Journal of Multidisciplinary Healthcare最新文献

{"title":"Round-Sharp Needle for Limb Spasms After a Stroke: Study Protocol for a Randomized Controlled Trial.","authors":"Hongkun Ye, Jiahui Liu, Hongmei Cheng, Yu He, Chongrui Li, Yahan Gao, Xinyin Xu","doi":"10.2147/JMDH.S512206","DOIUrl":"10.2147/JMDH.S512206","url":null,"abstract":"<p><strong>Objective: </strong>Stroke can cause limb spasticity, and numerous clinical studies have demonstrated that acupuncture is an effective treatment for this condition. The round-sharp needle, a type of acupuncture needle, has been reported to shorten treatment durations and reduce the number of clinic visits compared to traditional filiform needles, the conventional acupuncture. However, clinical trial research on its efficacy remains limited. Therefore, this clinical trial is designed to investigate the short-term effects and safety of round-sharp needle therapy in treating post-stroke limb spasticity.</p><p><strong>Methods and analysis: </strong>This research protocol outlines a randomized, single-blind, prospective, single-center pilot clinical trial to be conducted at Hubei Provincial Hospital of Traditional Chinese Medicine, scheduled to commence after completion of clinical trial registration. After the recruitment phase, eligible patients meeting the inclusion criteria will be randomly assigned to one of two groups: the round-sharp needle group (3 times per week) or the filiform needle group (5 times per week). The treatment will last for two weeks, with evaluation criteria including surface electromyography (sEMG), the Modified Ashworth Scale (MAS), the Fugl-Meyer Assessment (FMA), the Modified Barthel Index (MBI), and a safety assessment of acupuncture.</p><p><strong>Conclusion: </strong>This clinical trial investigates the safety and efficacy of using round-sharp needles to treat post-stroke limb spasticity, with the results expected to provide further evidence for the future clinical application of this therapy.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (ChiCTR), ID: ChiCTR2400087907. Registered on 7 August, 2024.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3179-3189"},"PeriodicalIF":2.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Neonatal Hypothermia Prediction Model for In-Hospital Transport Using Machine Learning Algorithms: A Single-Center Retrospective Study.","authors":"Wenyan Zhang, Xiaoying Gu, Chunjie Gu, Lili Yao, You Zhang, Ke Wang","doi":"10.2147/JMDH.S517499","DOIUrl":"10.2147/JMDH.S517499","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to predict hypothermia during neonatal in-hospital transport using machine learning techniques, identify risk factors, rank their importance, and visualize the results, allowing healthcare providers to rapidly assess the probability of hypothermia risk during transport.</p><p><strong>Methods: </strong>Clinical data of 9,060 neonates transported within a tertiary maternity hospital in Shanghai between January 2023 and June 2024 were collected, including maternal and neonatal data. Variables were selected using LASSO regression. Neonates were categorized into hypothermia and normal temperature groups based on their body temperature during transport, with 6:2:2 ratio for training, test and validation datasets. Six machine learning algorithms-Decision Tree (DT), Random Forest (RF), eXtreme Gradient Boosting (XGBoost), Support Vector Machine (SVM), Artificial Neural Network (ANN), and Naive Bayes (NB)-were used to develop predictive models. The effectiveness was evaluated using area under the ROC curve (AUC), along with F1 score, accuracy, sensitivity, specificity, and Hosmer-Lemeshow calibration tests with Brier scores. The best-performing model was further analyzed for risk factors using SHAP plots.</p><p><strong>Results: </strong>Among the neonates, 5,072 (55.98%) experienced hypothermia during transport. Ten risk factors were identified through univariate analysis and LASSO regression, including gestational age, weight, and immediate postnatal contact. The RF model demonstrated the best overall performance, achieving a training set AUC of 0.994 and an accuracy of 0.957, while the test set AUC and accuracy were 0.962 and 0.889, respectively.</p><p><strong>Conclusion: </strong>Hypothermia incidence during neonatal in-hospital transport is relatively high. The RF-based prediction model demonstrated strong predictive and generalization capabilities, providing actionable guidance for early identification of neonates at risk of hypothermia during transport.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3205-3217"},"PeriodicalIF":2.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Updated Scoping Review of Factors Associated with Length of Stay in Emergency Department.","authors":"Kurhayati Kurhayati, Etika Emaliyawati, Yanny Trisyani","doi":"10.2147/JMDH.S525451","DOIUrl":"10.2147/JMDH.S525451","url":null,"abstract":"<p><strong>Background: </strong>The Emergency Department (ED) is important to the hospital healthcare system. However, increasing patient visits to the ED have increased the length of stay (LOS), which contributes to overcrowding, resource constraints, and decreased quality of care. Factors affecting LOS are complex and involve patient characteristics, hospital operations, and health system policies.