Healthcare最新文献

{"title":"Multidisciplinary Care in a Public University Family Medicine Group in Québec (Canada): Data on Patients' Follow-Up and Cardiometabolic Risk Management.","authors":"Lise Leblay, Léanne Day Pelland, Josée Gagnon, Valérie Guay, Sophie Desroches, Jean-Philippe Drouin-Chartier, Jean-Sébastien Paquette","doi":"10.3390/healthcare13141704","DOIUrl":"10.3390/healthcare13141704","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Generating real-world data on the efficacy of multidisciplinary care in cardiometabolic risk management is essential to ensure that guidelines are both applicable and effective, especially in public healthcare settings, where organizational structures may impede healthcare professionals' agility. This study aimed to generate data on patient follow-up and cardiometabolic risk management during the early years of a public university family medicine group in Québec (Canada) that provides multidisciplinary care to adults with cardiometabolic conditions, in order to evaluate the implementation and effectiveness of its care model. <b>Methods:</b> This was a retrospective longitudinal study. Patients treated at the clinic from 31 January 2020 (clinic opening) to 8 May 2024 (n = 96) were invited to consent to the use of their medical data for research. <b>Results:</b> A total of 52 patients consented and were included in the study. Upon entry at the clinic, >90% of patients had anthropometry and blood pressure (BP) measured, but plasma glucose and lipids were assessed among 50% and 79% of patients, respectively. A total of 36 patients completed the personalized multidisciplinary care program. No evidence of associations between the total number of appointments or appointments with the registered dietitian specifically with changes in BMI, waist circumference, and BP was found. However, each pharmaceutical intervention was associated with a -0.51 cm (95%CI: -1.03, 0.02; <i>p</i> = 0.06) change in waist circumference and a -1.49 mm Hg (95%CI: -2.56, -0.43, <i>p</i> = 0.01) change in diastolic BP. <b>Conclusions</b>: These data highlight the challenges of implementing a research-oriented clinic within Québec's public healthcare system.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 14","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12294377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730024","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":"Family Self-Care in the Context of Intellectual Disabilities: Insights from a Qualitative Study in Portugal.","authors":"Teresa Dionísio Mestre, Manuel José Lopes, Ana Pedro Costa, Ermelinda Valente Caldeira","doi":"10.3390/healthcare13141705","DOIUrl":"10.3390/healthcare13141705","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Family self-care (FSC) is increasingly recognized as a vital aspect of caregiving in pediatric chronic conditions. However, its development in families of children with intellectual disabilities (IDs) remains underexplored. This study aimed to examine how families construct and sustain FSC, and to identify factors that shape its development across four domains: physical, cognitive, psychosocial, and behavioral. <b>Methods</b>: A qualitative study was conducted using an abductive approach, combining inductive thematic analysis with a deductively applied theoretical framework. Semi-structured interviews were carried out with nine families of children with ID in southern Portugal. The children ranged in age from 4 to 15 years, and the parents were aged between 29 and 53 years. The data was analyzed using Bardin's content analysis, supported by NVivo software, and organized according to the FSC framework. This study followed COREQ guidelines. <b>Results</b>: The families described a range of self-care strategies, including environmental adaptations, experiential learning, emotional regulation, and long-term planning. These practices were shaped by contextual factors such as access to healthcare, relationships with professionals, emotional support networks, and socioeconomic conditions. Four emergent conclusions illustrate how structural and relational dynamics influence FSC in daily caregiving. <b>Conclusions</b>: FSC is a dynamic, multidimensional process shaped by lived experience, family interactions, and systemic support. The findings support inclusive, family-centered care models and inform clinical practice, training, and policy in pediatric IDs.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 14","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12294613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729993","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 Adjunctive Role of Antimicrobial Photodynamic Therapy to Non-Surgical Treatment in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.","authors":"Alessia Pardo, Annarita Signoriello, Elena Messina, Elia Stilo, Rachele De' Manzoni Casarola, Elisabetta Ferrara, Giorgio Lombardo, Massimo Albanese","doi":"10.3390/healthcare13141703","DOIUrl":"10.3390/healthcare13141703","url":null,"abstract":"<p><p><b>Background:</b> This systematic review aimed to assess the outcomes related to the use of antimicrobial photodynamic therapy (aPDT) as an adjunct to non-surgical periodontal treatment (NSPT) of patients affected by periodontitis and with type 2 diabetes mellitus (T2DM). <b>Methods:</b> PubMed, Cochrane Library, Scopus, and Web of Science (core collection) were queried up to January 2025. The PICO question investigated the comparison between T2DM patients undergoing NSPT with or without aPDT, in terms of improvement of clinical