Health Services Insights最新文献

{"title":"Predicting Factors Affecting the Reporting of Medical Errors by Nurses Using the Theory of Planned Behavior: A Study in Iran.","authors":"Omolbanin Izadi, Abolfazl Raeyat Mohtashami, Sajad Delavari, Maryam Nikmaram, Ramin Ravangard","doi":"10.1177/11786329261454532","DOIUrl":"10.1177/11786329261454532","url":null,"abstract":"<p><strong>Background: </strong>Medical error reporting serves as a crucial indicator of healthcare professionals' commitment, accountability, and reliability, which ensures patient rights, and also functions as a mirror of organizational culture, reflecting staff attitudes and practices regarding patient safety. This study was conducted to predict factors affecting nurses' medical error reporting behavior using the theory of planned behavior (TPB) at Shiraz University of Medical Sciences, Iran, in 2024.</p><p><strong>Methods: </strong>This applied, cross-sectional study examined 280 nurses working in teaching hospitals. The required samples were selected using stratified random sampling proportional to size and simple random sampling methods. Data were collected using the Persian version of the medical error reporting questionnaire developed by Seyedin et al based on the theory of planned behavior and were analyzed and modeled through structural equation modeling (SEM) using Smart PLS 3.0.</p><p><strong>Results: </strong>The results showed that the model demonstrated a relatively strong overall fit (GOF = 0.342, SRMR <0.08, RSM Theta <0.12), and all its constructs were associated with and demonstrated predictive power for behavior, so that both direct and indirect paths on behavior were statistically significant (<i>P</i> < .001). However, perceived behavioral control (β = .385; <i>f</i> ² = 0.161) and behavioral intention (β = .378; <i>f</i> ² = 0.155) showed the strongest direct associations, and control beliefs (β = .175; <i>f</i> ² = 0.730) exhibited the greatest indirect association on behavior.</p><p><strong>Conclusion: </strong>The findings indicated that improving medical error reporting requires comprehensive attention to both behavioral and cognitive characteristics of nursing staff and providing a supportive environment that reinforces positive beliefs and attitudes toward error reporting. Practical recommendations include facilitating access to reporting systems, giving continuous feedback about reported errors to nurses and providing them with positive consequences, considering various rewards for timely and accurate reporting of medical errors, and creating continuous supportive mechanisms.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261454532"},"PeriodicalIF":2.1,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13272874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277169","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":"Reducing Wait-Times for Orthopaedic Consultations for Patients with Knee Osteoarthritis Through Advanced Practice Physiotherapy.","authors":"Jennie M Scarvell, Danealle Gilfillan, Tahlia J Stewart, Carol A McCrum, Angie M Fearon, Joseph T Lynch, Tom Ward, Theophile Niyonsenga","doi":"10.1177/11786329261461056","DOIUrl":"10.1177/11786329261461056","url":null,"abstract":"<p><p>Long wait-times for orthopaedic consultation in public hospitals, particularly for knee osteoarthritis patients, may be ameliorated when Advanced Practice Physiotherapists (APPs) are integrated into clinical pathways. APPs provide expert comprehensive assessment, accurately identifying patients not requiring surgery. This study aimed to quantify wait-time between general practitioner (GP) referral and consultation with an APP or surgeon outcomes following service changes including increased resourcing of the APP clinics.</p><p><strong>Method: </strong>This knowledge translation project was evaluated by comparing wait-time to consultation for three, 6-month cohorts from 1 March to 30 September, totalling 563 patients, at baseline in 2022, and post-intervention at year 1 (2023) and year 2 (2024). Evidence-based service changes included expanding APP clinic capacity and improving referral pathways to community osteoarthritis and obesity programs. The proportion of patients seen by APPs rose from 20% at baseline (2022) to 81% in 2023 and 76% in 2024. Concurrently, the health service implemented a digital medical records system. Data were analysed for patient characteristics, wait-times, care pathways (APP, surgeon, or both), and consultation outcomes.