</p><p><strong>Purpose: </strong>This review aimed to explore the factors influencing ED LOS.</p><p><strong>Methods: </strong>This study employed a scoping review with the PRISMA-ScR approach, analyzing articles from PubMed, Scopus, Taylor & Francis, and EBSCOhost databases published between 2022 and 2025. The keywords used were Emergency department patients OR ED patients OR Hospital admissions OR Emergency visits AND Length of stay OR hospital stay AND Predictor OR Factor. The quality appraisal of the articles was assessed using the Joanna Briggs Institute critical evaluation tool. Data were analyzed using descriptive qualitative and thematic analysis.</p><p><strong>Results: </strong>Factors influencing LOS in the ED were categorized into five main categories: (1) Patient characteristics (advanced age, male gender, comorbidities, and specific clinical conditions such as sepsis and blood diseases); (2) Time and environmental factors (nighttime, weekend, and winter visits); (3) Hospital and health system factors (hospital type, bed capacity, insurance status, and triage severity); (4) Diagnostic and treatment processes (waiting times for radiology and laboratory examinations, delays in specialist consultations, and limited inpatient beds); and (5) Patient arrival mode (arriving by ambulance or referred from another hospital).</p><p><strong>Conclusion: </strong>Longer LOS in the ED is influenced by various multidimensional factors that interact with each other. To reduce patient stays in the ED, efforts to optimize triage, improve diagnostic efficiency, and strengthen coordination between hospital units are needed. Evidence-based strategies such as digitizing medical records and predictive analytics can help improve service efficiency and reduce ED congestion.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3191-3203"},"PeriodicalIF":2.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Credibility of Public Health Campaigns and Its Impact on Infection Control Behaviors: Mediating Roles of Health Literacy and Motivation.","authors":"Khalid Abdullah Alotaibi","doi":"10.2147/JMDH.S520357","DOIUrl":"10.2147/JMDH.S520357","url":null,"abstract":"<p><strong>Background: </strong>Public health campaigns are vital in promoting infection control behaviors, particularly during health crises. The effectiveness of such campaigns can be influenced by various factors, including the perceived credibility of the messages, health literacy, and motivation to adopt health behaviors. Understanding the relationships between these factors is crucial for enhancing the impact of health campaigns. This study aimed to examine the effect of the perceived credibility of public health campaigns on infection control behaviors, with health literacy and motivation serving as mediators in Riyadh, Saudi Arabia.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted between November and December 2024 with 393 participants in Riyadh. Structural equation modeling (SEM) and path analysis were used to assess perceived credibility's direct and indirect effects on infection control behaviors through health literacy and motivation while controlling for age, gender, and education.</p><p><strong>Results: </strong>The results showed that perceived credibility had a significant direct effect on adherence to preventive behaviors (β = 0.44, p < 0.001) and motivation significantly mediated this relationship (indirect effect: β = 0.08, p < 0.01). However, no significant indirect effect was found through health literacy (indirect effect: β = 0.006, p > 0.05).</p><p><strong>Conclusion: </strong>This study emphasizes the critical roles of perceived credibility and motivation in driving infection control behaviors. The findings suggested that public health campaigns should focus on enhancing the credibility of health messages and fostering motivation to improve adherence to preventive measures. These insights have practical implications for designing more effective public health strategies in regions like Riyadh, Saudi Arabia.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3153-3163"},"PeriodicalIF":2.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Staged CBI for Reducing Anxiety and Depression in Lung Cancer Patients Undergoing Chemotherapy: A Retrospective Cohort Analysis.","authors":"Lei Chen, Yongxia Sun, Huanhuan Yu, Min Sun","doi":"10.2147/JMDH.S506310","DOIUrl":"10.2147/JMDH.S506310","url":null,"abstract":"<p><strong>Background: </strong>The success rate of Staged cognitive behavioral intervention (CBI) in reducing emotional discomfort and enhancing the life-quality of patients undergoing chemotherapy for lung cancer was assessed retrospectively in this study.