Clinics and Practice最新文献

{"title":"Exploring the Role of Guilt in Eating Disorders: A Pilot Study.","authors":"Fabiola Raffone, Danilo Atripaldi, Eugenia Barone, Luigi Marone, Marco Carfagno, Francesco Mancini, Angelo Maria Saliani, Vassilis Martiadis","doi":"10.3390/clinpract15030056","DOIUrl":"10.3390/clinpract15030056","url":null,"abstract":"<p><strong>Background/objectives: </strong>Eating disorders (EDs) are complex psychopathological conditions involving dysfunctional eating behaviors, excessive body image concerns, and impaired emotional regulation. Among moral emotions, guilt plays a significant role in ED dynamics, influencing both symptomatology and interpersonal relationships. This study examines specific guilt subtypes (normative and altruistic guilt) using a specific psychometric tool.</p><p><strong>Methods: </strong>Forty-three adults with anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED) were recruited from the Eating Disorder Center of the University of Campania \"Luigi Vanvitelli\" or referred by psychotherapists. Diagnoses followed DSM-5 criteria. Participants completed the Moral Orientation Guilt Scale (MOGS), assessing guilt subtypes, and the Eating Disorder Inventory-2 (EDI-2), measuring ED symptomatology. Spearman's rank correlation and stepwise multiple regression analyses were used to identify relationships between guilt dimensions and ED-related symptoms.</p><p><strong>Results: </strong>MOGS subscales were positively correlated with ED symptomatology. Normative guilt was significantly associated with binging and purging (ρ = 0.26, <i>p</i> < 0.05), while altruistic guilt predicted higher interpersonal distrust (t = 3.4, <i>p</i> < 0.01). Regression analysis revealed that age negatively influenced interpersonal distrust (t = -2.9, <i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>In the population examined, guilt significantly influences ED symptomatology and interpersonal functioning, with specific dimensions linked to distinct behaviors and traits. Therapeutic interventions targeting guilt may enhance treatment outcomes by addressing ED emotional underpinnings. However, the results should be interpreted with caution due to the small sample size and lack of longitudinal data to establish causality. Further research with larger samples and longitudinal designs is necessary to validate these findings.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two Long-Acting Antipsychotics in a Patient with Treatment-Resistant Schizophrenia: A Case Report.","authors":"Salvatore Cipolla, Flora Delli Carpini, Pierluigi Catapano, Valeria De Santis, Antonio Volpicelli, Francesco Perris, Francesco Catapano","doi":"10.3390/clinpract15030055","DOIUrl":"10.3390/clinpract15030055","url":null,"abstract":"<p><p>Treatment-resistant schizophrenia (TRS) poses significant therapeutic challenges due to persistent symptoms, poor adherence, and high relapse rates. Long-acting injectable (LAI) antipsychotics offer a promising approach, yet limited evidence exists regarding the combination of two LAI formulations. We report the case of a 62-year-old woman with TRS, characterized by recurrent hospitalizations and inadequate responses to oral and monotherapy treatments. During her latest hospitalization, she received alternating intramuscular administrations of haloperidol decanoate (100 mg/28 days) and aripiprazole (400 mg/28 days). The dual LAI strategy resulted in a marked improvement in psychotic symptoms, functional recovery, and treatment adherence, with no reported side effects. This case highlights the potential benefits of dual LAI therapy in managing TRS, particularly in patients with non-adherence to oral medications or limited response to standard treatments. Additional studies are required to evaluate the long-term effectiveness and safety of this innovative therapeutic approach.