Healthcare最新文献

{"title":"Basic Life Support Awareness, Knowledge, and Attitudes Among a Self-Selected Online Sample in the Aseer Region, Saudi Arabia: An Exploratory Cross-Sectional Survey.","authors":"Ibrahim Tawhari, Shahad Alshehri, Ahad Shafi Alaklabi, Raghad Jubran Alqahtani, Afaf Haif Qahtani, Baylasan Meraie E Alqahtani, Reema Abdullah S Alsharif, Danah Mansour Almutib, Ghala Ali Alshehri","doi":"10.3390/healthcare14193311","DOIUrl":"10.3390/healthcare14193311","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Basic life support (BLS) and cardiopulmonary resuscitation (CPR) are essential emergency interventions. This exploratory study described BLS awareness, reported training, self-assessed and objectively scored CPR knowledge, and attitudes in a self-selected online sample of adults in the Aseer Region, Saudi Arabia, and examined how these constructs related to one another; it was not designed to estimate regional prevalence. <b>Methods:</b> A cross-sectional online survey (April-June 2025) used convenience recruitment through social media. The study-specific questionnaire was expert-reviewed and pilot-tested but not psychometrically validated; the five technical items (Kuder-Richardson 20 = 0.59) were analyzed individually. Analyses were primarily descriptive; comparisons, including a multivariable logistic regression, were exploratory. <b>Results:</b> Of 364 respondents, 87.1% were female, 49.5% were students, and 67.9% held a bachelor's degree. Overall, 90.9% had heard of BLS, 47.3% reported CPR training, and 45.1% reported knowing how to perform CPR; 27.5% to 57.1% selected the keyed answer on individual objectively scored items. Only 20.7% of those reporting knowing how to perform CPR selected all four keyed answers. Respondents reporting CPR training selected keyed answers more often on every objectively scored item, most markedly for the 30:2 compression-to-ventilation ratio (50.6% vs. 18.2%), yet only 41.3% of them selected the \"at least 100 compressions/min\" option. Measured sociodemographic characteristics explained little of the variation in reported training (McFadden pseudo-R² = 0.11). <b>Conclusions:</b> In this demographically imbalanced sample, self-reported awareness and self-assessed ability to perform CPR were often not matched by objectively scored knowledge. Associations with reported training may reflect who seeks training rather than training effects, and item wording may have influenced responses. The shared dataset and identified instrument weaknesses can inform representative studies using validated measures and objective skills assessment.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192959","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":"Intensive Care Unit Nurses' Views on Recognizing and Caring for Inpatients' Anxiety Levels: A Qualitative Descriptive Study.","authors":"Yüksel Can Öz, Tuba Yilmaz Bulut, Esin Tekin","doi":"10.3390/healthcare14193301","DOIUrl":"10.3390/healthcare14193301","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Anxiety in intensive care patients is a significant concern, yet limited evidence exists regarding nurses' perspectives on its assessment and management. This study aimed to explore intensive care nurses' views and experiences regarding the recognition, assessment, and management of anxiety among hospitalized intensive care patients. <b>Methods</b>: A qualitative descriptive design was employed, and the study sample consisted of 21 nurses selected from 50 nurses working in the intensive care unit of the hospital. The data were collected through in-depth interviews conducted in person between July and September 2021. The data were analyzed manually using an inductive thematic analysis approach. <b>Results</b>: A thorough analysis of the interviews yielded four overarching themes: the nurses' initial assessment priorities, the nurses' recognition of and responses to patient anxiety, approaches to reducing anxiety, and factors affecting anxiety assessment. Four main themes and ten sub-themes emerged from the interviews. The theme \"Nurses' Initial Assessment Priorities\" comprised the sub-themes \"Prioritizing the Emergency\" and \"Getting to Know the Patient.\" The theme \"Nurses' Recognition of and Responses to Patient Anxiety\" included \"Under-recognition of Anxiety,\" \"Compliance with Care and Treatment,\" and \"Recognizing Psychological Needs.\" The theme \"Approaches to Reducing Anxiety\" comprised \"Providing Information\" and \"Therapeutic Communication and Emotional Support.\" Finally, the theme \"Factors Affecting Anxiety Assessment\" included \"Workload,\" \"Organizational and Work-Related Factors,\" and \"Training Needs.\" <b>Conclusions</b>: It is recommended that in-service training programmes covering psychosocial care, anxiety assessment and management be organised for intensive care nurses and that more emphasis be placed on psychosocial care and patient anxiety in intensive care in nursing undergraduate and graduate education programmes.