Risk Management and Healthcare Policy最新文献

{"title":"Avoidant/Restrictive Food Intake Disorder in Adult Patients with Gastrointestinal Diseases: A Concept Analysis Using Evolutionary Approach.","authors":"Yunqiu Che, Shuhua Li, Xiaju Hu, Hongyan Hu, Can Zhang, Chaozhu He","doi":"10.2147/RMHP.S520802","DOIUrl":"10.2147/RMHP.S520802","url":null,"abstract":"<p><strong>Background: </strong>Avoidant/restrictive food intake disorder is a recently introduced concept, initially focused on non-adult populations, and encompasses multiple dimensions such as physiological and psychological aspects. Due to symptom overlap, food avoidance and related symptoms in patients with gastrointestinal diseases are often overlooked or rationalized. The confusion and unclear definitions of related concepts have hindered further research and exploration.</p><p><strong>Objective: </strong>This study aims to clarify the concept of avoidant/restrictive food intake disorder in adults with gastrointestinal diseases and to enhance clinicians' awareness of this phenomenon.</p><p><strong>Design: </strong>Rodgers' evolutionary concept analysis.</p><p><strong>Methods: </strong>A systematic literature search targeting avoidant/restrictive food intake disorder in adult patients with gastrointestinal diseases was conducted using keywords and entry terms across seven databases, including PubMed, Web of Science, EBSCO, CINAHL, PsycINFO, EMBASE, and CNKI (up to September 28, 2024). A concept analysis framework was employed to identify the concept's attributes, antecedents, consequences, and other defining characteristics.</p><p><strong>Results: </strong>A total of 22 articles were included. Four attributes of avoidant/restrictive food intake disorder in adult patients with gastrointestinal diseases were extracted and identified: exclusionary/selective diet status, non-body image-related, negative/fearful response, and mixed/independent motivation. Antecedents include gastrointestinal diseases and symptoms, traumatic events and experiences, dietary adversities history, and nutritional misconceptions. Consequences involved nutritional/psychological consequences, poor overall health, complex disease management, and reduced quality of life.</p><p><strong>Conclusion: </strong>We found that avoidant/restrictive food intake disorder in the context of gastrointestinal diseases is a state of disordered eating characterized by food exclusion and selectivity, which may progress into a disorder when its impact on physical or psychological functioning exceeds adaptive threshold. This study clarifies the concept, and the findings provide a basis for developing assessment tools, guiding dietary management, and informing the implementation of targeted interventions in GI patients.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2063-2080"},"PeriodicalIF":2.7,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499486","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":"Experiences of Young and Middle-Aged Stroke Patients with Hemiplegia Who Actively Participate in Rehabilitation Exercises and Their Perceptions of Well-Being: A Descriptive Qualitative Study.","authors":"Yumeng Si, Xingxian Huang, Shiting Zhao, Ziyang Ou, Min Pi, Jing Du","doi":"10.2147/RMHP.S509536","DOIUrl":"10.2147/RMHP.S509536","url":null,"abstract":"<p><strong>Background: </strong>Young and middle-aged stroke patients who suffer from neurological deficits brought on by hemiplegia experience significant physical and psychological effects.This study was designed to explore the experience of these patients during active participation in rehabilitation exercises and their perception of well-being. The purpose was to inform the clinical development of individualized rehabilitation programs.</p><p><strong>Methods: </strong>Purposive sampling was employed to conduct semi-structured, in-depth interviews with 16 young and middle-aged stroke hemiplegic patients (18-59 years old) using a descriptive qualitative research approach. Thematic analysis was used for data analysis.</p><p><strong>Results: </strong>Five core themes were identified: (1) motivation for the rehabilitation movement, (2) the importance of the rehabilitation environment, (3) challenges for the rehabilitation movement, (4) psychological dynamics and growth in rehabilitation, and (5) rehabilitants' unique perception of well-being. In addition, it is important to note that, the well-being of the majority of the young and middle-aged stroke patients with hemiplegia in this study remained substantially reduced after the disease despite the fact that they were actively engaged in rehabilitation exercises.</p><p><strong>Conclusion: </strong>Young and middle-aged stroke patients with hemiplegia who actively participate in rehabilitation have a variety of needs and experiences. Their rehabilitation process includes not only the restoration of physical function but also the reconstruction of psychological adaptability and the dynamic transformation of well-being. Nonetheless, the current rehabilitation system has glaring flaws when it comes to considering the combined benefits of psychological and physical therapies. In order to remedy the situation, it is advised that well-being be included in stroke rehabilitation, that commonly used rehabilitation and psychological intervention programs be covered by health insurance, as well as reimbursement rates be raised. In this way, a system of health care coverage and support for patients' complete recovery will eventually be built.