Health Services InsightsPub Date : 2025-04-29eCollection Date: 2025-01-01DOI: 10.1177/11786329251336833
Walid Al-Qerem, Anan Jarab, Judith Eberhardt, Fawaz Alasmari, Alaa Hammad, Sarah Abu Hour, Lujain Al-Sa'di, Rama AlKhateeb
{"title":"Arabic Version of the Perceived Access to Health Care Questionnaire: Validation, Factor Analysis, and Rasch Modeling.","authors":"Walid Al-Qerem, Anan Jarab, Judith Eberhardt, Fawaz Alasmari, Alaa Hammad, Sarah Abu Hour, Lujain Al-Sa'di, Rama AlKhateeb","doi":"10.1177/11786329251336833","DOIUrl":"https://doi.org/10.1177/11786329251336833","url":null,"abstract":"<p><strong>Background: </strong>Access to healthcare is a critical determinant of individual and population health outcomes. However, few validated tools exist to evaluate healthcare access among Arabic-speaking populations.</p><p><strong>Objectives: </strong>This study aimed to validate the Arabic version of the Perception of Access to Health Care Services Questionnaire (PAHSQ) and assess its psychometric properties, including reliability and construct validity, using factor and Rasch analyses.</p><p><strong>Design: </strong>A cross-sectional study was conducted with 485 participants (53.4% female) recruited from hospitals and pharmacies in Jordan.</p><p><strong>Methods: </strong>Confirmatory factor analysis (CFA) and Rasch analysis were employed to evaluate the construct validity and item performance of the 30-item, six-factor model. Internal consistency was assessed using Cronbach's alpha.</p><p><strong>Results: </strong>The Arabic PAHSQ exhibited strong psychometric properties. CFA confirmed the suitability of the six-factor model (χ²/df = 3.2, RMSEA = 0.07, CFI = 0.93, TLI = 0.92). Cronbach's alpha values for the six dimensions ranged from 0.82 to 0.93. Rasch analysis demonstrated acceptable infit and outfit values for all items, with item thresholds correctly oriented. Key findings highlighted significant disparities in healthcare access, particularly among participants with low income and no insurance coverage.</p><p><strong>Conclusions: </strong>The Arabic PAHSQ is a reliable and valid tool for assessing healthcare access among Arabic-speaking populations. Its use can inform targeted interventions, guide resource allocation, and support health equity initiatives. Further research should explore its applicability across diverse Arabic-speaking regions and incorporate qualitative methodologies to capture more subtle access barriers.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251336833"},"PeriodicalIF":2.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health Services InsightsPub Date : 2025-04-18eCollection Date: 2025-01-01DOI: 10.1177/11786329251332797
Lara Maillet, Georges-Charles Thiebaut, Anna Goudet, Jean-Sébastien Marchand
{"title":"Promoting Coevolution Between Healthcare Organizations and Communities as Part of Social and Health Pathways Management in Quebec: Contributions of the Complex Adaptive Systems Approach.","authors":"Lara Maillet, Georges-Charles Thiebaut, Anna Goudet, Jean-Sébastien Marchand","doi":"10.1177/11786329251332797","DOIUrl":"https://doi.org/10.1177/11786329251332797","url":null,"abstract":"<p><p>The implementation of sociosanitary pathways in the Quebec healthcare system aims to better meet the needs of communities and strengthen their participation at all levels of governance. This initiative will form the basis of our article, which will look at the challenges of adaptation both inside and outside organizations. Drawing on the complex adaptive systems approach, we have developed an analytical framework to highlight the processes that can lead to the adaptation of governance to facilitate community participation in the management of this pathways. The aim of this article is to propose a better understanding of coevolution in the process(es) of adaption of the governance of a complex healthcare organization to its environment, by mobilizing the complex adaptive systems approach. We conducted a qualitative case study, based on 4 sources: documents (n = 70) produced or used during implementation, participatory observations on various tactical and operational committees of the management structure, collaborative workshops with members of the management committee, and semi-structured interviews (n = 18) with managers, department heads, partners, and