Healthcare最新文献

{"title":"Terrorism Catastrophizing and Sociodemographic Correlates Among Croatian Nursing Students: A Cross-Sectional Study.","authors":"Boris Ilić, Vesna Švab, Irena Kovačević, Biserka Sedić, Adriano Friganović, Ana Marija Švigir, Martina Smrekar, Štefanija Ozimec Vulinec, Samuel Justin Sinclair","doi":"10.3390/healthcare13182323","DOIUrl":"10.3390/healthcare13182323","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Fear of terrorism can impact psychological functioning and behavior even without direct exposure. Little is known about how anticipatory terrorism fears manifest among nursing students in European contexts. This study assessed terrorism catastrophizing among Croatian nursing students and examined sociodemographic predictors. <b>Methods</b>: A cross-sectional correlational study was conducted between October and December 2024 among 348 nursing students, using the validated Terrorism Catastrophizing Scale (TCS). Behavioral and habitual changes related to the terrorism threat were also measured. Non-parametric tests and bootstrapped regression analyses (1000 resamples) explored associations with sociodemographic variables. <b>Results</b>: Mean TCS score was 38.4 ± 8.0, indicating moderate catastrophizing, with subscale means of 16.8 (Helplessness), 11.7 (Rumination), and 9.8 (Magnification). Female students scored higher across all TCS measures (<i>p</i> < 0.001). Employment was associated with greater catastrophizing and behavioral changes, while urban residence was linked to fewer habitual and overall behavioral modifications. Higher income was associated with lower magnification. TCS scores correlated moderately with behavioral changes (rs = 0.27, <i>p</i> < 0.001). Non-parametric tests (Mann-Whitney U, Kruskal-Wallis, Spearman correlation) were applied due to non-normal distributions. <b>Conclusions</b>: Terrorism catastrophizing in this population is moderate and influenced by gender, employment, and residential context. Findings suggest targeted mental health support and tailored risk communication strategies may benefit nursing students in similar low-risk settings.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174837","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":"Policy-Driven Digital Health Interventions for Health Promotion and Disease Prevention: A Systematic Review of Clinical and Environmental Outcomes.","authors":"Muhammad Faizan, Chaeyoon Han, Seung Won Lee","doi":"10.3390/healthcare13182319","DOIUrl":"10.3390/healthcare13182319","url":null,"abstract":"<p><p><b>Objectives:</b> This systematic review investigates clinical and environmental outcomes associated with policy-driven digital health interventions for health promotion and disease prevention. <b>Methods:</b> Following PRISMA 2020 guidelines, six databases (Scopus, Web of Science, PubMed, IEEE Xplore, ScienceDirect, and MDPI) were systematically searched for empirical studies published between January 2020 and June 2025, using keywords including \"digital health,\" \"telemedicine,\" \"mHealth,\" \"wearable,\" \"AI,\" \"environmental impact,\" and \"sustainability.\" From 1038 unique records screened, 68 peer-reviewed studies met inclusion criteria and underwent qualitative thematic synthesis. <b>Results:</b> Results show digital health interventions such as telemedicine, mobile health (mHealth) apps, wearable devices, and artificial intelligence (AI) platforms improve healthcare accessibility, chronic disease management, patient adherence, and clinical efficiency. Environmentally, these interventions significantly reduce carbon emissions, hospital energy consumption, and medical waste. <b>Conclusion:</b> The studies lacked standardized environmental metrics and predominantly originated from high-income regions. Future research should prioritize the development of uniform sustainability indicators, broaden geographic representation, and integrate rigorous life-cycle assessments. Policymakers are encouraged to embed environmental considerations into digital health strategies to support resilient, sustainable healthcare systems globally.