Healthcare最新文献

{"title":"Presentation Delay After Symptom Recognition Among Breast Cancer Patients in Mongolia: A Retrospective Study.","authors":"Bolormaa Dalkhjav, Avirmed Damdin, Naranchimeg Sodovsuren, Solongo Dashnyam","doi":"10.3390/healthcare14193270","DOIUrl":"10.3390/healthcare14193270","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Delayed medical consultation after recognizing breast symptoms may contribute to breast cancer being diagnosed at a more advanced stage. Evidence on presentation delay and its determinants remains limited in Mongolia. This study aimed to determine the frequency and factors associated with presentation delay among symptomatic breast cancer patients and to examine its association with tumor characteristics at diagnosis. <b>Methods:</b> This retrospective observational study included symptomatic patients with newly diagnosed breast cancer treated at the National Cancer Center in Ulaanbaatar, Mongolia, between 2022 and 2024. Presentation delay was defined as ≥1 month from recognition of the initial breast symptom to first medical consultation. Sociodemographic, clinical, and tumor characteristics were compared according to presentation delay. Multivariable logistic regression was used to identify factors associated with presentation delay and to assess its association with advanced-stage disease. <b>Results:</b> Overall, 169 (69.3%) patients had a presentation delay of ≥1 month. Initial presenting symptom was independently associated with presentation delay. Compared with a breast lump, a long-standing breast lump (adjusted odds ratio [aOR] 7.92, 95% confidence interval [CI] 3.14-19.98), breast pain (aOR 3.80, 95% CI 1.89-7.66), and nipple changes (aOR 3.32, 95% CI 1.20-9.21) were associated with higher odds of presentation delay. Age, marital status, education, residence, and body mass index were not independently associated with delay. Stage III-IV disease was more frequent among patients with presentation delay than among those presenting within one month (39.1% vs. 13.3%), and presentation delay was independently associated with higher odds of stage III-IV disease (aOR 4.48, 95% CI 2.12-9.49). <b>Conclusions:</b> Presentation delay was common among symptomatic breast cancer patients in Mongolia. Among the factors measured in this study, initial presenting symptom showed the strongest association with presentation delay, while presentation delay was also associated with advanced-stage disease at diagnosis.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and Expert-Based Usability Evaluation of a Smart Mobile Application for Aphasia Rehabilitation.","authors":"İbrahim Can Yaşa, Ayça Ak, Sezen Bal, Ayşe Yayla, Vedat Topuz, Fatih Kazdal, Ipek Midi, Zehra Yılmaz Eksen, Mehmet Can Koray Çekim","doi":"10.3390/healthcare14193273","DOIUrl":"10.3390/healthcare14193273","url":null,"abstract":"<p><strong>Background/objectives: </strong>This paper aims to develop an artificial intelligence-assisted mobile application using speech recognition and image processing technologies to address language difficulties experienced by individuals with aphasia.</p><p><strong>Methods: </strong>The mobile application was developed in the Android Studio environment using the Java programming language. Google Speech API was used for speech recognition, and Google ML Kit's image labelling APIs were used for image recognition. The development process of the application was conducted using the Scrum methodology. Features developed during the sprints for each module were evaluated through Expectation Tests conducted with expert participation. In these tests, users' pre-application expectations and post-application experiences with the modules were analysed through comparison. At the end of the development process, a System Usability Scale (SUS) Test was conducted to assess the overall integration of all modules.</p><p><strong>Results: </strong>Based on the results of Expectation Tests, necessary updates were made, and improvements were implemented in the functionality of each module. According to the SUS Test results, the application demonstrated an acceptable level of usability rate, and positive feedback was received in terms of user experience. The expert evaluation indicated that the application has acceptable usability and shows promise as a supportive tool for aphasia rehabilitation.</p><p><strong>Conclusions: </strong>This prototype application has the potential to support speech skills of individuals with aphasia, especially those who face challenges in accessing a Speech and Language Therapist. The integration of artificial intelligence-supported speech recognition and image processing technologies offers a promising supportive tool for the language rehabilitation of individuals with aphasia. Testing this prototype with a wider group of users and continuously updating it will be crucial in providing further support to individuals with aphasia.