Risk Management and Healthcare Policy最新文献

{"title":"Evaluation of Medical Device Aging and Replacement Decisions within Hospital Environments: A User-Centered Approach.","authors":"Sewon Park, Gihong Seo, Yoonseo Park, Eun-Ji Kim, Haengjun Lee, Munjae Lee, Mihajlo Jakovljevic","doi":"10.2147/RMHP.S478245","DOIUrl":"10.2147/RMHP.S478245","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the factors influencing medical device replacement decisions from a user-centered perspective: medical technicians, engineers, and healthcare professionals. We seek to prioritize criteria for medical device replacement and develop feasible strategies applicable to real-world healthcare settings.</p><p><strong>Methods: </strong>This analysis was conducted by reviewing previous studies to identify the key factors in medical device replacements. The key variables were selected from the review, and the significant factors for analysis were determined.</p><p><strong>Results: </strong>An analytic hierarchy process (AHP) analysis was used to compare and analyze the priority of medical device replacement, which revealed that clinical factors emerged as the crucial in medical device replacement decisions. Additionally, unlike medical technicians, doctors, nurses, and pharmacists, for whom clinical factors are the primary considerations when replacing medical devices, safety is the most important factor for medical engineers.</p><p><strong>Conclusion: </strong>Medical device obsolescence significantly affects patient safety and healthcare operations. Therefore, the maintenance plans for medical devices should focus on clinical factors. Moreover, a more systematic medical device replacement system must be established, prioritizing the factors according to the occupations of medical workers.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2201-2215"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577049","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":"Critical Analysis of Markov Modeling for the Economic Evaluation of Obesity Interventions: A Systematic Review.","authors":"Qiucen Lin, Carolina Oi Lam Ung, Yunfeng Lai, Hao Hu, Mihajlo Jakovljevic","doi":"10.2147/RMHP.S528064","DOIUrl":"10.2147/RMHP.S528064","url":null,"abstract":"<p><strong>Background: </strong>Obesity poses significant health and economic burdens globally, with interventions requiring robust cost-effectiveness evaluations. Markov models are widely utilized in economic evaluation of obesity interventions, their structure, assumptions, and related uncertainties have not yet been thoroughly evaluated.</p><p><strong>Objective: </strong>This study aimed to systematically review the Markov models used for the economic evaluation of anti-obesity interventions, describe their structural characteristics, identify key uncertainties, and provide insights for future research.</p><p><strong>Methods: </strong>The review was conducted across three databases (PubMed, Embase, the Cochrane Library) and health technology assessment agency websites to identify published Markov model-based full economic evaluations in adults with obesity from their inception to 2 June 2024. Model structure, model uncertainty, and validation were extracted from the included studies. Philips checklist for the methodology quality of modeling studies was performed.</p><p><strong>Results: </strong>The review included 21 primary publications with 21 unique Markov models. Two modeling approaches regarding the progression of obesity and its impact were identified: direct BMI to cost and utility; and BMI-linked complications, with diabetes and cardiovascular diseases most frequently modeled. Validation practices were inconsistently reported (43% of models), and structural uncertainty (eg, BMI trajectory assumptions) was rarely addressed. Quality assessment revealed moderate rigor (a mean compliance rate of 78% across all criteria), with gaps in transparency and generalizability, particularly for non-Western populations. Probabilistic sensitivity analysis was universal, yet scenario analyses highlighted outcome sensitivity to complication inclusion and time horizons.</p><p><strong>Conclusion: </strong>While Markov models are commonly utilized in obesity intervention evaluations, methodological heterogeneity and insufficient validation limit comparability and reliability. Future models should prioritize standardized validation (eg, ISPOR guidelines), broader complication spectrum, and diverse population data. Enhancing transparency in structural assumptions and uncertainty analysis is critical for robust policy recommendations.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2169-2187"},"PeriodicalIF":2.7,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555925","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":"Global and Regional Trends in Autism Burden from 1990 to 2021: A Data Re-Analysis and Prediction from the Global Burden of Disease Study.","authors":"Lingping Zhu, Haiyan Zhang, Lili Wang, Xuefeng Yang","doi":"10.2147/RMHP.S510506","DOIUrl":"10.2147/RMHP.S510506","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate global incidence rates and disability-adjusted life-years (DALYs) for autism spectrum disorder (ASD) from 1990 to 2021 and forecast trends for the next 25 years.