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174839","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 Clinical Efficacy and Legal Boundaries: Implications of Nurse-Led Glycemic Management in Critical Care.","authors":"Giuseppe Neri, Andrea Bruni, Eugenio Garofalo, Federico Longhini, Vincenzo Bosco","doi":"10.3390/healthcare13182313","DOIUrl":"10.3390/healthcare13182313","url":null,"abstract":"<p><p>Maintaining optimal blood glucose levels in critically ill patients is a cornerstone of intensive care management. Nurse-led glycemic control protocols, i.e., structured algorithms empowering trained nurses to initiate and adjust insulin therapy, are increasingly adopted to improve the timeliness and consistency of glucose regulation in the Intensive Care Unit. These protocols offer substantial clinical benefits, including faster glucose correction, enhanced adherence to institutional practices, and reduced physician burden. However, their implementation also raises significant legal and ethical concerns. The complexity of critical illness, variability in nursing expertise, and the regulatory boundaries of professional roles may compromise protocol safety and nurse protection if not carefully managed. This paper explores the evidence supporting nurse-led glycemic control, highlighting the risks of both hyperglycemia and hypoglycemia, and examines institutional strategies to mitigate associated challenges. Recommendations include protocol flexibility, rigorous nurse training, structured escalation pathways, legal endorsement, and integration with electronic health records. When grounded in strong clinical governance and legal frameworks, nurse-led protocols can enhance patient outcomes while preserving professional accountability. However, their success depends on a comprehensive, interdisciplinary approach that balances efficiency with individualized care and safeguards all practitioners involved.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174679","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":"Learning from the Implementation of Disability-Inclusive Maternity Care: A Scoping Review.","authors":"Sarah Clifford, Meighan Mary, Briana Kramer, Mairead C Minihane, Brina Ratangee, Erin M Gilmer, Andreea A Creanga","doi":"10.3390/healthcare13182315","DOIUrl":"10.3390/healthcare13182315","url":null,"abstract":"<p><p><b>Background/Objectives</b>: A growing body of evidence has revealed the multifaceted barriers populations with disabilities face during pregnancy and postpartum. This scoping review aimed to synthesize the literature on the implementation of disability-inclusive maternity care services for patients with disabilities. <b>Methods</b>: PubMed/MEDLINE, Embase, Scopus, PsycInfo were sourced for literature between January 2013 and July 2025. Articles were eligible for inclusion in the review if they reported on the implementation of interventions that aimed to improve quality of maternity care for pregnant or postpartum patients with physical, sensory, intellectual, mental impairments. In total, 6279 studies were screened to yield a final sample of 13 eligible articles. Key characteristics and implementation outcomes were extracted and synthesized from each eligible article. <b>Results</b>: Three of the studies targeted populations with physical impairments, five targeted populations with intellectual impairments, and five focused on populations with mental impairments. A variety of interventions were employed to improve the quality of care, targeting functional referral systems (<i>n</i> = 4), competent and motivated human resources (<i>n</i> = 4), actionable information systems (<i>n</i> = 3), effective communication (<i>n</i> = 1), and evidence-based practices (<i>n</i> = 1). Eligible studies reported acceptability (<i>n</i> = 11), adoption (<i>n</i> = 7), fidelity (<i>n</i> = 2), and penetration (<i>n</i> = 1) outcomes. The interventions generally reported high acceptability among providers and patients and emphasized the importance of participatory development and phased introduction. <b>Conclusions</b>: Significant gaps in the evidence remain across all categories of impairments. Additional research is needed to understand what types of interventions can be effectively implemented to improve the quality of maternity care for pregnant and postpartum patients with disabilities.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174724","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":"Autonomic Dysregulation Mediates the Association Between Childhood Trauma and Pain Severity: Evidence from a Mediation Model.","authors":"Eleonora C V Costa, Patrícia Gonçalves, Fernando Martins, Sílvia Monteiro, Carla Pais-Vieira","doi":"10.3390/healthcare13182310","DOIUrl":"10.3390/healthcare13182310","url":null,"abstract":"<p><p><b>Background:</b> Childhood trauma is increasingly recognized as a key risk factor for autonomic nervous system (ANS) dysregulation and chronic pain. However, the mechanisms underlying this association remain insufficiently explored, particularly within integrated healthcare frameworks. <b>Objective:</b> This study examined whether autonomic reactivity mediates the relationship between childhood trauma and pain severity while accounting for age and gender. <b>Methods:</b> A total of 124 participants-64 with formally documented interpersonal trauma and 60 without-completed validated measures of childhood trauma (CTQ), cumulative trauma (LEC-17), autonomic