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Digital health technologies (DHTs) at the intersection of health, medical informatics, and business aim to enhance patient care through personalised digital approaches. Ensuring the efficacy and reliability of these innovations demands rigorous clinical validation. A PubMed literature review (January 2006 to July 2023) identified 1250 papers, highlighting growing academic interest. A focused narrative review (January 2018 to July 2023) delved into challenges, highlighting issues such as diverse regulatory landscapes, adoption issues in complex healthcare systems, and a plethora of evaluation frameworks lacking pragmatic guidance. Existing frameworks often omit crucial criteria, neglect empirical evidence, and clinical effectiveness is rarely included as a criterion for DHT quality. The paper underscores the urgency of addressing challenges in accreditation, adoption, business models, and integration to safeguard the quality, efficacy, and safety of DHTs. A pivotal illustration of collaborative efforts to address these challenges is exemplified by the Digital Health Validation Center, dedicated to generating clinical evidence of innovative healthcare technologies and facilitating seamless technology transfer. In conclusion, it is necessary to harmonise evaluation approaches and frameworks, improve regulatory clarity, and commit to collaboration to integrate rigorous clinical validation and empirical evidence throughout the DHT life cycle. [ABSTRACT FROM AUTHOR]

Cryoablation is a well-established medical procedure for surgically treating atrial fibrillation. Cryothermal catheter therapy induces cellular necrosis by freezing the insides of pulmonary veins, with the goal of disrupting abnormal electrical heart signals. Nevertheless, tissue damage induced by cold temperatures may also lead to other complications after cardiac surgery. In this sense, the simulation of catheter ablation can provide safer environments for training and the performance of cryotherapy interventions. Therefore, in this paper, we propose a novel approach to help better understand how temperature rates can affect this procedure by using computer tools to develop a simulation framework to predict lesion size and determine optimal temperature conditions for reducing the risk of major complications. The results showed that a temperature profile of around −40 °C caused less penetration, reduced necrotic damage, and smaller lesion size in the tissue. Instead, cryotherapy close to −60 °C achieved a greater depth of temperature flow inside the tissue and a larger cross-section area of the lesion. With further development and validation, the framework could represent a cost-effective strategy for providing personalized modeling, better planning of cryocatheter-based treatment, and preventing surgical complications. [ABSTRACT FROM AUTHOR]

Healthy aging requires the maintenance of good physical and cognitive activity. However, as they age, older adults often experience a decline in physical and cognitive activity, leading to a more sedentary lifestyle. Some older adults may not have a choice but to become increasingly sedentary as they age due to injury or deteriorated physicality. As such, they require assistive technologies to aid in their daily lives and activities to maintain healthy cognitive function. Social Robots are a newer form of assistive technology, specifically designed for social interactions and gameplay. As with other assistive technologies, compliance barriers to their acceptance and use for meaningful, seated activities among older adults are expected. To better explore this phenomenon, improve quality of life and understand what drives older adults to accept and use newer forms of technology like social robots, this conceptual paper conjoins two theoretical frameworks: The Activity Theory of Aging (ATA) and the Unified Theory of Acceptance and Use of Technology (UTAUT). As social robots hold great promise for improving the quality of life for older adults, exploring what driving factors could enable their greater acceptance and use is essential to furthering this field of study within Australia. [ABSTRACT FROM AUTHOR]

Background: Chiropractic, osteopathy, and physiotherapy (COP) professionals regulated outside the United States traditionally incorporate hands-on procedures aligned with their historical principles to guide patient care. However, some authors in COP research advocate a pan-professional, evidence-informed, patient-centered approach to musculoskeletal care, emphasizing hands-off management of patients through education and exercise therapy. The extent to which non-Western sociocultural beliefs about body representations in health and disease, including Indigenous beliefs, could influence the patient–practitioner dyad and affect the interpretation of pillars of evidence-informed practice, such as patient-centered care and patient expectations, remains unknown. Methods: our perspective paper combines the best available evidence with expert insights and unique viewpoints to address gaps in the scientific literature and inform an interdisciplinary readership. Results: A COP pan-professional approach tends to marginalize approaches, such as prevention-oriented clinical scenarios traditionally advocated by osteopathic practitioners for patients with non-Western sociocultural health assumptions. The Cynefin framework was introduced as a decision-making tool to aid clinicians in managing complex clinical scenarios and promoting evidence-informed, patient-centered, and culturally sensitive care. Conclusion: Epistemological flexibility is historically rooted in osteopathic care, due to his Indigenous roots. It is imperative to reintroduce conceptual and operative clinical frameworks that better address contemporary health needs, promote inclusion and equality in healthcare, and enhance the quality of manual therapy services beyond COP's Western-centered perspective. [ABSTRACT FROM AUTHOR]

Background: The Patient Protection and Affordable Care Act (ACA) established the Hospital Quality Initiative in 2010 to enhance patient safety, reduce hospital readmissions, improve quality, and minimize healthcare costs. In response, this study aims to systematically review the literature and conduct a meta-analysis to estimate the average cost of procedure-specific 30-day risk-standardized unplanned readmissions for Acute Myocardial Infarction (AMI), Heart Failure (HF), Pneumonia, Coronary Artery Bypass Graft (CABG), and Total Hip Arthroplasty and/or Total Knee Arthroplasty (THA/TKA). Methods: Eligibility Criteria: This study included English language original research papers from the USA, encompassing various study designs. Exclusion criteria comprise studies lacking empirical evidence on hospital financial performance. Information Sources: A comprehensive search using relevant keywords was conducted across databases from January 1990 to December 2019 (updated in March 2021), covering peer-reviewed articles and gray literature. Risk of Bias: Bias in the included studies was assessed considering study design, adjustment for confounding factors, and potential effect modifiers. Synthesis of Results: The review adhered to PRISMA guidelines. Employing Monte Carlo simulations, a meta-analysis was conducted with 100,000 simulated samples. Results indicated mean 30-day readmission costs: USD 16,037.08 (95% CI, USD 15,196.01–16,870.06) overall, USD 6852.97 (95% CI, USD 6684.44–7021.08) for AMI, USD 9817.42 (95% CI, USD 9575.82–10,060.43) for HF, and USD 21,346.50 (95% CI, USD 20,818.14–21,871.85) for THA/TKA. Discussion: Despite the financial challenges that hospitals face due to the ACA and the Hospital Readmissions Reduction Program, this meta-analysis contributes valuable insights into the consistent cost trends associated with 30-day readmissions. Conclusions: This systematic review and meta-analysis provide comprehensive insights into the financial implications of 30-day readmissions for specific medical conditions, enhancing our understanding of the nexus between healthcare quality and financial performance. [ABSTRACT FROM AUTHOR]

