around the household in addition to sports and recreation and the benefit of exercising with someone. Ethnic populations may be receptive to interventions that emphasize activities they are performing in their daily lives. Full article

(This article belongs to the Topic Sport and Society)

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14 pages, 1782 KiB

Open AccessArticle

Long-Term Effects of Microfiltered Seawater and Resistance Training with Elastic Bands on Hepatic Parameters, Inflammation, Oxidative Stress, and Blood Pressure of Older Women: A 32-Week, Double-Blinded, Randomized, Placebo-Controlled Trial

Carlos Babiloni-Lopez

Pablo Jiménez-Martínez

Jose Casaña

Josep C. Benitez-Martinez

Guillermo T. Sáez

Julio Fernández-Garrido

Carlos Alix-Fages

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Juan C. Colado

Healthcare 2024, 12(2), 204; https://doi.org/10.3390/healthcare12020204 - 15 Jan 2024

Abstract

The bulk of research on microfiltered seawater (SW) is based on its short-term effects. However, the long-term physiological adaptations to combining SW and resistance training (RT) are unknown. This study aimed to analyse the impact of an RT program using elastic bands combined with SW intake on hepatic biomarkers, inflammation, oxidative stress, and blood pressure in post-menopausal women. Ninety-three women voluntarily participated (age: 70 ± 6.26 years; body mass index: 22.05 ± 3.20 kg/m²; Up-and-Go Test: 6.66 ± 1.01 s). RT consisted of six exercises (32 weeks, 2 days/week). Nonsignificant differences were reported for hepatic biomarkers except for a reduction in glutamic-pyruvic transaminase (GPT) in both RT groups (RT + SW: p = 0.003, ES = 0.51; RT + Placebo: p = 0.012, ES = 0.36). Concerning oxidative stress, vitamin D increased significantly in RT + SW (p = 0.008, ES = 0.25). Regarding inflammation, interleukin 6 significantly decreased (p = 0.003, ES = 0.69) in RT + SW. Finally, systolic blood pressure significantly decreased in both RT groups (RT + placebo: p < 0.001, ES = 0.79; RT + SW: p < 0.001, ES = 0.71) as did diastolic blood pressure in both SW groups (RT + SW: p = 0.002, ES = 0.51; CON + SW: p = 0.028, ES = 0.50). Therefore, RT + SW or SW alone are safe strategies in the long term with no influences on hepatic and oxidative stress biomarkers. Additionally, SW in combination with RT positively influences vitamin D levels, inflammation, and blood pressure in older women. Full article

(This article belongs to the Special Issue Physical Fitness—Effects on Muscle Function and Sports Performance)

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16 pages, 545 KiB

Open AccessReview

How Does Trauma Make You Sick? The Role of Attachment in Explaining Somatic Symptoms of Survivors of Childhood Trauma

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Healthcare 2024, 12(2), 203; https://doi.org/10.3390/healthcare12020203 - 15 Jan 2024

Abstract

Exposure to traumatic events during childhood is common, and the consequences for physical and mental health can be severe. Adverse childhood experiences (ACEs) such as physical abuse, sexual abuse, emotional abuse, and neglect appear to contribute to the onset and severity of a variety of somatic inflictions, including obesity, diabetes, cancer, and heart disease. The aim of this scoping review was to try to gain insight into how this might occur. Given the evidence of indirect (i.e., through unhealthy behaviours such as excessive drinking or poor eating habits) and direct (i.e., through its impact on the endocrine, immune, and cardiovascular systems as well as on the brain) effects of attachment on health, we examined the possibility that insecure attachment might contribute to the development of somatic symptoms in adult survivors of childhood trauma. Eleven studies met our inclusion criteria. Findings from this review suggest that insecure and disorganized attachment orientations are related to DNA damage, metabolic syndrome and obesity, physical pain, functional neurological disorder, and somatization in adults exposed to childhood trauma. We discuss the implications of this for the conceptualization and treatment of trauma and stress disorders. Full article