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2049-2062"},"PeriodicalIF":2.7,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499487","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":"Association Between Intention to Provide Internet Plus Nursing Services, Psychological Resilience and Perceived Professional Benefits Among Chinese Nurses.","authors":"Lingling Zhang, Yongping Gao, Limei Tang, Xuegang Zhao, Qiuge Qiao","doi":"10.2147/RMHP.S520302","DOIUrl":"10.2147/RMHP.S520302","url":null,"abstract":"<p><strong>Aim: </strong>This study seeks to examine the present state of Chinese nurses' intentions to deliver Internet Plus Nursing Services (IPNS), their psychological resilience, and their perceived professional benefits (PPB), in addition to exploring the interrelationships among these variables. IPNS are defined as nursing services performed by registered nurses from medical institutions utilizing internet and other information technologies through an \"online application and offline service\" model.</p><p><strong>Background: </strong>Nurses are the primary providers of IPNS, and hence, their willingness is critical to developing IPNS. However, limited research has been conducted to investigate the relationship between nurses' intention to provide IPNS, psychological resilience and PPB.</p><p><strong>Methods: </strong>A convenience sampling approach was employed to conduct a cross-sectional survey of 611 nurses from three tertiary general hospitals in Shijiazhuang between April and October 2023. The research questionnaires include demographic information, nurses' intention to provide IPNS, psychological resilience and PPB. The statistical analysis included non-parametric testing, Spearman correlation analysis, hierarchical regression analysis, and mediation effect analysis.</p><p><strong>Results: </strong>The results indicated that nurses' intention to provide IPNS was positively correlated with both psychological resilience (<i>r</i>=0.566, <i>p</i><0.001) and PPB (<i>r</i>=0.561, <i>p</i><0.001). PPB was also positively correlated with psychological resilience (<i>r</i>=0.631, <i>p</i><0.001). Furthermore, the mediating effect of PPB between psychological resilience and nurses' intentions to provide IPNS was 0.127 (95% CI=0.089 to 0.167), accounting for 29.26% of the total effect.</p><p><strong>Conclusion: </strong>Nurses from tertiary institutions who participated in this study expressed a willingness to provide IPNS, and the research findings imply that PPB modulates psychological resilience and goals.</p><p><strong>Implications: </strong>Based on the findings of our study, we recommend that nursing managers implement a comprehensive training program aimed at enhancing psychological flexibility and professional practices. This program should encompass advanced nursing techniques, IPNS processes, emergency management, and skills in communication and stress reduction specifically tailored for home healthcare. Such skills may include meditation, deep-breathing workshops, and IPNS experience-sharing sessions. Additionally, it is advisable to offer individual and group counseling whenever feasible and to enhance the welfare of home-visiting nurses to facilitate the progress and implementation of IPNS.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2035-2047"},"PeriodicalIF":2.7,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499485","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":"Exploring Health-Related Quality of Life and Correlates Among Patients with Type 2 Diabetes Mellitus Attending Primary Health Centers in Aljouf Province, Saudi Arabia: A Multi-Site Cross-Sectional Study.","authors":"Aseel Awad Alsaidan, Abdulmajeed Ali Alshehri, Ashokkumar Thirunavukkarasu, Omar Awad Alsaidan, Hassan H Alhassan, Muaid Hashem Morad, Abdullah Alshehari, Alaa Alibrahim","doi":"10.2147/RMHP.S514414","DOIUrl":"10.2147/RMHP.S514414","url":null,"abstract":"<p><strong>Purpose: </strong>Type 2 diabetes mellitus (T2DM) impacts various elements of health-related quality of life (HRQoL). However, research on the HRQoL of T2DM patients in primary healthcare settings in Saudi Arabia is limited. Therefore, we aimed to determine the HRQoL and associated factors among patients with T2DM to plan policy-driven interventions and improve patient outcomes.</p><p><strong>Participants and methods: </strong>We surveyed 390 patients with T2DM attending primary health centers (PHCs) in the Aljouf province of Saudi Arabia. We included Saudi adults (≥18 years) diagnosed at least six months before the study and completed at least one follow-up visit at the PHC. In the present cross-sectional study, we used the validated 20-item short-form health survey (SF-20)-Arabic tool to assess different HRQoL domains. We performed Mann-Whitney U and Kruskal-Wallis tests for dichotomous and categorical variables, respectively, in each domain. Finally, a binomial logistic regression analysis was performed to determine the predictors of overall HRQoL.