</p><p><strong>Methods: </strong>Utilizing data from the Global Burden of Disease (GBD) study, we examined global and country-specific ASD incidence, prevalence, and burden. We also calculated age-standardized prevalence, analyzed by sex, age groups, sociodemographic index (SDI) regions, and GBD regions, and made predictions for the future.</p><p><strong>Results: </strong>In 2021, the GBD reported global age-standardized ASD incidence and prevalence at 0.019% and 0.788%, respectively. High-income Asia-Pacific had the highest burden, while Tropical Latin America had the lowest. From 1990 to 2021, global age-standardized prevalence rose by 1.95%, and incidence by 5.20%. Females and low-middle SDI regions saw the most significant increases in incidence, while the Caribbean and Serbia saw decreases. High-income Asia Pacific and Japan experienced the largest prevalence increases, and Middle SDI, East Asia, high-income Asia Pacific, and Equatorial Guinea saw the most significant DALY increases, with Oceania showing the largest decrease. Predictive models forecast continued increases in incidence, prevalence, and DALYs from 2022 to 2046.</p><p><strong>Conclusion: </strong>ASD incidence, prevalence, and DALYs are rising annually, with notable increases in females and middle-low income countries and a decline in the Caribbean. Tailored screening and interventions based on regional rates are essential for improving the health of individuals with autism.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2151-2168"},"PeriodicalIF":2.7,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562098","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":"Bronchial Blockers versus Double-Lumen Endotracheal Tubes: Impact on Postoperative Pneumonia in Lung Cancer Patients Undergoing Video-Assisted Thoracoscopic Surgery - A Propensity Score-Matched Study.","authors":"Xiaoxi Li, Ling Yu, Jiaonan Yang, Jin Wei, Miao Fu, Hongyu Tan","doi":"10.2147/RMHP.S521884","DOIUrl":"10.2147/RMHP.S521884","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the differential effects of bronchial blockers (BBs) versus double-lumen endotracheal tubes (DLETs) on postoperative pulmonary complications (PPCs) in patients undergoing video-assisted thoracoscopic surgery (VATS) for lung cancer.</p><p><strong>Patients and methods: </strong>This retrospective cohort study analyzed patients undergoing VATS requiring one-lung ventilation under general anesthesia from April 2023 to August 2024. Lung isolation was achieved using either BBs with single-lumen endotracheal tubes or DLETs. Propensity score matching was implemented to mitigate differences in patients' baseline characteristics. The primary outcome was the incidence of PPCs during hospitalization.</p><p><strong>Results: </strong>Propensity score matching resulted in 152 matched pairs of patients in the BB and DLET groups. The incidence rates of PPCs (6.6% vs 16.4%; <i>P</i> = 0.007) and pneumonia (3.9% vs 11.8%; <i>P</i> = 0.011) during hospitalization were significantly lower in the BB group than in the DLET group. Average oxygen saturation (<i>P</i> = 0.024), end-tidal carbon dioxide (<i>P</i> = 0.009), fraction of inspired oxygen (<i>P</i> = 0.010), and respiratory rate (<i>P</i> < 0.001) were significantly higher in the BB group. Mechanical ventilation parameters, including average peak airway pressure (<i>P</i> < 0.001), mean airway pressure (<i>P</i> < 0.001), and tidal volume (<i>P</i> = 0.003), were significantly lower in the BB group.</p><p><strong>Conclusion: </strong>Compared with patients intubated using a DLET, patients with lung cancer undergoing VATS and intubated using a BB experienced a lower incidence of PPCs.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2189-2199"},"PeriodicalIF":2.7,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555924","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":"Tracing Missing Surgical Specimens: A Quality Improvement Strategy for Adverse Events Based on Root Cause Analysis.","authors":"Li-Li Huang, Ju-Hong Yang, Wei-Wen Hong, Bin-Liang Wang, Hai-Fei Chen","doi":"10.2147/RMHP.S527015","DOIUrl":"10.2147/RMHP.S527015","url":null,"abstract":"<p><strong>Background: </strong>In 2022, a critical incident occurred at a Chinese hospital where a surgical specimen from a rectal prostate procedure was misplaced, necessitating repeat surgery for the patient. This event underscored systemic vulnerabilities in specimen handling processes and catalyzed an investigation into how healthcare systems manage medical errors to uphold patient safety.</p><p><strong>Methods: </strong>Using root cause analysis (RCA), we dissected the workflow gaps and organizational factors contributing to the specimen loss. Key failures identified included unclear role delineation among staff, inadequate specimen labeling protocols, and lack of real-time tracking mechanisms. Three interventions were implemented: (1) Redesigning specimen handling workflows with explicit role responsibilities; (2) Developing standardized, color-coded specimen bottles and racks to improve visual identification; (3) Integrating an electronic tracking system for closed-loop management of specimens.