Health Care Analysis最新文献

{"title":"Construct Validity of the Measurement Tools PH42 and I.ROC12 to Measure Positive Health in a General Population.","authors":"Vera P van Druten, Lenny M W Nahar-van Venrooij, Bea G Tiemens, Dike van de Mheen, Esther de Vries, Margot J Metz","doi":"10.1007/s10728-025-00533-2","DOIUrl":"https://doi.org/10.1007/s10728-025-00533-2","url":null,"abstract":"<p><p>'Positive Health' and 'recovery' seem to cover similar multidimensional health perspectives focussing on capabilities instead of incapabilities. The My Positive Health questionnaire and Individual Recovery Outcomes Counter were initially developed as dialogue tools, but nowadays also used as self-reported questionnaires. Structural validity of these dialogue tools was assessed in earlier research resulting in the 42-items Positive Health questionnaire (PH42) and 12-items Individual Recovery Outcomes Counter (I.ROC12). As a next step, we investigated their construct validity. An observational cross-sectional study was conducted in a representative general Dutch population (LISS-panel) determining (1) Coherence between the PH42 and I.ROC12 using correlation coefficients; (2) Convergent validity by testing hypotheses for PH42 and I.ROC12 with external health-related questions using correlation coefficients; (3) Discriminative validity for subgroups gender, age, educational level and healthcare use. (1) Nine out of twelve correlations between PH42 and I.ROC12 factors were substantial (> 0.5). (2) Hypotheses for PH42 and I.ROC12 factors with health-related questions were confirmed for 80% and 75%, respectively. (3) Scores on all factors increased (i.e., better health) from low to high educational level and decreased from no healthcare use to healthcare received from (medical) specialists. Only the factor physical health and functioning showed a continuous decrease in scores with increasing age. Women scored lower only on physical health and functioning. Convergent validity is adequate and discriminative validity is adequate for educational level and healthcare use supporting the conclusion that the PH42 and I.ROC12 are useful instruments to measure Positive Health in a general population.</p>","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Exploring Consent to Use Real-World Data in Lung Cancer Radiotherapy: Decision of a Citizens' Jury for an 'Informed Opt-Out' Approach.","authors":"Arbaz Kapadi, Hannah Turner-Uaandja, Rebecca Holley, Kate Wicks, Leila Hamrang, Brian Turner, Tjeerd van Staa, Catherine Bowden, Annie Keane, Gareth Price, Corinne Faivre-Finn, David French, Caroline Sanders, Søren Holm, Sarah Devaney","doi":"10.1007/s10728-025-00532-3","DOIUrl":"https://doi.org/10.1007/s10728-025-00532-3","url":null,"abstract":"","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatrics 4.0: the Transformative Impacts of the Latest Industrial Revolution on Pediatrics.","authors":"Derşan Onur, Çağla Özbakır","doi":"10.1007/s10728-025-00536-z","DOIUrl":"https://doi.org/10.1007/s10728-025-00536-z","url":null,"abstract":"<p><p>Industry 4.0 represents the latest phase of industrial evolution, characterized by the seamless integration of cyber-physical systems, the Internet of Things, big data analytics, artificial intelligence, advanced robotics, and cloud computing, enabling smart, adaptive, and interconnected processes where physical, digital, and biological realms converge. In parallel, healthcare has progressed from the traditional, physician-centered model of Healthcare 1.0 by introducing medical devices and digitized records to Healthcare 4.0, which leverages Industry 4.0 technologies to create personalized, data-driven, and patient-centric systems. In this context, we hereby introduce Pediatrics 4.0 as a new paradigm that adapts these innovations to children's unique developmental, physiological, and ethical considerations and aims to improve diagnostic precision, treatment personalization, and continuous monitoring in pediatric populations. Key applications include AI-driven diagnostic and predictive analytics, IoT-enabled remote monitoring, big data-powered epidemiological insights, robotic assistance in surgery and rehabilitation, and 3D printing for patient-specific devices and pharmaceuticals. However, realizing Pediatrics 4.0 requires addressing significant challenges-data privacy and security, algorithmic bias, interoperability and standardization, equitable access, regulatory alignment, the ethical complexities of consent, and long-term technology exposure. Future research should focus on explainable AI, pediatric-specific device design, robust data governance frameworks, dynamic ethical and legal guidelines, interdisciplinary collaboration, and workforce training to ensure these transformative technologies translate into safer, more effective, and more equitable child healthcare.