</p><p><strong>Results: </strong>The role functioning domain had the highest mean score (75.7±19.7), and the lowest scores were in the social functioning (47.9±20.2) and pain domains (48.9±21.4). Some characteristics, such as marital status, treatment type, and follow-up adherence, were significantly associated with most domains. HRQoL was significantly higher in male patients (p=0.002, adjusted odds ratio [AOR]=2.66) and those on oral hypoglycemic agents (OHAs; p=0.002, AOR=5.18). Obese patients had a significantly lower HRQoL (p=0.036, AOR=0.058). These factors remained significant after adjusting for age, sex, body mass index, treatment type, and comorbidities in the multivariate analysis.</p><p><strong>Conclusion: </strong>We recommend policy changes that incorporate interventions tailored to improve HRQoL, especially in social functioning and pain domains. Moreover, integrating comprehensive pain management strategies and enhancing patient follow-up within PHCs may improve quality of life, especially for high-risk patients with T2DM.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2007-2020"},"PeriodicalIF":2.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369654","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":"Development of a Training Content Index System for Pressure Injury Prevention Training Programs for Healthcare Assistants in Tertiary Hospitals.","authors":"Yan-Ying Zhu, Cai-Xiang Zhang, Lin Wang, Jin-Ai He, Jia-Jie Yan, Jing Liu","doi":"10.2147/RMHP.S516689","DOIUrl":"10.2147/RMHP.S516689","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to develop an index system for a pressure injury prevention training program specifically designed for healthcare assistants in tertiary hospitals, providing a theoretical basis for training initiatives. The \"index system\" developed in this study refers to a structured framework outlining the content and components of training programs, rather than a performance evaluation tool.</p><p><strong>Methods: </strong>Based on a literature review and expert interviews, a customized expert consultation questionnaire titled \"Pressure Injury Prevention Training System for healthcare assistants in Tertiary Hospitals\" was created. The Delphi method was employed to conduct two rounds of consultations with 23 experts who met the selection criteria, resulting in the establishment of the final training program indicator system.</p><p><strong>Results: </strong>The average positive coefficient from the two rounds of expert consultations was 100%, with an authority coefficient of 0.823, and a coefficient of variation of 0.2037. The degree of consensus among expert opinions was 0.380 (P = 0.000). The finalized training system comprises seven primary indexes and 40 secondary indexes. Key training elements include repositioning techniques, the use of pressure-relieving devices, and skin cleansing methods, which were rated with high consensus by experts.</p><p><strong>Conclusion: </strong>The findings of this study demonstrate good representativeness and authority, serving as a valuable reference for developing pressure injury prevention training programs for healthcare assistants in tertiary hospitals. This index system serves as a structured framework outlining key knowledge, skills, and training delivery components, rather than a performance evaluation tool.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2021-2034"},"PeriodicalIF":2.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369653","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":"Assessment of Hand Hygiene Knowledge, Attitude, and Practice Among Health Sciences Students in Herat, Afghanistan: A Cross-Sectional Study.","authors":"Enayatollah Ejaz, Mohammad Masudi, Ali Rahimi, Khadejah Osmani, Nasar Ahmad Shayan","doi":"10.2147/RMHP.S524485","DOIUrl":"10.2147/RMHP.S524485","url":null,"abstract":"<p><strong>Background: </strong>Hand hygiene (HH) is a fundamental practice in preventing hospital-acquired infections (HAIs), yet compliance among healthcare workers, including students, remains suboptimal. This study assesses the knowledge, attitude, and practice (KAP) related to HH among final-year health sciences students in Herat, Afghanistan.</p><p><strong>Methods: </strong>A convenience-based cross-sectional study was conducted in October to December 2023 at public and private health sciences institutions in Herat, using a structured questionnaire to assess KAP on HH. A sample of 427 participated. Data analysis in SPSS 27 included descriptive statistics, chi-square tests, and logistic regression.</p><p><strong>Results: </strong>The overall accuracy of responses was 84.61% (IQR: 76.92, 84.61), reflecting a strong level of awareness. Attitudes toward HH were also largely positive, with a correct rate of 81.25% (IQR: 75.00, 85.41). Additionally, self-reported adherence to proper HH practices was notably high at 92.85% (IQR: 85.71, 98.21). Students assigned to the emergency ward (23.6%) demonstrated significantly higher knowledge compared to those in other wards (p = 0.016). Logistic regression further confirmed that work setting played a crucial role, with students in the internal ward exhibiting significantly higher knowledge levels than their peers (95% CI: 1.001-4.448) (p = 0.050). The study objectives were met, revealing that final-year students possessed strong knowledge, positive attitudes, and high adherence to HH practices. However, the work environment was a key determinant of knowledge variation across wards.