Colombia has extensive laws prohibiting discrimination against sexual minority people. However, violence and discrimination toward sexual minorities are still frequent. While a growing body of research shows that sexual minority people experience elevated rates of discrimination and domestic abuse globally, little research has been conducted on these issues affecting sexual minorities in Colombia specifically. Using minority stress theory as a conceptual framework, this paper aims to fill this gap by examining the prevalence of experiencing intimate partner violence (IPV) and witnessed discrimination and the relationship of these stressors to self-reported health among a national sample of sexual minority Colombians. We found that bisexual individuals experienced higher rates of physical and sexual IPV, compared to lesbian and gay individuals. Additionally, sexual minority Colombians who experienced IPV and witnessed discrimination were more likely to report having poorer health, compared to those who had not. We discuss the implications of our findings for future research and clinicians working with sexual minority clients. [ABSTRACT FROM AUTHOR]

Collaboration between midwives and traditional birth attendants for maternal and child healthcare is a challenge in rural South African communities due to the absence of a guiding framework. To address this, this study sought to develop and validate an inclusive framework informed by the Donabedian structure–process–outcome (SPO) framework for collaboration between these healthcare professionals. Method: Key stakeholders were invited to participate in a co-creation workshop to develop the framework. Twenty (20) participants were purposively sampled based on their maternal and child healthcare expertise. A consensus design using the nominal group technique was followed. Results: Participants identified the components needed in the framework, encompassing (i) objectives, (ii) structures, (iii) processes, and (iv) outcomes. Conclusion: This paper will contribute to the development of an inclusive healthcare framework, providing insights for stakeholders, policymakers, and practitioners seeking to improve maternal and child healthcare outcomes in resource-constrained, rural settings. Ultimately, the proposed framework will create a sustainable and culturally sensitive model that optimises the strengths of midwives and TBAs and fosters improved healthcare delivery to rural South African communities. [ABSTRACT FROM AUTHOR]

Background: Oncology nurses support cancer patients in meeting their self-care needs, often neglecting their own emotions and self-care needs. This study aims to investigate the variations in the five facets of holistic mindfulness among Italian oncology nurses based on gender, work experience in oncology, and shift work. Method: A cross-sectional study was carried out in 2023 amongst all registered nurses who were employed in an oncology setting and working in Italy. Results: There were no significant differences in all five facets of holistic mindfulness (p ≥ 0.05) according to gender, work experience in the oncology field, and shift work. Conclusion: Could holistic mindfulness be defined as an intrinsic individual characteristic? Surely, more insights will be necessary to better define the holistic trend in oncology nursing. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) treatments in East Asian traditional medicine (EATM) originate from principles for treating abscesses and carbuncles. Understanding the therapeutic principles of Liu Juan Zi Gui Yi Fang (GYF) is essential for optimizing EATM treatment strategies for IBD, but quantitative analysis is lacking. This study aims to extract quantitative information on therapeutic strategies from GYF and present the EATM conceptual framework for IBD treatment. Oral prescriptions for carbuncles were selected, and their constituent herbs and indications were standardized and tokenized for analysis. An EATM expert group classified prescriptions based on the similarity of herbs and indications. Hierarchical and k-means cluster analyses were performed based on herb similarity. The herb–indication (H-I) network for all prescriptions was constructed. Additionally, H-I subnetworks based on the expert group's classifications and the k-means clustering results were constructed and compared to identify treatment goals and the herbs used for each goal. The results showed that the treatment focused on abscess status, wound healing, and patient's recovery capacity, with 'fever' and 'deficiency' as the main indications addressed by tonifying and anti-inflammatory herbs. The therapeutic principles identified in this study can serve as a foundation for developing future herbal intervention units. Further preclinical and clinical research is needed to validate these findings. [ABSTRACT FROM AUTHOR]

Eating disorders are complex psychiatric disorders characterized by compensatory and restrictive behavior and a preoccupation with one's body. Eating and purging behaviors are considered dysfunctional emotional regulation strategies. Therefore, psychological treatment is essential. The most common psychological interventions are dialectical behavior therapy (DBT), cognitive–behavioral therapy (CBT), family therapy (FBT), multi-family group therapy (MFTG) and mentalization-based treatment (MBT). The aim of this study was to summarize the current evidence on the impact of psychological treatments on emotional regulation difficulties and psychological symptoms in patients with eating disorders, especially anorexia nervosa. A search was conducted on PubMed and Web of Science using the terms "anorexia nervosa" and "emotion dysregulation". Of the 278 initial articles, we included 15 publications. The results indicate that the acquisition of coping strategies, through DBT, leads to an improvement in anxiety and alexithymia. DBT, CBT and MBT lead to a reduction in the use of dysfunctional emotional regulation strategies too. Eating disorders involve both physical and mental health; therefore, it is desirable for future research to focus on the mutual synergy between the mental and physical components by evaluating various factors, such as biomarkers and the most appropriate therapeutic approach, with respect to the treatment setting. [ABSTRACT FROM AUTHOR]

