BMC Health Services Research最新文献

{"title":"Associations between work experiences, health, well-being, and intention to remain in the profession among healthcare and social work professionals - a multicentre cross-sectional study.","authors":"Isabelle Andersson Hammar, Sandra Pennbrant, Håkan Nunstedt, Inger Ahlstrand, Aimée Ekman, Jenny Hallgren, Ingrid Larsson, Margaretha Larsson, Qarin Lood, Annelie J Sundler, Anna M Johnsen","doi":"10.1186/s12913-026-15575-y","DOIUrl":"10.1186/s12913-026-15575-y","url":null,"abstract":"<p><strong>Background: </strong>The relationship between work experiences, health, well-being, and job satisfaction is important, especially in high-stress professions like healthcare and social work. While work stress effects are well studied, less is known about how work experiences in early professional life impacts health, well-being, and intention to remain in the profession. Therefore, this study aimed to explore associations between work experiences, health, well-being, and the intention to remain in the profession among healthcare and social work professionals, three years after graduation.</p><p><strong>Methods: </strong>The study had a multicentre, cross-sectional design. As part of a larger longitudinal project on health-promoting factors during education and early careers, 165 of 1,751 invited graduates (from biomedical science, dental hygiene, nursing, occupational therapy, physiotherapy, radiology nursing, and social work) completed an online survey between December 2024 and January 2025. Instruments included the Work Experience Measurement Scale (WEMS), Sense of Coherence (SOC-13), and the Salutogenic Health Indicator Scale (SHIS), alongside questions on general health and well-being, physical activity, daily activity, sleep quality, and intention to remain in the profession. Data were analysed using descriptive statistics, non-parametric tests, and regression analyses.</p><p><strong>Results: </strong>Higher WEMS total scores were associated with better general health, better well-being, and a higher intention to remain in the profession. Supportive work conditions and internal work experiences were most strongly associated with intention to remain in the profession. Autonomy enhanced health and well-being but did not directly affect intention to remain in the profession. Participants aged 30-36 years reported a lower intention to remain in the profession than those in the younger and older age groups.</p><p><strong>Conclusions: </strong>Positive work experiences may be important for supporting health, well-being, and intention to remain in the profession among healthcare and social work professionals three years after graduation. Lower intention to remain in the profession among those aged 30-36 years suggests a potential need for targeted support during this specific stage of working life. The findings support the integration of early-career support, sustainable leadership, and supportive work conditions into workforce strategies across healthcare professions and social work.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001293","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":"Between opportunity and equity: navigating medical tourism in Türkiye's public hospitals.","authors":"Maha Al Hajeri, Şenol Demirci, Yasin Aras, Keziban Avcı","doi":"10.1186/s12913-026-15636-2","DOIUrl":"10.1186/s12913-026-15636-2","url":null,"abstract":"<p><strong>Background: </strong>Medical tourism has been proposed as a potential means of using available capacity in public hospitals, generating additional revenue, and supporting healthcare investment. However, public-sector participation also raises concerns regarding organizational readiness, resource allocation, and equitable access for local patients. Türkiye, with its extensive healthcare infrastructure and cost advantages, has become an important medical tourism destination where both public and private hospitals provide services to international patients. This study explored institutional stakeholders' perspectives on the provision of medical tourism services in Türkiye's public hospitals.</p><p><strong>Method: </strong>This study addresses a research gap by providing empirical evidence on medical tourism in public hospitals, a topic that has received limited attention. Focusing on public institutions allows exploration of the tension between economic gains and healthcare equity. A qualitative study was conducted using semi-structured interviews with 13 institutional stakeholders, including Ministry of Health officials, academics, hospital administrators, and medical tourism coordinators. The data were analyzed using inductive qualitative content analysis.