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Polyphenol Extra Virgin Olive Oil and Metabolically Unhealthy Obesity: A Scoping Review of Preclinical Data and Clinical Trials.","authors":"Konstantina Liva, Athanasios A Panagiotopoulos, Alexandra Foscolou, Charalampia Amerikanou, Alkistis Vitali, Stavros Zioulis, Konstantina Argyri, Georgios I Panoutsopoulos, Andriana C Kaliora, Aristea Gioxari","doi":"10.3390/clinpract15030054","DOIUrl":"10.3390/clinpract15030054","url":null,"abstract":"<p><p><b>Background/Objectives</b>: During the last decade, there has been an increased interest in phenolic compound-rich natural products as natural therapies for regulating the molecular pathways behind central obesity and associated metabolic disorders. The present scoping review presents the outcomes of clinical and preclinical studies examining the anti-obesity effects of high phenolic extra virgin olive oil (HP-EVOO) and its possible underlying molecular mechanisms. <b>Methods:</b> Studies published between 2014 and 2024 were searched via MEDLINE, Scopus, Cochrane, the Web of Science, Semantic Scholar, Google Scholar, Science.gov, and Clinicaltrials.gov databases. A combination of keywords and Boolean logic was used to search throughout the last decade in all databases, including \"hyperglycemia\" or \"hypertension\" or \"metabolic syndrome\" or \"dyslipidemia\" or \"hyperlipidemia\" or \"hypoglycemia\" or \"obesity\" or \"macrovascular diabetic complications\" or \"microvascular diabetic complications\" or \"cardiovascular disease\" or \"overweight\" or \"insulin sensitivity\" or \"insulin resistance\" and \"extra virgin olive oil\" or \"high phenolic olive oil\" and \"human\" or \"animal model\". <b>Results</b>: The 10-year literature survey identified 21 studies in both animal models and humans, indicating that HP-EVOO improves inflammation, glycemic control, oxidative stress and endothelial function, potentially protecting against metabolic syndrome, hypertension and type 2 diabetes, even compared to EVOO. Moreover, HP-EVOO's antiplatelet effect and improvement in HDL functionality reduce cardiovascular risk. <b>Conclusions</b>: The evidence presented in this study demonstrates that HP-EVOO represents an effective preventive and therapeutic dietary approach to cardiometabolic diseases.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Nordic Walking Intervention (NORDIN-JOY) on Individuals with Intellectual Disabilities and Their Families: A Multicenter Randomized Crossover Study.","authors":"Daniel González-Devesa, Carlos Ayán-Pérez, Eva González-Devesa, Jose Carlos Diz-Gómez","doi":"10.3390/clinpract15030053","DOIUrl":"10.3390/clinpract15030053","url":null,"abstract":"<p><strong>Background: </strong>We aim to evaluate the effect of the Nordic Walking program on the quality of life and functionality of individuals with intellectual disabilities; Methods: The NORDIN-JOY study is designed as a multicenter, randomized crossover trial. Participants in the experimental group will engage in a Nordic Walking intervention, while those in the control group will participate in a Fit 5-Fitness Cards intervention. Both physical training programs will consist of two 60 min sessions per week over a three-month period. The study will assess measures of quality of life and physical fitness. Additionally, the feasibility and cost-effectiveness of both programs, as well as the average weekly physical activity levels during the six months following the intervention, will be evaluated; Results: The results of this study are anticipated to provide valuable insights into the effects of structured exercise interventions on individuals with intellectual disabilities. These findings will be disseminated through peer-reviewed journals and academic conferences; Conclusions: This protocol seeks to establish evidence on the impact of exercise programs in individuals with intellectual disabilities. The findings have the potential to inform specific recommendations for healthcare professionals, caregivers, and policymakers, promoting physical activity as a cost-effective strategy for improving care and quality of life in this population.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insurance Payor Status and Outcomes in Pediatric Sports-Related Injuries: A Rapid Review.","authors":"Katherine M Kutzer, Lulla V Kiwinda, Daniel Yang, John Kyle Mitchell, Emily J Luo, Emily J Harman, Stephanie Hendren, Kendall E Bradley, Brian C Lau","doi":"10.3390/clinpract15030052","DOIUrl":"10.3390/clinpract15030052","url":null,"abstract":"<p><p><b>Introduction</b>: The rise in youth sports participation has led to an increase in pediatric sports-related injuries in the United States, contributing to growing healthcare costs and exacerbating socioeconomic disparities. Insurance payor status is a critical factor influencing access to care, treatment delays, and health outcomes. This study examines the association between insurance payor