</p><p><strong>Objective: </strong>The records of 55 affected role received/receiving chemotherapy for lung cancer were examined for Staged CBI.</p><p><strong>Methods: </strong>In this study, patients' life related information's were obtained through demographic questionnaires. The 36-Item Short Form Survey (SF-36) was included as a single question that indicates subjective shifts in well-being. The Functional Assessment of Cancer Therapy-General (FACT-G) and the Lung Cancer Symptom Scale (LCSS) were designed as measuring scales for quality of life (QoL). Cohen's d indexes were measured to analyze the group's effectual size. The follow-up data were collected 6-8 weeks after the Staged CBI sessions.</p><p><strong>Results: </strong>The SF-36 showed that effect size was large for most of the domains (Cohen's d > 1.2) and post CBI intervention was not significant except physical function. The FACT-G survey revealed that improvements were significant for observation group vs control for physical well-being (p = 0.004), social well-being (p = 0.007), emotional well-being (p = 0.008), and functional well-being (p = 0.045). The LCSS survey showed clinically marked changes for activity level, daily routine and social activities from 43.86 ± 20.16 to 71.29 ± 25.42, 45.36 ± 32.65 to 72.36 ± 26.78, and 35.36 ± 31.07 to 77.77 ± 28.58, respectively (P > 0.001). The resulting outcomes were significant in getting better the overall Global QoL of the patients. Besides these, the symptoms burden was also promisingly reduced.</p><p><strong>Conclusion: </strong>The function of CBI in lung cancer chemotherapy patients has not yet been examined retrospectively. This study investigated how CBI affects the treatment of mental health issues and enhances patients' treatment compliance and quality of life.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3165-3177"},"PeriodicalIF":2.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bibliometric Analysis of microRNA: A Comprehensive Evaluation of Its Contribution to Acute Coronary Syndromes.","authors":"Yuqian Gao, Tianli Li, Xiaohong Mu, Xiaoxia Ren, Jing Wang, Jiasai Fan, Haiyan Zhu, Xian Wang","doi":"10.2147/JMDH.S525150","DOIUrl":"10.2147/JMDH.S525150","url":null,"abstract":"<p><strong>Objective: </strong>This study employs bibliometric analysis to map the evolution, identify emerging trends, and evaluate key research themes in microRNA (miRNA) research related to Acute Coronary Syndromes (ACS). By analyzing global publications, we aim to highlight hotspots and translational directions for advancing miRNA applications in ACS diagnosis and therapy.</p><p><strong>Materials and methods: </strong>Articles on miRNA and ACS published between 2007 and 2023 were retrieved from the Web of Science Core Collection. Data from 1,244 eligible studies were analyzed using CiteSpace and VOSviewer to assess contributions by countries, institutions, authors, journals, and keywords. Visualization tools mapped collaboration networks, co-citation patterns, and keyword trends.</p><p><strong>Results: </strong>China contributed 60% of publications, followed by the United States (12.86%). Harbin Medical University was the most productive institution, while Thum Thomas emerged as the leading researcher. Key research areas included miRNA biomarkers for ACS diagnosis, therapeutic targets for ischemia-reperfusion injury, extracellular vesicles in cardiac repair, and mechanistic studies on apoptosis, autophagy, and inflammation. Emerging frontiers encompassed ventricular remodeling post-AMI, oxidative stress, and clinical translation of miRNA-based strategies.</p><p><strong>Conclusion: </strong>This study provides the first comprehensive bibliometric overview of miRNA research in ACS, revealing sustained growth and interdisciplinary potential. Findings underscore China's dominance in output and the need for enhanced international collaboration to bridge gaps between basic research and clinical applications. Prioritizing extracellular vesicle-mediated therapies, optimizing miRNA delivery systems, and validating biomarkers in multicenter trials are critical for future advancements.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3121-3137"},"PeriodicalIF":2.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Acupuncture Combined with Conventional Rehabilitation Training for Patients with Post-Stroke Dysphagia: A Randomized Controlled Trial.","authors":"Fangyuan Xu, Yiting Zhang, Xingxing Su, Fan Dai, Yu Ye, Meijuan Ling, Peijia Hu, Hongliang Cheng","doi":"10.2147/JMDH.S526827","DOIUrl":"10.2147/JMDH.S526827","url":null,"abstract":"<p><strong>Objective: </strong>Stroke is a significant global public health challenge. Evidence suggests that acupuncture contributes to the treatment and rehabilitation of post-stroke dysphagia (PSD), effectively improving swallowing function and enhancing patients' quality of life. This study aimed to examine the effects of acupuncture combined with conventional rehabilitation training (CRT) on swallowing function, neurotransmitter levels, nutritional status, and swallowing-related quality of life in patients with PSD.