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stakeholder Priorities for Strengthening Sports Medicine Services in Kazakhstan: A Cross-Sectional Health-System Survey.","authors":"Sabina Muzrapova, Nurlan Jainakbayev, Rashid Sapargaliyev, Murat Umurzakov, Saule Esengarayeva, Nurlan Baisynov","doi":"10.3390/healthcare14193264","DOIUrl":"10.3390/healthcare14193264","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Sports medicine systems require evidence-informed prioritization of medical, rehabilitation, preventive, and organizational interventions. This study aimed to assess and rank stakeholders' perceived importance of proposed development domains for sports medicine in Kazakhstan, rather than the current performance or quality of the existing system. <b>Methods:</b> An anonymous cross-sectional survey was conducted between December 2025 and January 2026 among 100 stakeholders involved in medical care, rehabilitation, diagnostics, coaching and training, athletic participation, or sports administration. Twelve development domains were rated on a five-point priority scale, followed by a Top-5 selection task. Because the survey form did not technically enforce selection of exactly five options, the primary Top-5 analysis was restricted to the 47 respondents who completed the task as instructed. <b>Results:</b> Among these 47 respondents, rehabilitation and recovery programs were selected by 30/47 (63.8%), injury prevention by 26/47 (55.3%), and both accessibility of medical support and financing/sustainability by 24/47 (51.1%). The all-questionnaire sensitivity ranking (<i>N</i> = 100) showed strong but incomplete agreement with the primary exact-five ranking (Spearman's <i>ρ</i> = 0.889; Kendall's <i>τ</i> = 0.762). The 12-domain ratings showed a pronounced ceiling/invariant-response pattern, and subgroup analyses were treated as exploratory because of small and compositionally unequal subgroups. <b>Conclusions:</b> The findings describe perceived priorities within the surveyed non-probability stakeholder sample. Given the purposive, snowball-assisted recruitment strategy and the lack of full psychometric validation of the study-specific questionnaire, they should not be interpreted as nationally representative estimates of service quality, current shortages, or national policy priorities.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Longitudinal Association Between Organized Leisure Sports and School-Related Social Well-Being.","authors":"Sanne Lund Clement, Rasmus Lind Ravn, Rasmus Juul Møberg, Lotte Stausgaard Skrubbeltrang","doi":"10.3390/healthcare14193288","DOIUrl":"10.3390/healthcare14193288","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Previous research has found positive associations between physical activity and leisure-time sport participation and subjective well-being among children and adolescents. However, most of this evidence is cross-sectional. In this study, we add to this discussion by examining the hypothesized positive longitudinal association between participation in organized leisure sports and subsequent school-related well-being. <b>Methods</b>: We utilize different data sources: (1) pooled three-wave panel data for fifth- to ninth-grade pupils on sports participation, (2) register data on socio-economic background, and (3) the National Danish Well-Being Survey (initial sample size of 1210 pupils). We compile a longitudinal dataset with a distinguishable temporal ordering of exposure (participation in organized leisure sports), which is measured prior to the outcome (school-related well-being). In the statistical analyses, we employ augmented inverse probability weighting to minimize observed confounding. <b>Results:</b> Adjusting for the major confounders discussed in the literature, we find that participation in organized leisure sports is associated with higher subsequent school-related well-being levels of pupils (n = 998). The association was 0.18 (CI = 0.091-0.268) on a scale of 1-5, corresponding to a 4.4 percent increase, and a Cohen's d of 0.31. <b>Conclusions</b>: Leisure-time sports participation was longitudinally associated with greater subjective well-being in a non-clinical population, with potential benefits extending to the school context. Further research using designs capable of strengthening causal inference is warranted.