Inquiry-The Journal of Health Care Organization Provision and Financing最新文献

{"title":"Web-Based COPD Risk Self-Assessment Identifies a High-Risk Group With HRQoL Resembling Self-Reported COPD: Cross-Sectional Survey.","authors":"Bernt Bøgvald Aarli, Kjell Garatun-Tjeldstø, Odd Erik Johansen, Laxmi Bhatta, Arnt-Ove Hovden, Oeystein Naess, Marthe Gundersen, Bjarte Nore","doi":"10.1177/00469580261432827","DOIUrl":"10.1177/00469580261432827","url":null,"abstract":"<p><p>This study aimed to evaluate a web-based self-assessment tool for COPD case finding using algorithm-based COPD risk stratification, and to compare breathlessness (mMRC) and respiratory health-related quality of life (HRQoL) across risk groups and with self-reported COPD. We conducted a cross-sectional web-based survey of anonymous visitors completing a web-based self-assessment tool including demographics, COPD risk factors, breathlessness (mMRC), and respiratory HRQoL (CAT and K-BILD). Only respondents with complete responses were analyzed. COPD risk was algorithmically classified as high- or low-risk based on responses to age, smoking or dust exposure, respiratory symptoms, history of exacerbations, and the mMRC score. Individuals classified as having a high-risk of COPD received a prompt recommendation to consult their general practitioners. Group comparisons were performed using chi-square or ANCOVA, adjusting for covariates (age, sex, and current smoking). All analyses were exploratory, without corrections for multiple testing. In total, 57 847 people visited the website between Oct 2018 and Nov 2024, of whom 8779 (63% female) completed the full survey. Of those 8779 (63% female), 799 reported a COPD diagnosis (mean age 64.1 years). The high-risk (n = 6569) and the low-risk (n = 1411) groups were younger than the self-reported COPD group (58.4, and 54.6 vs 60.1 years, <i>P</i> < .0001). Self-reported COPD was associated with a lower proportion of never smokers than the high- and low-risk groups (7.1% vs 15.0% and 22.0%, respectively; <i>P</i> < .0001). Individuals with self-reported COPD had greater breathlessness (mMRC: 1.74 ± 1.28, 1.39 ± 1.0 and 0 ± 0) and poorer HRQoL (CAT 18.9 ± 7.9, 15.9 ± 8.0 and 10.6 ± 5.5; K-BILD 64.4 ± 19.2, 73.1 ± 18.6 and 87.4 ± 12.8) than both high- and low-risk groups (all <i>P</i> < .0001). Breathlessness and respiratory HRQoL differed across algorithm-based COPD risk stratification groups, and the algorithmically identified high-risk group showed a profile closer to self-reported COPD than the low-risk group. These findings support a web-based self-assessment tool as an approach for early COPD case finding and identifying undiagnosed COPD, although further validation is required.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261432827"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640854","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":"Patterns of Social Risk Factors and Associations With Health Outcomes: Findings From a Latent Class Analysis.","authors":"Nicole Pereira, Beth A Glenn, Adam Schickedanz, Xi Zhu","doi":"10.1177/00469580261450821","DOIUrl":"10.1177/00469580261450821","url":null,"abstract":"<p><p>IntroductionWith growing attention to the role of social factors in shaping health, efforts have emerged to integrate social risk information into population health surveillance and healthcare delivery. However, current approaches to address social risk tend to focus on responding to each risk factor in isolation, overlooking the interconnected nature of multiple social risks that often cluster together.MethodsThis study used latent class analysis to identify profiles of co-occurring social risk using a national sample of 110,028 adults across 17 U.S. states.ResultsThree profiles emerged: Low Social Risk, Moderate Financial Strain with Food Insecurity, and High Financial Strain with Food and Housing Insecurity. These profiles were characterized by their health conditions and examined in relation to self-reported health (SRH). The High Financial Strain with Food and Housing Insecurity profile was characterized by elevated rates of depression, obesity, hypertension, and the highest odds of reporting poor/fair SRH (OR = 3.1, 95% CI: 2.78-3.67). The Moderate Financial Strain with Food Insecurity profile also showed increased odds of poor SRH (OR = 2.03, 95% CI: 1.85-2.23).ConclusionThe findings underscore the importance of understanding clustering of social risks to provide more targeted, effective population health strategies.