parameters. Two independent operators performed the study selection, data extraction, and risk of bias assessment (RoB-2 tool). The meta-analysis examined the reduction in bleeding on probing (BoP) and probing pocket depth (PPD) in sites > 4 mm, reporting mean difference (MD) and 95% confidence intervals (CIs). <b>Results:</b> Among 502 studies retrieved, 15 were finally included in the systematic review and meta-analysis. In T2DM individuals, the adjunct of aPDT to NSPT demonstrated a substantial reduction in BoP and PPD after 3 and 6 months compared to the use of NSPT alone. <b>Conclusions:</b> The outcomes of this systematic review suggest that adjunctive aPDT may provide additional benefit to NSPT in reducing inflammation in T2DM patients with periodontitis, indicating that this combined therapy could represent a potentially useful approach for individuals with T2DM. Review registration: registration in PROSPERO (International prospective register of systematic reviews) with ID CRD42024506295 on 6 February 2024.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 14","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12294592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730042","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 Role of Psychological Flexibility and Psychological Factors in Chronic Pelvic Pain Among Women: A Correlational Study.","authors":"Chiara Manna, Michelle Semonella, Giada Pietrabissa, Gianluca Castelnuovo","doi":"10.3390/healthcare13141697","DOIUrl":"10.3390/healthcare13141697","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Chronic Pelvic Pain (CPP) is a multifactorial condition that affects in many ways the daily life of patients suffering from it. Different psychological factors demonstrated to be associated with the genesis and maintenance of CPP. Less is known about the role of the Psychological Flexibility (PF) model. Thus, the aim of this study is to explore the relationship between the PF domains, psychological distress, pain, and quality of life in patients with chronic pelvic pain. <b>Methods:</b> A total of 114 women with a diagnosis of chronic pelvic pain were included in this study. Participants completed online self-report measures to assess psychological distress (anxiety, depression, stress), Psychological Flexibility, Pain interference, and Quality of life. <b>Results:</b> Psychological distress and Psychological Flexibility showed significant association with pain interference. Other PF dimensions related to pain interference were as follows: self as context, defusion, and values. Physical Quality of life showed significant association with Experiential avoidance and Lack of values clarity, while Mental Quality of life was associated with Psychological Inflexibility and Self as content. <b>Conclusions:</b> Psychological distress and Psychological Flexibility have a role in pain perception and its interference with a patient's daily life, affecting also physical and mental quality of life of CPP patients.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 14","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12295592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729981","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 Historical Development of the Successful Dialogues in Mental Health Model.","authors":"Marta Soler-Gallart, Alba Crespo-López, Garazi López de Aguileta, Mimar Ramis-Salas, Esther Oliver","doi":"10.3390/healthcare13141696","DOIUrl":"10.3390/healthcare13141696","url":null,"abstract":"<p><p><b>Background/Objectives:</b> The scientific literature shows that new scientific and social priorities regarding social impacts and co-creation are leading to profound transformations in all scientific and social contexts. In the field of mental health, one dimension of this transformation is the increasing visibility of dialogic models that support the improvement of mental health. While this is very positive, it carries a risk of deformations that can lead to negative outcomes for both society and science. There is a lack of scientific research about the errors related to the new visibility of the Successful Dialogues in Mental Health (SDMH) model. The objective of this research is to clarify a certain type of error, namely when the excellent results obtained through the use of this model in particular contexts are attributed to a supposed dialogic approach of psychiatric rehabilitation, made by researchers without a degree in medicine. <b>Methods:</b> In order to clarify this error, we use a communicative methodology through a qualitative research design, oriented to unveil the main steps in the original development of the model. <b>Results:</b> The results show that the SDMH model has never presented itself as psychiatric, but instead as a social-dialogic collaboration with psychiatrists with the aim of helping individuals to overcome mental health problems. <b>Conclusions:</b> This study clarifies the purpose of the SDMH model which contributes to benefiting citizens, particularly those with mental health conditions.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 14","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12294324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730046","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":"Factors Associated with Burnout in Medical Students: An Exploration of Demographic, Academic, and Psychological Variables.","authors":"Catalin Pleșea-Condratovici, Liliana Mititelu Tartau, Pantelie Nicolcescu, Gheorghe Gindrovel Dumitra, Mihail-Cristian Pirlog, Manuela Arbune, Mariana Stuparu-Cretu, Ciprian Vlad, Anamaria Ciubara, Karina Robles-Rivera, Roxana Surugiu, Alina Pleșea-Condratovici","doi":"10.3390/healthcare13141702","DOIUrl":"10.3390/healthcare13141702","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the prevalence and predictors of burnout among medical students at \"Dunărea de Jos\" University of Galați, Faculty of Medicine and Pharmacy.