Background: With the rapid improvement in healthcare technologies, the security and privacy of the most sensitive data are at risk. Patient privacy has many components, even when data are in electronic format. Although patient privacy has extensively been discussed in the literature, there is no study that has presented all components of patient privacy. Methods: This study presents a complete assessment framework, develops an inventory as an assessment tool, and examines the reliability and validity of the inventory. The study was carried out in three phases: conceptual framework development, inventory development, and an evaluation case study. Fuzzy conjoint analysis was used in the evaluation to deal with subjectivity and ambiguity. As a result of the evaluation, the case study institution was given a patient privacy maturity level between 1 and 5, where 1 is the worst and 5 is the best. Results: The case study evaluated the largest hospital in Turkey, which employs 800 nurses. Half of the nurses, 400, participated in the study. According to the literature, healthcare institutions do not invest enough in protecting patients' privacy, and the results of the study support this finding. The institution's maturity level was 2, which is poor. Conclusions: This study measured privacy maturity with many assessment components. The result of the assessment explains to patients and the public whether their data are secure or not. With the implementation of this maturity level, patients have an idea about which institution to choose, and the public can infer the reliability of institutions in terms of patient privacy. [ABSTRACT FROM AUTHOR]

Under the backdrop of global aging, the escalating number of elderly individuals in poor health poses a growing social burden and impacts economic development and social stability. A fundamental question arises as to whether the advancements of digital finance (DF) can effectively enhance the physical health of the elderly. This study aims to investigate the impact of DF on the physical health of the elderly by utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2013, 2015, and 2018. The results reveal a significant positive impact of DF on enhancing the physical health of the elderly. Furthermore, the study demonstrates that this impact is particularly pronounced among the elderly with higher educational attainment, stronger intergenerational links, and those residing in central cities. A mechanism analysis further reveals that DF contributes to improving the physical health of the elderly by augmenting household disposable income, alleviating liquidity constraints, and enhancing the utilization of medical services. These findings offer valuable insights for the future development of DF and the implementation of policies promoting healthy aging and active aging. [ABSTRACT FROM AUTHOR]

Improving healthcare requires appropriate community involvement supported by appropriate partner engagement methods. This research aims to develop a complex tool for evaluating the social responsibility of health facilities regarding community involvement and development. We developed areas of a new reference framework for the sustainability of healthcare organizations, which includes the area of community involvement and expansion. It is made up of nine indicators. These were designed using the most representative activities reported by hospitals around the world. Their testing was conducted in an orthopedic emergency hospital. The designed indicators are community engagement actions; the interventions' content adapted to the community; partnership and networking; the involvement of volunteers and training networks; the involvement and participation of professional associations; community-involved local opinion leaders; satisfaction with partnerships; initiatives together with the community; and educational visits. The testing and validation of health practices of the indicators highlighted their adequacy with the proposed purpose of the research and the promotion of sustainable development. We have also verified their compatibility with the requirements of national hospital accreditation legislation and the European framework for quality assurance in hospitals. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the long-term care insurance for older adults in South Korea in terms of community care. An analytical framework was designed for the study, focusing on comprehensiveness, adequacy, and integration. The findings suggest that Korean LTCI is significantly limited for the development of community care. First, in terms of comprehensiveness, the use of visiting nurses and the availability of short-stay services have been significantly reduced, and the supporting services for informal caregivers are at the beginning stage of their introduction. Second, in terms of adequacy, the quantity of benefits, such as three to four hours of care a day, are insufficient to meet older adults' substantial needs. Furthermore, the overall quality of home care services is low, particularly with regard to short-stay services and welfare equipment. Finally, in terms of integration, basic linkage of organizations has not been properly conducted in local areas, and there remains an absence of care managers in the LTCI system. To cope with these challenging issues, the following policy measures are suggested: the activation of rehabilitation services, the expansion of benefit quantities, the improvement of service quality, and the creation of organizational linkages through local authorities and long-term care centers. [ABSTRACT FROM AUTHOR]

In an era of global interdependence, universities play a crucial role in promoting social responsibility and sustainable development. The United Nations Convention on the Rights of Persons with Disabilities emphasizes the empowerment of individuals with disabilities, a key aspect of inclusion. The COVID-19 pandemic underscored the necessity of digital platforms to ensure equitable opportunities, particularly for those with disabilities. It highlighted challenges in transitioning to remote operations and stressed the importance of accessible digital tools in maintaining inclusivity during disruptions. This study investigates how university websites promote social responsibility and empower individuals with disabilities in Saudi Arabia, the UK, and the US. It also examines how these websites foster inclusivity, advocate for disability rights, and contribute to societal change. Using a qualitative case study design, the study evaluated university websites focusing on accessibility services, inclusive policies, and academic accommodations. Qualitative content and thematic analyses identified recurring themes and variations. The findings reveal diverse strategies in empowerment initiatives, website maintenance practices, community engagement approaches, the accessibility of support services, and the presentation of success stories. Despite differences among websites, this study underscores their significance in empowering individuals with disabilities. Recommendations aim to guide universities worldwide in enhancing their digital platforms, ensuring inclusivity, especially during challenges like the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The widespread use of novel psychoactive substances (NPSs)—defined as new narcotic or psychotropic agents not classified under the Single Convention on Narcotic Drugs of 1961 or the Convention on Psychotropic Substances of 1971—poses a significant challenge to contemporary mental health paradigms due to their impact on psychiatric disorders. This study revisits and expands upon the theory of mental automatism as proposed by Gaëtan Gatian de Clérambault, aiming to elucidate the psychopathological mechanisms underlying substance-induced psychoses (SIP) and their distinction from non-induced psychoses (schizophrenia and related disorders). Through a phenomenological and clinical investigation, we explore the relevance of mental automatism in the development of toxic psychoses, drawing upon the historical and contemporary literature. This research highlights the psychopathological distinctions between induced and non-induced psychoses and the transition mechanisms from acute to chronic psychosis states. De Clérambault's theory, supplemented by Janet, Jackson, and Bonhoeffer's contributions, provides a foundational framework for understanding the genesis of SIP. Our findings suggest that NPS consumption, particularly among adolescents and psychiatric patients, significantly correlates with increased risks of SIP, marked by a transition to chronicity influenced by biological lesions triggered by substance use. Furthermore, we propose a comprehensive framework for SIP, integrating mental automatism, psychopathological distinctions, and transition mechanisms. This framework aims to refine diagnostic criteria and therapeutic approaches, addressing gaps in clinical practice and research. The study underscores the need for a nuanced understanding of SIP, advocating for a paradigm shift in psychiatric assessment and treatment approaches to better address the complexities of substance-induced mental health disorders. [ABSTRACT FROM AUTHOR]

