Risk Management and Healthcare Policy最新文献

{"title":"A Risk Prediction Nomogram Model for Postoperative Pulmonary Complications in Children Aged 0-6 years.","authors":"Qian Wang, Yanhong Li, Kuangyu Zhao, Zhiguang Ping, Jiaqiang Zhang, Jun Zhou","doi":"10.2147/RMHP.S507147","DOIUrl":"10.2147/RMHP.S507147","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pulmonary complications (PPCs) in children are common. However, few models tailored specifically for children are available to identify risk factors for PPCs and enable preoperative interventions. This study aimed to identify independent risk factors for PPCs in children and establish a risk prediction model.</p><p><strong>Methods: </strong>The clinical data of pediatric patients aged 0-6 years with an American Society of Anesthesiologists (ASA) physical status of I or II, and had undergone surgery with mechanical ventilation at Henan Provincial People's Hospital between January 2020 and December 2021 were retrospectively reviewed. Univariate and multivariate logistic regression analyses were employed to identify risk factors for PPCs. The corresponding nomogram prediction model was constructed based on the regression coefficients. The receiver operating characteristic curve and calibration curve were used respectively to evaluate the discriminant validity and calibration of the prediction model.</p><p><strong>Results: </strong>Among 1545 patients included, 211 (13.4%) developed PPCs (156 of 1082 patients in the discovery cohort and 55 of 463 patients in the test cohort). In the multivariate logistic regression analysis, age (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.79-0.96, <i>P</i>=0.007), mechanical ventilation time (OR 1.36, 95% CI 1.20-1.55, <i>P</i><0.001), airway device (OR 1.67, 95% CI 1.04-2.68, <i>P</i>=0.033), ASA physical status (OR 1.96, 95% CI 1.34-2.88, <i>P</i>=0.001), and type of surgery (the total effect, <i>P</i>=0.004) were identified as the independent risk factors for PPCs in the discovery cohort. The prediction model showed good discrimination and calibration performance in both the discovery and test cohorts. The corresponding area under the curve was 0.762 (95% CI: 0.722, 0.803) and 0.818 (95% CI: 0.760, 0.875), respectively.</p><p><strong>Conclusion: </strong>We identified age, ventilation device and duration, ASA physical status, and surgical site as independent risk factors for PPCs in children aged 0-6 years. The predictive model performed well and demonstrated a certain capability in predicting the risk of PPCs.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1085-1097"},"PeriodicalIF":2.7,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774790","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":"Public Awareness and Perceptions of Congenital Disabilities in Saudi Arabia: A Cross-Sectional Study.","authors":"Fahad S Alshehri, Ahmed M Ashour, Nasser M Alorfi","doi":"10.2147/RMHP.S513016","DOIUrl":"10.2147/RMHP.S513016","url":null,"abstract":"<p><strong>Objective: </strong>This cross-sectional study aimed to assess the public awareness, knowledge, and perception of congenital disabilities in Saudi Arabia, with a focus on identifying demographic factors that influence these perceptions.</p><p><strong>Methods: </strong>A structured questionnaire was distributed to 1007 participants across various regions of Saudi Arabia. The questionnaire covered demographic information, knowledge of congenital disabilities, awareness of genetic and pharmacological risk factors, and engagement in preventive practices. Statistical analysis included descriptive statistics, correlation coefficients, and general linear modeling to understand the impact of demographic variables on awareness and preventive behaviors.</p><p><strong>Results: </strong>The study showed moderate public awareness and knowledge about congenital disabilities, with 49.6% of respondents acknowledging awareness and only 8.3% demonstrating excellent understanding. Perceived risks associated with genetic and environmental factors were recognized by over half of the participants. The awareness did not consistently translate into engagement in preventive practices, which remained suboptimal across the population. Demographic factors such as age and having children significantly influenced both risk perception and engagement in preventive behaviors.</p><p><strong>Conclusion: </strong>Despite moderate levels of awareness, there remains a significant gap in comprehensive knowledge and active engagement in preventive practices against congenital disabilities in Saudi Arabia. The findings suggest the need for targeted educational programs and public health initiatives to enhance understanding and proactive management of risk factors associated with congenital disabilities. These efforts should particularly focus on younger populations and those without children, where risk perception and engagement were lower.