status and outcomes in pediatric sports-related injuries. <b>Methods</b>: A systematic review of the Medline database was conducted. Included studies reported insurance payor status and pediatric sports orthopedic patient outcomes following surgery. Outcomes included time to be seen by a provider, treatment access, complication and revision rates, postoperative Emergency Department (ED)/Urgent Care utilization, readmission rates, hospital length of stay, pain, functional scores, discharge destinations, return to activity, and follow-up. <b>Results</b>: A total of 35 studies comprising 535,891 pediatric patients were included. Publicly insured or uninsured patients consistently experienced significant delays in accessing care, with average wait times for clinic visits, imaging, and surgery up to six times longer compared to privately insured patients. These delays were associated with worsened injury severity, higher rates of postoperative complications, and poorer functional outcomes. Publicly insured patients were less likely to receive advanced treatments such as bracing or physical therapy, further compounding disparities. Minority groups faced delays even when controlling for insurance status. <b>Conclusions</b>: Public and uninsured pediatric patients face systemic barriers to timely and equitable care, resulting in worse outcomes following sports-related injuries. Future research should explore targeted solutions to ensure equitable care for this vulnerable population.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Electroencephalographic Aspects, Adaptive Features, and Clinical Phenotypes in a Group of Children with Autism-A Pilot Study.","authors":"Alexandru Capisizu, Leon Zăgrean, Elena Poenaru, Elena Tudorache, Mihaela Anca Bulf, Adriana Sorina Capisizu","doi":"10.3390/clinpract15030050","DOIUrl":"10.3390/clinpract15030050","url":null,"abstract":"<p><p>(1) Background: Autism, as an important global problem that affects many phenotypically different individuals, is associated with electroencephalographic (EEG) abnormalities and adaptability impairment. (2) Materials and Methods: In this retrospective study of a group of 101 autistic children, we aimed to evaluate the presence of EEG abnormalities, adaptive features, and clinical phenotypes via EEG, the Adaptive Behavior Assessment System II (ABAS II) scale, and neurological examination. (3) Results: Our results showed statistically significant associations between the level of adaptability obtained through the ABAS II scale and neurological deficit, specifically in terms of coordination impairment. There were also statistically significant differences between the level of adaptability and clinical phenotypes between autism type groups. (4) Conclusions: This study shows that children with autism are likely to exhibit neurological and adaptive abnormalities. Non-invasive assessment tools, such as EEG recordings, the ABAS II scale, and neurological examination offer valuable support for improved diagnosis and management.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Efficacy of Prolotherapy for Temporomandibular Joint Disorders: A Systematic Review and Meta-Analysis.","authors":"Antonios Saramantos, Athanassios Kyrgidis, Gregorios Venetis, Georgios Hatziantoniou, Anestis Chrysostomidis, Chrysanthi Sardeli, Ioannis Tilaveridis","doi":"10.3390/clinpract15030051","DOIUrl":"10.3390/clinpract15030051","url":null,"abstract":"<p><p><b>Background:</b> Temporomandibular disorders (TMDs) encompass a group of conditions characterized by anatomical, histological, and/or functional abnormalities that affect the muscular and/or articular components of the temporomandibular joint. Prolotherapy is an injectable treatment modality for chronic musculoskeletal pain that involves dextrose solution administration in the joint. <b>Aims:</b> To summarize, the aims involve considering the existing quality of clinical evidence on the efficacy of prolotherapy versus placebo and other active comparators, such as autologous blood products or botulinum toxin, in improving the outcomes of TMDs. <b>Methods:</b> A literature search in MEDLINE, Scopus, and Cochrane databases was performed, following the PRISMA statement guidelines, to identify randomized controlled trials (RCTs) of patients with TMDs receiving prolotherapy. The maximal incisor opening (MIO), visual analogue score (VAS) for pain, and frequency of