Cardiovascular disease is the leading cause of mortality among nonalcoholic steatohepatitis (NASH) patients who undergo liver transplants. In the present study, machine learning algorithms were used to identify important risk factors for cardiovascular death and to develop a prediction model. The Standard Transplant Analysis and Research data were gathered from the Organ Procurement and Transplantation Network. After cleaning and preprocessing, the dataset comprised 10,871 patients and 92 features. Recursive feature elimination (RFE) and select from model (SFM) were applied to select relevant features from the dataset and avoid overfitting. Multiple machine learning algorithms, including logistic regression, random forest, decision tree, and XGBoost, were used with RFE and SFM. Additionally, prediction models were developed using a support vector machine, Gaussian naïve Bayes, K-nearest neighbors, random forest, and XGBoost algorithms. Finally, SHapley Additive exPlanations (SHAP) were used to increase interpretability. The findings showed that the best feature selection method was RFE with a random forest estimator, and the most critical features were recipient and donor blood type, body mass index, recipient and donor state of residence, serum creatinine, and year of transplantation. Furthermore, among all the outcomes, the XGBoost model had the highest performance, with an accuracy value of 0.6909 and an area under the curve value of 0.86. The findings also revealed a predictive relationship between features and cardiovascular death after liver transplant among NASH patients. These insights may assist clinical decision-makers in devising strategies to prevent cardiovascular complications in post-liver transplant NASH patients. [ABSTRACT FROM AUTHOR]

This study examines mental health service providers who provided care to evacuees during the Israel–Hamas conflict. Utilizing a phenomenological qualitative method, the research delves into the psychological impact on the participants' lived experiences. The sample included 25 mental health providers (13 female, age range 28–63, mean 42.4, SD 7.3; 15 psychologists and 10 social worker, average seniority 10.8 years, SD 5.2, range 2–18 years). Data were collected through semi-structured interviews conducted between December 2023 and March 2024. The data analysis revealed a dual narrative: Participants paid a major personal price and experienced secondary traumatization manifesting in emotional detachment, physical symptoms, and heightened arousal. They also derived a profound sense of meaning and fulfillment from their work, contributing to personal and professional growth. These findings underscore the complexity of their experiences, which were marked by the challenges of secondary trauma and the resilience fostered through their work. This study emphasizes the importance of support systems, including social and familial networks and professional supervision, in navigating these challenges. This study has several limitations, including small sample size and the use of virtual interviews, suggesting the need for further research with a broader participant base and in different contexts. [ABSTRACT FROM AUTHOR]

(1) Background: Illness perception (IP) is an important psychological construct for couples dealing with cancer, which impacts health outcomes and the psychological adjustment to cancer. More research is needed to explore the traits of IP and the efforts of couples coping with cancer. Thus, this study was designed to explore the coping experiences and features of the IPs of couples dealing with cancer. (2) Methods: A total of 24 patients with colorectal cancer (CRC) and 20 spousal caregivers (SCs) participated in semi-structured interviews. All interviews were recorded digitally, transcribed, and analyzed by using an inductive thematic analysis. (3) Results: Two themes (individualized and predominant IP; IP sharing and restructuring) were developed. A preliminary framework was formulated to illustrate the relations among subthemes and the relations between themes with an adjustment of a positive IP to CRC. In this framework, based on multiple sources and factors, the natural disparities formed the IPs of the partners of couples and determined the incongruence of IPs. The effects of IP incongruence on lives under the disease guided the three directions of coping approaches (i.e., information and available support, appropriate disclosure and reflection, and leaving the CRC diagnosis behind) which were adopted by couples dealing with CRC to share and restructure the IP with their spouses for effective dyadic coping. (4) Conclusions: This study provides insights to healthcare providers into the experiences of couples dealing with CRC and the development of couple-based IP intervention programs: (a) it initially provides adequate factual knowledge for enhancing beliefs in the ability to control illness, (b) encourages illness-centered conversations and disclosure regarding thoughts and emotions for promoting positive congruence of IP between the partners of couples dealing with a hard dilemma, and (c) guides couples to perceive positive changes and explore the illness's meaning. Understanding each theme of personalized IP and adopting effective IP coping approaches can help guide couples dealing with CRC to efficiently promote constructive IP and better health outcomes. [ABSTRACT FROM AUTHOR]