</p><p><strong>Results: </strong>Post-intervention, the recognition rate of post-use specimen vials improved from 0% to 100% after implementing a dual-color sealing system (white cap with red ring), enabling visual confirmation of proper sealing. Over two years, no surgical pathology specimens were lost post-intervention.</p><p><strong>Conclusion: </strong>The RCA-driven reforms effectively addressed systemic flaws in specimen management, demonstrating that targeted process redesign, ergonomic tools, and digital tracking can mitigate risks of medical errors. This case highlights the importance of analyzing localized workflow failures within broader systemic contexts to build resilient, patient-centered medical care systems.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2139-2150"},"PeriodicalIF":2.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12212431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546293","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 of, Attitudes toward, Barriers to, and Uptake Rate of Influenza Virus Vaccine among Adults Aged ≥65 Years in Jordan: A Multicenter Cross-Sectional Study.","authors":"Munir Abu-Helalah, Mohammad Al-Hanaktah, Mary Almadani, Amro Asfour, Fadi Essam Batarseh, Nadine N Abdelhadi, Baraa Ayed Al Odat, Satani G Sharkas, Alaa Ibraheem Alhashaika Jnr","doi":"10.2147/RMHP.S521918","DOIUrl":"10.2147/RMHP.S521918","url":null,"abstract":"<p><strong>Purpose: </strong>Seasonal influenza significantly impacts global health, especially among high-risk groups such as the elderly. People aged ≥65 years have the highest morbidity and mortality due to influenza infections. Despite international recommendations, influenza vaccine-uptake rates remain low in many regions worldwide. In Jordan, data on influenza vaccine uptake in people aged ≥65 years is lacking. This study aimed to assess vaccination rates, knowledge, attitudes, and barriers among the elderly in Jordan.</p><p><strong>Methods: </strong>This national cross-sectional study included 455 adults aged ≥65 years living at representative sites in Jordan in Amman, Irbid, Zarqa, and Karak. The study questionnaire was based on the health belief model and included data on demographics, influenza vaccination history, and knowledge of, attitudes toward, perceptions of, and barriers to influenza vaccine uptake.</p><p><strong>Results: </strong>Only 11.4% of participants received the influenza vaccine in the 2022-2023 season, while 30.1% had ever been vaccinated. Rural residents, higher-income groups, and those insured by private institutions demonstrated higher vaccination rates of 14% and 15.4%, respectively (<i>P</i><0.05). Barriers to being vaccinated included perceived low susceptibility (43.7%), concerns about adverse effects (52.7%), and lack of social network recommendations (38.9%). Positive predictors included trust in vaccination guidelines, higher perceived risk, and health-care provider advice (P<0.001).</p><p><strong>Conclusion: </strong>Influenza vaccination rates among older adults in Jordan are low compared to regional and international data. Interventions tailored to address barriers are needed to improve awareness, accessibility, and trust to reduce influenza-related morbidity and mortality.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2121-2137"},"PeriodicalIF":2.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531274","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 Effects of Comparisons of Physical Appearance on Social Media and Social Approval on Eating Attitudes.","authors":"Bahar Kefeli Col, Ayse Gumusler Basaran, Tugba Birben Kurt, Burcu Genc Kose","doi":"10.2147/RMHP.S517472","DOIUrl":"10.2147/RMHP.S517472","url":null,"abstract":"<p><strong>Objective: </strong>This study was conducted to evaluate the effects of comparisons of physical appearance on social media and social approval on eating attitudes among university students.</p><p><strong>Methods: </strong>This was a descriptive cross-sectional study. The social media physical appearance comparison scale measured individuals' tendencies to compare their physical appearance with that of others, and the need for social consent scale determined the need for social consent. Ethics committee approval was received for this research. The research sample consisted of 371 students enrolled in a university.</p><p><strong>Results: </strong>In the sample, 80.3% of the participating students were female, and 23.7% were overweight/obese. Eating disorders were detected in 11.6% of the students. The findings of this study show that eating attitudes in university students are affected by comparisons of appearances on social media and the need for social approval. It was determined that there was a positive relationship between eating attitudes and comparisons of physical appearance on social media, and as these comparisons increased, eating disorders also increased. It was determined that there was a positive relationship between eating attitudes and the need for social approval, and as the need for social approval increased, eating disorders also increased.