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192137","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":"Navigating Dental Implant Information on Social Media: A Qualitative Exploration of Digital Health Literacy and Resilience to Misinformation.","authors":"Waad Alshehri, Rayan Sharka, Mansour Alghamdi, Ammar Almarghlani","doi":"10.3390/healthcare14193298","DOIUrl":"10.3390/healthcare14193298","url":null,"abstract":"<p><strong>Background/objectives: </strong>Social media has become a common source of information about dental implant treatment. While it offers easy access to treatment-related information, concerns remain about the quality and accuracy of online content. This study explored how patients evaluate and respond to dental implant information on social media and the factors and behaviors that may help them navigate potentially misleading information.</p><p><strong>Methods: </strong>A qualitative study was conducted using semi-structured interviews with adult patients attending a dental school clinic in Saudi Arabia. Participants were purposively recruited and interviewed between March and July 2026. Interviews explored social media use, perceptions of information credibility, experiences with misinformation, information verification practices, and treatment-related decision-making. Data were analyzed using Braun and Clarke's reflexive thematic analysis.</p><p><strong>Results: </strong>Five themes were identified: (1) trust in professional and experiential sources, (2) verification before decision-making, (3) the influence of reputation and social proof, (4) skepticism toward potentially misleading information, and (5) social media as a source of information rather than a final authority. Participants commonly relied on dentists, cross-checked information across sources, drew on patient experiences and recommendations, and questioned exaggerated or commercially motivated claims before making treatment decisions.</p><p><strong>Conclusions: </strong>Participants reported using trust, verification, social influences, and critical evaluation when navigating dental implant information on social media. These behaviors may support informed treatment-related decision-making and highlight the importance of digital health literacy, as well as the role of dentists and health organizations in providing accessible and trustworthy information.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193131","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":"Virtual and Augmented Reality for Cognitive and Language Rehabilitation in Children and Adolescents: A Scoping Review.","authors":"Maria Pagano, Irene Cappadona, Anna Anselmo, Alessio Codispoto, Davide Cardile, Rosaria De Luca, Angelo Quartarone, Rocco Salvatore Calabrò, Francesco Corallo","doi":"10.3390/healthcare14193299","DOIUrl":"10.3390/healthcare14193299","url":null,"abstract":"<p><p><b>Background:</b> Virtual reality (VR) is increasingly used in pediatric rehabilitation to deliver engaging, adaptive, and ecologically relevant interventions. <b>Objective:</b> To map the available evidence on VR interventions targeting cognitive and linguistic functions in pediatric populations, focusing on intervention characteristics, technologies, outcome domains. <b>Methods:</b> A scoping review was conducted across PubMed, Web of Science, Cochrane Library, IEEE Xplore, Embase, PsycINFO and Scopus without publication-date restrictions. English-language journal articles involving participants younger than 18 years were considered. Eligible interventions targeted attention, executive functions, memory, processing speed, language, speech, or related cognitive-linguistic abilities. Methodological quality was assessed using design-specific Joanna Briggs Institute critical appraisal checklists. <b>Results:</b> Twelve studies were included. Considerable heterogeneity was observed in populations, treatment intensity, comparator conditions, technologies, and outcome measures. The most consistent benefits concerned attention and executive functions, particularly inhibitory control, cognitive flexibility, working memory, planning, processing speed, and metacognition. Evidence for language, memory, and social cognition was promising but more limited. Positive findings were reported across immersive, semi-immersive, and non-immersive VR systems, with no clear evidence of superiority according to level of immersion. Follow-up assessments were uncommon, and methodological quality was heterogeneous across study designs. <b>Conclusions:</b> VR interventions appear promising for pediatric cognitive and language rehabilitation. Larger controlled studies using standardized outcomes, active comparators, and longer follow-up are needed.