To deliver spiritual care, professionals must be skilled in physical, mental, social, and spiritual care. Spiritual care competence includes knowledge, behaviors, attitudes, and skills that enable successful or efficient care. This review aims to identify the scope of competence and the specific skills, knowledge, and attitudes used in providing spiritual care to people needing palliative care, and the main challenges and facilitators. A scoping review was developed using the Joanna Briggs Institute methodology. Six databases (Web of Science; MEDLINE/Pubmed; Scopus; CINAHL; MedicLatina and SciELO) were searched in September 2023, with an update in January 2024. The resulting 30 articles were analyzed using a content analysis approach. Information was categorized into three domains: cognitive, affective, and functional (based on three personal resources: intrapersonal, interpersonal, and transpersonal). Palliative care professionals face a lack of training and insufficient preparation to deliver spiritual care. Spiritual care competence depends on professional spiritual development and experience, spiritual intelligence (cognitive), spiritual humility (affective), and having a critical and reflexive mind (functional). In the future, palliative care should seek to improve competent spiritual care. This review could help clarify the real configuration of competent spiritual care and lead to improvements in a professional's empowerment when delivering effective spiritual care to patients and families. [ABSTRACT FROM AUTHOR]

(1) Background: Social isolation, which has numerous adverse effects on health status, is prevalent among cancer patients. This review proposes to identify the influencing factors of social isolation among cancer patients. (2) Methods: Articles published in English or Chinese from six electronic databases before December 2023 were identified via a systematic search. A manual search was also performed. (3) Results: Twenty-eight studies were identified in this systematic review. The factors associated with social isolation can be summarized into the following categories: demographic characteristics, having cancer, health status, coping, social support and social interaction. Despite the heterogeneity, 20 factors were significantly associated with social isolation, including age, gender, comorbidity burden, education level, residence, medical insurance, occupation status, personality, race, smoking status, having children, not living alone, household income level, marital status, the role of primary caregiver, physical health status, mental health status, social health status, coping styles, and the level of social support and social interaction. (4) Conclusions: The systematic review showed that cancer patients' social isolation was influenced by their demographic characteristics, cancer-related factors, physical condition, psychological status, social health status, coping styles, and level of social support and social interaction. In addition, future group intervention could be considered to improve social isolation. [ABSTRACT FROM AUTHOR]

(1) Background: Patient safety culture (PSC) encompasses the values, attitudes, norms, beliefs, practices, perceptions, competencies, policies, and behaviours of professionals that determine organisational commitment to quality and patient safety. Few studies use mixed methods to analyse patient safety culture, and none offer the richness of using a mixed methodology to develop their theoretical model. This study aims to identify the factors nurses believe contextualise and influence PSC in relation to existing theoretical frameworks. (2) Methods: This study employed a sequential explanatory mixed-methods design combined with the Pillar Integration Process for data integration. (3) Results: In the final data integration process, 26 factors affecting nurses' PSC were identified. Factors nurses related to PSC not being assessed with the tool used in phase 1 were notification system, flow of patients, patient involvement, resources and infrastructure, and service characteristics. (4) Conclusions: This mixed-methods study provides an opportunity to identify the weaknesses and strengths of currently developed theoretical frameworks related to PSC and offers content for its improvement. Even though multiple studies aim to assess PSC using existing quantitative method tools, the development of this study offers a glimpse of some aspects relevant to nurses' PSC not included in the theoretical framework of the said tools, such as patient involvement, the flow of patients, and service infrastructure. [ABSTRACT FROM AUTHOR]

Background: The existing literature has limited detail on theory-driven interventions, particularly in pain studies. We adapted Bandura's self-efficacy framework toward a theory-driven, non-pharmacological intervention using auricular point acupressure (APA) and evaluated participants' perceptions of this intervention on their pain self-management. APA is a non-invasive modality based on auricular acupuncture principles. Methods: We mapped our study intervention components according to Bandura's key sources of self-efficacy (performance accomplishments, vicarious experience, verbal persuasion, and emotional arousal) to facilitate the self-management of pain. Through a qualitative study design, we conducted virtual interviews at one and three months after a 4-week APA intervention among 23 participants using purposive sampling to describe their experiences in managing their pain based on our theory-driven APA intervention. Results: Using thematic analyses, we found four themes: the enhanced self-management of pain, improved pain outcomes, the feasibility of technology, and the sustainability of APA. Conclusions: Describing how interventions are mapped according to the elements of theoretical frameworks can help to guide intervention development, advance science and knowledge development, and promote the implementation of interventions. As such, using Bandura's self-efficacy theory as a foundation for the APA intervention, APA was found to be feasible and sustainable, improving self-management, pain intensity, and pain-related outcomes. Participants provided recommendations for the further improvement of this theory-driven intervention. [ABSTRACT FROM AUTHOR]

Introduction: Paramedic practice is highly variable, occurs in diverse contexts, and involves the assessment and management of a range of presentations of varying acuity across the lifespan. As a result, attempts to define paramedic practice have been challenging and incomplete. This has led to inaccurate or under-representations of practice that can ultimately affect education, assessment, and the delivery of care. In this study, we outline our efforts to better identify, explore, and represent professional practice when developing a national competency framework for paramedics in Canada. Methods: We used a systems-thinking approach to identify the settings, contexts, features, and influences on paramedic practice in Canada. This approach makes use of the role and influence of system features at the microsystem, mesosystem, exosystem, macrosystem, supra-macrosystem, and chronosystem levels in ways that can provide new insights. We used methods such as rich pictures, diagramming, and systems mapping to explore relationships between these contexts and features. Findings: When we examine the system of practice in paramedicine, multiple layers become evident and within them we start to see details of features that ought to be considered in any future competency development work. Our exploration of the system highlights that paramedic practice considers the person receiving care, caregivers, and paramedics. It involves collaboration within co-located and dispersed teams that are composed of other health and social care professionals, public safety personnel, and others. Practice is enacted across varying geographical, cultural, social, and technical contexts and is subject to multiple levels of policy, regulatory, and legislative influence. Conclusion: Using a systems-thinking approach, we developed a detailed systems map of paramedic practice in Canada. This map can be used to inform the initial stages of a more representative, comprehensive, and contemporary national competency framework for paramedics in Canada. [ABSTRACT FROM AUTHOR]