</p><p><strong>Results: </strong>Compared to 2022, wait-times to consultation significantly reduced. Median wait-time fell from 114 days in 2022 to 45 days (86% less) in 2023 and 46 days (90% less) in 2024. Patients seen by APPs experienced fewer delays (Incidence risk ratio (IRR): 0.55; 95% CI: 0.43-0.72), including those seen in both APP and surgeon clinics (IRR: 0.54; 95% CI: 0.41-0.70). Total patients listed for surgery declined from 48% in 2022, to 36% in 2023, and 35% in 2024, while patients directed to a surgeon were twice as likely to need knee replacement in 2023, 2024.</p><p><strong>Conclusions: </strong>Shorter wait-times appear linked to increased APP clinic activity, improved digital systems, and enhanced access to community programs. These changes supported clinical standards and timely care for patients with knee osteoarthritis.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261461056"},"PeriodicalIF":2.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270804","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":"Determinants of Patient Satisfaction in a Public University Hospital in Ghana: A Structural Equation Modelling Approach.","authors":"Bhavana Singh, Kwame Tieku Asaaseasa, Julius Kwabena Karikari, Douglas Aninng Opoku, Irene Ohene-Manu, Richmond Darko, Ricky Antwi Boasiako, Alfred Matthew Owusu, Akwasi Ohene Adjei, Edward Osei-Boateng, Emmanuel Konadu, Eric Kojo Nsa Oduro, Nana Kwame Ayisi-Boateng","doi":"10.1177/11786329261460714","DOIUrl":"10.1177/11786329261460714","url":null,"abstract":"<p><strong>Background: </strong>Despite the recognised importance of communication in healthcare delivery, limited research has examined how communication interacts with other service quality (SERVQUAL) dimensions to shape patient satisfaction in Ghanaian hospital settings. This study aimed to assess communication and SERVQUAL dimensions as determinants of satisfaction among patients accessing outpatient services at a university hospital in Ghana.</p><p><strong>Methods: </strong>This cross-sectional study collected data from 366 patients who accessed outpatient services from November 1, 2025, to December 20, 2025. A structured questionnaire incorporating socio-demographic characteristics, communication, SERVQUAL model, and satisfaction was used to collect study data. Structural equation modelling was used to examine the relationship between the SERVQUAL dimensions, communication, and satisfaction. A mediation analysis was conducted to test whether communication mediated the relationship between the SERVQUAL dimensions and satisfaction.</p><p><strong>Results: </strong>The median satisfaction and communication scores were 75.0 [58.3-91.7] and 75.0 [50.0-90.0], respectively. Among the SERVQUAL domains, tangibility (median: 75.0 [62.5-87.5]) was the highest-rated, whereas reliability (median: 68.8 [50.0-81.2]) was the lowest-rated. Communication (β = 0.400, p = 0.002) and empathy (β = 0.434, p = 0.043) were identified as determinants of patient satisfaction. Communication did not significantly mediate the association between the SERVQUAL dimensions and patient satisfaction.</p><p><strong>Conclusion: </strong>This study highlights the critical role of communication and empathy in shaping patient satisfaction in outpatient services at the university hospital. Prioritising patient-centred communication and compassionate care should therefore be an integral part of healthcare quality improvement strategies aimed at strengthening health systems and advancing progress towards universal health coverage.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261460714"},"PeriodicalIF":2.1,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251236","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":"Direct and Indirect Costs per Visit for Elderly Patients and Their Caretakers Receiving Complete Dentures in Health Region 9, Thailand.","authors":"Surachai Phimha, Prapassara Sirikarn, Nawaporn Rattanachariya, Chanaporn Pinsuwan, Kannika Sirichan, Norraphat Noysuwan","doi":"10.1177/11786329261458508","DOIUrl":"10.1177/11786329261458508","url":null,"abstract":"<p><strong>Objectives: </strong>To estimate direct and indirect costs per visit for elderly patients and their caretakers receiving complete dentures in Health Region 9, Thailand.</p><p><strong>Method: </strong>This cross-sectional household cost analysis collected data through a structured questionnaire with 346 elderly patient-caretaker pairs at three tertiary hospitals in Health Region 9 between September 2024 and February 2025. Costs were reported as means with 95% confidence intervals estimated using the bootstrap method.