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1069-1083"},"PeriodicalIF":2.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774796","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":"Constructing a Resilience Assessment Index System for Tuberculosis Healthcare Services Under Public Health Emergencies: A Modified Delphi Study.","authors":"Mingkuan Fan, Yushu Liu, Kui Liu, Canyou Zhang, Yuhong Li, Xiaoqiu Liu, Hui Zhang, Jun Cheng","doi":"10.2147/RMHP.S506867","DOIUrl":"10.2147/RMHP.S506867","url":null,"abstract":"<p><strong>Purpose: </strong>Understanding the resilience of tuberculosis healthcare services (TB-HSs) is crucial for the targeted reinforcement of weak links and mitigation of the impact of public health emergencies (PHEs). However, assessment systems in this domain are lacking. This study aims to construct a resilience assessment index system (RAIS) for TB-HSs in China.</p><p><strong>Methods: </strong>The following four-step design process was conducted: 1) establishing the RAIS index pool based on a literature review, 2) designing an initial RAIS for TB-HSs following Donabedian's \"structure-process-outcome\" framework through expert meetings; 3) employing a two-round Delphi survey to obtain a consensus on the RAIS; and 4) using the analytic hierarchy process to quantify the weight of each indicator included in the final RAIS.</p><p><strong>Results: </strong>The expert panel (n=26) had 100.0% and 96.2% response rates in the first and second Delphi rounds, respectively. The expert authority coefficients for the two rounds were 0.908 and 0.906. Both rounds showed high levels of expert coordination (<i>P</i><0.001). The final RAIS comprising three first-grade, nine second-grade, and 39 third-grade indicators. Our findings reveal that tuberculosis service provision/utilization tops the first-grade indicators, weighing 49.05%. Among the second-grade indicators, service outcomes (20.79%) and patient treatment (20.67%) were the top-weighted. Of the third-grade indicators, the treatment discontinuation proportion (10.29%) and the treatment coverage rate in confirmed TB patients (8.90%), were critical components in evaluating the resilience of TB-HSs.</p><p><strong>Conclusion: </strong>This study developed a unified hierarchical resilience assessment index system for TB-HSs in China. Further research is required to validate and improve our results. The study's findings could help develop strategies that benefit public health.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1057-1067"},"PeriodicalIF":2.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756014","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":"Challenges in Results Robustness of Trials with Missing Data for the Primary Endpoint: Insights from Coronary Balloon/Stent Trials.","authors":"Xinyue Lang, Yanyan Zhao, Yingxuan Zhu, Lei Song, Chuangshi Wang, Duoer Wang, Chilie Danzeng, Yang Wang, Wei Li","doi":"10.2147/RMHP.S511449","DOIUrl":"10.2147/RMHP.S511449","url":null,"abstract":"<p><strong>Background: </strong>To assess the consequence of different degrees of missing primary endpoint data for randomized controlled trials and to find the influence factors.</p><p><strong>Methods: </strong>PubMed, Cochrane Library, EMBASE and ClinicalTrials.gov were searched up to Nov 30, 2023. We included trials of the drug-coated balloon/drug-eluted stent with angiographic outcomes as the primary endpoint. The tipping-point analysis was used to deal with the missing data for the primary endpoint. The inconsistency rate, tipping-point standardized effect size (SES) and tipping-point ratio were used to assess the result robustness.</p><p><strong>Results: </strong>A total of 101 trials were included, which had 109 trial comparisons. Among them, 89 (81.7%) comparisons had superior/non-inferior conclusions (H₀ rejected); 85 (78.0%) comparisons had a missing rate of ≥10%, and 30 (27.5%) comparisons had a missing rate of ≥20%. For H₀ rejected comparisons with a missing rate of ≥10%, the median of inconsistency rate, tipping-point SES and tipping-point ratio was 32.2% (IQR 19.7%, 45.4%), 0.90 (IQR 0.17, 1.79) and -1.53 (IQR -2.43, -0.39). A higher missing rate and a larger (worse) observed-target SES were associated with a more unreliable result.</p><p><strong>Conclusion: </strong>A high dropout rate and inflated target effect size could cause an unreliable result. We emphasize a robust evaluation of the results for clinical trials with missing data for the primary endpoint.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1045-1056"},"PeriodicalIF":2.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756012","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 and Validation of a Nomogram Prediction Model for Key Symptoms of Post-Intensive Care Syndrome-Family in Family Members of Critically-Ill Patients: Focusing on Sleep Disturbance, Fatigue, Anxiety, and Depression.","authors":"Haili Dong, Li Liu, Shasha Ma, Haixia Han, Jiadong Zhang, Jordan Tovera Salvador, Xiaoxiao Liu","doi":"10.2147/RMHP.S490487","DOIUrl":"10.2147/RMHP.S490487","url":null,"abstract":"<p><strong>Purpose: </strong>To construct and validate a nomogram model predicting the risk of post-intensive care syndrome-family (PICS-F) in family members of critically ill patients.