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261450821"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13263511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229140","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":"Self-Medication for Upper Respiratory Tract Infections (URTIs) Among Clinical Medical Students: A Cross-Sectional Study of Knowledge, Attitudes, and Practices.","authors":"Abishesh Shakya, Rishi Bhatta, Ashish Khadgi, Ayush Rauniyar, Sandeep Shrestha, Prem Prasad Panta, Sunil Shrestha","doi":"10.1177/00469580261452843","DOIUrl":"10.1177/00469580261452843","url":null,"abstract":"<p><p>BackgroundSelf-medication, defined as the use of medicines without prior professional consultation, is a widespread public health concern. When practiced inappropriately, particularly through the misuse of antibiotics, it contributes to adverse drug reactions and the growing threat of antimicrobial resistance (AMR). Medical students represent a population of particular interest, as their clinical knowledge may predispose them to self-treat conditions such as upper respiratory tract infections (URTIs), which are predominantly viral and self-limiting. This study aimed to assess the prevalence of self-medication for URTIs and to evaluate the knowledge, attitudes, and practices of clinical-phase medical students toward this behavior.MethodsA cross-sectional study was conducted among 165 clinical-phase MBBS students, including third-, fourth-, and fifth-year students and interns, selected by simple random sampling. Data were collected using a structured, self-administered questionnaire adapted from World Health Organization guidelines, covering sociodemographic characteristics and knowledge, attitudes, and practices regarding self-medication for URTIs. Statistical analysis was performed using SPSS version 25 and included descriptive statistics, chi-square tests, and correlation analyses, with statistical significance defined as p < 0.05.ResultsThe mean age of participants was 23.5 ± 2.25 years, with a nearly equal gender distribution. Three-quarters of students (74.5%) reported having self-medicated for URTIs, with community pharmacies serving as the primary source of medicines (71.5%). Only 21.2% of participants demonstrated good knowledge, while 54.5% showed moderate knowledge. Although 79.4% recognized the link between antibiotic misuse and AMR, 27.9% still believed antibiotics to be effective against viral URTIs, and 21.2% admitted to not completing prescribed antibiotic courses. Despite the majority (77.6%) holding negative attitudes toward self-medication in principle, unsafe practices remained prevalent. The year of study was significantly associated with both knowledge level and self-medication practices (p < 0.05).ConclusionSelf-medication for URTIs is highly prevalent among clinical-phase medical students, revealing a concerning disconnect between knowledge, attitudes, and actual clinical behavior. Addressing this gap will require reinforcing antimicrobial stewardship within medical curricula, strengthening clinical supervision, and implementing stricter regulation of over-the-counter antibiotic availability, all of which are essential steps toward promoting rational drug use and mitigating the escalation of antimicrobial resistance.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261452843"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Physical Activity Levels and Self-Esteem Among Children With and Without Disabilities: A Cross-Sectional Study.","authors":"Salmah A Alghamdi","doi":"10.1177/00469580261453894","DOIUrl":"10.1177/00469580261453894","url":null,"abstract":"<p><p>IntroductionPhysical activity is important to support health and well-being. Studies have shown an association between self-esteem and physical activity. However, there is a lack of studies assessing these relationships among children with disabilities. This study aimed to determine the relationship between physical activity and self-esteem among children with and without physical and sensory disabilities.MethodsThis cross-sectional study included convenience samples of typically developing children and children with physical or sensory disabilities. Data collection was conducted using an online survey.ResultsChildren with disabilities had significantly lower levels of self-esteem than children without disabilities (<i>p</i>=0.001), while their overall physical activity score was lower but not statistically significant. After adjustment for the included factors, each unit increase in physical activity score was significantly associated with an increase in self-esteem score by 1.82 (95%CI: 0.78 to 2.85, <i>p</i>=0.001).ConclusionHigher physical activity levels were associated with increased self-esteem. Promoting and facilitating physical activity is essential for improving children's well-being and self-esteem.