</p>","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Third-Party Consent To Medical Treatment in Malaysia: A Critical Analysis from Ethical and Malaysian Legal Perspectives.","authors":"Mohamad Iqhbal Bin Kunji Mohamad, Aimi Nadia Mohd Yusof, Hazdalila Yais Haji Razali, Julina Azimah Md Noor, Muhammad Aidil Idham Bin Sharom","doi":"10.1007/s10728-025-00531-4","DOIUrl":"https://doi.org/10.1007/s10728-025-00531-4","url":null,"abstract":"<p><p>Third-party consent, while common in medical practice, presents complex ethical dimensions and intricate legal connotations. In Malaysia, the absence of comprehensive legislation governing third-party consent for adults lacking decision-making capacity due to temporary conditions creates profound dilemmas for healthcare professionals. This article critically examines these challenges through a compelling case study of an 18-year-old female with respiratory failure who required immediate invasive intervention but did not receive consent from her mother. Despite medical urgings and a favourable prognosis, the mother's refusal highlights the difficulties healthcare providers face when navigating between their ethical obligations to act in the patient's best interests and the patient's family's wishes. Employing a dual analysis from ethical and Malaysian legal perspectives, the study explores the tensions between universal medical ethics-particularly the principles of autonomy, beneficence, and non-maleficence-and the existing Malaysian legal framework. It reveals contradictions between the Malaysian Medical Council's guidelines, which appear to grant decision-making authority to family members, and English common law principles that emphasise acting in the patient's best interests, especially in emergency situations. This inconsistency generates significant uncertainty for healthcare professionals, potentially compromising patient care and exposing physicians to litigation when acting without explicit consent. Through systematic examination of both emergency and non-emergency scenarios, the article underscores the urgent need for comprehensive legislation in Malaysia to address third-party consent, particularly for patients not covered by the Mental Health Act 2001. It advocates for laws that clearly differentiate between emergency and non-emergency situations, delineate the authority of relatives and legal guardians, and align with international practices and fundamental medical ethics principles. By harmonising legal statutes with ethical imperatives, Malaysia can resolve the contradictions that currently jeopardise patient welfare and physician security. These findings have important implications for healthcare policy development and clinical practice, emphasising the necessity for ethical and legal coherence in medical care in Malaysia.</p>","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical Challenges in Research Involving Hospitalized Patients: A Phenomenological Study.","authors":"Moustaq Karim Khan Rony, Dilruba Akther, Umme Rabeya Peu, Md Shafiul Alam, Abu Zafor Md Shaleah, Md Zahirul Alam, Mst Rina Parvin, Ibne Kayesh, Sandra Rumi Madhu, Daifallah M Alrazeeni, Fazila Akter","doi":"10.1007/s10728-025-00534-1","DOIUrl":"https://doi.org/10.1007/s10728-025-00534-1","url":null,"abstract":"<p><p>Hospital-based research plays a crucial role in advancing medical knowledge, but it also presents significant ethical challenges, particularly when involving hospitalized patients. Ethical concerns such as informed consent, patient autonomy, and the power dynamics between healthcare providers and patients are critical to maintaining the integrity of such research. The aim of this research was to explore and analyze the ethical considerations in conducting research involving hospitalized patients. A qualitative phenomenological approach was used to investigate the experiences and perceptions of healthcare professionals involved in clinical or public health research in hospital settings. Semi-structured interviews were conducted with 33 participants from both public and private hospitals in Dhaka, Bangladesh. The data were analyzed using thematic analysis to identify recurring ethical themes. This study identified five key themes: (1) Ethical challenges in hospital-based research, (2) Informed consent and patient vulnerability, (3) Patient autonomy and decision-making in research, (4) Institutional Review Boards (IRBs) and ethical oversight, and (5) Strategies to improve ethical research practices in hospitals. Participants reported concerns about coercion, difficulties in obtaining consent from critically ill patients, conflicts in surrogate decision-making, and delays in IRB approval. The findings also emphasized the importance of ethical training, continuous consent practices, and patient-centered approaches. Ethical research practices in hospital settings require a balance between scientific progress and patient protection. The study emphasizes the need for improved ethical guidelines, better informed consent processes, and ongoing training for healthcare professionals to ensure patient autonomy is respected. The findings also call for streamlined Institutional Review Board (IRB) processes to support timely and ethical research execution.