</p><p><strong>Methods: </strong>This study was conducted on family members (parents, spouses, or children) of critically ill patients in the three intensive care units of Binzhou Medical University Hospital from December 2023 to June 2024, responsible for medical decisions and primary care. The sleep disturbances, fatigue, anxiety, and depression were assessed using the Pittsburgh Sleep Quality Index, the Subscale of Fatigue Assessment Instrument, and the Hospital Anxiety and Depression Scale, respectively. Predictive factors were identified through univariate and multivariate logistic regression, and a nomogram was constructed using R4.2.3. Internal validation used the Bootstrap sampling method, and external validation employed the time-period method.</p><p><strong>Results: </strong>The study involved 567 participants divided into a modeling group (n = 432; median age = 46 years; 209 males, 223 females) and an external validation group (n = 135; median age = 45 years; 70 males, 65 females). The model included five predictive factors: family age, patient age, APACHE II score, average monthly income per family member, and PSSS score. The AUC of the modeling group was 0.894 (0.864 ~ 0.924), with a specificity of 85.4%, a sensitivity of 78.0%, and a maximum Youden index of 0.634. The H-L test revealed a good fit (<i>X</i> ² value = 9.528, <i>P</i> = 0.300). The internal validation results of the Bootstrap sampling method showed that the calibration curve of the model was close to the ideal curve, and the DCA curve results indicated high clinical practicality. Moreover, the external validation results showed that AUC was 0.847 (0.782 ~ 0.912), with sensitivity and specificity of 74.5% and 86.3%, respectively. The H-L test results indicated a good fit (<i>X</i> ² value = 9.625, <i>P</i> = 0.292).</p><p><strong>Conclusion: </strong>The nomogram demonstrated strong predictive performance for PICS-F risk in ICU patients' families, offering a valuable tool for clinical assessment.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1031-1043"},"PeriodicalIF":2.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756018","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":"Early Detection of Malignant Cells in Gastric Lavage via Hexokinase 2 and Single-Cell Sequencing for Gastric Cancer Diagnosis.","authors":"Peiyu Qian, Jie Sun, Zhenya Zhao, Peihua Lu","doi":"10.2147/RMHP.S510123","DOIUrl":"10.2147/RMHP.S510123","url":null,"abstract":"<p><strong>Objective: </strong>Gastric cancer represents a significant global health challenge due to its high prevalence and mortality rates, largely attributed to the limitations of current screening methods, such as endoscopy, which impede early diagnosis. This study presents an innovative method for early detection by identifying exfoliated tumor cells in gastric lavage, aiming to overcome challenges related to patient compliance and the variability in endoscopist expertise.</p><p><strong>Methods: </strong>Hexokinase 2 (HK2), a metabolic marker, was utilized to identify exfoliated tumor cells with heightened glycolytic activity in gastric lavage fluid. The malignancy of these HK2-positive, high-glycolytic tumor cells was further validated using single-cell sequencing (SCS), specifically through genome-wide copy number variation analysis.</p><p><strong>Results: </strong>A total of 60 individuals were assessed, including 10 patients with gastric cancer (9 at stage IA and 1 at stage IIA), 26 patients with precancerous lesions, 15 patients with benign gastric conditions, and 9 healthy controls. The HK2 assay demonstrated an 80% diagnostic sensitivity for stages IA and IIA of gastric cancer and a 96% diagnostic specificity in distinguishing benign conditions from healthy controls. Importantly, the assay exhibited 57% sensitivity for cases of severe dysplasia, underscoring its potential for early gastric cancer detection and preventive diagnostics.</p><p><strong>Conclusion: </strong>The study highlights the feasibility of a novel gastric lavage-based HK2 assay, complemented by SCS for malignancy confirmation, as a highly accurate method for the early detection of gastric cancer. This approach offers a promising alternative to traditional gastroscopy, particularly for early-stage disease, potentially enhancing detection rates and improving patient outcomes.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1011-1021"},"PeriodicalIF":2.