dislocations were analyzed as the outcomes. The weighted mean difference was used to pool outcomes. The risk of bias was recorded for the included studies. <b>Results:</b> Six studies comparing prolotherapy to placebo were identified. Prolotherapy is uniformly more efficient in reducing the VAS for pain when compared to the placebo (mean difference = 1.20, 95%CI: 0.56-1.84, <i>p</i> < 0.001). Perceived jaw mobility was improved among prolotherapy patients, (mean difference = 0.47, 95%CI: 0.05-0.90, <i>p</i> = 0.003) when compared to the placebo. A beneficial effect for prolotherapy with regard to MIO (mean difference = 0.84, 95%CI: -2.12-3.80, <i>p</i> = 0.58) was not confirmed. Prolotherapy appears to be more efficient than autologous blood products in reducing VAS for pain (mean difference = 0.49, 95%CI: 0.11-0.87, <i>p</i> = 0.01). Prolotherapy was found to be more effective in reducing pain, MIO, and clicking when compared to an occlusal splint in a single study. <b>Conclusions:</b> Prolotherapy is also a promising modality for TMDs, despite the limited number of randomized clinical trials. Existing evidence supports its use to reduce TMD-related pain, even against other modalities. Further research is needed to better describe the benefit of prolotherapy for other outcomes.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastasis of Squamous Cell Carcinoma of the Larynx to the Right Adrenal Gland-A Case Report.","authors":"Eliza Działach, Michał Simlot, Karolina Osowiecka, Elżbieta Nowara, Jarosław Markowski, Mateusz Grajek","doi":"10.3390/clinpract15030049","DOIUrl":"10.3390/clinpract15030049","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Malignant adrenal tumors comprise both primary adrenal neoplasms and metastatic lesions, with the latter being significantly more common. Squamous cell carcinoma (SCC) of the larynx is a prevalent head and neck cancer that typically spreads to the cervical lymph nodes, with distant metastases being rare. Among such metastases, adrenal gland involvement is particularly uncommon, presenting unique diagnostic and therapeutic challenges. The study aimed to explore the progression, diagnostic process, and therapeutic management of a rare case of SCC of the larynx metastasizing to the adrenal gland, highlighting the role of advanced diagnostic imaging and a multidisciplinary approach in patient care. <b>Methodology</b>: A 66-year-old male with grade 3 SCC of the larynx underwent total laryngectomy, selective cervical lymphadenectomy, and radiotherapy with a dose of 70 Gy. Chemotherapy was discontinued due to hematological complications. Post-treatment monitoring included CT and PET-CT imaging, leading to the detection of a large adrenal mass. Surgical biopsy confirmed metastatic SCC in the adrenal gland, as resection was not feasible due to extensive invasion. Diagnostic imaging and histopathological examination were complemented by biochemical evaluations to assess hormonal activity. <b>Results</b>: The adrenal mass was identified as a metastasis from the laryngeal SCC. Imaging studies provided detailed insights into the lesion's size, metabolic activity, and non-functional status. Despite comprehensive efforts, the tumor was deemed unresectable, highlighting the aggressive nature of the disease and the limitations of current therapeutic modalities. <b>Conclusions</b>: This rare case emphasizes the importance of early detection, advanced imaging techniques, and interdisciplinary collaboration in managing complex metastatic presentations. It underscores the critical need for further research into systemic treatments, such as immunotherapy, and the development of standardized protocols for rare metastatic patterns. The study contributes to the growing body of literature on the management of uncommon cancer metastases, advocating for individualized patient care and innovation in treatment strategies.