BMC Health Services Research最新文献

{"title":"Healthy Lives 5 Axis Scale for individuals with complex health and social needs: assessment of validity and reliability.","authors":"Henry White, Peter Gonzalez, Sagi Sashar, Zoe Silver, Hannah Scott, Victor Novack","doi":"10.1186/s12913-025-13069-x","DOIUrl":"10.1186/s12913-025-13069-x","url":null,"abstract":"<p><strong>Background: </strong>The field of complex care management for patients with urgent health and social challenges has rapidly grown, leading to calls for improved tools for measuring quality and outcomes. Most available measures were not developed specifically for a clinical context with a population with complex needs. The Healthy Lives 5 Axis Scale (HL-5) was created to fulfill this role. This concise, multidimensional scale measures key domains, including health-related functioning, physical and social needs, capacity for self-care, access, and utilization. The purpose of this study was to determine the interrater and test-retest reliability and the construct and concurrent validity of the HL-5.</p><p><strong>Methods: </strong>The study population included adults who attended an appointment with a primary care physician at an urban community health center. The reliability assessment of the HL-5 questionnaire included test-retest ratings by the same scorer and between two different scorers. Criterion convergent validity was evaluated by comparing the HL-5 domains with relevant domains of external questionnaires using Pearson correlation coefficients (r). The comparison measures have a strong evidence base, are widely used, and are nonproprietary.</p><p><strong>Results: </strong>There were 64 participants, with a mean age of 39.1. Test-Retest Reliability, measured by the intraclass coefficient (ICC), was greater than 0.8 for Functioning, Needs, Utilization, and Access, indicating very strong internal consistency and 0.754 for Self-Care, representing good internal consistency. Criterion Validity for the axes, assessed by each axis' correlations with a criterion measure, was statistically significant at of p < 0.05.</p><p><strong>Conclusions: </strong>This study of the psychometric properties of the Healthy Lives 5 Axis Scale (HL-5) demonstrated its value for assessing patients' complex health and social needs. It showed high levels of reliability in a clinical setting with a diverse patient populations and strong correlations with well-established measures of functioning, needs, self-care, access, and utilization. HL-5 requires only a few minutes to complete and yields actionable results, demonstrating its potential for integration into the workflow of a primary care practice or care management program.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"880"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic determinants of affordability of medication: a panel data econometric analysis in Iran.","authors":"Mohammad Javad Rajabi, Mojtaba Ghasemi, Mohammad Peikanpour, Hamid Reza Rasekh","doi":"10.1186/s12913-025-13061-5","DOIUrl":"10.1186/s12913-025-13061-5","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"827"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The self-perceived role of tech champions in municipal healthcare services-a descriptive qualitative study.","authors":"Sissel Pettersen, Hilde Eide, Anita Berg","doi":"10.1186/s12913-025-12994-1","DOIUrl":"10.1186/s12913-025-12994-1","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"856"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-driven healthcare innovations for enhancing clinical services during mass gatherings (Hajj): task force insights and future directions.","authors":"Ala'a Alquayt, Ohoud Aljuhani, Abdullah F Alharthi, Rahaf Alqahtani, Anas Khan, Ahmed Al-Jedai, Abdulqader Almoeen, Mohammed Alshennawi, Hisham A Badreldin, Abdulrhman Aljouie, Lubna A Alnasser, Abdulmajeed M Alshehri, Mohammed Y Alzahrani, Haifa A Alhaidal, Raghad Alhajaji, Salman Alotaibi, Esraa Z Redhwan, Fahad Alharthi, Badr G Alghamdi, Khalid Al Sulaiman","doi":"10.1186/s12913-025-13045-5","DOIUrl":"10.1186/s12913-025-13045-5","url":null,"abstract":"<p><strong>Background: </strong>Due to the high complexity of healthcare during mass gatherings (MG), the integration of Artificial Intelligence (AI) might be crucial. AI can enhance healthcare delivery, improve patient care, optimize resources, and ensure efficient management of the large-scale healthcare demands during Hajj. This paper aims to provide an overview of AI utilization specifically during Hajj and explore the potential role of AI-driven tools in healthcare and clinical services provided to pilgrims.