</p><p><strong>Results: </strong>Six interrelated codes were identified: healthcare service quality, access to care, the balance between international and local patients, organizational capacity, financial implications, and equity in service delivery. Participants perceived selected public hospitals, particularly large city hospitals, as having relevant infrastructural and clinical assets. However, readiness was described as heterogeneous and conditional on investment in international outreach, pre-arrival assessment and coordination, trained personnel, translation, travel and accommodation coordination, and post-treatment follow-up. Participants also emphasized risks related to workforce pressure, longer waiting times, preferential access, financial uncertainty, and the possible diversion of resources from local healthcare needs. The study did not establish whether the expected revenues would exceed the full financial and opportunity costs of these investments.</p><p><strong>Conclusion: </strong>Stakeholders viewed selected public hospitals as possible settings for medical tourism, but physical infrastructure alone was not considered evidence of operational readiness. Public-sector involvement would require hospital-specific assessment of workforce capacity, financing, governance, local patient access, and equity implications. Given the uncertainty surrounding funding sources, net public benefit, and public acceptability, any expansion should be preceded by feasibility, budget-impact, and equity assessments and should initially be considered only in institutions with demonstrable excess capacity.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079539","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":"Impact of a pharmacist adherence intervention on medication beliefs and drug-related problems in coronary patients - a process evaluation of the MIMeRiC trial.","authors":"Malin Johansson Östbring, Ahmed Al Musawi, Tommy Eriksson, Lina Hellström","doi":"10.1186/s12913-026-15037-5","DOIUrl":"10.1186/s12913-026-15037-5","url":null,"abstract":"<p><strong>Background: </strong>The Motivational Interviewing and Medication Review in Coronary Heart Disease (MIMeRiC) randomized controlled trial investigated the effects of a pharmacist-led intervention at a cardiology clinic on patient adherence and clinical outcomes. The results demonstrated that the intervention group had increased adherence to cholesterol-lowering medications and aspirin, as well as improved overall beliefs about medicines. However, the intervention did not lead to a higher proportion of patients reaching the target for low-density lipoprotein cholesterol (LDL-C) levels. This paper reports on the implementation of the intervention and explores potential mechanisms underlying these outcomes, focusing on the content of medication reviews, quality of prescribing, and changes in beliefs about medicines.</p><p><strong>Methods: </strong>Medication reviews were evaluated by classification of identified drug-related problems (DRPs), actions taken to address these problems, and the outcomes of those actions, utilizing data from electronic health records (EHR). The Medication Assessment Tool for secondary prevention of Coronary Heart Disease (MAT-CHDsp) was applied to EHR data to evaluate prescribing quality. Beliefs about medicines were evaluated using the Beliefs about Medicines Questionnaire specific (BMQ-S), completed by participants at baseline and follow-up. Descriptive and comparative statistics were used to analyze the data.</p><p><strong>Results: </strong>Medication reviews were conducted for 144 of the 159 patients in the intervention group, with a mean of 4.3 DRPs per patient. Pharmacists identified 500 DRPs and managed 245 of these with patients alone, while 196 required discussions with physicians. The resulting status of 218 DRPs was known, and for 194 of these, the issue was solved or improved. No differences in prescribing quality were observed between groups at six months post-discharge. The mean concern score on the BMQ-S decreased more in the intervention group, and 52.8% of intervention patients vs. 31.0% of control patients (p = 0.051) shifted from an ambivalent to an accepting attitudinal category.</p><p><strong>Conclusions: </strong>This process evaluation demonstrates that clinical pharmacists were effective in identifying and managing DRPs through collaboration with patients and physicians, leading to the resolution or improvement of a substantial number of DRPs. The intervention did not impact prescription quality. Patients in the intervention group reported reduced concerns about their medications, which explains the improved medication adherence.</p><p><strong>Trial registration: </strong>This study is based on data from a randomized controlled trial (RCT) registered at ClinicalTrials.gov (NCT02102503; registered 03/04/2014).</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001279","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":"Development and psychometric validation of the hospital Security Personnel Narrative Competency Scale (HSPNCS).","authors":"Binru Fang, Lina Guo, Hao Zhang, Yongting Yang, Rong Wu, Jin Wu, Shunjie Jiang, Liming Zhu","doi":"10.1186/s12913-026-15542-7","DOIUrl":"10.1186/s12913-026-15542-7","url":null,"abstract":"<p><strong>Background: </strong>Hospital security personnel frequently interact with patients and families in emotionally complex and potentially conflict-prone situations. However, no specific instrument is available to assess narrative competency in this healthcare support workforce. This study aimed to develop and psychometrically validate the Hospital Security Personnel Narrative Competency Scale (HSPNCS).