reactivity (BPQ), and pain severity (BPI). Group comparisons, correlation analyses, and hierarchical regressions were used to assess associations among variables. A mediation model was used to test whether autonomic reactivity explained the trauma-pain relationship. <b>Results:</b> Trauma-exposed participants showed significantly higher autonomic reactivity than those without, while pain severity did not differ significantly between groups (<i>p</i> < 0.001). Childhood physical and emotional abuse was strongly associated with autonomic reactivity and moderately associated with pain severity but not directly linked to pain. Mediation analysis supported a full mediation, with childhood trauma predicting pain severity indirectly via autonomic reactivity (β = 0.220, 95% CI [0.087-0.422], <i>p</i> = 0.009). A preliminary gender effect on the trauma-ANS pathway was observed but was not sustained in weighted models correcting for sample imbalance. <b>Conclusions:</b> Autonomic dysregulation was found to mediate the link between childhood trauma and pain vulnerability. Incorporating autonomic assessment into trauma-informed, integrated healthcare could inform early detection and tailored interventions, with preliminary evidence suggesting generalizability across gender.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174672","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":"Bridging Gaps in Holistic Rehabilitation After Critical Illness: A Systematic Review.","authors":"Anna Korompeli, Kalliopi Kydonaki, Pavlos Myrianthefs","doi":"10.3390/healthcare13182324","DOIUrl":"10.3390/healthcare13182324","url":null,"abstract":"<p><strong>Background: </strong>Holistic care in the Intensive Care Unit (ICU) addresses the full spectrum of patient needs-physical, emotional, psychological, social, spiritual, and environmental-to support recovery and improve long-term outcomes after critical illness.</p><p><strong>Objective: </strong>This systematic review aimed to synthesize evidence on the effectiveness of holistic care interventions across these six dimensions of wellness in adult ICU patients.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, and Web of Science was conducted following PRISMA guidelines. The SPICE framework was used to define the scope (Setting: ICU; Perspective: patients; Intervention: holistic care; Comparison: standard care; Evaluation: multi-dimensional outcomes). Studies published in English between 1999 and 2024 were included. Methodological quality was appraised using Joanna Briggs Institute (JBI) tools.</p><p><strong>Results: </strong>Seven studies, comprising randomized controlled trials, observational, and mixed-methods designs, met the inclusion criteria. The interventions were diverse, encompassing corporeal rehabilitation, spiritual care toolkits, reflexology, early physical therapy, patient diaries, and family involvement. A narrative synthesis of these heterogeneous studies suggested potential benefits and high acceptability for various patient-centered outcomes.</p><p><strong>Conclusions: </strong>The limited but promising evidence indicates that holistic care interventions may contribute positively to ICU patient recovery. The findings underscore the need for more robust, high-quality research to conclusively determine their efficacy and support their integration into standard critical care practice.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174792","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":"RETRACTED: Malenković et al. Resilience and Perceived Social Support in Cancer Survivors: Validity, Levels, and Sociodemographic Correlates of CD-RISC-25 and MSPSS Scales. <i>Healthcare</i> 2025, <i>13</i>, 1747.","authors":"Goran Malenković, Jelena Malenković, Sanja Tomić, Silvija Lučić, Armin Šljivo, Fatima Gavrankapetanović-Smailbegović, Slobodan Tomić","doi":"10.3390/healthcare13182308","DOIUrl":"10.3390/healthcare13182308","url":null,"abstract":"<p><p>The journal retracts the article titled \"Resilience and Perceived Social Support in Cancer Survivors: Validity, Levels, and Sociodemographic Correlates of CD-RISC-25 and MSPSS Scales\" [...].</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130158","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":"Correction: Berkovich et al. Total Hip Arthroplasty in Post-Bariatric Surgery Patients: Increased Risks and Economic Burden? <i>Healthcare</i> 2025, <i>13</i>, 887.","authors":"Yaron Berkovich, Lahav Rosenberg, Linor Fournier, Yaniv Steinfeld, David Maman","doi":"10.3390/healthcare13182305","DOIUrl":"10.3390/healthcare13182305","url":null,"abstract":"<p><p>There was an error in the original publication [...].