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192398","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":"Investigation of the Relationship Between Health Literacy and Fall-Prevention Behaviours in Older Adults.","authors":"Nuray Girgin, Ayşe Göktaş, Mete Özgün","doi":"10.3390/healthcare14193302","DOIUrl":"10.3390/healthcare14193302","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Falls are a leading cause of morbidity and loss of independence in later life, and more than half are preventable. Health literacy has been proposed as a modifiable determinant of preventive behaviour, but the evidence rests largely on unadjusted associations and on outcomes such as fear of falling rather than on behaviour itself. This study examined how health literacy relates to fall-prevention behaviour in community-dwelling older adults, and whether that relationship holds once sociodemographic and health-related characteristics are considered. <b>Methods:</b> In this cross-sectional study, 253 adults aged 65 years and over completed a structured questionnaire comprising the Turkey Health Literacy Scale-32 (THLS-32) and the Falls Behavioural Scale for Older People (FaBS) between December 2023 and March 2024. The primary multivariable analysis used hierarchical multiple linear regression, with covariates selected on theoretical and clinical grounds and no automated variable selection. <b>Results:</b> Health literacy was inadequate or problematic-limited in 73.5% of participants. Health literacy and fall-prevention behaviour were negatively correlated (r = -0.304, <i>p</i> < 0.001). Exploratory subscale analyses showed the strongest inverse estimates for protective mobility (r = -0.388), practical strategies (r = -0.342) and avoidance (r = -0.331), whereas awareness-related subscales were not associated with health literacy. The sociodemographic and health-related covariate block explained 28.1% of the variance; in the final model, male sex, higher educational attainment, and assistive-device use were associated with FaBS scores. THLS-32 did not significantly improve the model (ΔR² = 0.006, <i>p</i> = 0.151). <b>Conclusions:</b> Fall-prevention behaviour was more strongly associated with measured sociodemographic and health-related characteristics than with health literacy. Higher FaBS scores may partly reflect activity restriction as well as protective behaviour. These findings do not support the assumption that higher general health literacy alone is associated with greater use of the behaviours captured by the FaBS.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192427","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":"Effects of a Standardized Music Intervention on Propofol Requirements and Serum Interleukin-6 and Prolactin in Deeply Sedated Mechanically Ventilated Adults: A Prespecified Secondary Analysis of a Randomized Clinical Trial.","authors":"Carmen Fernández-Álvarez, María Pilar Mosteiro-Díaz, David Zuazua-Rico, Alba Maestro-González","doi":"10.3390/healthcare14193300","DOIUrl":"10.3390/healthcare14193300","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Prolonged exposure to sedative agents in critically ill patients receiving invasive mechanical ventilation (IMV) is associated with adverse clinical outcomes. Music interventions have emerged as a promising non-pharmacological strategy to improve patient comfort and potentially reduce sedative requirements. This prespecified secondary analysis of a randomized controlled trial originally powered to detect differences in cortisol concentrations evaluated the effects of a standardized music intervention on sedative requirements and selected inflammatory and neuroendocrine biomarkers in deeply sedated mechanically ventilated adults. <b>Methods</b>: An open-label randomized controlled trial involving 110 critically ill adults receiving IMV under deep sedation was conducted. Participants were randomly assigned to a 60-min standardized music intervention delivered through active noise-cancelling headphones or to standard care. Changes in sedative requirements, serum interleukin-6 (IL-6) and prolactin (PRL) concentrations, physiological parameters, and safety outcomes were assessed. <b>Results</b>: Among participants receiving propofol at the time of the intervention (n = 84), the music intervention group showed a significantly greater reduction in propofol requirements than those receiving standard care (between-group difference 0.079 mg/kg/h, 95% CI 0.008-0.149; <i>p</i> = 0.029). Any reduction in propofol requirements was observed in 46.7% of intervention participants compared with 7.7% of controls. BIS values remained within the target range for deep sedation throughout the intervention period, and no clinically relevant changes were observed in physiological or ventilatory parameters. No significant between-group differences were observed in IL-6 or PRL concentrations after adjustment for baseline values (IL-6: <i>p</i> = 0.606; PRL: <i>p</i> = 0.093). No intervention-related adverse events were reported. <b>Conclusions</b>: A standardized music intervention was associated with reduced propofol requirements without evidence of a between-group difference in BIS trajectory during the intervention period and without clinically relevant physiological instability in mechanically ventilated critically ill patients. No significant between-group effects were observed on IL-6 or PRL concentrations during the study period. As a prespecified secondary analysis of a trial originally powered for a different primary outcome, these findings should be interpreted in that context and warrant confirmation in future randomized trials specifically designed to evaluate music-related effects on sedative requirements. Future randomized trials incorporating appropriate attention-control conditions are warranted to further clarify the specific effects attributable to the musical stimulus.