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dupilumab, a Potential Novel Treatment for Hailey-Hailey Disease.","authors":"Liliana Gabriela Popa, Calin Giurcaneanu, Florentina Zaharia, Andreea Grigoras, Alexandra Denisa Oprea, Cristina Beiu","doi":"10.3390/clinpract15030048","DOIUrl":"10.3390/clinpract15030048","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Hailey-Hailey disease (HHD) is an uncommon genodermatosis with autosomal dominant inheritance caused by loss-of-function mutations in the ATP2C1 gene, which lead to disruption in keratinocyte adhesion and intraepidermal acantholysis. The chronic nature of the disease, its frequent recurrences and the lack of specific treatment pose real challenges in the long-term management of these patients. Recent studies have evaluated the effect of dupilumab, a human monoclonal antibody that blocks interleukin-4 and -13 receptor in refractory HHD, with very promising results. The aim of this study was to review the published data on the use of dupilumab for the treatment of HHD, to present our own experience in the field, and to discuss the mechanisms underlying dupilumab's beneficial effects in HHD and the future treatment perspectives. <b>Methods:</b> A search of the medical literature on the use of dupilumab in the treatment of HHD was conducted. The terms \"Hailey-Hailey disease\", \"benign familial pemphigus\", \"benign chronic pemphigus\", and \"dupilumab\" were searched across multiple databases (Medline, Chrocane Library, EMBASE) from inception until 30 September 2024. <b>Results:</b> To date, six manuscripts describing 11 refractory HHD cases treated with dupilumab have been published. All the patients experienced significant clinical improvement. The authors reported sustained disease quiescence in seven patients (64%), monitored for 5 to 24 months. None of the patients experienced adverse effects related to dupilumab. To the existing evidence, we add a new case of recalcitrant HHD successfully treated with dupilumab. <b>Conclusions:</b> Mounting evidence indicates dupilumab as a safe and efficient therapeutic alternative in patients with severe, refractory HHD. However, the long-term efficacy of dupilumab and the optimal therapeutic regimen for HHD are yet to be determined.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Paramedics' Competence and Training in End-of-Life Care: A Cross-Sectional Study in Saudi Arabia.","authors":"Ahmed Alanazy, Fatimah Khalifah Alsahli, Zahra Essam Alhassan, Zahra Hassan Alabdrabulridha, Moneerah Khalifah Aljomaan, Abdullah Alruwaili","doi":"10.3390/clinpract15030046","DOIUrl":"10.3390/clinpract15030046","url":null,"abstract":"<p><p><b>Background</b>: End-of-life (EOL) care is an integral part of paramedic services, requiring not only medical expertise but also communication skills and emotional support. With the evolving role of paramedics in providing palliative care, understanding their attitudes toward EOL care and the impact of specialized training becomes crucial. <b>Aim</b>: This study aims to assess the attitudes of Saudi Arabian paramedics toward EOL care and evaluate the influence of prior EOL care training on these attitudes. <b>Methods</b>: A cross-sectional study was conducted among paramedics in Saudi Arabia using convenience and snowball sampling. Data were collected via an online survey distributed through emails and social networks, encompassing demographic information and attitudes toward EOL care. The survey was structured into two parts, with the second part developed from the relevant literature. Statistical analysis was performed using STATA version 18, employing chi-squared and Fischer exact tests for comparison. <b>Results</b>: The study involved 1049 paramedics, with the majority being aged 26-35 years (54.43%) and predominantly male (65.59%). About half of the participants (50.43%) had previously participated in EOL care courses. Paramedics who received EOL training demonstrated significantly more positive attitudes toward the role of EOL care in their jobs (98.49% versus 32.12%, <i>p</i> < 0.001) and were more comfortable discussing death with patients (51.42% versus 29.23%, <i>p</i> < 0.001). A significant majority viewed caring for a dying patient as a worthwhile experience (95.42%), and 95.33% agreed on the importance of involving the patient's family in care. <b>Conclusions</b>: The findings highlight the positive impact of EOL care training on paramedics' attitudes toward palliative care. Specialized training enhances paramedics' comfort in discussing death and their perceptions of the role of EOL care, underscoring the need for integrating comprehensive palliative care education into paramedic training programs. Future research should focus on developing standardized EOL care courses to further explore their impact on paramedics' knowledge, attitudes, and practices.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}