(1) Background: The role of the nurse case manager is unknown to the population. The main objective is to analyze the existing differences within the national territory in order to make known the situation in Spain with a view to the recognition of its functions and the creation of the professional profile in an equal manner. (2) Methods: A scoping review was conducted in order to achieve the main aim. Selected articles were subjected to a critical reading, and the levels of evidence and grades of recommendation of the Joanna Briggs Institute were verified. The search field was limited to the last ten years. (3) Results: Case management models are heterogeneous in different autonomous communities in Spain. Case nurse management is qualified for high-complexity patients, follow up on chronic patients, and coordinate health assistance. (4) Conclusions: It concludes that nursing's role is crucial in the field of case management, being required in the follow-up of chronic patients of high complexity. Despite the proven health benefits, efficacy, and efficiency of case management, there are many heterogeneous models that coexist in Spain. This involves a restriction in the development of a nursing career because of the lack of a definition of its functions and competences. [ABSTRACT FROM AUTHOR]

Background: In children's palliative care, the term "respite" refers to a temporary break offered to primary caregivers of a child with a life-limiting illness. The aim of this study was to assess the perceptions of parents who have benefited from respite care services in the Lumina Association, Bacău hospice unit and the benefits it can bring in improving their psycho-emotional state. Methods: The study consisted of quantitative research involving 34 parents/caregivers who responded to a questionnaire with 26 questions, and qualitative research which involved the organization of a focus group with 12 parents who benefited from respite services. Results: The use of respite services was associated with a significant reduction of psycho-emotional distress on the part of primary caregivers; 91% of respondents said that this type of service reduces the level of psycho-emotional stress. Conclusions: All participants in the study confirmed that the most important benefit of respite is the time gained to care for family and health. The development of respite services could reduce the risk of emotional exhaustion and mental health problems. [ABSTRACT FROM AUTHOR]

The implementation of monitoring for general medical practice (GMP) can contribute to improving the quality of diabetes mellitus (DM) care. Our study aimed to describe the associations of DM care performance indicators with the structural characteristics of GMPs and the socioeconomic status (SES) of patients. Using data from 2018 covering the whole country, GMP-specific indicators standardized by patient age, sex, and eligibility for exemption certificates were computed for adults. Linear regression models were applied to evaluate the relationships between GMP-specific parameters (list size, residence type, geographical location, general practitioner (GP) vacancy and their age) and patient SES (education, employment, proportion of Roma adults, housing density) and DM care indicators. Patients received 58.64% of the required medical interventions. A lower level of education (hemoglobin A1c test: β = −0.108; ophthalmic examination: β = −0.100; serum creatinine test: β = −0.103; and serum lipid status test: β = −0.108) and large GMP size (hemoglobin A1c test: β = −0.068; ophthalmological examination β = −0.031; serum creatinine measurement β = −0.053; influenza immunization β = −0.040; and serum lipid status test β = −0.068) were associated with poor indicators. A GP age older than 65 years was associated with lower indicators (hemoglobin A1c test: β = −0.082; serum creatinine measurement: β = −0.086; serum lipid status test: β = −0.082; and influenza immunization: β = −0.032). Overall, the GMP-level DM care indicators were significantly influenced by GMP characteristics and patient SES. Therefore, proper diabetes care monitoring for the personal achievements of GPs should involve the application of adjusted performance indicators. [ABSTRACT FROM AUTHOR]

Background: This article investigates the determinants of the intention to migrate of nursing students at a major medical university in Romania and relates them to major international developments, specifically the Brexit referendum and the COVID-19 pandemic. Methods: An online survey about the intention to migrate was made available to nursing students at the University of Medicine and Pharmacy "Iuliu Hațieganu", Cluj-Napoca, Romania, in 2016 (before Brexit) and again in 2016 (after Brexit), 2017, 2018, and 2021 and 2022 (during the pandemic). A total of 549 students responded (response rate: 84.6%). Results: Before the Brexit referendum, 62.6% of the respondents had a plan to seek employment abroad, whereas after the Brexit referendum, only 34.7% indicated that they had such a plan after graduation. Before the pandemic, 43.6% of the students expressed an intention to work abroad, while during the pandemic, only 19.8% had such plans. Conclusions: This study documented the effect of significant international developments—such as the Brexit referendum and the COVID-19 pandemic—on decreasing the intention to migrate. As expected, the change in preference for the UK as a destination country changed dramatically. Additionally, the study provides both theoretical and empirical insights into the types of and the consistency of preparation for migration of nursing students. [ABSTRACT FROM AUTHOR]

Due to the coronavirus pandemic, telerehabilitation has become increasingly important worldwide. While the effectiveness of telerehabilitation is considered proven for many indications, there is comparatively little knowledge about the implementation conditions. Therefore, this scoping review summarises the current state of facilitating and inhibiting factors that may influence the uptake of telerehabilitation. The review follows the JBI methodology for scoping reviews. The article search was carried out in five databases (MEDLINE, EMBASE, Web of Science, Cochrane and Psyndex) in May 2022, with an update in October 2023. Two independent researchers identified relevant studies according to the inclusion and exclusion criteria. The Consolidated Framework for Implementation Research served as the theoretical basis for the categorisation of the facilitating and inhibiting criteria in the organisational context. A total of 28 studies (timespan 2012 to 2023) have been included. The most relevant barriers identified are technical issues and a lack of technical skills. The factors considered most favourable for implementation are patients' motivation and the involvement of high-level leaders. The results provide clear indications of factors that inhibit and facilitate implementation, but also show that further research is needed. [ABSTRACT FROM AUTHOR]