(This article belongs to the Special Issue Clinical Psychology: The State of the Art)

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12 pages, 4496 KiB

Open AccessArticle

Garrè Sclerosing Osteomyelitis of the Clavicle: Clinical Results after Clavicular Resection

Andrea Gabriele Calamita

Davide Stimolo

Serena Puccini

Matteo Innocenti

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Domenico Andrea Campanacci

Healthcare 2024, 12(2), 202; https://doi.org/10.3390/healthcare12020202 - 15 Jan 2024

Abstract

(1) Background: Chronic non-bacterial osteomyelitis (CNO), also known as sclerosing osteomyelitis of Garrè, is a rare inflammatory bone disease with a specific clinical picture, uncertain pathogenesis, and no consensus on an effective treatment. Most frequently affecting other long bones, CNO may rarely involve the clavicle. The aim of this study was to present the results of a series of patients affected by CNO of the clavicle treated with total and partial clavicula resection. In addition, a literature review of different types of treatment of CNO was performed. (2) Methods: We retrospectively reviewed three patients with Sclerosing Osteomyelitis of Garre’ of the clavicle treated with partial resection of the clavicle (one) and with total clavicular resection (two). (3) Results: Patients (two female and one male) were an average age of 35.7 years at the time of the operation. At the 4-year follow-up, the mean active ROM was: 143° forward flexion, 133° abduction, 42° external rotation with an internal rotation of two patients at the interscapular level and one patient at the lumbosacral junction. The mean ASES score was 92/100 (range 87–100). In the literature review, after screening the abstracts and full texts for eligibility, 34 studies met the inclusion criteria. Conclusions: Partial or total clavicular resection resulted an effective treatment of CNO of the clavicle. The procedure seems to be particularly indicated after the failure of more conservative treatments. Full article

(This article belongs to the Special Issue Biotechnology & Orthopaedics. Work in Progress—IORS 2023 Meeting Proceedings)

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10 pages, 251 KiB

Open AccessArticle

Ligament Injuries in Professional Male Handball Players: A 6-Year Longitudinal Study

Luis Manuel Martínez-Aranda

Sergio García-Esteban

Manuel Sanz-Matesanz

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Javier Raya-González

Healthcare 2024, 12(2), 201; https://doi.org/10.3390/healthcare12020201 - 15 Jan 2024

Abstract

Handball is a sport that involves high-intensity actions throughout the game, such as sprints, jumps, landings, and high-speed, repeated throws. This, along with competitive and tactical factors, congested schedules, and the need to maintain a high level of performance throughout the season, contributes to a high injury rate. This study aimed to analyse ligament injuries in a professional handball team over six consecutive seasons. A total of 68 elite male Spanish handball players participated, with 54 time-loss injuries (i.e., injuries involving at least one day of absence) observed during this study period. Ligament injury information was recorded following the International Olympic Committee consensus statement. The overall incidence was 0.89 ligament injuries per 1000 h of exposure. Additionally, a higher incidence and burden of ligament injuries was observed during match-play compared to training. Most ligament injuries were classified as minor or moderate (i.e., 79.63% of the total), and 46.29% were reinjuries. A significantly higher incidence of ligament injuries was suffered in the lower limbs compared to the upper limbs (0.81 vs. 0.08 ligament injuries per 1000 h; p < 0.001). Specifically, the highest incidence was observed in the anterior talofibular ligament of the ankle (0.57 injuries per 1000 h of exposure), while the greatest burden was related to the anterior cruciate ligament (24.08 absence days per 1000 h of exposure). This study provides an overview of ligament injuries among professional handball players, highlighting the need to implement strategies with positive effects during competition (e.g., specific activation strategies or training programmes based on strength and balance) and to reduce injury recurrences. Full article