users of health and social services. To understand the co-evolutionary processes involved in the implementation of management by social and health pathways, we present our results in response to 3 research proposals on the theme of internal and external coherence in a healthcare organization, in terms of vision (cultural), structures (organizational and clinical), and relationships with external partners (environment). Our findings show that to implement and manage an innovation in a healthcare organization, it is fundamental to foster coevolution at operational, tactical and strategic levels, as well as with the external environment. To achieve this, it is necessary to maintain a balance and internal coherence between the structure being implemented and the existing structure, to establish formal and informal communication channels to ensure seamless interactions, while recognizing and reinforcing mutual interdependence in a systemic perspective.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251332797"},"PeriodicalIF":2.4,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health Services InsightsPub Date : 2025-04-11eCollection Date: 2025-01-01DOI: 10.1177/11786329251331779
Peter J Mallow, Pierson Savarino
{"title":"Opening the Door to Wholistic Patient Care: Results from a Nationally Representative Database on the Use of Spiritual and Religious Counseling.","authors":"Peter J Mallow, Pierson Savarino","doi":"10.1177/11786329251331779","DOIUrl":"https://doi.org/10.1177/11786329251331779","url":null,"abstract":"<p><strong>Background: </strong>The introduction of the International Classification of Diseases 10th Revision (ICD-10) code Z71.81 in 2015 enabled the systematic documentation of spiritual and religious counseling (SRC) in hospital settings, opening avenues for research into its effect on patient outcomes and healthcare resource utilization. Religion and spirituality are integral to many patients' lives, influencing their well-being, recovery and health outcomes. Despite its potential to improve outcomes, limited data exist on SRC's application and effect in the hospital setting.</p><p><strong>Objectives: </strong>This study evaluated the frequency and characteristics of SRC documentation and explored its associations with patient outcome in the inpatient hospital setting.</p><p><strong>Design: </strong>A retrospective observational study.</p><p><strong>Methods: </strong>Data were drawn from the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample from 2016 to 2021, encompassing all United States hospitalizations excluding military and specialty facilities. This dataset provided a nationally representative sample of all hospitalizations. Inpatient visits coded for SRC were identified using ICD-10 Z71.81. Statistical analyses assessed descriptive trends and associations with outcomes such as mortality, length of stay (LOS), and healthcare charges.</p><p><strong>Results: </strong>The analysis included 5910 SRC-documented inpatient visits from 89 hospitals. SRC was frequently documented for patients with severe or terminal conditions, as evidenced by a significantly higher mortality rate (10.9% vs 2.3% overall). Temporal trends demonstrated a steady, albeit modest, increase in SRC documentation over the study period. While SRC utilization varied across demographic groups, differences in access and outcomes were evident.</p><p><strong>Conclusion: </strong>SRC is primarily utilized in complex, high-mortality cases, underscoring its role in holistic care for severely ill patients. The disparities observed highlight the need for standardized SRC documentation and equitable access to SRC. Future research should investigate the clinical and economic impacts of SRC to enhance patient-centered care in alignment with value-based care practices.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251331779"},"PeriodicalIF":2.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health Services InsightsPub Date : 2025-04-11eCollection Date: 2025-01-01DOI: 10.1177/11786329251331311
Mohammad Ali Beheshtinia, Masood Fathi, Morteza Ghobakhloo, Muhammad Faraz Mubarak