</p><p><strong>Conclusion: </strong>Research findings can contribute to designing interventions to improve eating attitudes, the need for social consent and media literacy among students. In line with these findings, media literacy training, activities that promote positive body perception, and programs that encourage conscious consumption of content on social media can be developed. Such interventions help young people develop positive eating attitudes and become more resilient against the adverse effects of digital media and their social environment.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2091-2105"},"PeriodicalIF":2.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531277","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":"Risk Stratification for Cephalosporin-Induced Thrombocytopenia: Development and Validation of a Multidimensional Predictive Model in Older Adults.","authors":"Xiuyan Li, Wanlin Lei, Maofeng Wang, Lili Xu","doi":"10.2147/RMHP.S529488","DOIUrl":"10.2147/RMHP.S529488","url":null,"abstract":"<p><strong>Objective: </strong>Third-generation cephalosporins, while widely prescribed, carry underquantified thrombocytopenia risks in older adults. This study aimed to develop and validate a clinical prediction model for cephalosporin-associated thrombocytopenia in hospitalized patients aged over 65 years.</p><p><strong>Methods: </strong>A retrospective cohort (2019~2023) initially included 45,779 cephalosporin treated patients. After applying exclusion criteria, 12,917 patients were analyzed. Predictors were selected via LASSO regression, with backward elimination multivariate logistic regression constructing a nomogram. Model performance was assessed using AUC, calibration curves, and decision curve analysis (DCA) in training and testing sets.</p><p><strong>Results: </strong>The final model identified eight predictors: baseline platelet count (PLT), red blood cell count (RBC), presence of tumor, renal insufficiency (RI), liver cirrhosis (LC), meropenem use, use of antifungal drugs (AD), and daily usage frequency (DUF). It demonstrated strong discrimination (training AUC 0.82 [95% CI 0.79-0.85]; testing AUC 0.80 [0.76-0.84]) and calibration (Brier score 0.057). DCA confirmed clinical utility across wide risk thresholds.</p><p><strong>Conclusion: </strong>This nomogram tool enables rapid thrombocytopenia risk assessment in elderly patients receiving cephalosporins. Clinically, it guides antibiotic selection by quantifying comorbidity-drug interactions, and improves toxicity monitoring accuracy in complex geriatric cases with polypharmacy.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2107-2120"},"PeriodicalIF":2.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531276","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":"Manuscript Title: Regulatory and Implications of Complementary and Alternative Medicine (CAM) Use for Infection Prevention: Insights From the Gulf Cooperation Council (GCC) Countries.","authors":"Farah Kais Alhomoud","doi":"10.2147/RMHP.S522405","DOIUrl":"10.2147/RMHP.S522405","url":null,"abstract":"<p><strong>Purpose: </strong>The growing use of complementary and alternative medicine (CAM) for infection prevention across Gulf Cooperation Council (GCC) countries raises important concerns regarding patient safety and the lack of evidence-based regulation. This study aimed to assess the prevalence of CAM use, identify associated demographic factors, and explore public perceptions to support healthcare policy development.</p><p><strong>Patients and methods: </strong>A cross-sectional online survey was conducted over a three-month period among GCC residents aged 18 years and older. A self-administered questionnaire was distributed via social media platforms (eg Facebook, WhatsApp, and Twitter) using a convenience sampling approach, supplemented by snowballing. Although the calculated target sample size was 385, a total of 340 participants completed the survey. The questionnaire included items related to demographics, CAM practices, knowledge, and beliefs. Data were analyzed using IBM SPSS Statistics version 26, and chi-square tests were used to explore associations between CAM use frequency and participant characteristics.</p><p><strong>Results: </strong>Herbal products (62%) and spiritual healing (14%) emerged as the most commonly used CAM practices, with ginger, Curcuma longa, and garlic being the most frequently used herbs. More frequent CAM use was significantly associated with education level (χ²(3) = 19.01, p <0.001, Cramér's V = 0.160), country of residence (χ²(5) = 35.28, p <0.001, Cramér's V = 0.217), and prior infection experience (χ²(2) = 35.14, p <0.001, Cramér's V = 0.217). Higher usage was reported among Saudis, individuals with higher education, and those previously ill. No significant associations were found with age, health status, or fear of infection. Although 85% of users reported no side effects, reliance on informal sources and limited provider consultation raised safety concerns.</p><p><strong>Conclusion: </strong>Widespread CAM use highlights the urgent need for regulatory oversight, provider education, and culturally sensitive public health strategies to ensure safe integration into infection prevention efforts.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2081-2090"},"PeriodicalIF":2.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531275","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":"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}