(This article belongs to the Special Issue Sport Injury Prevention and Rehabilitation in Adolescents)

11 pages, 646 KiB

Open AccessArticle

Reliability and Validation Study of Advance Care Planning Practice Scale among Health and Social Care Professionals

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Healthcare 2024, 12(2), 200; https://doi.org/10.3390/healthcare12020200 - 15 Jan 2024

Abstract

Advance care planning (ACP) is a crucial process in clinical practice, enabling individuals to articulate their care preferences and goals, with significant implications for future healthcare. However, ACP practice of health and social care professionals (HSCPs) concerning patients, or their family members are rarely explored. The objective of the study was to adapt and validate a four-item scale assessing ACP practices of HSCPs toward patients or their family members. The ACP Practice Scale was evaluated through a cross-sectional online survey administered to HSCPs in Macao, assessing its factor structure, validity, and reliability. Based on a sample of 186 valid responses, the ACP Practice Scale demonstrated satisfactory levels of validity and reliability among HSPCs in Macao. The four-item scale explained 65.87% of the variance in ACP practice and exhibited strong internal consistency, with Cronbach’s alpha and McDonald’s omega coefficients of 0.82. Furthermore, item factor loadings ranged from 0.71 to 0.90. The ACP Practice Scale provides reliable and valid measurements of ACP practice among HSCPs. This instrument can help to enhance our understanding of ACP practices in clinical settings and support the advancement of advance care planning. Full article

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9 pages, 232 KiB

Open AccessArticle

Cognitive and Emotional Perceptions of Illness in Patients Diagnosed with Type 2 Diabetes Mellitus

Lucija Gosak

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Gregor Stiglic

Healthcare 2024, 12(2), 199; https://doi.org/10.3390/healthcare12020199 - 15 Jan 2024

Abstract

Type 2 diabetes mellitus (T2DM) affects a patient’s physical, social, and mental well-being. Perceptions of the illness are linked to quality of life. The aim of this study was to assess illness perception in patients diagnosed with T2DM and to validate the Brief Illness Perception Questionnaire in the Slovenian language. A cross-sectional study involved 141 patients diagnosed with T2DM. We performed a content analysis of the questionnaire and estimated the S-CVI, I-CVI, kappa coefficient. We also used Cronbach’s alpha to assess the reliability. Participants did not have a very threatening perception of T2DM, but being overweight and having cardiovascular disease were significant contributors to a more threatening perception. The most frequently indicated factors influencing the onset and development of T2DM were heredity and genetics, stress and other psychological distress, and poor and inadequate nutrition. I-CVI ranged from 0.833 to 1.00, while the kappa is greater than 0.74, confirming the excellent validity of the questions. The content validity assessment of the questionnaire further confirms that the questionnaire is suitable for use with the target population in Slovenia. The questionnaire proved to be a valid and reliable tool that can be used to assess the relationship between illness perception and self-management of T2DM. Full article

15 pages, 768 KiB

Open AccessArticle

A STEPwise Approach for Oral Hygiene Behavior of Schoolchildren in Romania

Anca-Cristina Perpelea

Ruxandra Sfeatcu

Mihaela Tănase

Marina Meleșcanu Imre

Alexandra Ripszky Totan

Ana Cernega

Cristian Funieru

and

Silviu-Mirel Pițuru

Healthcare 2024, 12(2), 198; https://doi.org/10.3390/healthcare12020198 - 14 Jan 2024