</p><p><strong>Methods: </strong>A task force was formed and included experts healthcare providers, AI specialists, and members from the Saudi Society for Multidisciplinary Research Development and Education (SCAPE Society), Saudi Critical Care Pharmacy Research (SCAPE) platform, Saudi Society of Clinical Pharmacy (SSCP), policymakers, and frontline healthcare practitioners involved in Hajj. The task force first agreed on the framework and voting system, then organized into teams to draft content for specific domains. Consensus was reached using a voting system requiring over 80% agreement, and all task force members reviewed and finalized the drafts. The selection of AI specialists, policymakers, and frontline healthcare practitioners for the task force was based on their expertise and relevance to healthcare during Hajj.</p><p><strong>Results: </strong>The task force identified key focus areas: (1) Patient Care: AI tools for predictive analytics, triage, resource management, and virtual healthcare. (2) Healthcare Providers: AI in medical imaging, care delivery, provider-patient communication, and training. (3) Operational Management: AI for healthcare documentation and reducing administrative burden. (4) Healthcare Systems: AI for early detection and automation during Hajj. The task force constructed ten statements to guide future initiatives.</p><p><strong>Conclusion: </strong>Expanding the role of AI in healthcare during MGs will help optimize healthcare outcomes and utilization. Concerns about AI ethics and data security need to be addressed. Additional data is needed to address the gaps in the literature regarding AI's applicability in healthcare services during MGs.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"876"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the gap between policy and practice: community health workers' contributions to nutrition services in Sub-Saharan Africa.","authors":"Akriti Singh, Mahamadou Mansour Ndiath, Djeinam Toure, Romance Dissieka, Lennie Kyomuhangi Bazira, Carolyne Wanyonyi, Rolf Dw Klemm","doi":"10.1186/s12913-025-13044-6","DOIUrl":"10.1186/s12913-025-13044-6","url":null,"abstract":"<p><strong>Background: </strong>Community health workers (CHWs) are the backbone of healthcare service provision in Africa, particularly in delivering critical health and nutrition services. Despite their pivotal role, there is limited understanding of the alignment between CHW responsibilities as defined in national policies and the actual nutrition services they provide. This study aimed to compare the nutrition-related responsibilities assigned to CHWs in national policies with the nutrition services CHWs report delivering to women and children in six Sub-Saharan African countries: Guinea, Mali, Niger, Côte d'Ivoire, Democratic Republic of Congo (DRC), and Kenya.</p><p><strong>Methods: </strong>We combined structured interviews with 735 CHWs from six countries with a document review of national CHW policies and training manuals to assess the alignment between policy and practice in nutrition service delivery.</p><p><strong>Results: </strong>The policy documents revealed notable differences in the CHW scope of responsibilities across the six countries. Training for CHWs was inconsistently documented across countries. Financial compensation for CHWs was mentioned in policy documents from five out of six countries, though the nature and amount of compensation varied significantly. Among the CHWs surveyed, a high percentage (68-84%) reported receiving financial compensation. Most CHWs provided promotional services but were more likely to dispense preventive and curative commodities for children (e.g., Vitamin A, deworming, oral rehydration solution, and Zinc) than women (iron-folic acid, intermittent preventive treatment for Malaria). Service provision was closely linked to the training received. Discrepancies were noted between policy-defined responsibilities and reported service delivery, particularly in growth monitoring and promotion and management of wasting.</p><p><strong>Conclusions: </strong>This study found a critical need for stronger alignment between policy directives and CHW training and service provision. By informing policy reforms, standardizing training, and guiding resource allocation, our findings can strengthen CHW programs and improve delivery of lifesaving nutrition interventions to women and children-particularly in remote and underserved communities.