</p><p><strong>Results: </strong>The mean realized cash loss per visit was 148.23 PPP-USD (95% CI: 117.11 to 179.34). Costs explicitly attributed to patients accounted for 46.9% of the total cash losses (69.57 PPP-USD, 95% CI: 37.29 to 101.84), comprising out-of-pocket medical expenses (42.71 PPP-USD) and actual income loss (26.86 PPP-USD). Caretakers incurred 37.6% of total costs (55.76 PPP-USD, 95% CI: 53.08 to 58.44), strictly from foregone earnings driven by significant time spent at the hospital (averaging 6.3 hours per visit). Shared out-of-pocket non-medical costs, such as transportation and meals, accounted for the remaining 15.5% (22.90 PPP-USD, 95% CI: 20.33 to 25.47). Sensitivity analyses valuing unpaid time demonstrated a substantially broader economic burden.</p><p><strong>Conclusion: </strong>Although patients bear the majority of out-of-pocket expenses for treatment, caretakers face substantial actual income loss and prolonged visit durations. Health policies supporting household expenses and the adoption of service delivery innovations to improve clinic efficiency are needed to minimize these time requirements and realized cash losses.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261458508"},"PeriodicalIF":2.1,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13241606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198852","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":"The Social Life of Migraine: A Meta-Ethnography of Lived Experience in Adults With Migraine.","authors":"Qin Xiang Ng, Kevin Xiang Zhou, Chloe Ying Xuan Lin, Claire Kar Min Chan, Sassidaran Murugasu, Asher Yu Han Ang, Gurshant Singh Sandhu, Yu Liang Lim, Ansel Shao Pin Tang","doi":"10.1177/11786329261457982","DOIUrl":"10.1177/11786329261457982","url":null,"abstract":"<p><strong>Background: </strong>Migraine is a common and disabling neurological disorder that affects physical, emotional, and social functioning. Despite its prevalence, it remains under-recognized and stigmatized. Understanding the lived experience of migraine is essential to inform person-centred care and improve health system responsiveness.</p><p><strong>Objectives: </strong>To synthesize qualitative research on how adults experience, interpret, and cope with migraine, and to develop an interpretive model of its lived experience.</p><p><strong>Methods: </strong>We conducted a meta-ethnography following Noblit and Hare's seven-phase approach, guided by the PRISMA 2020 and eMERGe reporting standards. Five databases were searched from inception to April 2025 for qualitative studies exploring the lived experience of adults with migraine. Two reviewers independently screened studies, extracted data, and appraised methodological quality using the Critical Appraisal Skills Programme (CASP) checklist. Concepts were translated across studies and developed into a line-of-argument synthesis to generate higher-order interpretations.</p><p><strong>Results: </strong>Forty-six studies were included, covering North America, Europe, Asia, and Australasia, with most participants being women. Four overarching domains were identified. First, embodied disruption and uncertainty captured migraine as an unpredictable and intrusive condition that fragmented bodily control and everyday life. Second, negotiating stigma and social legitimacy described the burden of living with an invisible illness that was often misunderstood, minimized, or doubted by others. Third, coping, adaptation, and identity work reflected the active labour of self-management, acceptance, and reconstruction of identity in the pursuit of agency. Fourth, seeking care and system navigation highlighted delayed diagnosis, therapeutic pessimism, fragmented care, and the search for validation. These domains recast migraine as more than recurrent neurological symptoms: it emerges as a biographically disruptive condition that must be continually managed and incorporated into one's sense of self.</p><p><strong>Conclusion: </strong>Migraine is lived not only as a neurological disorder but as a socially embedded and biographically disruptive condition that reshapes identity, relationships, and participation in everyday life. Its invisibility and unpredictability create uncertainty and stigma, compelling individuals to reconstruct coherence and agency. Clinicians should design holistic, empathic migraine care that addresses these psychological and social realities.