BMC Health Services Research最新文献

{"title":"A realist review of factors critical for the implementation of eHealth in chronic disease management.","authors":"Nida Shahid, Gillian Parker, Joanna M Bielecki, Valeria Rac, Whitney Berta","doi":"10.1186/s12913-025-12361-0","DOIUrl":"10.1186/s12913-025-12361-0","url":null,"abstract":"<p><strong>Background: </strong>In Canada, chronic disease is responsible for 88% of deaths and $120 billion in cost each year. With 44% of Canadian adults living with at least one chronic condition, only 66% receive necessary care. Ehealth interventions are instrumental in chronic disease management (CDM), especially since the pandemic, as they provide accessible, cost-effective solutions for self-management. Despite its promise and accelerated use, its implementation remains challenging. This paper reports on a realist review of critical factors for the implementation of eHealth interventions relevant to conditions such as heart failure, chronic obstructive pulmonary disease, chronic kidney disease, and diabetes. The findings are presented in terms of context, mechanisms, and outcomes.</p><p><strong>Methods: </strong>A realist review of the primary literature was conducted by searching five databases: Medline, Embase, Cochrane, CINALH and PsycInfo. The initial search was run for a date spanning from the databases' inception to September 2018 and subsequently updated to dates spanning from October 2018 to May 2022. A systematic and iterative approach to data extraction was used. Thematic analysis was used to identify context-mechanism-outcome (CMO) configurations.</p><p><strong>Results: </strong>Among the 13,209 citations retrieved, 64 articles were included. This paper reports the top ten configurations found to facilitate or hinder eHealth implementation. Key themes related to context, such as team-based care, and action, including program use, perceived usefulness and motivation, are reported.</p><p><strong>Conclusions: </strong>This study explores the role of context, mechanisms, and outcomes in ehealth implementation, highlighting the nonlinear relationships between these factors. Future implications include empirical testing CMOs as middle-range theories in real-world settings to determine causality.</p><p><strong>Trial registration: </strong>The review protocol was registered with PROSPERO (CRD42020208275) on 1 October 2020.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"496"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770931","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":"Implementing Learning from Excellence in a postanaesthesia care unit: a qualitative study of healthcare professionals' experiences after six months.","authors":"Gørill Birkeli, Ellen Catharina Tveter Deilkås, Randi Ballangrud, Anne Karin Lindahl","doi":"10.1186/s12913-025-12626-8","DOIUrl":"10.1186/s12913-025-12626-8","url":null,"abstract":"<p><strong>Background: </strong>Prevailing efforts to ensure patient safety have primarily focused on learning from errors and adverse events (Safety-I). However, it is advocated that complex systems also learn from success (Safety-II) and focus on healthcare professionals' well-being at work to increase resilience. Learning from Excellence is a British initiative designed to learn from successful practices and provide positive feedback to the staff. It has gained enthusiastic followers in several countries, including Norway. However, how it influences learning, well-being and quality improvement, has not been studied in-depth. This study intends to address these gaps. Thus, this study aimed to describe healthcare professionals' experiences with Learning from Excellence six months after its implementation in a postanaesthesia care unit.</p><p><strong>Methods: </strong>A qualitative descriptive design was applied. Learning from Excellence was implemented in a postanaesthesia care unit of a Norwegian university hospital between November 2022 and May 2023. Six semi-structured focus group interviews were conducted, from May to June 2023, with a convenience sample of nurses (n = 17) and physicians (n = 7). The data were analysed through inductive reflexive thematic analysis. The study adhered to the COREQ guidelines.</p><p><strong>Results: </strong>This study reports four prominent themes encapsulating healthcare professionals' experiences with Learning from Excellence. These themes were termed as follows: 1) 'Facilitates a more positive working climate', including sub-themes 'Helps spread positive feedback' and 'Feeling seen and motivated'; 2) 'Why don't I get any 'likes'?'; 3) 'Organisational learning is challenging', including sub-themes 'Hesitating to report' and 'Provides mostly superficial learning'; and 4) 'Success inspires quality improvement project'.