This study assessed differences in interprofessional collaboration, perception of nonbeneficial care, and staff well-being between critical care and palliative care teams. In six German hospitals, a staff survey was conducted between December 2013 and March 2015 among nurses and physicians in intensive and palliative care units. To allow comparability between unit types, a matching was performed for demographic characteristics of staff. N = 313 critical care and 79 palliative care staff participated, of which 72 each were successfully matched. Critical care nurses perceived the poorest overall quality of collaboration compared with critical care physicians and palliative care physicians and nurses. They also reported less inclusive leadership from attendings and head nurses, and the least collaboration on care decisions with physicians. They were most likely to perceive nonbeneficial care, and they reported the lowest levels of job satisfaction and the highest intention to leave the job. In partial correlations, aspects of high-quality collaboration were associated with less perceived nonbeneficial care and higher staff well-being for both critical care and palliative care staff. Our findings indicate that critical care teams could improve collaboration and enhance well-being, particularly among nurses, by adopting principles of collaborative work culture as established in palliative care. [ABSTRACT FROM AUTHOR]

The Republic of Korea has established an institutional framework to expedite the provision of rehabilitation sports public services to individuals with disabilities post-hospital discharge (Act on Guarantee of Right to Health and Access to Health Services for People with Disabilities in December 2017). Regrettably, this service remains non-operational to date. This study employs a service design approach to identify and develop essential elements for the effective implementation of public rehabilitation sports services in Korea. Adopting the service design method, including the empathize–define–ideate–prototype phases, co-creation activities were conducted with three teams comprising people with disabilities, caregivers, rehabilitation physicians, specialized sports instructors, facility managers, and government officials, emphasizing equitable distribution. By leveraging the experiences of people with disabilities, these teams collaboratively engaged in creative activities to formulate strategies for delivering prompt and user-friendly rehabilitation sports public services post-hospital discharge. Contributions from each team were meticulously collected and organized, incorporating diverse perspectives into the development of the Korean Rehabilitation Sports Public Service Information System (KRSPSIS). Additionally, we presented a scenario illustrating the practical application of the KRSPSIS. Through this system, we anticipate providing more efficient and convenient rehabilitation sports public services to individuals with disabilities during the critical early stages following hospital discharge. [ABSTRACT FROM AUTHOR]

Background: Family-centered care places the family at the core of care, with family nurses playing a pivotal role in supporting and guiding members through pregnancy and the transition to parenthood and acknowledging the significant adjustments during these phases. Aim: To map the evidence concerning family nurses' care for families during the transition to parenthood. Method: The scoping review followed the Joanna Briggs Institute (JBI) methodology, focusing on family-centered care during pregnancy adaptation and the initial months of parenthood. Using a PCC (population, concept, and context) strategy, the research covered various databases: Scopus; Web of Science; and CINAHL Complete, MedLine Complete, and MedicLatina by EBSCOhost. Results: A Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) flow diagram was used to present the results. Eighteen articles were included, mainly from the Middle East and Europe, including cross-sectional studies and reviews. Key findings addressed the transitioning process to parenthood, the impact of family characteristics, and the role of family nurses in enhancing these processes. Conclusion: Home care is considered vital during this transition. Family nursing should concentrate on both individuals and the parental subsystem, addressing social determinants equitably. Through these efforts, they empower families to establish an optimal environment for children's development. [ABSTRACT FROM AUTHOR]

The present study seeks to evaluate the factors determining the continuance intention to use hearing aids in older adults. This cross-sectional study was carried out in 2021. The technology post-acceptance model (PAM) framework was used to develop a model for the continuance intention to use hearing aids. In total, 300 hearing aid users aged ≥60 years, who were selected via a randomized stratified sampling method, completed the self-evaluation tools used in this study. With a mean age of 71.38 years (SD = 8), the participants comprised 50.7% and 49.3% females and males, respectively. The path analysis results showed that the continuance intention to use hearing aids was positively and significantly influenced by the actual use of hearing aids, the perceived benefits, satisfaction, confirmation, self-efficacy in using hearing aids, an extraverted personality trait, self-perceived hearing handicap, and perceived social support. The main results of the present study can help hearing care providers develop a better understanding of older users to design effective rehabilitation strategies and ensure their continuance intention to use hearing aids. [ABSTRACT FROM AUTHOR]

Self-management interventions (SMIs) offer a promising approach to actively engage patients in the management of their chronic diseases. Within the scope of the COMPAR-EU project, our goal is to provide evidence-based recommendations for the utilisation and implementation of SMIs in the care of adult individuals with type 2 diabetes mellitus (T2DM). A multidisciplinary panel of experts, utilising a core outcome set (COS), identified critical outcomes and established effect thresholds for each outcome. The panel formulated recommendations using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach, a transparent and rigorous framework for developing and presenting the best available evidence for the formulation of recommendations. All recommendations are based on systematic reviews (SR) of the effects and of values and preferences, a contextual analysis, and a cost-effectiveness analysis. The COMPAR-EU panel is in favour of using SMIs rather than usual care (UC) alone (conditional, very low certainty of the evidence). Furthermore, the panel specifically is in favour of using ten selected SMIs, rather than UC alone (conditional, low certainty of the evidence), mostly encompassing education, self-monitoring, and behavioural techniques. The panel acknowledges that, for most SMIs, moderate resource requirements exist, and cost-effectiveness analyses do not distinctly favour either the SMI or UC. Additionally, it recognises that SMIs are likely to enhance equity, deeming them acceptable and feasible for implementation. [ABSTRACT FROM AUTHOR]

The pandemic represented a challenge for hospital managers at different levels, required to reorganise services without compromising care. This study aimed to analyse the experiences of hospital managers during the COVID-19 pandemic. A narrative inquiry was conducted in a multisite acute hospital. Data were collected through narratives and open-ended questions. Direct and non-direct-care managers were invited to participate. Data were analyzed considering Clandinin & Connelly's (2000) framework and Braun & Clarke, (2006). Thirty-six narratives and open-ended question responses were analysed. Participants were nurses (n = 20), doctors, technicians, administrative and hospitality service managers. Themes were grouped into three narrative dimensions: (1) personal—"the emergency engulfed us", (2) practical/professional—"managing the pandemic", (3) social—"the strength of the team and people". Different narrative threads were identified between direct-care and non direct-care managers. Problems faced, factors helpful for management and suggestions for improvement were also reported. The pandemic had an important impact on managers and their roles, in terms of the need for clear concise information, staff support, and adequate professional and technical resources. A sense of unity and belonging facilitated management. [ABSTRACT FROM AUTHOR]