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193060","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 of Maintenance Hemodialysis with Transfer to Post-Acute Rehabilitation After Stroke: A Single-Center Retrospective Cohort Study.","authors":"Hidetaka Onda, Shoji Yokobori, Masato Miyauchi","doi":"10.3390/healthcare14193303","DOIUrl":"10.3390/healthcare14193303","url":null,"abstract":"<p><strong>Background/objectives: </strong>Maintenance hemodialysis (HD) is associated with poor outcomes after stroke, but its association with access to post-acute rehabilitation remains unclear. We examined rehabilitation transfer and outcomes according to maintenance HD status.</p><p><strong>Methods: </strong>This single-center retrospective cohort included consecutive stroke patients admitted to a tertiary emergency care center during 2015-2023. The primary outcome was rehabilitation transfer among in-hospital survivors. Rehabilitation eligibility and reasons for non-transfer were assessed in the HD group. Firth logistic regression evaluated rehabilitation transfer, and multivariable logistic regression evaluated in-hospital mortality and favorable functional outcome.</p><p><strong>Results: </strong>Among 1173 patients, 54 received maintenance HD. Rehabilitation transfer occurred in 2 of 33 HD survivors (6.1%) and 299 of 937 non-HD survivors (31.9%; risk ratio, 0.19; 95% confidence interval [CI], 0.05-0.62; <i>p</i> < 0.001). After adjustment using Firth logistic regression, maintenance HD remained associated with lower odds of rehabilitation transfer (adjusted odds ratio [aOR], 0.21; 95% CI, 0.04-0.65; <i>p</i> = 0.005). Of 12 rehabilitation-eligible HD patients, 2 (16.7%) were transferred; no facility providing both maintenance HD and inpatient rehabilitation could be secured for the other 10. Maintenance HD was associated with higher in-hospital mortality (aOR, 4.26; 95% CI, 2.20-8.24; <i>p</i> < 0.001) and lower odds of a favorable functional outcome (aOR, 0.38; 95% CI, 0.19-0.77; <i>p</i> = 0.007).</p><p><strong>Conclusions: </strong>Maintenance HD was associated with markedly lower rehabilitation transfer and poorer acute outcomes. Expanding access to facilities integrating dialysis and rehabilitation may improve continuity and equity of post-stroke care.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192941","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":"Supporting Breast Milk Expression During Mother-Infant Separation: A Scoping Review of Interventions, Technologies, and Service Delivery Models.","authors":"Ana Catarina Silva, Sara Palma, Mónica Antunes","doi":"10.3390/healthcare14193297","DOIUrl":"10.3390/healthcare14193297","url":null,"abstract":"<p><strong>Background/objectives: </strong>Mother-infant separation can interrupt direct breastfeeding while lactation is being established. We mapped recent evaluations of strategies supporting milk expression during actual or anticipated separation.</p><p><strong>Methods: </strong>Following JBI guidance and PRISMA-ScR, we searched four databases for English-, Portuguese- or Spanish-language reports published in 2021-2026. Eligible sources evaluated a deliberately implemented technique, technology, equipment-access strategy, professional-education initiative or service change. One reviewer screened and charted the studies; a second reviewer verified decisions and charting, with disagreements resolved by consensus.</p><p><strong>Results: </strong>Twenty-nine reports representing 27 operational study families were included: 12 randomised, three non-randomised controlled and 12 uncontrolled, historical-comparison or descriptive studies. Digital and sensory approaches often improved anxiety, connection or acceptability, whereas effects on milk volume varied. Technique and equipment comparisons were inconsistent. Service changes were repeatedly associated with improved process outcomes, but all five studies in this domain used uncontrolled designs.</p><p><strong>Conclusions: </strong>No expression method was consistently superior. Early practical assistance, appropriate equipment access, individualised support and continuity across maternity and neonatal services appear important, but heterogeneous designs, short-term outcomes and uncontrolled evaluations limit conclusions about effectiveness.