</p><p><strong>Conclusions: </strong>Implementing LfE mostly contributed to a positive working climate in a postanaesthesia care unit. For LfE to be worth implementing, it is essential to improve organisational learning, while minimising the negative effects of LfE, such as exclusivity issues.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05794490; first registered on March 4, 2023.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"493"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771147","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":"Three-medical linkage in China: trend evolution and obstacle identification.","authors":"Lingyun Guo, Fanyi Kong, Liangru Zhou, Ruojun Xiang, Kexin Zhang, Yufei Su, Qiuying Zheng, Ruifeng Li","doi":"10.1186/s12913-025-12650-8","DOIUrl":"10.1186/s12913-025-12650-8","url":null,"abstract":"<p><strong>Background: </strong>\"Three-medical linkage\" is a key concern of the healthcare system reform deepening in China, while it has not achieved the expected outcomes yet. The issues of \"no-linkage\" or \"linkage without moving\" have increasingly become a major challenge.</p><p><strong>Methods: </strong>Data was obtained from various Yearbooks in China. Coupling coordination degree and gravity models were employed to analyze the spatio-temporal evolution pattern of the \"three-medical linkage\" in 31 provinces. The combination forecasting method was used to forecast the development trend of the \"three-medical linkage.\" We constructed the obstacle degree model to identify the main obstacles to coordinated development.</p><p><strong>Results: </strong>The overall development of the three systems exhibited a continuous upward trend. The coupling coordination grade of the \"three-medical linkage\" system has progressed from the disorderly development stage to the transitional stage in most provinces. The Beijing-Tianjin-Hebei and Yangtze River Delta regions are the most closely connected. Regional disparities in the degree of coupling coordination will widen in the future. The number of people benefiting from maternity insurance, per capita total health expenditure, and new drug research and development (R&D) costs hindered the coordinated development of the three systems.</p><p><strong>Discussion: </strong>Highlighting the improvement of the \"three-medical linkage\" is essential. Under the goals of Healthy China and SDG3 (Good Health and Well-being), further efforts are needed to address systemic barriers and institutional deficiencies. The Chinese government should increase capital input to overcome major obstacles and carefully evaluate the imbalance in regional development.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"488"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771253","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":"Medication-related infrastructure and medication reviews in nursing homes-a rapid appraisal study.","authors":"Carla Meyer-Massetti, Magdalena Osińska, Naomi Welte, Franziska Zúñiga","doi":"10.1186/s12913-025-12505-2","DOIUrl":"10.1186/s12913-025-12505-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Around 86% of Switzerland's nursing home (NH) residents have polypharmacy (≥ 5 concomitant medications); almost 80% use a potentially inappropriate medication increasing their risk of medication-related problems. Medication reviews can optimize medication safety by fostering interprofessional collaboration, leading to medication therapy adjustments; they are currently being considered as a future national quality indicator of NH performance in Switzerland. The present study aimed to survey current medication-use infrastructure and processes and medication review practices in NHs in the German-speaking part of Switzerland. It also aimed to explore the barriers to, facilitators of, and prerequisites for medication review to become a national NH quality indicator.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We took a rapid appraisal approach. Between February and August 2022, we distributed a structured online questionnaire to the participating NHs assessing the infrastructure and processes surrounding medication use, analyzing them quantitatively and descriptively. We followed up with 60-minute, in-depth, interprofessional, online group interviews, using a semi-structured interview guide, focusing on interprofessional collaboration and medication reviews. Data analysis was done iteratively in a descriptive manner.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Fourteen NHs in German-speaking regions of Switzerland completed the questionnaire, with 31 professionals from eleven of these NHs participating in group interviews. Almost half of the NHs (42.9%) had a cantonal license to run an in-house pharmacy, and in two-thirds of these, the legally responsible specialist was an external pharmacist. Community pharmacies supplied 92.9% of NHs with their medicines, mostly stored on the wards and prepared by nurses (57.1%). Accordingly, pharmacists were predominantly tasked with logistics, but were also key contacts for medication information. A clinical pharmacist participated in monthly ward rounds in just one NH. Medication verification occurred predominantly in the presence of physicians and sometimes nurses, mostly in the form of discussions during ward rounds or medication checks subsequent to an adverse event, rather than as part of comprehensive, proactive, interprofessional medication reviews. Interviewees identified numerous prerequisites before medication review could be used as a national NH quality indicator.