Background: Active aging is considered one of the most effective methods for a healthy aging process. There are numerous clinical practice guidelines that address this model and propose multiple strategies for its achievement through the improvement of motor and cognitive function. Virtual reality is emerging as a potential tool, with various modalities focused on promoting good health maintenance in older adults. The objectives of this review were to map the potential benefits of virtual reality for active aging and delve into adaptability and adherence in older individuals. Methods: A scoping review was conducted on studies published between 2013 and 2023 in English, Spanish, or Catalan, examining virtual reality interventions in older adults. The search was performed using the Medline, CINAHL, Scopus, and Web of Science databases. The methodological quality was assessed using CASPe and FLC 3.0 critical appraisal guidelines. The graphical data were reported narratively, grouping results based on the study characteristics and the impact of virtual reality. Results: The review process resulted in the inclusion of 22 articles out of the initial 459 following the application of the selection criteria. Most articles were randomized controlled trials (45.4%; n = 10), systematic reviews (40.9%; n = 9), observational studies (9%; n = 2), and pilot studies (4.5%; n = 1). The information was organized based on the virtual reality modality (immersive, non-immersive, and 360) and application area (motor, cognitive, and mental health). Conclusions: Virtual reality (both immersive and non-immersive) is a valuable tool for promoting physical exercise in older adults, helping to prevent recurrent accidental falls. It also yields positive results for cognitive stimulation in healthy older individuals, improving memory, depression, and mental health in those with cognitive impairment. Virtual reality is generally well-received by older adults, achieving high adherence rates. [ABSTRACT FROM AUTHOR]

Objective: In the age of digital transformation, there is a need for a sustainable information management vision in health. Understanding the accumulation of health information management (HIM) knowledge from the past to the present and building a new vision to meet this need reveals the importance of understanding the available scientific knowledge. With this research, it is aimed to examine the scientific documents of the last 40 years of HIM literature with a holistic approach using science mapping techniques and to guide future research. Methods: This study used a bibliometric analysis method for science mapping. Co-citation and co-occurrence document analyses were performed on 630 academic publications selected from the Web of Science core collection (WoSCC) database using the keyword "Health Information Management" and inclusion criteria. The analyses were performed using the R-based software Bibliometrix (Version 4.0; K-Synth Srl), Python (Version 3.12.1; The Python Software Foundation), and Microsoft® Excel® 2016. Results: Co-occurrence analyses revealed the themes of personal health records, clinical coding and data quality, and health information management. The HIM theme consisted of five subthemes: "electronic records", "medical informatics", "e-health and telemedicine", "health education and awareness", and "health information systems (HISs)". As a result of the co-citation analysis, the prominent themes were technology acceptance, standardized clinical coding, the success of HISs, types of electronic records, people with HIM, health informatics used by consumers, e-health, e-mobile health technologies, and countries' frameworks and standards for HISs. Conclusions: This comprehensive bibliometric study shows that structured information can be helpful in understanding research trends in HIM. This study identified critical issues in HIM, identified meaningful themes, and explained the topic from a holistic perspective for all health system actors and stakeholders who want to work in the field of HIM. [ABSTRACT FROM AUTHOR]

Background: The literature shows a relationship between sexual activity and low back pain (LBP). The aim of this work is to provide a theoretical framework and practical proposal for the management of sexual disability in individuals with LBP. Methods: Based on a literature review, a team of specialized physical therapists developed a pattern for the management of LBP-related sexual disability. Results: A patient reporting LBP-related sexual disability may be included in one of four clinical decision-making pathways corresponding to one of the following: #1 standard physical therapy (PT); #2 psychologically informed physical therapy (PIPT); #3 PIPT with referral; or #4 immediate referral. Standard PT concerns the management of LBP-related sexual disability in the absence of psychosocial or pathological issues. It includes strategies for pain modulation, stiffness management, motor control, stabilization, functional training, pacing activities comprising education, and stay-active advice. PIPT refers to patients with yellow flags or concerns about their relationship with partners; this treatment is oriented towards a specific psychological approach. "PIPT with referral" and "Immediate referral" pathways concern patients needing to be referred to specialists in other fields due to relationship problems or conditions requiring medical management or pelvic floor or sexual rehabilitation. Conclusions: The proposed framework can help clinicians properly manage patients with LBP-related sexual disability. [ABSTRACT FROM AUTHOR]

Community-acquired pneumonia is a serious public health problem, and more so in older patients, leading to high morbidity and mortality. However, this problem can be reduced by optimising in-hospital nursing care. Accordingly, this study describes a systematic process of designing and developing a tailored theory- and research-based implementation strategy that supports registered nurses (RNs) in delivering evidence-based and person-centred care for this patient population in a hospital setting. The implementation strategy was developed by completing the six steps of the Intervention Mapping framework: (1) developing a logic model of the problem and (2) a logic model of change by defining performance and change objectives, (3) designing implementation strategy interventions by selecting theory-based change methods, (4) planning the interventions and producing materials through a co-design approach, (5) developing a structured plan for adoption, maintenance and implementation and (6) developing an evaluation plan. This method can serve as a guide to (1) target behavioural and environmental barriers hindering the delivery of nursing care in local clinical practice, (2) support evidence uptake, (3) support RNs in the delivery of nursing care according to individual patient needs and thereby (4) optimise health-related patient outcomes. [ABSTRACT FROM AUTHOR]