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The POSH-Ex Study: Study Protocol for a Randomized Controlled Trial of a 12-Week Online Physiotherapy Intervention for Improving Postpartum Sexual Health.","authors":"Nikolina Zaplatić Degač, Ivana Živoder, Špela Bogataj","doi":"10.3390/healthcare14193277","DOIUrl":"10.3390/healthcare14193277","url":null,"abstract":"<p><strong>Background/objectives: </strong>Postpartum sexual dysfunction is common and multifactorial, yet structured physiotherapy interventions specifically targeting sexual function after childbirth remain insufficiently investigated. This study aims to evaluate the effectiveness of Postpartum Sexual Health Exercise (POSH-Ex), a standardized, multimodal, physiotherapist-led online therapeutic exercise programme designed to improve postpartum sexual function. We hypothesise that participants allocated to POSH-Ex will have a higher mean FSFI total score at 12 weeks than participants receiving usual postpartum care, after adjustment for baseline FSFI score.</p><p><strong>Methods: </strong>This randomized controlled trial will include 84 women recruited at 10-12 weeks postpartum and randomly allocated (1:1) to the POSH-Ex intervention or control group. The intervention will consist of a 12-week progressive programme delivered twice weekly in 60-min sessions, integrating pelvic floor muscle training, breathing and relaxation exercises, trunk stabilization, functional strengthening, flexibility, and movement re-education, while the control group will receive usual postpartum care and continue their usual activities without a study-specific exercise intervention. Outcomes will be assessed at baseline and after 12 weeks. Sexual function, assessed using the Female Sexual Function Index (FSFI), is the primary outcome; physical activity (IPAQ-SF), fatigue (FAS), and depressive symptoms (EPDS) are secondary outcomes. The primary analysis will compare FSFI scores at 12 weeks between groups using analysis of covariance (ANCOVA) adjusted for baseline FSFI. The trial was prospectively registered at ClinicalTrials.gov (NCT07747285).</p><p><strong>Conclusions: </strong>The POSH-Ex trial is designed to determine whether a structured, multimodal, physiotherapist-led online therapeutic exercise programme improves postpartum sexual function compared with usual postpartum care. If effective, POSH-Ex may inform the development of structured physiotherapy approaches that recognise sexual health as an integral component of comprehensive postpartum care.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Meal Regularity and Obesity Among Korean Older Adults: A Population-Based Study Using KNHANES VIII.","authors":"Hyo-Eun Park, Kyoung-Eun Jeong, Hye-Young Song","doi":"10.3390/healthcare14193278","DOIUrl":"10.3390/healthcare14193278","url":null,"abstract":"<p><p><b>Background:</b> Obesity in older adults is a major public health concern associated with chronic disease and reduced healthy life expectancy. This study examined the associations between habitual meal regularity and general and abdominal obesity among Korean older adults using Andersen's Behavioral Model. <b>Methods:</b> Data from 3559 adults aged ≥65 years who participated in the eighth Korea National Health and Nutrition Examination Survey (2019-2021) were analyzed. Dietary behaviors included regular breakfast, lunch, and dinner consumption and the number of meal types regularly consumed. General obesity was defined as body mass index ≥ 25 kg/m², and abdominal obesity as waist circumference ≥ 90 cm in men and ≥85 cm in women. Complex-sample hierarchical logistic regression analyses were conducted after adjusting for predisposing, enabling, and need factors. <b>Results:</b> Participants who regularly consumed all three meal types had lower body mass index and lower prevalence of general and abdominal obesity. In fully adjusted models, regular breakfast (adjusted odds ratio [aOR] = 0.64), dinner consumption (aOR = 0.51), and regular consumption of all three meal types (aOR = 0.61) were associated with lower odds of general obesity. Regular lunch consumption (aOR = 0.74) showed a nominally significant association with general obesity, but this association did not remain significant after the post hoc false discovery rate adjustment. Regular lunch consumption (aOR = 0.67) and regular consumption of all three meal types (aOR = 0.66) were also associated with lower odds of abdominal obesity. <b>Conclusions:</b> Regular meal consumption, particularly regular consumption of all three meal types, was associated with lower odds of general and abdominal obesity among Korean older adults. Meal regularity warrants further evaluation as a potential target in longitudinal and intervention studies, although causal relationships cannot be inferred from this cross-sectional study.