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;None of our participants contested the importance of medication safety and quality in NHs; they mostly favored regular medication reviews. However, interviewees expected that the nationwide introduction of medication reviews would require a standardized guide about its content, execution, analysis, and documentation, as well as interprofessional collaboration and some form of financial incentive. Promoting the use of medication reviews in NHs will have to involve interprofessional stakeholders in de","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"495"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771093","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":"Patient perceptions and predictors of intention to use telehealth for follow-up care: a mixed methods study among adults living with HIV in Kampala, Uganda.","authors":"Charles Peter Osingada, Barbara J McMorris, Mary Fran Tracy, Noeline Nakasujja, Tom Denis Ngabirano, Carolyn M Porta","doi":"10.1186/s12913-025-12636-6","DOIUrl":"10.1186/s12913-025-12636-6","url":null,"abstract":"<p><strong>Background: </strong>The human immunodeficiency virus (HIV) remains a significant global public health challenge. Despite progress in addressing the pandemic, people living with HIV continue to report challenges in accessing HIV testing, care, and treatment services. Telehealth presents a promising solution to some of these barriers. However, its potential remains unrealized, particularly in low- and middle-income settings, partly due to insufficient supporting evidence.</p><p><strong>Methods: </strong>Our mixed methods study investigated patient perceptions and predictors of intention to use telehealth for follow-up HIV care in Uganda. Quantitative data were collected from 266 participants using a questionnaire, followed by one-on-one interviews with 12 people living with HIV. Quantitative analysis involved Chi-square tests, t-tests, and binary logistic regression, while qualitative data were analyzed using conventional content analysis.</p><p><strong>Results: </strong>Our findings show that the intention to use telehealth was significantly associated with effort expectancy (aOR 1.26, CI 1.13-1.41), facilitating conditions (aOR 1.44, CI 1.19-1.73), estimated monthly income (aOR 2.94, CI 1.05-8.23; aOR 7.29, CI 1.12-47.49), and antiretroviral medication adherence (aOR 1.93, CI 1.12-3.33). Qualitative insights underscore the importance of digital literacy and availability of support services to enhance the utilization of telehealth. While performance expectation and stigma score did not significantly predict intention to use telehealth, participants perceived telehealth to be beneficial in combating stigma and improving access to HIV care services.</p><p><strong>Conclusions: </strong>To optimize the utilization of telehealth, we recommend measures aimed at addressing economic disparities and enhancing digital literacy among people living with HIV. Future research should explore the effectiveness of economic empowerment programs in promoting telehealth use and investigate the impact of telehealth on HIV care models, stigma reduction, and linkage and retention in HIV care.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"490"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771203","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":"Patient satisfaction with ambulatory care services delivery and respect for patient rights: findings from 2022 national survey in Rwanda.","authors":"Corneille Killy Ntihabose, Stephenson Musiime, Joy Atwine, Viateur Kalinda, Jean Marie Vianney Nkurikiyintwali, Bienvenu Niyongabo, Kara L Neil","doi":"10.1186/s12913-025-12596-x","DOIUrl":"10.1186/s12913-025-12596-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This study evaluated the factors influencing patient satisfaction with hospital services and respect for patient rights in outpatient consultation in Rwanda, aiming to provide insights into improving the overall quality of care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was cross-sectional study design. We recruited participants from all (30) districts in Rwanda using stratified sampling. A structured questionnaire assessed satisfaction across seven hospital areas, including cashier, waiting, triage, doctor consultation, laboratory, pharmacy, and respect