</p>","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considering Culturally Sensitive Dementia Care as a Prerequisite for Person-Centered Care: The Turkish Community in Germany as an Example.","authors":"Zümrüt Alpinar-Segawa, Sabine Salloch","doi":"10.1007/s10728-025-00529-y","DOIUrl":"https://doi.org/10.1007/s10728-025-00529-y","url":null,"abstract":"<p><p>Culturally diverse societies often struggle with providing appropriate dementia care. Cultural sensitivity is considered an important prerequisite for meeting the needs of persons with dementia. This article discusses culture specific aspects of dementia care by referring to the Turkish community in Germany as an example. Factors are discussed that specifically infringe on the quality of dementia care for migrants. The article defends the claim that good dementia care for migrants can be provided through a person-centered approach which is again based on culturally sensitive approach. We show how culture shapes health phenomena but also argue that a focus on culture may stereotype individuals as belonging to a particular culture, grouping people together irrespective of their heterogeneity. Person-centered care is ideal for recognizing diverse needs and values. It is often seen as being at odds with culturally sensitive care, but this paper suggests a way of reconciling them. We argue that culture does indeed provide a framework to create the necessary foundation for person-centered care. Finally, some criticisms and plausible replies are discussed and practical implications arising from the analysis are presented.</p>","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harm Reduction in Inpatient Hospital Settings: An Ethics (Principlist) Analysis.","authors":"Katherine Birkness, Cheryl Forchuk, Jonathan Serrato, Abraham Rudnick","doi":"10.1007/s10728-025-00530-5","DOIUrl":"https://doi.org/10.1007/s10728-025-00530-5","url":null,"abstract":"<p><p>The opioid epidemic continues to be a prevalent crisis in North America. How best to address this challenge has long been debated. Abstinence is currently the preferred policy within the inpatient hospital setting, however, this is fraught with difficulties such as withdrawal and using substances in secrecy. It can also result in stigma and a lack of knowledge on substance use among health care providers. The concept of harm reduction could provide an ethical approach to supporting people with substance use disorder. Through Principlism and the principles of Autonomy, Beneficence, Justice and Non-Maleficence, this paper suggests that harm reduction practices represent a viable and more ethically sound approach to health care compared to abstinence-based approaches. Harm reduction practices could result in a more equitable health care system that reduces stigma and increases help-seeking behaviour. More empirical research in other jurisdictions or other settings such as long-term care is needed. Future research should address additional theoretical frameworks such as dialogical bioethics, care ethics and the capabilities approach.</p>","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical, Legal and Social Issues in Utilizing In Vitro Gametogenesis (IVG) and Stem Cell-Based Embryo Models (SCBEMs) for Human Reproduction in Singapore.","authors":"Alexis Heng Boon Chin, Ido Alon, Timothy Anand Weerasekera, Jean Didier Bosenge-Nguma, Ningyu Sun","doi":"10.1007/s10728-025-00521-6","DOIUrl":"https://doi.org/10.1007/s10728-025-00521-6","url":null,"abstract":"<p><p>Singapore is a small, affluent and technologically advanced city-state located in Southeast Asia. Due to its lack of natural resources, this country relies heavily on its highly educated and skilled workforce to drive its economic engine. However, in recent years, Singapore has been facing a demographic crunch due to its ultra-low fertility rate and rapidly aging population, which poses an existential threat to its survival as a nation-state. The advent of new reproductive technologies such as In Vitro Gametogenesis (IVG) and Stem Cell-Based Embryo Models (SCBEMs) may thus provide novel fertility treatment options for local patients, which may possibly alleviate Singapore's ultra-low birthrate. Nevertheless, these new technology