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261457982"},"PeriodicalIF":2.1,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13234403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198849","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":"Antimicrobial-Resistant Infections in the Eastern Mediterranean Region (EMR): Burden, Mortality Trends, and Progress Toward AMR Reduction Milestones (2013-2023).","authors":"Nehad Jaser Ahmed","doi":"10.1177/11786329261457984","DOIUrl":"10.1177/11786329261457984","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) is a rapidly expanding worldwide health concern, disproportionately affecting low- and middle-income countries. The Eastern Mediterranean Region (EMR) presents unique issues, including war, inadequate surveillance systems, and widespread antibiotic abuse.</p><p><strong>Objective: </strong>This study evaluates AMR burden, mortality changes between 2013 and 2023, and progress toward AMR reduction milestones in EMR nations using Global Burden of Disease (GBD) AMR-based indicators.</p><p><strong>Methods: </strong>This ecological analysis used publicly available IHME and GBD-AMR estimates to examine AMR mortality rates (per 100,000), burden categories, milestone achievements, and AMR ranking among the top 10 causes of death in 2013 and 2023 across EMR countries.</p><p><strong>Results: </strong>AMR mortality in the EMR ranged from 4 to 75 deaths per 100,000, with Gulf countries reporting the lowest rates and Pakistan, Afghanistan, Somalia, Yemen, and Djibouti the highest. Twelve countries made no progress between 2019 and 2023, while nine achieved reductions in AMR mortality. In Pakistan, Afghanistan, Somalia, Yemen, and Sudan, AMR ranked among the top 10 causes of death in 2013 and/or 2023, unlike most other EMR countries.</p><p><strong>Conclusion: </strong>AMR burden in the EMR varies widely, rising in high-burden, conflict-affected countries with little improvement. Strengthening labs, stewardship, and surveillance is essential. This study provides regional baseline data to guide targeted interventions and national AMR plans.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261457984"},"PeriodicalIF":2.1,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149749","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":"Most-Favored-Nation Benchmarking Versus Value-Based Contracting: Institutional Fit of Pharmaceutical Pricing Tools in the United States, Canada, and the United Kingdom.","authors":"Kola Adegoke, Olajide Alfred Durojaye, Abimbola Adegoke, Adeyinka Adegoke","doi":"10.1177/11786329261448992","DOIUrl":"10.1177/11786329261448992","url":null,"abstract":"<p><strong>Background: </strong>Soaring drug prices pose a significant obstacle to affordable and equitable access to medicines in high-income healthcare systems. This study compares two leading reform tool families, Most Favored Nation (MFN)/international reference pricing (IRP) and value-based contracting (VBC), across the United States, Canada, and the United Kingdom, with attention to cost containment, value-linked incentive design, equity of access, and implementation feasibility. U.S. policy developments (CMS Innovation Center's GENEROUS, GLOBE, and GUARD models) extend international benchmark-based design options beyond the 2020 MFN rule.</p><p><strong>Methods: </strong>Guided by institutional and governance theories, we conducted a structured comparative policy analysis using a four-dimensional trade-off matrix. Cases from the United States, Canada, and the United Kingdom were selected using a most-different-systems design. Documents from 2007 to 2025 were coded for cost containment, value-linked incentive design, equity, and implementation feasibility. To reduce subjectivity, scores were assigned using prespecified rubric anchors, conservative scoring rules for borderline cases, and a sensitivity check of adjacent-score judgments. Design-stage U.S. benchmark-based model materials assessed on March 5, 2026, were incorporated descriptively and not considered as outcome evidence.</p><p><strong>Results: </strong>The United Kingdom model, centered on the National Institute for Health and Care Excellence (UK NICE) and the Voluntary Scheme for Branded Medicines Pricing, Access and Growth (VPAG), was most consistently aligned across all four dimensions (design-feature alignment). Canada's Patented Medicine Prices Review Board (PMPRB) supports affordability and baseline access, with implementation variation across provinces and more limited adoption of outcomes-based contracting. U.S. MFN/IRP initiatives and VBC pilots show lower alignment on equity and feasibility in a multi-payer environment characterized by contested authority and variable data/contracting capacity. Emerging CMS Innovation Center proposals (GENEROUS, GLOBE, GUARD) indicate continued federal interest in benchmark-based designs, but empirical impacts remain to be evaluated.