for patient rights. We used descriptive statistics, Chi-square, and Multivariate Regression analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study showed that most participants expressed satisfaction with hospital services and respect for their rights: doctor consultations (93.8%), triage (92.0%), dispensing pharmacy (88.2%), laboratory services (87.2%), waiting area (85.3%), patient rights (74.3%), cashier services (73.3%). At bivariate analysis, we observed that satisfaction in waiting areas was associated with location ( p = 0.036), provinces (p &lt; 0.001), and hospital rank (p &lt; 0.001), while satisfaction in triage was associated with age categories (p &lt; 0.001) and visits ( p = 0.02). The association of satisfaction in cashier services with age categories (p &lt; 0.001), visits (p = 0.032), and hospital rank (p = 0.005) was also significant, as well as satisfaction in dispensing pharmacy and provinces (p &lt; 0.001), location (p = 0.002), and visits (p = 0.008). Multiple logistic regression indicated higher satisfaction in waiting areas among patients from Northern (OR = 3.81, 95%CI = 1.85-5.64), Western (OR = 1.95, 95%CI = 1.48-3.60), and Southern provinces (OR = 1.93, 95%CI = 1.17-2.85), while urban patients (OR = 0.65, 95%CI = 0.47-0.91) and those from high-rank hospitals had lower satisfaction (OR = 0.59, 95%CI = 0.43-0.82). High-rank hospital patients were more satisfied with triage (OR = 1.86, 95% CI = 1.14-3.13) while returning patients were less satisfied (OR = 0.51, 95%CI = 0.33-0.90). Lower satisfaction in dispensing pharmacy was observed among the City of Kigali (OR = 0.11, 95%CI = 0.05-0.24), Northern province (OR = 0.43, 95%CI = 0.23-0.80), and returning patients (OR = 0.51, 95%CI = 0.33-0.76). Urban (OR = 2.5, 95%CI = 1.32-5.16) and high-rank hospital patients (OR = 1.96, 95%CI = 1.08-3.77) reported higher laboratory satisfaction. However, cashier services had lower satisfaction among Kigali (OR = 0.37, 95%CI = 0.21-0.64), Northern (OR = 0.44, 95%CI = 0.29-0.65), and Western province patients(OR = 0.63, 95%CI = 0.43-0.91), returning patients (OR = 0.73, 95%CI = 0.55-0.96), and those from high-rank hospitals(OR = 0.70, 95%CI = 0.54-0.92).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our study has revealed disparities in satisfaction with ambulatory care services delivery by provinces, hospital rank and visit status. We recommend hospital to take initiatives aiming at stream","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"486"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762537","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":"Investigating the impact of armed conflict, cultural factors, and demographic characteristics on access to family planning services in Northwest Syria: a cross-sectional study.","authors":"Okba Doghim, Abdulselam Daif, Abdulkarim Ekzayez, Kristen Meagher, Preeti Patel","doi":"10.1186/s12913-025-12600-4","DOIUrl":"10.1186/s12913-025-12600-4","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Against the backdrop of a protracted conflict, northwest Syria faces significant challenges in delivering sexual and reproductive health and rights (SRHR) services. The conflict, which began in 2011, has severely impacted maternal and child health, women's wellbeing, and agency. This disruption has been exacerbated by widespread displacement, infrastructure damage, and interruptions in reproductive healthcare provision. Addressing these challenges is crucial for advancing family planning and empowering women in the region. This study investigates the factors influencing family planning service accessibility in northwest Syria, considering the intricate interplay of cultural norms, beliefs, and the backdrop of armed conflict. The study employed a cross sectional-methods approach incorporating structured surveys with a sample size of 2175 women, representing diverse demographics across the region.38% of the 2175 participants were in early marriages, defined as any formal marriage or informal union between a child under the age of 18 and an adult or another child (UNICEF India, Child marriage, 2017). Among them, 58% reported current contraceptive use. Analysis by age groups revealed that individuals aged 26-35 exhibited the highest proportion of contraceptive usage at 41.5%, while the under-18 age group showed the lowest at 7.7%. Predominantly, oral contraceptive pills were the most used contraceptive method (40%), followed by intrauterine devices (IUDs) (31%), condoms (7%), and injectables (5%). Of contraceptive users, 29% reported experiencing side effects, with bleeding between periods or spotting being the most prevalent (26%), followed by irregular periods (21%). Despite 75.5% of participants being internally displaced persons (IDPs), there was no significant difference in usage between IDPs and residents (p = 0.337), although IDPs residing in camps showed the highest usage