</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174858","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 Pilot Analysis of Bioparameters in Patients with Dyspepsia Accompanied by Abdominal Hardness: An Exploration of <i>Damjeok</i> Syndrome Rooted in Traditional Medicine.","authors":"Yun-Seo Lim, Chang-Gue Son, Jin-Hee Lee, Sung-Don Yang, Daeui Park, Gi-Hwan Rho, Gyu-Ho Choi, Seo-Hyung Choi","doi":"10.3390/healthcare13182307","DOIUrl":"10.3390/healthcare13182307","url":null,"abstract":"<p><p><b>Background</b>: A subset of patients with chronic dyspepsia exhibits palpable upper abdominal hardness and systemic symptoms like headache, chest discomfort, neck/shoulder stiffness, fatigue, and depression. In traditional Korean medicine (TKM), this symptom complex is referred to as <i>Damjeok</i> syndrome (, DJS). Although DJS is frequently observed in TKM practice, it lacks a clear case definition and biological mechanism, limiting its integration in gastroenterology research and evidence-based practice. Clarifying its clinical and biological features is essential to understand its pathophysiology and clinical significance. <b>Methods</b>: This case-control study aimed to characterize DJS by comparing 16 female patients diagnosed with DJS and 15 age-matched healthy females as controls. A female-only cohort was selected to reflect the higher prevalence of chronic dyspepsia in women and reduce biological variability. Clinical characteristics and potential DJS-specific biomarkers were evaluated through complete blood count (CBC), serum biochemical tests, heart rate variability (HRV) for autonomic function, and plasma 5-hydroxyindoleacetic acid (5-HIAA), a serotonin metabolite linked to gastrointestinal motility and autonomic regulation. <b>Results</b>: The DJS group had a mean disease duration of 58.0 ± 46.2 months, with epigastric fullness and underlying abdominal hardness as primary complaints. Postprandial distress syndrome (PDS) was the most common (43.8%) dyspepsia subtype, often combined with epigastric pain syndrome (EPS). Extra-gastrointestinal symptoms such as headache/fatigue (87.5%) and anxiety/depression (81.3%) were highly prevalent. Neutrophil counts were significantly lower in the DJS group (<i>p</i> = 0.01), while other hematological or biochemical markers showed no differences (<i>p</i> > 0.1). HRV analysis revealed decreased parasympathetic activity (RMSSD and HF, <i>p</i> < 0.1), and plasma 5-HIAA levels were significantly elevated compared to healthy controls (<i>p</i> = 0.01). <b>Conclusions</b>: DJS aligns with functional gastrointestinal disorders (FGIDs), sharing psychosomatic symptoms and reduced parasympathetic activity, suggesting gut-brain axis dysregulation. However, distinct features like palpable upper abdominal hardness and elevated plasma 5-HIAA levels indicate that DJS may represent a unique subtype within the category of FGIDs. These findings highlight the need for larger, well-designed studies to further elucidate the pathophysiology of DJS.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174761","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":"Living with Dysphagia and Dysarthria: A Qualitative Exploration of the Perspectives of People with Motor Neuron Disease and Their Caregivers.","authors":"Rebecca Packer, Anna Rumbach, Anna Farrell, Nicole Hutchinson, Stacey Verner-Wren, Robert Henderson, Pamela McCombe","doi":"10.3390/healthcare13182306","DOIUrl":"10.3390/healthcare13182306","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Dysphagia and dysarthria are common and distressing symptoms of motor neuron disease (MND) progression. The medical complications of dysphagia and the influence of dysarthria on communication effectiveness have been documented. The aim of the current study was to describe the lived experience of dysphagia and dysarthria from the perspectives of both people with motor neuron disease (pwMND) and their caregivers. <b>Methods</b>: A qualitative descriptive study influenced by phenomenological principles was utilized in interviews with six pwMND and six caregivers. <b>Results</b>: Three themes were developed that captured participants' experiences of dysphagia and dysarthria: (1) \"This is the way things are\"; (2) Your whole life changes, but some things stay the same; (3) Juxtaposition to information and support. <b>Conclusions</b>: The findings advance our understanding of the lived experience of dysphagia and dysarthria in MND. Health professionals need to consider broader assessment practices across both mealtimes and communicative interactions and each individual's unique information and support needs when providing healthcare information.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 18","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12469646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174676","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}