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193162","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 Psychosocial Pathways of Expectancy-Value Beliefs, Physical Fitness, and Executive Function Among Adolescents.","authors":"Dijun Shen, Sarina Bao, Xiaoxia Zhang","doi":"10.3390/healthcare14193305","DOIUrl":"10.3390/healthcare14193305","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Adequate physical fitness has been associated with cognitive health among adolescents, and psychosocial processes may help explain this relationship. However, evidence regarding the mechanisms linking physical fitness and cognitive health remains limited. Guided by expectancy-value theory, this study examined the direct and indirect effects of expectancy-value beliefs on executive function through physical fitness among adolescents. <b>Methods</b>: A prospective research design was used. Participants were 424 adolescents (58% female; Mage = 12.72 years, SD = 0.93) recruited from the southwestern United States. Physical fitness components, including cardiovascular fitness, muscular fitness, flexibility, and body mass index (BMI), were assessed using the FITNESSGRAM^® test battery. Expectancy-value beliefs and executive function were measured using validated self-report instruments. Structural equation modeling was conducted to examine the proposed relationships. <b>Results</b>: Expectancy-value beliefs were significantly associated with all physical fitness components (rs ranged from -0.86 to 0.46, ps < 0.01) except flexibility. Cardiovascular fitness and muscular fitness were negatively associated with executive function scores (rs ranged from -0.29 to -0.21, ps < 0.01), whereas BMI was positively associated with executive function scores. The proposed model demonstrated an acceptable fit (χ²/df = 284.16/113, <i>p</i> < 0.001; CFI = 0.90; RMSEA = 0.06, 90% CI [0.05, 0.07]). There was a significant indirect effect of expectancy-value beliefs on executive function through physical fitness (β = -0.11). The model explained 12% of the variance in physical fitness and 9% of the variance in executive function. <b>Conclusions</b>: The findings provide evidence for the proposed psychosocial mediation model linking expectancy-value beliefs, physical fitness, and executive function among adolescents. It suggests strategies that strengthen perceived competence and task values may improve physical fitness and, in turn, enhance executive function.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193207","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":"Vibration Therapy for Poststroke Clinical Balance: A Domain-Specific Systematic Review and Multilevel Meta-Analysis.","authors":"Jeong-Woo Seo, Ji-Woo Seok, Jung-Dae Kim","doi":"10.3390/healthcare14193307","DOIUrl":"10.3390/healthcare14193307","url":null,"abstract":"<p><strong>Background/objectives: </strong>Balance impairment is a major target of poststroke rehabilitation, but the effectiveness of mechanical vibration therapy remains uncertain. This systematic review and multilevel meta-analysis evaluated vibration therapy for validated clinical balance outcomes after stroke and explored potential effect modifiers. The review was prospectively registered in PROSPERO (CRD420251110102).</p><p><strong>Methods: </strong>PubMed, MEDLINE, Embase, the Cochrane Library, and Web of Science were searched from inception to 31 March 2026. Nineteen controlled studies contributed 22 effect-size estimates. The primary analysis used standardized between-group changes from baseline and a three-level random-effects model with study-clustered CR2 inference. Sensitivity analyses, FDR-adjusted moderator analyses, risk-of-bias assessment, and GRADE were performed.</p><p><strong>Results: </strong>Vibration therapy improved clinical balance on average (Hedges' g = 0.593, 95% CI 0.191-0.995; <i>p</i> = 0.006), although the 95% prediction interval crossed the null. Restriction to 16 randomized trials yielded a similar effect (g = 0.507, 95% CI 0.141-0.873; <i>p</i> = 0.010). Excluding studies at high or serious risk of bias attenuated the effect to g = 0.161 (95% CI -0.116-0.439; <i>p</i> = 0.217). None of seven moderators remained significant after FDR correction. The BBS-specific mean difference was 3.326 points (95% CI 1.714-4.938). Certainty was low for randomized and very low for non-randomized evidence.</p><p><strong>Conclusions: </strong>Vibration therapy may improve poststroke clinical balance on average, but heterogeneity and sensitivity to study quality limit confidence in effect magnitude and reproducibility. Current evidence does not support a specific vibration protocol; rigorous dose-ranging randomized trials are needed.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"14 19","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13665116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192438","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}