at 67%. Attending awareness sessions on family planning was associated with increased contraceptive usage, with 67% of attendees reporting usage compared to 44% of non-attendees. Education level and family monthly income strongly influenced usage, with higher education and income correlating with increased usage (p &lt; 0.001 for both). Moreover, the number of children significantly impacted usage, with higher rates observed among women with more children (p &lt; 0.001). Logistic regression analysis further demonstrated that awareness of family planning methods significantly influenced usage (OR: 2.39, p &lt; 0.001).Our findings underscore the pronounced influence of cultural beliefs on individuals' attitudes towards family planning. Displacement, infrastructure damage, and interruptions in healthcare delivery pose formidable barriers, further marginalising vulnerable populations. Community engagement and resilient healthcare infrastructure emerge as critical facilitators, fostering trust and service utilisation. Conversely, stigma, misinformation, and resource constraints hind","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"489"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771149","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 paradox of enhancing male involvement in family planning uptake in rural Tanzania: insights from Bahi District, Dodoma Region.","authors":"Fabiola H Odira, Chakupewa J Mpambije, Yohannes E Kachenje","doi":"10.1186/s12913-025-12467-5","DOIUrl":"10.1186/s12913-025-12467-5","url":null,"abstract":"<p><strong>Background: </strong>Family Planning (FP) is a requirement of global and national legal instruments to ensure its full provision to both men and women. Male involvement in FP is internationally streamlined to ensure it is achieved in resource-constrained countries. However, because of lack of sustainable means of ensuring men are fully engaged, less is documented on male involvement in FP uptake among developing countries. This study examined the paradox of enhancing male involvement in FP uptake in rural Tanzania.</p><p><strong>Methods: </strong>The study held from May to July 2022 employed mixed methods, whereby, quantitative and qualitative data were collected. A questionnaire was used to collect quantitative data from 90 respondents in Bahi District, whereas, in-depth interviews were conducted with 25 key informants. Quantitative data such as descriptive statistics including frequencies, cross tabulation and descriptive ratio statistics; categorical outcome predictions to specifically investigate relations; and cluster analysis to determine the relationship between variables related to this study, performing chi-square test was conducted through IBM SPSS software version 26. Besides, a thematic approach was employed for qualitative data to identify and interpret themes in the data set.</p><p><strong>Results: </strong>Most men are not effectively involved in FP due to several limitations that revolve around contextual issues emanating from institutional and community settings. It was revealed that 71% of respondents mentioned inefficient practice of specific policies and guidelines as limiting FP uptake. Also, 93% mentioned limited FP method choices for men, whereas 95% argued over the existing myths and misconceptions in the community, with 67% pointing to social norms limiting FP uptake. Religious beliefs were also cited as limiting male involvement in FP matters.</p><p><strong>Conclusion: </strong>Male involvement is an essential aspect of effective FP uptake. Given the low male involvement in Bahi District, this study recommends designing participatory programmes to enforce the available policy geared to improving male involvement is imperative. Thus, efforts are needed to ensure friendly environments in health facilities to attract males to accompany their partners for FP services. On the whole, effective community engagement from the local government is encouraged. In this, non-state actors have the opportunity to design effective interventions to address the problem.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"491"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771244","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 significance of a dementia diagnosis from the perspective of the family caregivers: a qualitative study.","authors":"Inger Molvik, Grete Kjelvik, Geir Selbæk, Anne Marie Mork Rokstad","doi":"10.1186/s12913-025-12657-1","DOIUrl":"10.1186/s12913-025-12657-1","url":null,"abstract":"<p><strong>Background: </strong>With the anticipated increase in dementia prevalence over the coming decade, understanding the experience of receiving a dementia diagnosis for people living with cognitive impairment remains limited. This study aims to explore the implications of a family member with cognitive impairment receiving a dementia diagnosis or not from the perspective of their next of kin.