</p><p><strong>Methods: </strong>Following screening, 90 patients with PSD were randomly assigned to either the intervention group (receiving acupuncture combined with CRT) or the control group (receiving CRT only). Both groups underwent treatment six times per week for four weeks. Primary outcome measures included the standardized swallowing assessment (SSA), the modified Mann assessment of swallowing ability (MMASA), the water swallowing test (WST), and 5-hydroxytryptamine (5-HT) levels. Secondary outcomes assessed swallowing-related quality of life and nutritional indicators.</p><p><strong>Results: </strong>Compared with baseline data, both groups showed improvements after 2 and 4 weeks of treatment, with reductions in SSA scores and increases in MMASA, hemoglobin (HB), albumin (ALB), serum total protein (STP), swallowing quality of life questionnaire (SWAL-QoL) scores, and WST performance. And the intervention group exhibited significantly greater improvements than the control group at the fourth week. Notably, the 5-HT levels in the intervention group were significantly higher than those in the control group after 4 weeks (362.44±88.63 vs 310.16±86.79, <i>P</i> = 0.006).</p><p><strong>Conclusion: </strong>A 4-week course of acupuncture combined with CRT demonstrated significant benefits in enhancing swallowing function, neurotransmitter levels, nutritional status, and quality of life in patients with PSD.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3139-3152"},"PeriodicalIF":2.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Health Literate Healthcare Organization Index System for China: Based on CiteSpace and Qualitative Analysis.","authors":"Shenyu Zhao, Yang Chen, Xiyang Xia, Jing Zhou, Xiaoyu Wang, Qing Sun, Jiaqian Chang, Jiaying Ge, Lingmin Hu, Renjie Lu","doi":"10.2147/JMDH.S520366","DOIUrl":"10.2147/JMDH.S520366","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to analyze the current status and development trends of health literate healthcare organization (HLHO) worldwide, and preliminarily construct an index system suitable for HLHO in China.</p><p><strong>Methods: </strong>This study first utilized CiteSpace for bibliometric analysis to explore global research hotspots and trends in HLHO. Based on these findings, expert opinions were gathered through focus group interviews to preliminarily develop the index system. Finally, semi-structured interviews in primary hospitals were conducted to optimize the system, assess its adaptability, and collect feedback for refinement.</p><p><strong>Results: </strong>CiteSpace bibliometric analysis identified high-frequency themes-including health literacy, education, service, communication, health information, digital healthcare, special populations, community, and management-as the primary indices of HLHO. Based on expert input from focus group discussions, an index system comprising 14 primary and 120 secondary indices was developed, covering key domains such as organizational management, health education, provider-patient communication, self-management, digital services, and support for vulnerable groups. Further expert interviews indicated that the system also had good local adaptability and strong potential for broader implementation in primary hospitals.</p><p><strong>Conclusion: </strong>The index system developed in this study provides both a theoretical framework and a practical tool to support the standardized construction of health-literate healthcare organizations in China. It not only integrates cutting-edge international experience but also aligns with the practical needs of the Chinese healthcare context, demonstrating strong adaptability and relevance. The system is expected to facilitate hospital self-assessment, quality improvement, patient support, and health education efforts, thereby laying a solid foundation for enhancing healthcare service quality and improving patients' health literacy. Moving forward, our research team will continue to optimize the index system for practical use, and initiate multicenter pilot studies and quantitative scale development to strengthen its operability and value for broader implementation.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3065-3090"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Clinical Ambiguity on the Decision-Making Process Among Intensive Care Unit Providers in Northern America Using Clinical Vignettes in Mixed Methods Study.","authors":"Desiree Fleck, Hossam Gad, Beth Hogan Quigley, Mohamed Antar, Ahmed Sayed Ahmed, Mohamed A Mahmoud, Krzysztof Laudanski","doi":"10.2147/JMDH.S514274","DOIUrl":"10.2147/JMDH.S514274","url":null,"abstract":"<p><strong>Purpose: </strong>Our study investigates how healthcare professionals in the Intensive Care Unit make decisions under highly ambiguous conditions, where the patient's presentation triggers initial protocolized treatment but subsequently fails to respond to medical treatment. We hypothesize that providers with a low tolerance for ambiguity and specific risk-taking preferences are likely to rapidly engage in adequate evidence-based strategies when dealing with high-risk illnesses such as sepsis.