{"title":"Enhancing Hospital Services: Achieving High Quality Under Resource Constraints.","authors":"Mohammad Ali Beheshtinia, Masood Fathi, Morteza Ghobakhloo, Muhammad Faraz Mubarak","doi":"10.1177/11786329251331311","DOIUrl":"https://doi.org/10.1177/11786329251331311","url":null,"abstract":"<p><strong>Objectives: </strong>This research aims to enhance the quality of hospital services by utilizing Quality Function Deployment (QFD) with a novel Multi-Dimensional House of Quality (MD-HOQ) approach. This method integrates Service Quality (SERVQUAL) analysis and considers resource constraints, such as financial and workforce limitations, to select and prioritize technical requirements effectively.</p><p><strong>Methods: </strong>The proposed MD-HOQ approach was applied to a private hospital in Tehran, Iran. Data were gathered from a sample of 8 experts and a sample of 386 patients, using 2 in-depth interviews and 4 questionnaires. The process included identifying hospital sections and determining their importance using the Analytic Hierarchy Process. Patients' needs in each section were then identified and weighted through SERVQUAL analysis. Subsequently, technical requirements to meet these needs were listed and weighted using MD-HOQ. A mathematical model was employed to determine the optimal set of technical requirements under resource constraints.</p><p><strong>Results: </strong>Application of the MD-HOQ approach resulted in the identification of 50 patient needs across 5 hospital sections. Additionally, 40 technical requirements were identified. The highest implementation priorities were assigned to \"training practitioners and nurses,\" \"improving the staff's sense of responsibility,\" and \"using experienced specialists, physicians, and surgeons.\"</p><p><strong>Conclusions: </strong>The integrated QFD approach, utilizing MD-HOQ and SERVQUAL analysis, provides a comprehensive framework for hospital managers to prioritize technical requirements effectively. By considering resource constraints and the gap between patient expectations and perceptions, this method ensures that resources are allocated to the most impactful technical requirements, leading to improved patient satisfaction and better overall hospital service quality. This approach not only enhances the quality of hospital services but also ensures efficient utilization of resources, ultimately benefiting patient satisfaction.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251331311"},"PeriodicalIF":2.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health Services InsightsPub Date : 2025-03-31eCollection Date: 2025-01-01DOI: 10.1177/11786329251330032
Paul Eze, Chioma Lynda Aniebo, Stanley Ilechukwu, Lucky Osaheni Lawani
{"title":"Understanding Unmet Healthcare Needs in Nigeria: Implications for Universal Health Coverage.","authors":"Paul Eze, Chioma Lynda Aniebo, Stanley Ilechukwu, Lucky Osaheni Lawani","doi":"10.1177/11786329251330032","DOIUrl":"10.1177/11786329251330032","url":null,"abstract":"<p><strong>Background: </strong>Many individuals in low- and middle-income countries with healthcare needs do not access the necessary, often lifesaving healthcare services. Existing universal health coverage (UHC) indicators do not account for a portion of the population with unmet healthcare needs.</p><p><strong>Objective: </strong>To estimate the prevalence, wealth-related inequality, and determinants of unmet healthcare needs in Nigeria using data from the nationally-representative Nigeria Living Standards Survey, 2018-2019.</p><p><strong>Methods: </strong>We analyzed data from a cross-sectional sample of 116 320 Nigerians from 22 110 households selected using multi-stage probability sampling. The outcome variable was self-reported unmet healthcare needs. We conducted concentration index (CIX) analyzes to assess wealth-related inequalities and performed multilevel logistic regression analysis to identify the determinants of unmet healthcare needs at the individual, household, and community levels.</p><p><strong>Results: </strong>The prevalence of unmet healthcare needs was 5.2% (95% CI: 5.0-5.5), representing about 11 million Nigerians (95% CI: 10.5-11.5 million). The most common reasons were high costs (unaffordability) and the perception that the illness or injury was not serious. Wagstaff-normalized CIX for unmet healthcare needs was pro-poor: -0.09730 for the general population and -0.10878 for those with chronic illnesses. Significant determinants of unmet healthcare needs include age (AOR: 0.99, 95% CI: 0.99-1.00), chronic illness (AOR: 8.73, 95% CI: 7.99-9.55), single-person households (AOR: 1.55, 95% CI: 1.20-2.02), poorest quintile households (AOR: 1.45, 95% CI: 1.19-1.78), and mildly (AOR: 1.17, 95% CI: 1.01-1.36) or moderately food-insecure households (AOR: 1.30, 95% CI: 1.11-1.51).