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756020","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":"Pattern and Neonatal Outcome of the Neonatal Intensive Care Unit in Qassim, Saudi Arabia.","authors":"Abdullah Al-Nafeesah, Ashwaq Al Eed, Abdullrahman Alsalamah, Osama Al-Wutayd, Abdulrahman A Alshoshan, Lamees Abdulaziz Algubllan, Mohammad Alhasoon, Ishag Adam","doi":"10.2147/RMHP.S490593","DOIUrl":"10.2147/RMHP.S490593","url":null,"abstract":"<p><strong>Purpose: </strong>Neonatal mortality is one of the main public health problems, especially in developing countries. Limited studies on neonatal mortality exist in Saudi Arabia, particularly in central Saudi Arabia. Therefore, this study aimed to determine the incidence, causes, and associated factors for mortality among neonates admitted to the neonatal intensive care unit (NICU) in a single center in Al-Qassim, Saudi Arabia.</p><p><strong>Patients and methods: </strong>This retrospective study included 988 neonates admitted to the NICU in Saudi Arabia, between January and December 2023. Data were obtained from the hospital records using a questionnaire composed of sociodemographic data, neonatal and maternal information, and neonatal outcomes. Logistic regression analyses were performed, and the adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated.</p><p><strong>Results: </strong>Data from 970 neonates (46.6% female) were collected and included in the analysis. Of the 970 neonates, 291 (30.0%) were preterm births, and 317 (32.7%) were low-birth-weight (LBW) babies. Overall, 417 (43.0%) neonates were delivered via cesarean section. Prematurity (51.7%), hypothermia/hypoglycemia (17.6%), neonatal jaundice (11.4%), congenital malformations (5.4%), respiratory distress syndrome (3.9%) and neonatal sepsis/infection (3.1%) were the main diagnoses at admission. Nineteen (2.0%) neonates died during the time of admission to discharge in the NICU. Univariate analysis showed that preterm birth (OR = 4.12, 95% CI = 1.60‒10.5) and LBW (OR = 5.9, 95% CI = 2.13‒16.77) were associated with increased odds of neonatal mortality. Maternal age, number of children, duration of admission, mode of delivery, and sex of the neonate were not associated with neonatal mortality. In the multivariable logistic regression analysis, LBW (AOR 4.2, 95% CI = 1.24‒14.39) was associated with neonatal mortality.</p><p><strong>Conclusion: </strong>The current study showed that prematurity, neonatal jaundice, and congenital malformations were the main causes of admission to the NICU. Neonatal mortality is lower than in other regions and is associated with LBW.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1023-1030"},"PeriodicalIF":2.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755838","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":"Correlations Between Leadership, Self-Efficacy, and Evidence-Based Practice Competency in Nursing in a Chinese Tertiary Hospital.","authors":"Jing Li, Ya-Qi Liu, Jia Song, Xu-Fang Huang, Mei-Fen Chen","doi":"10.2147/RMHP.S500221","DOIUrl":"10.2147/RMHP.S500221","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the interplay between nursing leadership, innovative self-efficacy, and evidence-based practice competencies, aiming to identify predictive factors for enhancing nursing performance in evidence-based care.</p><p><strong>Methods: </strong>A convenience sampling strategy was employed to enlist 1104 clinical nurses from a tertiary A-level general hospital in Lishui city. Data collection involved the utilization of a general information survey, an implementation leadership scale, the Innovative Self-Efficacy Questionnaire (IS-EQ), and a simplified scale designed to assess evidence-based practice.</p><p><strong>Results: </strong>The mean total scores observed were 37.34±9.77 for nursing supervisor implementation leadership, 29.04±5.39 for nurses' innovation self-efficacy, and 28.80±4.98 for evidence-based practice competency. Through correlation analysis, it was found that in the actual nursing work scenarios, when head nurses effectively exert their leadership and nurses have a relatively high level of innovative self-efficacy, the nurses' evidence-based practice ability will subsequently improve, and the two show a highly significant positive correlation (p < 0.01). The multiple stepwise regression analysis further reveals in depth that the leadership implemented by head nurses, nurses' innovative self-efficacy, as well as nurses' educational level and the degree of participation in academic conferences are all key factors for accurately predicting nurses' evidence-based practice ability. These factors work together and account for 52.8% of the variance in evidence-based practice ability (P < 0.05).</p><p><strong>Conclusion: </strong>Strengthening the leadership training for head nurses, improving nurses' professional quality, and providing more academic exchange opportunities could effectively improve nurses' evidence-based practice ability to practically optimize the quality and professional level of nursing services.