</p><p><strong>Conclusions: </strong>MFN/IRP anchoring and VBC are implementation-intensive tools whose performance depends on institutional fit. A hybrid approach, using international benchmarks as inputs for negotiations and expanding value-linked agreements where measurement and governance prerequisites are met, may offer a more feasible U.S. pathway. This study provides a repeatable framework for assessing drug pricing reforms and illustrates how institutional alignment conditions the implementability of tools. Design-feature scores reflect policy design and governance capacity, not realized outcomes.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261448992"},"PeriodicalIF":2.1,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987245","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":"The Impact of Ramadan Fasting on Glycemic and Blood Pressure Control in a Large Saudi Arabian Cohort with Type 2 Diabetes and Hypertension: A Longitudinal Interrupted Time Series Analysis.","authors":"Ziyad S Almalki, Nehad J Ahmed, Rasha A Mandil, Naheda S Alsammak, Nada Abou Chahin, Haitham H Alanazi, Abdulhadi M Alqahtani, Ahmad A Albassam, Abdulla Alalwan, Abdullah Alahmari","doi":"10.1177/11786329261450733","DOIUrl":"10.1177/11786329261450733","url":null,"abstract":"<p><strong>Introduction: </strong>The yearly observance of Ramadan, which includes prolonged daily fasting, presents a challenging scenario for patients with chronic illnesses, with existing studies presenting inconsistent findings on its metabolic implications.</p><p><strong>Objective: </strong>This study aimed to objectively measure the immediate and sustained impacts of Ramadan fasting on monthly mean Hemoglobin A1c (HbA1c), Systolic Blood Pressure (SBP), and Diastolic Blood Pressure (DBP) in a large, real-world cohort of Saudi Arabian patients with concomitant T2DM and HTN.</p><p><strong>Methods: </strong>A retrospective longitudinal study was carried out using electronic health record (EHR) data from a Saudi multi-facility healthcare system from December 2023 to May 2024. The analysis used a segmented regression for Interrupted Time Series (ITS) to estimate changes in outcomes, with Ramadan (March 2024) serving as the intervention point.</p><p><strong>Results: </strong>The final cohort comprised 15 289 patients. The ITS analysis showed that Ramadan resulted in a substantial reduction in mean HbA1c by -0.25% (<i>P</i> < .001) and mean SBP by -4.12 mmHg (<i>P</i> < .001). However, the post-Ramadan trend for HbA1c demonstrated a significant monthly increase of 0.15% (<i>P</i> = .002), indicating a rebound impact. The reduction in SBP was not sustained, as it returned to pre-Ramadan levels in the months that followed.</p><p><strong>Conclusions: </strong>In this large Saudi cohort, Ramadan fasting was linked to transitory improvements in glycemic and blood pressure control. The ensuing rebound implies that, while fasting can be metabolically advantageous, the effects do not last without ongoing intervention. These results highlight the important necessity for rigorous post-Ramadan clinical follow-up to consolidate any gains made during the fasting period. These findings position Ramadan as a novel window for metabolic reset and a potential preventive opportunity against cardiorenal metabolic syndrome progression in high-risk populations.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261450733"},"PeriodicalIF":2.1,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972190","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":"Perceptions of Changes in the Operating Environment and Their Impact on Occupational Health Care Practices: A Qualitative Interview Study.","authors":"Sari Nissinen, Mari-Anne Wallius, Erja Sormunen","doi":"10.1177/11786329261447088","DOIUrl":"10.1177/11786329261447088","url":null,"abstract":"<p><strong>Background: </strong>Occupational health services in Finland have undergone changes due to digitalization, remote work, and evolving professional roles, all of which challenge traditional service models and require adaptation from occupational health professionals. In addition, increasing mental health demands have created new expectations of occupational health services. However, the implications of these changes for occupational health care practices are not sufficiently understood.