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"838"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the digital divide: Understanding COVID-19 diagnostic and vaccination experiences in a socioeconomically disadvantaged neighborhood in Sweden.","authors":"Rathi Ramji, Dipak Surie, Stefan Cirovic, Margareta Rämgård, Sergey Shleev, Anders Kottorp","doi":"10.1186/s12913-025-13033-9","DOIUrl":"10.1186/s12913-025-13033-9","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"870"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Teamwork is needed\": care management of patients receiving haemodialysis through the eyes of their nurses - a qualitative study.","authors":"Cansu Kosar Sahin, Esin Sevgi̇ Doğan, Özden Dedeli̇ Çaydam","doi":"10.1186/s12913-025-12968-3","DOIUrl":"10.1186/s12913-025-12968-3","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"843"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A patient survey on outpatient physiotherapy services in Nepal: service received, and patients' recommendations.","authors":"Nishchal Ratna Shakya, Nistha Shrestha, Gillian Webb, Hellen Myezwa, Biraj Man Karmacharya, Ann-Katrin Stensdotter","doi":"10.1186/s12913-025-13055-3","DOIUrl":"10.1186/s12913-025-13055-3","url":null,"abstract":"<p><strong>Background: </strong>A global rising burden of non-communicable diseases and disability increases the need of and demand on physiotherapy. In Nepal, knowledge is lacking about provision and utilisation of physiotherapy. This study aimed to explore patients' perception about physiotherapy and the service received at their outpatient physiotherapy clinic. The rationale was to understand the needs and identify areas of potential improvement in service delivery.</p><p><strong>Methods: </strong>A cross-sectional survey with closed and open-ended questions was performed in the Bagmati province of Nepal at 29 health-centres of 6 districts including 20 patients per facility (n = 580). Descriptive and regression analysis were performed for closed ended questions and thematic content analysis used for the open-ended questions.</p><p><strong>Results: </strong>Among patients receiving physiotherapy, 55.3% were females and 48.1% belonged to the upper caste or advantaged ethnic groups, 76.4% were referred by doctors and 76.6% were paying out of pocket. Musculoskeletal (80.7%) and neurological (29.1%) conditions were most common with some comorbidity. The most frequent interventions were electrotherapy and resistance training (≈ 65%). Accessibility was explained by educational level, urban / rural area and travel time. Affordability was explained by age, mode of payment and treatment duration. Age, educational level, and mode of payment likewise explained satisfaction. Patients' recommendations for improving physiotherapy were clustered on nine: satisfaction, availability, equipment, awareness, service improvement, human resources, affordability, adequate space and proper counselling.</p><p><strong>Conclusion: </strong>Based on the findings, Nepal should target political priorities including infrastructure, quality system for evidenced practice and clinical conduct, rural development and availability for the poor.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"839"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring healthcare workers' perceptions and experiences regarding post-traumatic stress disorder after 2 years of the last global pandemic.","authors":"Maryam Khazaee-Pool, Tahereh Pashaei, Fereshteh Yazdani, Koen Ponnet","doi":"10.1186/s12913-025-13004-0","DOIUrl":"10.1186/s12913-025-13004-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The adverse mental health consequences of the coronavirus epidemic for healthcare workers (HCWs) affect the quality of care and patient satisfaction; HCWs need to maintain good mental health during and after an epidemic, especially in low-income countries like Iran, where human resources in the health care sector are insufficient. The aims of this study are to explore the perceptions and experiences of healthcare workers regarding post-traumatic stress disorder (PTSD) after 2 years of the last Global Pandemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted the present study in Mazandarn province, Iran, using a qualitative approach based on conventional content analysis. Participants were Iranian healthcare workers (HCWs) aged 30 and above, all with a history of post-traumatic stress disorder (PTSD) symptoms. Eligible candidates were selected through both purposive sampling (with maximum variation) and snowball sampling to ensure diversity in demographic characteristics and lived experience of phenomena. Data were collected through in-depth, semi-structured interviews, continuing until data saturation was reached. The interviews were analyzed using MAXQDA10 software, following the conventional content analysis approach as outlined by Graneheim and Lundman.