</p><p><strong>Conclusion: </strong>A significant proportion of Nigerians, particularly the very poor, chronically ill, those living alone, or food insecure, have unmet healthcare needs. This highlights the necessity for targeted interventions to ensure vulnerable populations can access essential healthcare services. To progress toward UHC, the Nigerian health system must address critical issues related to healthcare accessibility.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251330032"},"PeriodicalIF":2.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health Services InsightsPub Date : 2025-03-24eCollection Date: 2025-01-01DOI: 10.1177/11786329251326461
Frederick North, Rebecca J Buss, Elissa M Nelson, Matthew C Thompson, Jennifer Pecina, Nathaniel E Miller, Brian A Crum
{"title":"Enhancing the Performance of Patient Appointment Scheduling: Outcomes of an Automated Waitlist Process to Improve Patient Wait Times for Appointments.","authors":"Frederick North, Rebecca J Buss, Elissa M Nelson, Matthew C Thompson, Jennifer Pecina, Nathaniel E Miller, Brian A Crum","doi":"10.1177/11786329251326461","DOIUrl":"10.1177/11786329251326461","url":null,"abstract":"<p><strong>Introduction: </strong>Online self-scheduling of medical appointments is increasingly common. An automated waitlist can be used for patients who desire an earlier appointment time if one becomes available after they are scheduled. Our study examines outcomes of an automated waitlist and self-rescheduling process.</p><p><strong>Methods: </strong>We studied outcomes of an automated waitlist self-rescheduling process in which patients with existing appointments elected to be placed on an automated waitlist for an earlier appointment offer. When software found earlier dates for the same visit type, patients were then notified through an automated process and could self-reschedule. We reviewed appointments for which patients were sent new offers when earlier appointment slots were found. We compared the accepted appointment offers with the original scheduled appointments and determined the number of days that the appointment had been moved up.</p><p><strong>Results: </strong>Spanning the calendar year 2023 there were 1 019 698 appointment offers generated by an automated waitlist process for 229 998 appointments and sent to 164 248 patients. The waitlist process automatically found open appointments as they became available and sent the first new appointment offer within 2 days after being placed on the waitlist for 74 736 (32.5%) of the 229 998 waitlisted appointments. Patients sent back at least 1 response for 104 554 (45.4%) of the waitlisted appointments. Of the responses, 56 636 accepted one of the sent offers for an accept rate of 24.6% (56 636/229 998). For accepted, moved-up visits, appointments were self-rescheduled earlier by a mean of 22.6 days (95%CI; 22.2, 22.9, <i>P</i> < .0001).</p><p><strong>Conclusion: </strong>New appointments can be successfully self-rescheduled using an automated waitlist process that allows patients to accept or decline new appointment offers. This process can increase the efficiency of scheduling and decrease appointment wait time for patients desiring more timely access to healthcare. In addition, this process can be successfully applied across several different appointment type categories.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251326461"},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence, Patterns, and Determinants of Workplace Violence Among Healthcare Providers in Ethiopia: A Systematic Review and Meta-Analysis.","authors":"Bikila Balis, Usmael Jibro, Nesredin Ahmed, Efrem Lelisa, Dawit Firdisa, Magarsa Lami","doi":"10.1177/11786329251325405","DOIUrl":"10.1177/11786329251325405","url":null,"abstract":"<p><strong>Background: </strong>Workplace violence remains a persistent health and occupational issue, but stakeholders often lack sufficient evidence to guide effective mitigation strategies. This review aims to ascertain the prevalence and determinants of workplace violence among healthcare providers in Ethiopia, where the issue is under-researched.