</p><p><strong>Methods: </strong>A qualitative descriptive design was applied using individual interviews for data collection. Participants were recruited based on the cognitive function level of their family members, which was compatible with dementia as assessed with the Montreal Cognitive Assessment Scale (MoCA). The sample consisted of eight participants, comprising family members of five individuals with confirmed dementia diagnoses and three undiagnosed. The analysis was performed using four steps of systematic text condensation to discern codes, categories, and the overarching theme.</p><p><strong>Results: </strong>Three main categories were created: (1) Impact of observed cognitive decline, (2) Impact of diagnosis on service engagement, and (3) Support and follow-up for family caregivers. The findings show that next of kin who have received a dementia diagnosis for their family members are more proactive in seeking help and services, are better informed about available resources, and are more concerned about future challenges. On the other hand, next of kin to family members without a diagnosis are more inclined to handle the situation on their own, have less access to information and services, and generally express less concern about future problems.</p><p><strong>Conclusion: </strong>The study reveals the benefits of receiving a timely dementia diagnosis in shaping more effective support systems and policies. This ensures that the next of kin and the person with cognitive impairment can navigate the complexities of dementia with greater confidence and preparedness, thereby enhancing their quality of life.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"487"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771248","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":"Community pharmacy workforce willingness, readiness, and infrastructural capacity to deliver vaccination services: a cross-sectional survey in Nigeria.","authors":"Adewale Aderemi Oladigbolu, Ukamaka Gladys Okafor, Charles Oluwole Oluwaseyi, Omokhafe Mary Ashore","doi":"10.1186/s12913-025-12655-3","DOIUrl":"10.1186/s12913-025-12655-3","url":null,"abstract":"<p><strong>Background: </strong>There is a growing need for community pharmacists to support universal health coverage by providing vaccination services to address low coverage, as they are among the most accessible healthcare professionals. In some Nigerian states, community pharmacists were trained in vaccination, but there are concerns about their capacity to enroll as vaccination service providers. This study evaluated the community pharmacy workforce willingness, readiness, and infrastructural capacity to deliver vaccination services in Nigeria.</p><p><strong>Methods: </strong>We conducted a descriptive cross-sectional study using a self-administered structured questionnaire among community pharmacists in Nigeria using a Google Form and administered through WhatsApp platforms. Descriptive statistics were performed on the collected data using SPSS statistical software, version 21.</p><p><strong>Results: </strong>Of the 414 community pharmacists sampled, 395 (response rate = 95.4%) were retrieved and included in the final analysis. Although most community pharmacists did not currently practice vaccine administration in their pharmacies (n = 295, 74.9%), most were willing to start administering vaccines (n = 359, 91.3%), participate in routine and supplemental immunization services (n = 373, 95.4%), receive training related to vaccination (n = 374, 95.2%), and encourage patients to get vaccinated in their pharmacies (n = 367, 93.6%). Tetanus vaccine was the most common (n = 158, 40%) among the vaccines administered by the respondents. Infrastructure was inadequate in many critical areas: vaccine-specific equipment (n = 263, 67.8%), safety boxes (n = 216, 55.7%), medical waste bins (n = 178, 45.8%), portable vaccine refrigerators in case of power failures (n = 218, 56.1%), anaphylaxis response kit (n = 340, 87.4%), and anaphylaxis management guidance (n = 346, 88.9%). Barriers to the pharmacists' willingness to deliver vaccination services were inadequate funds to procure appropriate storage equipment (n = 269, 70.0%), inadequate training (n = 265, 69.1%), conflicts with other professionals (64.4%), concerns about patient safety (n = 185, 47.7%), and handling vaccines and disposal of sharps (n = 182, 47.4%).</p><p><strong>Conclusions: </strong>Community pharmacists have indicated their willingness to embrace the advanced role of vaccine administration. The government and other healthcare stakeholders should address the infrastructural gaps and other barriers highlighted in the study to help improve vaccine access and availability.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"485"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762968","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}