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attitude, Self-Reported Practices and Knowledge of Pediatricians Regarding the Recommendation of Goat-Milk-Based Formula for Management of Infantile Colic: A Cross-Sectional Study in Saudi Arabia.","authors":"Rheem Almhizai, Ibraheem Alnashmi, Alanoud Zaid Aljarbou, Areej Alkahtani, Dana Albassam, Fawaz Faruqui, Ibtisam Alqahtani, Kamel Alenazi, Mohammad Alriyahi, Sara Alshehri, Sultan Alwehaibi, Hassan Al-Shehri","doi":"10.3390/healthcare14193283","DOIUrl":"10.3390/healthcare14193283","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Infantile colic is common among infants. Few studies in Saudi Arabia have examined pediatrician attitudes, knowledge, and practices related to goat-milk-based formula for the management of infantile colic. The aim of this study was to examine the practices and knowledge of pediatricians in using goat-milk-based formula for infantile colic management. &lt;b&gt;Methods:&lt;/b&gt; This is a cross-sectional study that was conducted in Saudi Arabia between March and May 2026. The questionnaire tool for this study was developed based on the previous literature and interviews with pediatricians in Saudi Arabia, reflecting their current practices in the management of infantile colic and recommendations for goat-milk-based formula. The face validity and exploratory factor analysis suitability were confirmed. The study participants were recruited using the convenience sampling technique. Multivariable logistic and linear regression analyses were used to identify predictors of better knowledge of goat milk and positive attitudes toward recommending it among the participating pediatricians. The mean knowledge score (1.92 (SD: 1.03)) and the mean attitude score (5.77 (SD: 2.17)) were utilized to define the dummy variable for the regression analysis to define better knowledge and positive attitudes. &lt;b&gt;Results:&lt;/b&gt; A total of 152 participants were involved in this research. Just over half of the study sample (50.7%) reported that they diagnosed infantile colic using formal criteria. Just under one-fifth of them (19.1%) reported that they recommend a formula change in formula-fed infants with colic. A total of 62.5% of the participants showed a higher level of knowledge of goat milk. Approximately 67.1% of the participants showed a positive attitude toward it. The most commonly agreed statement was that national guidelines are needed for goat-milk formula prescription, including its indicated clinical use. The multivariable linear regression analysis (the sensitivity analysis) showed that the region of practice was an important predictor variable that was significantly associated with pediatricians' knowledge of goat milk recommendation (B = 0.221; 95% CI: 0.062 to 0.379; β = 0.223; &lt;i&gt;p&lt;/i&gt;-value: 0.007). Pediatricians who worked in private hospitals had a higher attitude score toward recommending goat milk compared to those working in governmental healthcare settings (B = 1.053; 95% CI: 0.209 to 1.896; &lt;i&gt;p&lt;/i&gt;-value: 0.015). &lt;b&gt;Conclusions:&lt;/b&gt; The findings of this study suggest that pediatricians in Saudi Arabia adopt different approaches and practices for diagnosing and managing infantile colic. The knowledge of and attitudes toward goat-milk formula were generally moderate, indicating opportunities for improvement through additional professional education and awareness campaigns. There was a wide acceptance of the need for explicit national guidelines to define appropriate clinical indications for goat-milk formula utilization and recommendat","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of Fertility-Related Anxiety Among Women with Polyendocrine Metabolic Ovarian Syndrome: A Qualitative Study.","authors":"Selinay Aktaş Demir, Rüveyda Ölmez Yalazı, Destina Gizem Dağcı","doi":"10.3390/healthcare14193249","DOIUrl":"10.3390/healthcare14193249","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome, is a chronic condition with reproductive, metabolic, and psychological consequences. Fertility-related anxiety may be shaped by individual, relational, sociocultural, and healthcare experiences, but these experiences remain insufficiently understood. This study explored fertility-related anxiety and its personal, relational, and healthcare contexts among married women with PMOS who had no children. <b>Methods:</b> This qualitative descriptive study included 15 married, childless women recruited through purposive sampling from a private gynecology outpatient clinic in Istanbul, Türkiye. Face-to-face semi-structured interviews were audio-recorded and transcribed verbatim in Turkish. Data were examined using a codebook approach to thematic analysis by three researchers. Reporting followed the Consolidated Criteria for Reporting Qualitative Research. <b>Results:</b> The participants' mean age was 25.5 ± 4.1 years. Nine had previously attempted to conceive, seven had received fertility treatment, and fourteen reported that the diagnosis had affected their thoughts about having children. Five themes were generated: perceptions of the effect of PMOS on fertility; experiences and evaluations regarding treatments; social circle, family, and spousal pressure; expectations from healthcare professionals; and self-management and coping strategies. Participants described anxiety about future conception, cycles of hope and disappointment, social pressure, supportive partner relationships, unmet information and psychological support needs, and efforts to manage their health and emotions. <b>Conclusions:</b> Fertility-related anxiety was multidimensional and varied according to women's individual, relational, and healthcare experiences. Clear individualized fertility information, psychologically supportive communication, and coordinated multidisciplinary care tailored to women's reproductive intentions and needs may help address these experiences.