</p><p><strong>Conclusion: </strong>Despite high awareness and adherence, misconceptions and barriers to compliance exist. Strengthening educational interventions, institutional policies, and real-time monitoring is crucial to ensuring sustained HH practices among future healthcare professionals.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1991-2005"},"PeriodicalIF":2.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369580","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":"Long-Term Quality of Life Among Intensive Care Units Survivors.","authors":"Hassan Y Aljohani, Naif A Albarak, Talal A Alanazi, Muhnad A Alabdulsalam, Rayan A Alzahrani, Saleh S Algarni, Tareq F Alotaibi, Mohammed M Alqahtani, Mobarak K Alqahtani, Taha T Ismaeil, Lafi H Olayan","doi":"10.2147/RMHP.S517832","DOIUrl":"10.2147/RMHP.S517832","url":null,"abstract":"<p><strong>Background: </strong>The long-term health-related quality of life (HRQoL) of intensive care unit (ICU) survivors is a key concern. This study investigates HRQoL among ICU survivors in Saudi Arabia, highlighting its importance for advancing healthcare and improving outcomes.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among ICU survivors and a control healthy group. Participants were aged ≥18 years, with ICU survivors discharged for at least six months excluding individuals with severe cognitive impairments or mental illness. The SF-36 questionnaire assessed HRQoL across eight domains, with data collected from a tertiary hospital in Riyadh. Statistical analysis included the Mann-Whitney <i>U</i>-test, the Fisher exact, and multiple linear regression.</p><p><strong>Results: </strong>Data from 151 ICU survivors and 181 controls were analyzed. Chronic diseases were more common among ICU survivors (51.7% vs 23.8%, p=0.00). Independent of chronic diseases, ICU survivors had significantly lower scores in HRQoL. Prolonged ICU stays were associated with worse quality outcomes. Additionally, being discharged for ≥ seven months improved general health (p=0.05). ICU survivors displayed notably lower scores in physical functioning (65 [IQR 55] vs 80 [IQR 45], p=0.00), limitations due to physical health (25 [IQR 100] vs 100 [IQR 75], p=0.00), limitations due to emotional problems (33.33 [IQR 100] vs 66.67 [IQR 100], p=0.00), less social functioning (62.5 [IQR 50] vs 75 [IQR 38], p=7.00), more pain 67.5 [IQR 45] vs 80 [IQR 33] (p=0.00), and general health (55 [IQR 25] vs 65 [IQR 23], p=0.00).</p><p><strong>Conclusion: </strong>ICU survivors experience significant HRQoL impairments exacerbated by prolonged ICU stays, highlighting the need for early and comprehensive rehabilitation services. The low utilization of these rehabilitation services suggests a need to provide access and quality for tailored early rehabilitation services to improve ICU survivors' long-term HRQoL.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1969-1978"},"PeriodicalIF":2.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369655","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 Impact of Social, Cultural, and Identity-Related Factors on Delayed Childbearing: A Multi-Center Study.","authors":"Ying Lei, Xiao Wang, Yaling Zhou, Yalan Li, Luyao Wang, Xiaoying Jia, Qingzhan Ma, Changsheng Lin, Jie Liao, Xin Li, Tianjiao Liu","doi":"10.2147/RMHP.S517401","DOIUrl":"10.2147/RMHP.S517401","url":null,"abstract":"<p><strong>Background: </strong>Delayed childbearing has become an increasingly prevalent trend, influenced by various psychological and social factors. This study aimed to explore the impact of these factors on the timing of childbirth among women of reproductive age.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 1,128 women attending their first prenatal visit at six hospitals between January and December 2023. Sociodemographic, psychological, and health-related data were collected through structured interviews and self-administered questionnaires. Bivariate and multivariate analyses were performed to identify significant predictors of delayed childbearing.</p><p><strong>Results: </strong>Reproductive health issues, educational level, employment status, career advancement aspirations, and age-related anxiety were significantly associated with delayed childbearing. Multivariate logistic regression revealed that reproductive health issues (OR = 2.70), educational level (OR = 1.84), and career aspirations (OR = 2.53) were independent predictors of delayed childbearing. Interestingly, age-related anxiety was associated with an increased likelihood of earlier reproductive decision-making, reducing the odds of delayed childbirth by 69% (OR = 0.31, 95% CI: 0.23-0.56, p < 0.001). Subgroup analysis indicated that both low-income and high-income women were more likely to delay childbirth compared to women with medium income (p < 0.05).</p><p><strong>Conclusion: </strong>Psychological and social factors, including career goals, educational attainment, and reproductive health issues, play a critical role in the decision to delay childbearing. Understanding these influences is essential for developing policies and interventions that support women in making informed reproductive choices. Further research with more diverse populations is needed to confirm these findings and explore the broader societal implications.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1959-1968"},"PeriodicalIF":2.