Abstract

This research analyzes the dental hygiene habits of schoolchildren from parents’ perspectives, using the STEPS approach recommended by the World Health Organization. The key points of oral health care in children include the role of the family in encouraging and maintaining proper oral hygiene practices. This study aimed to assess the oral hygiene practices of schoolchildren with on-site dentists in Romania. Additionally, it sought to establish correlations between these behaviors and the educational levels of the adults with whom they live with. The participants were selected from the zero grade to the eighth grade, totaling 3843students. Statistical analysis involved the application of Fisher’s Exact Test and Z-tests with Bonferroni correction. Multinominal and binominal logistic regression models were employed to predict the impact of parents’ education on children’s oral health status and behavior. The oral health status of children evaluated by parents as poor was more frequent in children whose parents had a primary or gymnasium education (p < 0.001). Female adults with a university education evaluated the gum health of their children as very good to a much greater extent (41.7%, p < 0.001). Regarding the use of auxiliary means, the majority of parents with a university education mentioned that their children use dental floss (26.4% females/27.4% males) (p < 0.001), compared to those with primary education, where the percentage was only (1.2% males/3.5% females) (p < 0.001). The results of this study highlight that the education level of the adults with whom the children live with influences the perception of the teeth and gums health status, the frequency of oral hygiene, the use of fluoride toothpaste, and auxiliary brushing aids. Full article

(This article belongs to the Special Issue Oral Health Care and Services for Patients)

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25 pages, 7526 KiB

Open AccessReview

Effects of Physical Activity on Body Composition, Muscle Strength, and Physical Function in Old Age: Bibliometric and Meta-Analyses

Yerim Choi

Daekyoo Kim

and

Seung Kyum Kim

Healthcare 2024, 12(2), 197; https://doi.org/10.3390/healthcare12020197 - 13 Jan 2024

Abstract

Objectives: Accumulating evidence suggests that physical activity (PA) is an efficient intervention to maintain functional capabilities and mitigate physiological changes in the older population. However, an attempt has yet to be made to comprehensively investigate the published landscape on the subject. Methods: This study had two aims. The first aim was to perform a bibliometric analysis for two keywords, “aging” and “PA”, to analyze the research trend. Since “frailty” was the most noticeable co-occurring keyword with the two keywords, the second aim was to investigate the effects of PA, particularly, resistance training (RT), on frailty using a meta-analysis to provide a summary of the current evidence base. Results: The bibliometric analysis revealed that the number of publications on this research topic has gradually increased, highlighting the importance of understanding the role of PA in aging. The meta-analysis found that RT had significant beneficial effects on physical frailty factors, including handgrip strength, lower limb strength, balance, gait speed, and stair-climbing ability. Conclusion: These findings demonstrate that RT is an effective intervention for improving physical function in frail populations; thus, it has important implications for the development of PA programs for older adults with frailty. Future research is warranted to explore the optimal dose, frequency, and duration of RT programs for older adults, as well as the potential benefits of combining RT with other forms of PA, such as aerobic or balance exercises. Full article

(This article belongs to the Special Issue Effects of Exercise on Skeletal Muscle and Healthy Aging)

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16 pages, 1193 KiB

Open AccessArticle

Assessment of Preferences in Taking Painkillers among Students of Medicine, Dentistry, and Pharmacy: A Pilot Study

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Healthcare 2024, 12(2), 196; https://doi.org/10.3390/healthcare12020196 - 13 Jan 2024

Abstract

Students of pharmacy, medicine, and dentistry are important for shaping drug policy. The aim of this study is to assess and compare students preferences in taking painkillers. The study group consists of 382 students of pharmacy (28.8%), medicine (40.0%), and dentistry (30.1%). An anonymous questionnaire consisting of 17 questions was prepared using the Google Forms platform and distributed through social media. Ibuprofen was the most frequently preferred, regardless of the study major (57.8%). Pharmacy students expressed the least concern about the possible side effects of analgesics (17.5%). The fast onset of painkillers was more important for dental students (59.1%) and pharmacy students (44.7%), compared to medical students (39.22%). Medicine and pharmacy students indicated their studies to be their main source of information about painkillers compared to dentistry students (p = 0.001). There are no differences in pain severity regarding which analgesics are used among student groups (p = 0.547). Dental students experienced odontogenic pain less frequently (57.3%) than medical (79.7%) and pharmacy students (79.8%), (p = 0.000). Ketoprofen was the most frequently chosen prescription painkiller for odontogenic pain in all groups (49.4%). Gastrointestinal complaints were the most often reported side effects, regardless of the study major (87.1%). Choice of studies, gender, and year of study were the most important determinants of the choice of painkillers. Full article