</p><p><strong>Methods: </strong>The search included studies conducted in Ethiopia, regardless of publication year, that reported workplace violence among healthcare providers using PubMed, SCOPUS, Web of Sciences, EMBASE, CINHAL, Google Scholar, university repositories, and reference. After each author independently evaluated a study for inclusion, data was extracted, and disagreements were discussed and settled. A random-effects meta-analysis approach was used to evaluate the pooled prevalence, patterns, and determinants of workplace violence at 95% confidence intervals. Additionally, the <i>I</i> <sup>2</sup> and <i>P</i>-value were used to evaluate the heterogeneity. Meta-regression and subgroup analysis were used to assess the difference by study-level characteristics. Additionally, to evaluate the stability of pooled values to outliers and publication bias, sensitivity analysis and funnel plots were performed.</p><p><strong>Results: </strong>A total of 6986 participants from 17 eligible studies were included in this study. Of the participants, 56% (95% CI: 48%-63%) reported having experienced any form of workplace violence. Verbal abuse accounted for 57% (95% CI: 49-65%), sexual harassment for 56% (95% CI: 48-65%), physical violence for 55% (95% CI: 46-63%), and bullying/mobbing for 51% (95% CI: 40-62%), according to the participants' reports of workplace violence. Working night hours (AOR: 1.57; 95% CI: 1.20-1.93), being female (AOR: 2.24; 95% CI: 1.07-3.41), being single (AOR: 4.58; 95% CI: 2.44-6.73), working in an emergency department (AOR: 3.87; 95% CI: 2.33-5.41), and consuming alcohol (AOR: 2.69; 95% CI: 1.10-4.28) were all associated with a higher risk of workplace violence. Egger's test and the funnel plot revealed no publication bias, and sensitivity analysis demonstrated that the pooled odds ratios were stable.</p><p><strong>Conclusion: </strong>Given the comparatively high prevalence of workplace violence and its various types among healthcare providers, a multilevel intervention strategy was necessary to address and lessen its effects. In order to make the workplace safer and avoid negative consequences for health care providers as well as the larger healthcare system, this strategy should incorporate both individual-level strategies and targeted policies.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251325405"},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health Services InsightsPub Date : 2025-03-20eCollection Date: 2025-01-01DOI: 10.1177/11786329251324842
Helan Rajan, S Johnson, Bhagyashree Sharma
{"title":"Redefining Antibiotic Use in Palliative Care: Insights From End-of-Life Prescribing Patterns.","authors":"Helan Rajan, S Johnson, Bhagyashree Sharma","doi":"10.1177/11786329251324842","DOIUrl":"10.1177/11786329251324842","url":null,"abstract":"","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251324842"},"PeriodicalIF":2.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health Services InsightsPub Date : 2025-03-14eCollection Date: 2025-01-01DOI: 10.1177/11786329241299317
Fahad Alabbas, Ibrahim Alharbi, Naveed Ahmad, Walid Ballourah, Khalid Alnajashi, Ghaleb Elyamany, Nawaf Alkhayat, Yaser Borai, Omar Alsharif, Hasna Hamzi, Amal Bin Hasan, Waleed Ibrahim, Luluah Albahlal, Sara Alnasser, Sulaiman Alajlan, Abdelrahman A Aboush, Reem Al-Sudairy, Abdulrahman Alsultan
{"title":"Long-term Follow-up for Survivors of Childhood Cancer in Saudi Arabia: A Multicenter Cross-Sectional Study.","authors":"Fahad Alabbas, Ibrahim Alharbi, Naveed Ahmad, Walid Ballourah, Khalid Alnajashi, Ghaleb Elyamany, Nawaf Alkhayat, Yaser Borai, Omar Alsharif, Hasna Hamzi, Amal Bin Hasan, Waleed Ibrahim, Luluah Albahlal, Sara Alnasser, Sulaiman Alajlan, Abdelrahman A Aboush, Reem Al-Sudairy, Abdulrahman Alsultan","doi":"10.1177/11786329241299317","DOIUrl":"https://doi.org/10.1177/11786329241299317","url":null,"abstract":"<p><strong>Background: </strong>With the advancement of childhood cancer therapy, long-term survivors are on the rise. Reports on childhood cancer survivors in Saudi Arabia are scarce. This study aims to assess the spectrum and burden of long-term complications among survivors of childhood cancer in Saudi Arabia.