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261453894"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13261037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229286","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":"Knowledge, Attitudes, and Practices Toward HIV/AIDS Among Health Faculty Students at a University in East Java, Indonesia: A Path Analysis Approach.","authors":"Dimas Setyadi Putra, Sofa Dewi Alfian, Ika Ratna Hidayati, Aghnia Fuadatul Inayah, Irma Melyani Puspitasari","doi":"10.1177/00469580261458944","DOIUrl":"10.1177/00469580261458944","url":null,"abstract":"<p><p>IntroductionEast Java ranked second among Indonesian provinces for HIV/AIDS cases in June 2022. Barriers to prevention include limited knowledge, negative attitudes, and risky practices. This study assessed knowledge, attitudes, and practices (KAP) toward HIV/AIDS and examined their relationships with sexual activity status and preventive sexual behaviors among health faculty students at a University in East Java, Indonesia.MethodsA cross-sectional study was conducted from May to June 2024 using a validated questionnaire. Descriptive statistics summarized participant characteristics and KAP levels. Path analysis using a partial least square examined relationships among variables, with sexual activity status in the full sample and preventive sexual behaviors in the sexually active sub-sample as outcomes.ResultsA total of 441 students were included. Most participants demonstrated high HIV/AIDS knowledge (75.3%), positive attitudes toward people living with HIV/AIDS (PLWHA) (61%), and safe practices (91.6%). In model 1, knowledge had a significant positive relationship with attitudes (β = 0.165; p = 0.000) and sexual activity status (β = 0.038; p = 0.048), while attitudes showed a significant negative relationship with sexual activity status (β = -0.065; p = 0.019). In model 2, knowledge had a significant positive relationship with attitudes (β = 0.615; p = 0.000). However, both knowledge and attitudes showed a non-significant relationship with preventive sexual behaviors.ConclusionsHealth faculty students exhibited high KAP levels. Knowledge consistently was related to attitudes across models, emphasizing the importance of strengthening information-based curricula to improve HIV/AIDS knowledge, including transmission, prevention, and treatment.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261458944"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13261012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229040","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":"Clinimetric Properties of the Integrated Self-Screening Instrument for Geriatric Health Testing (INSIGHT) to Identify Healthcare Problems Among Older Adults.","authors":"Chia-Ming Chang, Ya-Li Wang, Ching-Ju Chiu, Chung-Ying Lin, Chi-Chang Huang, Mark D Griffiths, Mei-Ju Chen, Hui-Chen Chao, Yi-Ching Yang","doi":"10.1177/00469580261483969","DOIUrl":"10.1177/00469580261483969","url":null,"abstract":"<p><p>Administration of comprehensive geriatric assessment is time-consuming and labor intensive. A new instrument, the Integrated Self-Screening Instrument for Geriatric Health Testing (INSIGHT), was developed to quickly identify common geriatric problems. The present study evaluated the clinimetric properties of the INSIGHT. Content Validity Index (CVI) was measured via expert review. Older adults (≥65 years) attending geriatric outpatient visits for the first time (N=224) completed the INSIGHT. Internal consistency was calculated using McDonald's ω, greatest lower bound, and Cronbach's α. Factor structure was evaluated using parallel analysis and exploratory factor analysis (EFA) based on domain scores. After two rounds of expert review, scale-level CVI/universal agreement was 0.95, and all scale-level CVIs/average were 1.00. Using the INSIGHT, 15.2% of the 224 participants had no potential health problems identified, while 14.3% had one, and over 70% had ≥ two. Internal consistency was good (> 0.8), and EFA confirmed unidimensionality with all domain factor loadings >0.3. The INSIGHT demonstrates good content validity, internal consistency, and unidimensional structure, supporting its reliability for rapid geriatric health screening.