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Family Quality of Life Among Saudi Families of Children with Autism Spectrum Disorder.","authors":"Mohammed Al Jaffal","doi":"10.3390/healthcare14193233","DOIUrl":"10.3390/healthcare14193233","url":null,"abstract":"<p><strong>Background/objectives: </strong>Family quality of life (FQOL) among families of children with autism spectrum disorder (ASD) is influenced by family life, services, and social experiences. Although research in Saudi Arabia has examined caregiver well-being and services, less is known about how families experience FQOL in everyday life. This study explored the experiences and perceptions of Saudi parents and caregivers of children with ASD.</p><p><strong>Methods: </strong>A qualitative descriptive design was used. Semi-structured interviews were conducted with 12 Saudi parents and caregivers of children with ASD. Data were analyzed using thematic analysis, with the FQOL framework used as a sensitizing conceptual lens.</p><p><strong>Results: </strong>Five themes were identified: (1) Diagnostic Experiences and Family Reorientation; (2) Caregiving and Family Reorganization; (3) Responsive Services and Family Quality of Life; (4) Family Adaptation Through Knowledge and Resilience; and (5) Community Understanding and Social Inclusion. Findings showed that FQOL was influenced by caregiving demands, responsive services, family adaptation, child progress, and opportunities for social participation.</p><p><strong>Conclusions: </strong>FQOL is shaped by families' changing experiences and needs over time. Supporting Saudi families requires responsive services, family-centered support, continuity across service systems, and more inclusive communities.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Narrative Review of Medication Optimisation in Older Adults with Polypharmacy: From Structured Medication Review to AI-Enabled Medication Safety.","authors":"Rania Aro, Zyta Beata Wojszel, Pierre Duez, Fabian Lecron, Stéphanie Patris","doi":"10.3390/healthcare14193240","DOIUrl":"10.3390/healthcare14193240","url":null,"abstract":"<p><strong>Context: </strong>Polypharmacy, commonly defined as the concurrent use of five or more medicines, and excessive polypharmacy, often defined as the use of ten or more medicines, are highly prevalent among older adults with multimorbidity. Although appropriate polypharmacy may be necessary, polypharmacy can be associated with adverse drug reactions, drug-drug interactions, falls, hospitalisation, cognitive impairment, non-adherence, treatment burden and (preventable) harm during transitions of care.</p><p><strong>Methods: </strong>This narrative review examines medication optimisation in older adults, tracing its evolution from structured medication review, pharmacist-led interventions, explicit prescribing and deprescribing criteria to digital decision support, artificial intelligence (AI)-enabled pharmacovigilance and personalised medication-risk management. European implementation perspectives, with Belgium and Poland as illustrative examples, are used to examine how professional roles, reimbursement mechanisms, clinical tools and health-data infrastructure shape medication safety.</p><p><strong>Results: </strong>This review integrates geriatric medication optimisation, European implementation experience and AI-enabled pharmacovigilance within a framework linking risk detection, clinical interpretation and treatment optimisation. Current evidence is more consistent for improvements in prescribing quality and medication-related problems than for hard clinical outcomes such as mortality, falls or hospitalisation. AI-supported approaches may improve risk detection and prioritisation, but their clinical value depends on data quality, interoperability, explainability, external validation, human oversight and prospective evidence of patient benefit.</p><p><strong>Conclusions: </strong>Future geriatric medication safety should combine comprehensive geriatric assessment, explicit clinical criteria, patient-centred deprescribing, pharmacist-led multidisciplinary review, interoperable health data and accountable AI-enabled decision support.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}