</p><p><strong>Methods: </strong>This cross-sectional study, conducted at multiple cancer centers in Saudi Arabia, enrolled survivors who had been diagnosed with cancer before the age of 14 and had completed at least 5 years after completion of cancer therapy. The primary outcome was to estimate the prevalence of chronic health conditions (CHC) among these survivors. The secondary outcome was to assess the impact of primary cancer diagnosis and cancer therapies on the occurrence of CHC.</p><p><strong>Results: </strong>A total of 305 survivors met the inclusion criteria as of July 2022. Females were 165 participants. The median follow-up and age at evaluation were 8.5 and 14 years, respectively. Leukemia was the most common cancer type (49.3%), followed by lymphoma (16.7%) and solid tumors (15.7%). Chemotherapy was administered to 287 survivors. Radiotherapy and surgery were used in 29.2% and 22.3% of cases, respectively. Seventy-eight percent of participants experienced at least 1 CHC, with 31.1% and 14.2% having 2 and 3 CHC, respectively. A multivariate logistic regression identified significant association between CHC and solid tumors compared to hematological malignancies (OR 2.2; 95% CI: 1.1-4.3; <i>P</i> = .023). Growth impairment was the most common CHC, followed by endocrinopathy. Radiotherapy was significantly associated with short stature (95% CI: 1.2-3.6; <i>P</i> = .008). The majority of CHC, 77.3%, were mild in severity, while 19.3% were moderate, 2.9% were severe, and .5% were life-threatening.</p><p><strong>Conclusion: </strong>The long-term complications of childhood cancer have revealed a prevalent concern. To optimize health outcomes, it is essential to implement well-structured and long-term follow-up tailored to risk profiles, utilize cost-effective screening methods, and promote prospective clinical research and establishment of a registry.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329241299317"},"PeriodicalIF":2.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health Services InsightsPub Date : 2025-03-11eCollection Date: 2025-01-01DOI: 10.1177/11786329251318586
Meng Lv, Jing Zhai, Li Zhang, Hong Wang, Ben-Hua Li, Ting Zhang, Paulo Moreira
{"title":"Change Fatigue Among Clinical Nurses and Related Factors: A Cross-sectional Study in Public Hospitals.","authors":"Meng Lv, Jing Zhai, Li Zhang, Hong Wang, Ben-Hua Li, Ting Zhang, Paulo Moreira","doi":"10.1177/11786329251318586","DOIUrl":"10.1177/11786329251318586","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the levels of change fatigue among clinical nurses in public hospitals and identify the potential contributing factors.</p><p><strong>Design: </strong>A cross-sectional, multi-stage sampling study was conducted in accordance with the STROBE guideline.</p><p><strong>Methods: </strong>This study surveyed 2,228 nurses in China from October to December 2023 using Wen Juan Xing (www.wjx.cn) and employed stepwise multiple linear regression analysis to assess factors associated with change fatigue.</p><p><strong>Results: </strong>The average change fatigue score of nurses was found to be at a medium to high level. Factors such as female, professional title, average overtime hours, workflow changes, workload increase, work-content changes, work pressure increases, new technology implementation and the change frequency were all identified as exacerbating nurses' experience of fatigue related to change. Contrary to this, the support of change resources, communication and transmission of change information, distributed leadership, inclusive climate, readiness for change, change efficacy and workforce agility were found to alleviate the change fatigue to some extent.</p><p><strong>Conclusions: </strong>It is urgent and challenging for nursing managers to manage change fatigue. All of these identified predictors in study significantly contribute to the understanding of change fatigue among nurses and can provide valuable insights for health policies aimed at improving the effectiveness of nursing changes. Furthermore, they also offer a theoretical foundation for managers to develop targeted intervention programs for preventing and mitigating the negative impact of change fatigue on nurses and organizational outcomes.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251318586"},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}