</p><p><strong>Methods: </strong>Burnout was measured using the School Burnout Inventory-U 9 (SBI-U 9), and potential predictors, including social media addiction (Bergen Social Media Addiction Scale-BSMAS), procrastination, age, gender, year of study, admission grade, last annual grade, hobbies, achievements, close friends, and relationship status, were assessed using appropriate instruments. Correlation and hierarchical multiple regression analyses identified predictors of burnout. Mediation analysis tested procrastination as a mediator between BSMAS and burnout, while moderation analysis examined whether procrastination moderated this relationship.</p><p><strong>Results: </strong>Social media addiction was an independent predictor of burnout. While younger age was correlated with higher burnout, it was not a significant predictor in the multivariate model. Procrastination did not significantly mediate the link between social media addiction and burnout but significantly moderated it. The effect of social media addiction on burnout was stronger for students with lower levels of procrastination.</p><p><strong>Conclusions: </strong>The study shows increased susceptibility to burnout among younger students and identifies social media addiction as a key risk factor. Procrastination moderates this relationship, indicating the need for interventions targeting both digital habits and time management in medical education.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 14","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12295907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729992","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":"Social Media Exposure and Muscle Dysmorphia Risk in Young German Athletes: A Cross-Sectional Survey with Machine-Learning Insights Using the MDDI-1.","authors":"Maria Fueth, Sonja Verena Schmidt, Felix Reinkemeier, Marius Drysch, Yonca Steubing, Simon Bausen, Flemming Puscz, Marcus Lehnhardt, Christoph Wallner","doi":"10.3390/healthcare13141695","DOIUrl":"10.3390/healthcare13141695","url":null,"abstract":"<p><p><b>Background and Objectives:</b> Excessive social media use is repeatedly linked to negative body image outcomes, yet its association with muscle dysmorphia, especially in athletic youth, remains underexplored. We investigated how social media exposure, comparison behavior, and platform engagement relate to muscle dysmorphia symptomatology in young German athletes. <b>Materials and Methods:</b> An anonymous, web-based cross-sectional survey was conducted (July-October 2024) of 540 individuals (45% female; mean age = 24.6 ± 5.3 years; 79% ≥ 3 h sport/week) recruited via Instagram. The questionnaire comprised demographics, sport type, detailed social media usage metrics, and the validated German Muscle Dysmorphic Disorder Inventory (MDDI-1, 15 items). Correlations (Spearman's ρ, Kendall's τ) were calculated; multivariate importance was probed with classification-and-regression trees and CatBoost gradient boosting, interpreted via SHAP values. <b>Results:</b> Median daily social media time was 76 min (IQR 55-110). Participants who spent ≥ 60 min per day on social media showed higher MDDI scores (mean 38 ± 7 vs. 35 ± 6; <i>p</i> = 0.010). The strongest bivariate link emerged between perceived social media-induced body dissatisfaction and felt pressure to attain a specific body composition (Spearman ρ = 0.748, Kendall τ = 0.672, <i>p</i> < 0.001). A CatBoost gradient-boosting model out-performed linear regression in predicting elevated MDDI. The three most influential features (via SHAP values) were daily social media time, frequency of comparison with fitness influencers, and frequency of \"likes\"-seeking behavior. <b>Conclusions:</b> Intensive social media exposure substantially heightens muscle dysmorphia risk in young German athletes. Machine-learning interpretation corroborates time on social media and influencer comparisons as primary drivers. Interventions should combine social media literacy training with sport-specific psychoeducation to mitigate maladaptive comparison cycles and prevent downstream eating disorder pathology. Longitudinal research is warranted to clarify causal pathways and to test targeted digital media interventions.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 14","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12294503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730032","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 Global Postural Re-Education on Pain, Functionality, and Range of Motion in Chronic Non-Specific Neck Pain: A Systematic Review of Randomized Controlled Trials.","authors":"Philippine Picher, Adérito Seixas, Isabel Moreira-Silva, Joana Azevedo, Ricardo Cardoso","doi":"10.3390/healthcare13141689","DOIUrl":"10.3390/healthcare13141689","url":null,"abstract":"<p><p><b>Objective:</b> Although Global Postural Re-education (GPR) is widely used for musculoskeletal conditions, its specific benefits for this population remain unclear due to inconsistent findings across studies. This systematic review aims to analyze the effects of GPR on pain intensity, functionality, and range of motion (ROM) in individuals with chronic non-specific neck pain. <b>Methods:</b> Computerized