</p><p><strong>Objectives: </strong>To explore how occupational health professionals perceive the impact of changes in the operating environment, such as digitalization, remote work, increasing mental health demands, and evolving professional roles, on occupational health care practices.</p><p><strong>Design: </strong>A qualitative interview study using inductive content analysis.</p><p><strong>Methods: </strong>Data were collected through 8 focus group interviews with 34 occupational health professionals from 8 service providers. The interviews were analyzed using inductive content analysis to identify themes related to changes in services.</p><p><strong>Results: </strong>Six main themes emerged: strengthened client orientation in occupational health service delivery, adaptation of health care practices to multilocation client organizations, technology-driven development of occupational health practices, diversified remote occupational health practices, strengthened mental health support structures, and transformed role of the occupational health physiotherapist in service delivery. Remote services have become routine, improving the accessibility of occupational health services. Multidisciplinary collaboration has shifted to virtual platforms, enabling broader participation. Mental health services have expanded, and occupational health psychologists now play a more active role in both individual and organizational support. The redefined role of occupational health physiotherapists has changed their scope of practice and improved the flexibility of and access to services.</p><p><strong>Conclusion: </strong>Occupational health professionals are responding to environmental changes by reshaping their service practices. The results highlight a shift toward more client-centered, flexible, and collaborative service models, supported by digital tools and evolving professional roles. These adaptations contribute to the development of sustainable and responsive occupational health services.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261447088"},"PeriodicalIF":2.1,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147928703","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":"The Role of Self-Efficacy in the Utilization of Integrated Health Service Post (IHSP) for NCDs Among Indonesian Industrial Workers.","authors":"Nasrul Zaman, Said Usman, Atik Badi'ah, Fahrun Nur Rosyid, Yuseva Sariati, Irwan Saputra","doi":"10.1177/11786329261445981","DOIUrl":"10.1177/11786329261445981","url":null,"abstract":"<p><strong>Introduction: </strong>Non-communicable diseases (NCDs) are currently the leading cause of mortality in Indonesia, particularly impacting the industrial workforce. Although the government provides the Integrated Health Service Post (IHSP) for NCDs as an early detection service, its utilization rate is low. This study aimed to analyze the influence of self-efficacy and social support (from family, IHSP cadres, health workers, and peers) on the use of IHSP NCD services among industrial workers.</p><p><strong>Methods: </strong>This quantitative study employed a cross-sectional design involving 1200 industrial workers across 4 provinces in Indonesia. Participants were selected using stratified random sampling. Data were collected through a structured questionnaire and analyzed using partial least squares structural equation modeling (PLS-SEM).</p><p><strong>Results: </strong>The findings revealed a low utilization rate of IHSP services, with only 40% of respondents participating. Hypothesis analysis showed that self-efficacy was the only significant predictor of service utilization (β = .385; <i>P</i> < .001). Conversely, social support variables, including family, cadre, health worker, and peer support, were found to have no statistically significant influence.</p><p><strong>Discussion: </strong>Self-efficacy is the dominant factor driving the utilization of NCD early detection services among industrial workers, surpassing the role of social support. Therefore, workplace health interventions should prioritize programs that build individuals' confidence and their ability to manage their health.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261445981"},"PeriodicalIF":2.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868133","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}