</p><p><strong>Patients and methods: </strong>This is a single-center cohort mixed method study of healthcare providers (attendings, fellows, residents, and advanced care providers) (n=138) using clinical vignettes (Vignette#1 representing the case of sepsis, Vignette#2 representing an ambiguous case). Participants were recruited using an internal Email distribution list (response rate 13.63%). Providers were asked to choose any number of specific therapies while being assessed for tolerance of ambiguity, denial mechanism, anxiety, prevalence of risk-taking behavior, optimism, and decision-making style.</p><p><strong>Results: </strong>Providers sparsely used antibiotics in vignette #2, while fluids were rarely given in vignette #1 during the first 48 hours. By day three, providers had implemented mechanical ventilation and renal replacement therapies. Bicarbonate and corticosteroids were used significantly as collateral therapies. Study participants were not very tolerant of ambiguity, used defensive mechanisms, and more often used rational decision-making rather than intuitive decision-making. Healthcare experience correlated negatively with the stress of uncertainty, defensiveness, and rational thinking. Optimism correlated positively with years of healthcare experience. The percentage of intensive care unit responsibilities correlated with risk-taking behaviors and defensiveness. There was no difference between implementers of the bundle and never implementers in their demographic, professional, and psychological characteristics. A similar lack of correlation was seen between different levels of tolerance of ambiguity among providers.</p><p><strong>Conclusion: </strong>Providers' experience working in the intensive care unit, combined with their level of optimism, seemed to influence the relatively low implementation of the sepsis bundle across two vignettes.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3091-3104"},"PeriodicalIF":2.7,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitudes, and Practices of Cardiac Healthcare Workers Toward Thoracoscopic Surgery in Xinjiang: A Cross-Sectional Study.","authors":"Aili Aibibula, Zheng Liu, Aikeremu Tuerxun, Abudousaimi Aini, Guojun Yu, Duolikun Mutailifu, Qiang Huo, Abudunaibi Maimaitiaili","doi":"10.2147/JMDH.S507226","DOIUrl":"10.2147/JMDH.S507226","url":null,"abstract":"<p><strong>Purpose: </strong>Thoracoscopic cardiac surgery can achieve better patient outcomes than median sternotomy, but it is a complex procedure with pros and cons. This study investigated the Knowledge, attitude, and practice (KAP) of cardiac healthcare workers (HWs) toward thoracoscopic surgery in Xinjiang.</p><p><strong>Methods: </strong>This cross-sectional study was conducted from September 2023 to May 2024 at the Department of Cardiac Surgery, First Affiliated Hospital of Xinjiang Medical University, and enrolled HWs working in cardiac surgery (convenience sampling). An investigator-designed questionnaire was used to collect the demographic and KAP data. The effects of demographic factors on KAP were analyzed using multivariable analyses. Relationships among KAP dimensions were examined using a structural equation modeling (SEM) analysis.</p><p><strong>Results: </strong>The analysis included 194 participants. The mean knowledge, attitude, and practice scores were 12.97±5.74 (/24, 54.04%), 26.11±2.57 (/35, 74.60%), and 30.70±9.34 (/45, 68.22%), indicating poor knowledge, positive attitudes, and poor practices. Having a doctoral degree (OR=25.7, 95% CI: 1.59-416, P=0.022) and no experience in applying thoracoscopic cardiac surgery for patient treatment (OR=0.05, 95% CI: 0.01-0.31, P=0.001) were independently associated with knowledge. Being a nurse (OR=0.48, 95% CI: 0.24-0.94, P=0.034) was independently associated with attitudes. The knowledge scores (OR=1.17, 95% CI: 1.05-1.30, P=0.003), the attitude scores (OR=1.45, 95% CI: 1.22-1.73, P<0.001), and working in the cardiology (OR=0.17, 95% CI: 0.03-0.95, P=0.044), anesthesiology (OR=0.20, 95% CI: 0.05-0.77, P=0.019), and the operating room (OR=0.04, 95% CI: 0.00-0.32, P=0.002) departments were independently associated with practice. Knowledge influenced attitude (β=0.08, P=0.010), attitude influenced practice (β=0.98, P<0.001), and knowledge influenced practice (β=0.90, P<0.001).</p><p><strong>Conclusion: </strong>Cardiac HWs in Xinjiang had poor knowledge, positive attitudes, and poor practice regarding thoracoscopic cardiac surgery.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"3105-3119"},"PeriodicalIF":2.7,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}