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our analysis yielded five main themes and 18 categories: [1] Helplessness, including six categories: physical consequences, psychological reactions, feeling of guilt, job-related consequences, social consequences, and lack of support; [2] poor risk management, encompassing four categories: inadequate vocational skills training, poor anger management, low sense of security, and hazardous work environments; [3] life and death experience, with two categories: hopelessness about life and the future, and witnessing unexpected deaths; [4] seeking support, comprising three categories: social support, psychological support, and organizational support, and [5] self-care, involving three categories: personal responsibility for health, maintaining a healthy lifestyle, and building resilience against PTSD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our findings reveal a concerning picture of the mental health status of Iranian HCWs, particularly regarding the impact of the most recent pandemic. Many participants reported significant symptoms of stress, depression, anxiety, and PTSD, all of which profoundly affect their overall well-being. The most prominent themes identified were feelings of helplessness, inadequate risk management, encounters with life-and-death situations, and insufficient support systems. Alarmingly, several HCWs expressed intentions to leave their current positions or exit the healthcare profession altogether. Such trends pose a serious threat to the stability of Iran's healthcare system. Consequently, proactive, solution-oriented strategies must be developed-both at the national level and in collaboration with international stakehol","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"861"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global perspectives on challenges, coping strategies, and future preparedness of nursing home staff during COVID-19: a systematic review and meta-synthesis.","authors":"Xiu-Fen Yang, Jia-Yi Guo, Wei-Si Peng, Bing-Dong Wang, Chao-Ran Qv, Si-Jia Zhou, Rui Sun, Lulu Liao, Wei-Wei Zhang, Ling-Yan Liu, Lian-Chi Ren, Lin Zou, Shi-Hai Xu","doi":"10.1186/s12913-025-12926-z","DOIUrl":"10.1186/s12913-025-12926-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The global public health crisis caused by COVID-19 in late 2019 was unprecedented. Due to their vulnerable population, nursing homes are a key epidemic response area. This study described the challenges and coping strategies of nursing home staff during COVID-19 and proposed recommendations for future public health crises in nursing homes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;A meta-synthesis was performed to address the research question: What are the experiences of nursing home staff from the perspectives of COVID-19? From the beginning until August 31, 2024, searches were conducted in five international databases (CINAHL, PubMed, Web of Science, PsycINFO, and the Cochrane Library) and three Chinese databases (CNKI, VIP, and Wanfang). Two reviewers used the Joanna Briggs Institute's (JBI) qualitative research checklist to evaluate each manuscript. The findings were synthesized using pragmatic meta-aggregators.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The meta-synthesis included 22 qualitative studies and four mixed studies, which including 906 participants was analyzed to identify 268 findings that were organized into 15 categories and combined into three syntheses. Three synthesized findings were identified: Challenges (sub-findings: challenges implementing epidemic prevention and control, resource shortage, negative emotions, inadequate departmental communication and coordination, lack of support, physical strain); coping strategies (sub-findings: role adaptation and redefinition, innovative solutions and technology, work organisation and cooperation, positive psychological service, seeking community and organisational support, Improving infection prevention awareness), and suggestions for future preparedness (sub-findings: Enhancing communication and decision-making in response to COVID-19 changes, Optimizing material supply channels and physical space, and increasing medical related team and training).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion(s): &lt;/strong&gt;This study focuses on the COVID-19 experiences and coping strategies of nursing home staff. Key coping strategies include role transition and redefinition, with staff taking on additional tasks to ensure ongoing diagnosis and treatment; innovative concepts and technologies, such as remote healthcare and digital tools, reduce the risk of infection; and strengthening collaboration and cooperation, improving efficiency, and decreasing employee workload. Mental health services and social support can alleviate stress and promote health. Maintaining optimism among staff members necessitates community and organisational support, resources, and effective communication. The findings of this study have implications for nursing home practices and policies. Sanatoriums require PPE, medical supplies, and trained personnel. Encourage system and organisational transformation. Emergency preparedness and flexible workforce initiatives enhance organisational adaptability. Increase infection prevention awar","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"872"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12217812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}