platforms also raise various controversial ethical, legal and social issues. It is anticipated that the application of SCBEMs (also known as synthetic embryos) in human reproduction will likely be banned because these entities are viewed as human clones. Conversely, IVG technology is expected to receive approval in Singapore for a narrow range of applications in human clinical assisted reproduction, as it seeks to recapitulate the natural process of human sexual reproduction and is more aligned with Singapore's family laws and sociocultural values. It is anticipated that IVG will be permitted for the treatments of primary infertility and age-related female infertility, facilitating transgender and intersex parenthood and preventing the transmission of genetic diseases. However, the applications of IVG in posthumous reproduction, mass production of donor gametes, genetic enhancement of offspring, same-sex, solo- and multiplex-parenthood, will likely be banned.</p>","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and Validation of an Instrument to Evaluate Cognitive-Physiological Repercussions and Coping Strategies in a Pandemic Situation.","authors":"Noelia Gallego-Ausín, María-Camino Escolar-Llamazares, Sandra Corral-Puente, María-Yolanda González-Alonso, Diego Serrano-Gómez, Andrea-Liliana Ortiz-González, Isabel Serrano-Pintado, María-Ángeles Martínez-Martín","doi":"10.1007/s10728-025-00528-z","DOIUrl":"https://doi.org/10.1007/s10728-025-00528-z","url":null,"abstract":"<p><p>The coronavirus disease (COVID-19) pandemic has significantly affected mental health worldwide, highlighting the need for reliable tools to assess emotional impact (cognitive-psysiological repercusiones) and coping strategies. To validate the psychometric properties of an evaluation instrument with an ad hoc design, called the Evaluation Inventory of Cognitive-Physiological Repercussions and Coping Strategies in a Pandemic Situation (EICPCP), which has two scales: \"Cognitive and Physiological repercussions arising from the pandemic due to COVID-19\" (RCFPC19-13) and \"Coping strategies during the pandemic due to COVID-19\" (EAPC19-15). A total of 1,629 participants (students, teachers, and healthcare professionals) from Spain and Colombia completed the instrument. Exploratory and confirmatory factor analyses were conducted to assess their structure and reliability. Both exploratory and confirmatory factor analyses supported the five proposed dimensions: cognitive and physiological impacts on the RCFPC19-13 scale, and adaptation, support, and organization on the EAPC19-15 scale. In addition, satisfactory internal consistency, reliability indices, and temporal stability were obtained for both scales. The EICPCP is a valid and reliable tool for evaluating the cognitive-physiological impact of the pandemic and coping strategies employed. This instrument provides valuable insights for clinical research and psychological interventions in pandemic-related mental-health studies..</p>","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Professional Practice of Ukrainian Doctors in Germany and Poland-Legal and Ethical Considerations.","authors":"Helena Hointza, Nikola Biller-Andorno, Michael Leitzmann, Julian Werner März","doi":"10.1007/s10728-025-00526-1","DOIUrl":"https://doi.org/10.1007/s10728-025-00526-1","url":null,"abstract":"<p><p>The ongoing war in Ukraine, which began in 2022, has displaced millions of people, creating immense challenges for healthcare systems in refugee-receiving countries. While temporary protection aims to grant refugees access to medical care, significant structural barriers and ethical shortcomings exist in refugee healthcare. To meet this challenge, the authors propose considering the integration of displaced physicians into the medical care systems of host countries. This solution not only meets the immediate healthcare demands but also leverages the expertise of Ukrainian doctors. The implementation in Germany and Poland exemplifies the current heterogeneity of regulations governing the professional practice of Ukrainian physicians, with individual workarounds such as the possibility of treating fellow Ukrainians while waiting for the approval of the license. From an ethical perspective, the dilemma between the urgent need for additional physicians and ensuring patient safety by thoroughly assessing all doctors' qualifications is a critical concern. Considering all the analyzed aspects, the authors advocate for harmonizing the regulations across the EU and removing barriers that limit healthcare access for refugees. They further stress the importance of developing comprehensive long-term strategies to ensure sustained healthcare access for Ukrainian refugees.</p>","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}