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369656","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 Impact of Triglyceride-Glucose Index on Carotid Atherosclerosis: A Prospective Cohort Study in Middle Aged and Elderly Low-Income in Rural Chinese.","authors":"Juan Meng, Yuting Lu, Xuewei Gao, Juan Hao, Xiao Li, Xianjia Ning, Wenjuan Zhang, Jinghua Wang","doi":"10.2147/RMHP.S522995","DOIUrl":"10.2147/RMHP.S522995","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerotic cardiovascular disease (ASCVD) is a major global health burden. The triglyceride-glucose (TyG) index, as a surrogate marker of insulin resistance, is associated with atherosclerosis, but its role in predicting carotid plaque and intima-media thickness (IMT) changes remains unclear. This study aimed to assess the relationship between the TyG index and carotid plaque incidence and IMT changes over a six-year period in a cohort of middle-aged and elderly individuals with low income and low education in rural China.</p><p><strong>Methods: </strong>The study was conducted from 2014 to 2020 in 18 rural villages in Tianjin, China. A total of 2702 participants were included in the IMT analysis, and after excluding those with carotid plaques at baseline, 1595 participants were included in the plaque incidence analysis. Multivariate logistic regression was used to assess the relationship between the TyG index and outcomes. Subgroup analyses were based on significant indicators from the multivariate adjustment.</p><p><strong>Results: </strong>During the six-year follow-up, 551 new cases of carotid plaque were identified, with an incidence rate of 34.5%. Univariate analysis showed a significant association between the TyG index and increased plaque incidence. However, after adjusting for multiple confounders, the TyG index emerged as an independent predictor only for IMT increase. Each 1-unit increase in TyG was associated with a 49% increased risk (RR: 1.49; 95% CI: 1.05-2.13; P = 0.026), with this association being particularly strong in males, individuals aged ≥60 years, and those without hypertension.</p><p><strong>Conclusion: </strong>Results highlight the importance of incorporating the TyG index into cardiovascular risk assessments, especially for IMT changes in specific subpopulations. The study underscores the need for targeted prevention strategies in rural, low-education and low-income populations. Future research is needed to elucidate the potential interactions between the TyG index and other metabolic factors in ASCVD.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1979-1990"},"PeriodicalIF":2.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369657","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":"Analysis of the Current Status of Perceived Stress and Factors Associated with It in Patients with Chronic Wounds: A Cross-Sectional Study.","authors":"Liuju Su, Min Zhou, Xiulin Wen, Yuan Guo, Bao Li, Liqun Luo, Qian Xiao, Jingrong Wang","doi":"10.2147/RMHP.S509414","DOIUrl":"10.2147/RMHP.S509414","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess perceived stress levels in patients with chronic wounds and examine the associations between perceived stress and demographic factors, clinical characteristics, wound healing status, social support, and coping styles.</p><p><strong>Methods: </strong>We conducted a cross-sectional study from December 2023 to August 2024 at the Wound Care Clinic of the First Affiliated Hospital of Xi'an Jiaotong University. A convenience sampling method was used to recruit 292 patients with chronic wounds who received standardized wound treatment. Data were collected using the general information questionnaire, Chinese Perceived Stress Scale (CPSS), Pressure Ulcer Scale for Healing (PUSH), Social Support Rating Scale (SSRS), and Simplified Coping Style Questionnaire (SCSQ). Statistical analysis utilized Spearman correlation and multiple linear regression to identify factors associated with perceived stress.</p><p><strong>Results: </strong>The mean perceived stress score among the 292 participants was 34.98±7.03, with 78.8% reporting clinically significant stress (score>28). Multiple linear regression analysis showed a positive correlation between perceived stress and marital status, comorbid chronic diseases, and wound healing status in patients with chronic wounds. Patients who were married, had multiple chronic diseases, or exhibited poor wound healing tended to have higher perceived stress. Conversely, social support and positive coping maintained inverse relationships with perceived stress, suggesting that patients with strong social support and positive coping style experienced lower stress levels. Together, these factors accounted for 42.7% of the variance in perceived stress.</p><p><strong>Conclusion: </strong>Chronic wound patients commonly exhibit moderate-to-high levels of perceived stress. Healthcare providers should systematically assess patients' perceived stress levels and implement individualized interventions, including enhancing social support networks and teaching positive coping strategies, to alleviate perceived stress and ultimately improve wound healing outcomes.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1947-1957"},"PeriodicalIF":2.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369579","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}