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"999-1009"},"PeriodicalIF":2.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756016","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":"Examining the Impact of Availability and Accessibility of Community Benefit Provisions on County Health Outcomes.","authors":"Jinyoung Cha, Ahreum Han, Keon-Hyung Lee","doi":"10.2147/RMHP.S492160","DOIUrl":"10.2147/RMHP.S492160","url":null,"abstract":"<p><strong>Background: </strong>The recent rise of accountability in healthcare providers has spurred a keen interest in improving community benefit provisions and how these are associated with community health development. However, prior studies predominantly focus on the adequate amount of community benefit provisions (availability), disregarding the potential influence of distributional provisions (accessibility). To fill this gap, this study explores how the total amount (availability) and Blau's Index (accessibility) of community benefits are positively associated with county health outcomes.</p><p><strong>Methods: </strong>This study adopts a cross-sectional time series two-way fixed effect analysis from 2014 to 2019 for the county level. Independent variables are calculated as the total amount and Blau's Index of community benefit provisions in hospital referral regions (HRRs). Dependent variables are county health outcomes, measured by physical and mental unhealthy days and distress days.</p><p><strong>Results: </strong>The results demonstrated that both the availability and accessibility of community benefit provisions are correlated with lower physical and mental healthy days and distress. Remarkably, the accessibility of community benefit provisions by hospitals became pivotal to improving county health outcomes.</p><p><strong>Conclusion: </strong>From the theoretical aspects, it provides empirical evidence between community benefit provisions and community health outcomes and extends the theory of access into community benefit provisions. From the practical aspects, it offers invaluable insights for hospital managers and policymakers for their strategic decision-making to contribute to community health outcomes.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"963-974"},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756022","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":"Prevalence and Associated Factors of Poor Sleep Quality Among Nurses in a Tertiary Care Hospital: A Cross-Sectional Study.","authors":"Rahma Yusuf Haji Mohamud, Nur Adam Mohamed, Ali Abdullahi Abdi, Iftin Mohamed Osman, Amal Nor Ali, Serpil Doğan, Said Mohamed Mohamud, Zerife Orhan","doi":"10.2147/RMHP.S511543","DOIUrl":"10.2147/RMHP.S511543","url":null,"abstract":"<p><strong>Background: </strong>Poor sleep quality among nurses negatively impacts job performance, patient care, and mental well-being, leading to compromised cognitive ability, decision-making, and increased errors, which ultimately jeopardize patient care and safety. This study aimed to determine the prevalence of poor sleep quality and its associated factors among nurses at a tertiary care hospital in Mogadishu, Somalia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among nurses working at a tertiary care hospital between May and August 2024. Data were collected using a standardized questionnaire, which included socio-demographic information, the Pittsburgh Sleep Quality Index (PSQI), the Depression, Anxiety, and Stress Scale (DASS-21), and the Oslo Social Support Scale (OSSS-3). Bivariate and multivariate logistic regression analyses were used to identify risk factors for poor sleep quality. A p-value of 0.05 was considered the threshold for statistical significance.</p><p><strong>Results: </strong>A total of 280 nurses participated in the study, with 45.7% (95% CI: 39.8-51.7) reporting poor sleep quality. The odds of reporting poor sleep quality were higher among female nurses (AOR = 2.68; 95% CI: 1.35-5.32), those working night shifts (AOR = 4.76; 95% CI: 2.06-11.02), those with poor social support (AOR = 2.82; 95% CI: 1.09-7.27), and those experiencing depression (AOR = 5.35; 95% CI: 2.22-12.88), anxiety (AOR = 5.58; 95% CI: 2.61-11.92), and stress (AOR = 3.92; 95% CI: 1.11-13.90).</p><p><strong>Conclusion: </strong>This study revealed a significantly high prevalence of poor sleep quality among nurses. These findings underscore the importance of addressing sleep quality as a key component of nursing well-being. It is recommended that nursing managers assess both the mental and physical health of their staff, implement targeted interventions such as stress management and counseling, and develop workplace strategies to improve sleep, including flexible scheduling and education on sleep hygiene.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"975-986"},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756034","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}