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18 pages, 581 KiB

Open AccessArticle

Advance Directives in Portugal: A Qualitative Survey

João Carlos Macedo

Ermelinda Macedo

and

Rui Nunes

Healthcare 2024, 12(2), 195; https://doi.org/10.3390/healthcare12020195 - 13 Jan 2024

Abstract

(1) Background: Advance directives (ADs) in Portugal have been legalized since 2012. What has been observed over time, from the few studies carried out, is that despite the positive attitudes in the population, there is a low level of adherence to ADs. To try to understand the reasons for these data, the current study aimed to explore and describe the experiences of the Portuguese population regarding AD. (2) Methods: For this exploratory and descriptive qualitative study, the researchers conducted open (unstructured) interviews with a convenience sample aged over 18 years until data saturation was achieved. (3) Results: A total of fifteen interviews were conducted—eight with women and seven with men. The following four categories emerged from the content analysis of the interviews: (1) AD literacy, (2) AD relevance, (3) AD attitudes, and (4) conditionalities for compiling the ADs. (4) Conclusions: The study pointed out the good receptivity of the participants to the ADs; however, literacy on this subject was low, and identifying the conditionalities in the development of ADs could contribute to improvements in implementation in the population. The data from this study suggest the need to implement measures to increase the literacy of the Portuguese population on ADs and review the legal framework for improving the accessibility of the citizen population. There is also a need to continue researching and obtain more evidence about the ways in which the Portuguese population perceives ADs; thus, in this way, a society can better respond to its citizens’ right to freely exercise their prospective autonomy at the end of their lives. Full article

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10 pages, 1167 KiB

Open AccessArticle

Impact of an Evidence-Based Prioritization System and Electronic Consultation in Early Diagnosis of Colorectal Cancer

Francisco Valverde-López

Marta Librero-Jiménez

Raúl Fernández-García

Teresa Vezza

Clara Heredia-Carrasco

Mercedes López de Hierro Ruiz

Julio Galvez

Rita Jiménez-Rosales

and

Eduardo Redondo-Cerezo

Healthcare 2024, 12(2), 194; https://doi.org/10.3390/healthcare12020194 - 13 Jan 2024

Abstract

(1) Background: Colorectal cancer (CRC) is one of the most common causes of cancer. Timely diagnosis is critical, with even minor delays impacting prognosis. Primary care providers face obstacles in accessing specialist care. This study investigates the impact of implementing an electronic consultation (eConsult) system combined with a specific prioritization system on CRC diagnosis delay and tumor staging. (2) Methods: The study analyzes 245 CRC patients from November 2019 to February 2022, comparing those referred before and after the eConsult system’s implementation during the COVID-19 pandemic. Data on referral reasons, pathways, diagnosis delays, and staging were collected. Multivariate analysis aimed to identify independent risk factors for advanced staging at diagnosis. (3) Results: The eConsult system significantly reduced CRC diagnosis delay from 68 to 26 days. The majority of patients referred via eConsult presented with symptoms. Despite expedited diagnoses, no discernible difference in CRC staging emerged between eConsult and traditional referrals. Notably, patients from screening programs or with a positive fecal immunochemical test (FIT) experienced earlier-stage diagnoses. A positive FIT without symptoms and being a never-smoker emerged as protective factors against advanced-stage CRC. (4) Conclusions: This study highlights eConsult’s role in reducing CRC diagnosis delay, improving diagnostic efficiency and prioritizing urgent cases, emphasizing FIT effectiveness. Full article

(This article belongs to the Section TeleHealth and Digital Healthcare)

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