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261483969"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851877","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":"Cross-Cutting Symptom Burden and Health-Related Quality of Life in Hospitalized Patients With Chronic Illness: A Cross-Sectional Study.","authors":"Helika Shrestha, Lalita Rai, Roshani Gautam, Samriddhi Thapa, Sochana Sapkota, Sunil Shrestha","doi":"10.1177/00469580261489187","DOIUrl":"10.1177/00469580261489187","url":null,"abstract":"<p><p>IntroductionChronic illnesses pose significant global and individual health challenges, with patients experiencing high symptom burden that adversely affects health-related quality of life (HRQoL). Despite this, symptoms are underreported, and many patients with substantial needs do not receive palliative care. This study aimed to assess symptom burden and HRQoL of hospitalized adults with diverse chronic conditions at tertiary centers in Nepal, and examine their association.MethodsA descriptive cross-sectional study was conducted from September to October 2023 among 164 adult patients admitted to selected tertiary hospitals. Participants were recruited using non-probability purposive sampling. Data was collected through face-to-face interviews using the ESAS-r and the SF-36. Descriptive statistics (frequency, percentage, median, interquartile range) and inferential tests (chi-square, continuity correction, Fisher's exact test, and Spearman's rank correlation) were applied, with significance set at <i>P</i> < 0.05.ResultsThe median age was 55.5 years (IQR 40-57.5), and 56.7% were male. Nearly 30% had chronic kidney disease, and 62.8% had comorbidities. Median duration since diagnosis was 2 years (IQR 1-2). Overall, 92.1% reported high symptom burden (median 50.5; IQR 40-57.5), 95% CI [48.00-53.00], with fatigue the most severe symptom (68.3%). Poor HRQoL was reported by 65.9% (median 44.29; IQR 33.63-55.50; 95% CI [39.75-47.25]). Among heart failure patients, 57.1% experienced severe symptoms, and all reported diminished HRQoL. Symptom burden was significantly associated with comorbidities and hospital admissions (<i>P</i> < 0.05). HRQoL was significantly associated with sex, education, employment, marital status, family type, disease duration, and comorbidities (<i>P</i> < 0.05). A strong negative correlation was found between symptom burden and HRQoL (r_s= -0.620, 95% CI [-0.941 to -0.641], <i>P</i> < 0.001).ConclusionPatients with diverse chronic illnesses experience substantial symptom burden strongly related to reduced HRQoL, which is hypothesis-generating rather than causal. This underscores the need for routine assessment, referral for symptom management, and integrated palliative care.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261489187"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Fatal Health Outcomes of Low Back Pain Among Adults Aged 55 Years and Above in Ethiopia From 1990 to 2023.","authors":"Sebsibe Tadesse, Sina Temesgen Tolera, Wolyu Korma, Embay Amare Alemseged, Yonas Angaw, Hailu Lemma, Lechisa Asefa","doi":"10.1177/00469580261448603","DOIUrl":"https://doi.org/10.1177/00469580261448603","url":null,"abstract":"<p><p>IntroductionThere is a dearth of information explaining how low back pain (LBP) impacts populations aged 55 years and above (55⁺) in Ethiopia. Thus, this analysis provides insightful information on the metrics of low back pain (LBP), specifically prevalence, incidence, and years lived with disability (YLDs) among populations aged 55+ in Ethiopia.MethodsNon-fatal health outcomes of LBP among adults aged 55⁺ years per 10⁵ populations were analyzed. This study has used methods and tools of the GBD 2023 study. Disease modeling with Bayesian meta-regression was used. Spatial and temporal variations in metrics were smoothed by applying the spatiotemporal Gaussian process regression. Each metric from 1990 to 2023 was declared along with 95% uncertainty intervals (UIs).ResultsThe prevalence of LBP was estimated to be 18,777 cases/10⁵ (95% UI: 15,600-22,114) among adults aged 55⁺ years in Ethiopia by 2023, with significant differences observed by sex [22,919 cases/10⁵ females (19,252-26,791) versus 15,828 cases/10⁵ males (13,125-18,619)]. The incidence of LBP was estimated to be 9,160 new cases/10⁵ adults aged 55⁺ years (7,744-9,837) in 2023, with 6,631 new cases among 10⁵ females (5,570-7,902) and 7,320 new cases among 10⁵ males (6172-8794). There were an estimated 2,092 YLDs/10⁵ adults aged 55⁺ years (1,455-2,841) in 2023, with 2,480 YLDs/10⁵ females (1,729-3,386) and 1,732 YLDs/10⁵ males (1,206-2,340). Higher rates of LBP were estimated among adults aged 65 to 94 years. However, there was no significant variation in the rates by region. There was a notable decline in the rates between 1990 and 2023, except for stable rates in Addis Ababa, Amhara, and Tigray.ConclusionThis study determined high rates of morbidity and disability from LBP in Ethiopia, with considerable decline from 1990 to 2023. Physical activity, body weight management, ergonomic adjustments, and lifestyle changes can be recommended.