search was performed in the Cochrane CENTRAL, Lilacs, EBSCO, PEDro, Pubmed, RCAAP and Scielo databases using the keyword combination (\"Global Postural Rehabilitation\" OR \"Global Postural Reeducation\" OR \"Global Posture Reeducation\" OR \"Global Postural Re-education\" OR \"GPR\") AND (\"Neck Pain\" OR \"Cervicalgia\"). Methodological quality was assessed using the Physiotherapy Evidence Database Scale. <b>Results:</b> Six studies with a total of 393 participants (322 women, aged 18-80) were included. The methodological quality was moderate (average PEDro score: 6.7/10), with frequent limitations related to lack of blinding and allocation concealment. Risk of bias was rated as \"some concerns\" in four studies and \"high\" in two. GPR was associated with improvements in pain intensity, functionality, and cervical ROM (flexion/extension). While three studies found no significant differences between GPR and static stretching or specific cervical exercises, the remaining three studies reported greater improvements with GPR compared to manual therapy or traditional neck education and exercise therapy. No adverse effects were reported in any of the included trials. <b>Conclusions:</b> GPR appears to be a safe and potentially effective intervention for individuals with chronic non-specific neck pain, particularly in improving pain, function, and cervical ROM. Nonetheless, further high-quality randomized controlled trials are needed to confirm its superiority over other physiotherapeutic interventions and to determine the optimal treatment parameters. PROSPERO registration: CRD420251068974.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 14","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12294582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729970","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":"Circadian Lighting Was Associated with a Reduction in the Number of Hospitalized Patients Experiencing Falls: A Retrospective Observational Study.","authors":"Takeshi Okinami, Toshihiro Suzuki, Nobuyuki Nishikawa, Hiromitsu Negoro","doi":"10.3390/healthcare13141692","DOIUrl":"10.3390/healthcare13141692","url":null,"abstract":"<p><p><b>Background</b>: Falls in hospitalized patients are a significant healthcare concern. This study examined whether circadian lighting, which helps to regulate circadian rhythms, reduces fall risk. <b>Methods</b>: A retrospective study was conducted in a 49-bed subacute and rehabilitation ward after the renovation and the installation of circadian lighting. Patients admitted during the five months with circadian lighting (intervention group) were compared to those admitted in the previous five months under fluorescent lighting (control group). Circadian lighting was defined as at least 275 equivalent melanopic lux between 7 a.m. and 12 p.m. <b>Results</b>: Significantly fewer patients in the intervention group experienced falls (7.4% vs. 15.0%, <i>p</i> = 0.0182). Logistic regression analysis identified circadian lighting as a protective factor (adjusted odds ratio [aOR] = 0.558, 95% confidence interval [CI]: 0.351-0.887, <i>p</i> = 0.0137), while age ≥ 80 (aOR = 2.48, 95% CI: 1.18-5.21, <i>p</i> = 0.0167) and anticonvulsant use (aOR = 3.68, 95% CI: 1.39-9.72, <i>p</i> = 0.0087) were significant risk factors. <b>Conclusion</b>: Circadian lighting was associated with a reduction in the number of patients who experienced falls, while advanced age and anticonvulsant use were significant risk factors.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 14","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12294480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729949","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":"Transforming Palliative Care for Rural Patients with COPD Through Nurse-Led Models.","authors":"Kristen Poston, Alexa Nasti, Carrie Cormack, Sarah N Miller, Kathleen Oare Lindell","doi":"10.3390/healthcare13141687","DOIUrl":"10.3390/healthcare13141687","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, with rural populations experiencing higher prevalence and worse outcomes. This paper explores the transformative potential of nurse-led palliative care models in addressing the unique challenges faced by rural patients with COPD and their informal caregivers and synthesizes current evidence on nurse-led palliative care interventions, highlighting their impact on symptom management, advance care planning, and psychosocial support. <b>Methods</b>: This is a comprehensive synthesis of nurse-led palliative care programs, focusing on home-based care, telehealth, community outreach, and primary care integration. <b>Results</b>: Nurse-led interventions significantly improve patient satisfaction, reduce symptom burden, and enhance the likelihood of advance care planning discussions. Home-based care models and telehealth are particularly effective in rural settings, offering accessible and continuous support. <b>Conclusions</b>: Nurses have a critical role in bridging the palliative care gap for rural patients with COPD and their informal caregivers. Expanding nurse-led palliative care services can improve quality of life, reduce healthcare utilization, and promote health equity. Future research should focus on long-term outcomes, cost-effectiveness, and strategies for scaling nurse-led palliative care programs in rural contexts.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 14","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12294539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729983","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}