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261448603"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asynchronous Online Platforms Can Reduce Healthcare Costs for STI and HIV Testing: Evaluating GetaKit.ca in Ontario, Canada.","authors":"Patrick O'Byrne, Lauren Orser","doi":"10.1177/00469580261489227","DOIUrl":"10.1177/00469580261489227","url":null,"abstract":"<p><p>IntroductionRates of sexually transmitted infections (STIs) are increasing in Canada, while clinic capacity for testing and treatment remains constrained.MethodsTo improve access to STI screening, we developed GetaKit.ca, a web-based platform in Ontario, Canada that allows individuals to complete an online risk assessment, receive STI testing recommendations, and access laboratory-based testing with follow-up through partnerships with local public health units. As part of the service evaluation, we conducted a two-year cost analysis comparing GetaKit with (1) public health STI clinic models in Ontario and (2) the publicly funded Ontario Health Insurance Plan (OHIP) system.ResultsFrom August 2023 to July 2025, 15,837 requests for STI testing were made through GetaKit.ca, with testing requests increasing by 264% from year 1 to year 2. The overall positivity rate was 3.8%, remaining stable across both years. Total GetaKit costs were $248,098 in year 1 and $427,914 in year 2, corresponding to $72.73 and $34.44 per person tested, respectively. Comparable per-person costs were $49.39 under OHIP in both years and $68.59 (year 1) and $54.95 (year 2) in the STI clinic model. Although implementation-year costs were higher with the GetaKit model, per-person costs declined by more than 50% in year 2, resulting in savings of $14.95-$20.51 per test compared with traditional models.ConclusionTogether, these findings support online STI platforms as a cost-efficient complement to in-person services that can enhance timely diagnosis and treatment while helping to reduce longer-term healthcare costs associated with untreated infections.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261489227"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972249","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":"Acute Myeloid Leukemia Survivors Report Transplant-specific Burdens in Interviews Two Years after Receiving Allogeneic Hematopoietic Cell Transplantation During the Peak of the COVID-19 Pandemic: A Qualitative Study.","authors":"Natalie S McAndrew, Sam Patterson, Lathika Mohanraj, Iwalola Awoyinka, Erin S Costanzo, Steve W Cole, Jennifer M Knight","doi":"10.1177/00469580261478062","DOIUrl":"10.1177/00469580261478062","url":null,"abstract":"<p><p>IntroductionAllogeneic hematopoietic cell transplantation (HCT) for acute myeloid leukemia (AML) entails prolonged recovery, serious complications, functional limitations, psychological distress, and extended isolation to prevent infection. During the peak of the COVID-19 pandemic, treatment disruptions, restricted caregiver access, and intensified isolation compounded these transplant-specific burdens. The longer-term influence of the pandemic experience on HCT recovery and survivorship remains poorly understood.MethodsIn this qualitative descriptive study, adults with AML who underwent allogeneic HCT from March through September 2020 participated in virtual semi-structured interviews from July 2022 through April 2023, approximately two years post-transplant. Participants were identified through the Center for International Blood and Marrow Transplant Research registry. Zoom or phone interviews were recorded, transcribed verbatim, and analyzed using inductive qualitative content analysis to describe survivorship experiences and opportunities to improve supportive care.ResultsA total of 25 AML survivors (ages 24-78, 56% male) were interviewed approximately two years post-transplant. Three themes were found: (1) Transplant is an arduous journey; (2) The COVID-19 pandemic shaped the transplant experience in complex and far-reaching ways; (3) Transplant demands sustained personal and relational investment throughout the transplant journey.ConclusionsThis study enhances our understanding of the stressors associated with transplantation during periods of heightened adversity, while also identifying opportunities to strengthen healthcare systems and supportive care services for this population. Situating these experiences within the context of a global health emergency offers a rare lens into how external stressors can exacerbate the already demanding nature of HCT survivorship. By understanding survivors' experiences, healthcare systems can better anticipate and address the evolving needs of transplant survivors.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261478062"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801788","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}