</p><p><strong>Methods: </strong>A methodological study was conducted to develop and validate the HSPNCS. Scale development followed a theory-driven adaptation approach based on the classical conceptualization of narrative competence and previously validated instruments. The initial item pool was generated through literature review, narrative medicine and medical humanities frameworks, the Nominal Group Technique, content validity assessment, and adaptation to the work context of hospital security personnel. A cross-sectional survey was then conducted among 645 hospital security personnel from 17 hospitals in Zhejiang Province, China. Psychometric evaluation included item analysis, content validity assessment, exploratory factor analysis, confirmatory factor analysis, convergent validity assessment, and internal consistency reliability testing.</p><p><strong>Results: </strong>The final HSPNCS consisted of 36 items organized into nine first-order subdomains nested within three higher-order dimensions: self-reflection, empathy, and professionalism. The scale demonstrated excellent internal consistency, with a Cronbach's alpha of 0.967 for the total scale and alpha coefficients ranging from 0.911 to 0.945 for the three higher-order dimensions. Content validity was acceptable, with an S-CVI/Ave of 0.972. Factor analyses supported the proposed multidimensional structure, and confirmatory factor analysis indicated acceptable model fit. Composite reliability and average variance extracted values also supported the internal consistency and convergent validity of the scale.</p><p><strong>Conclusion: </strong>The HSPNCS demonstrated preliminary evidence of content validity, construct validity, convergent validity, and internal consistency among hospital security personnel. It may serve as a useful tool for assessing narrative competency and identifying training needs in this healthcare support workforce. Further studies using independent, multicenter, and culturally diverse samples are needed to confirm its factor structure, test-retest reliability, external validity, and responsiveness to training interventions.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975604","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":"Validation and psychometric evaluation of the Diabetes Quality-of-Life Brief Clinical Inventory: Tamil version (DQoL-BCI-T).","authors":"Nuwan Darshana, Illanchellien Thuvarahan, Alex Vancuylenberg, Jennifer Perera","doi":"10.1186/s12913-026-15638-0","DOIUrl":"10.1186/s12913-026-15638-0","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) significantly impairs quality of life (QoL) through its chronic course, treatment burden, and complications. Disease-specific QoL tools provide more clinically relevant assessment than generic instruments. Although the Diabetes Quality of Life-Brief Clinical Inventory (DQOL-BCI) has been widely validated internationally, no validated Tamil version exists despite large Tamil-speaking populations affected by type 2 diabetes mellitus (T2DM). This study aimed to translate, culturally adapt, and validate a Tamil version of the DQOL-BCI (DQOL-BCI-T) among Tamil-speaking adults with T2DM in Sri Lanka.</p><p><strong>Methods: </strong>A cross-sectional validation study of DQOL-BCI-T was conducted among 165 native Tamil-speaking adults with T2DM attending an urban outpatient clinic in Colombo from May to October 2025). Translation followed a standardized forward-backward procedure with expert panel review and cognitive debriefing. Reliability was assessed using Cronbach's alpha. Construct validity was evaluated through convergent validity with the Tamil WHOQOL-BREF and discriminant validity across clinical variables. Factor structure was examined using principal component analysis with oblimin rotation.</p><p><strong>Results: </strong>The DQOL-BCI-T demonstrated acceptable internal consistency (Cronbach's α = 0.682) and stability over two weeks. Significant moderate negative correlations with WHOQOL-BREF total (r = - 0.559, p < 0.001) and domain scores supported convergent validity. Discriminant validity was demonstrated by significantly lower QoL among patients with microvascular complications (p = 0.040). Factor analysis showed satisfactory sampling adequacy (KMO = 0.729) and acceptable item loadings, explaining 72% of total variance.</p><p><strong>Conclusions: </strong>The DQOL-BCI-T demonstrates satisfactory validity, reliability, and cultural appropriateness for measuring diabetes-specific quality of life among Tamil-speaking adults with T2DM. Its concise format and strong psychometric performance make it a practical tool for routine clinical assessment and research, supporting patient-centred diabetes care. Further validation across diverse clinical populations, socio-cultural contexts, and treatment regimens is warranted to confirm its broader applicability and generalisability.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058360","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":"Application of the Theoretical Framework of Acceptability in healthcare interventions: a scoping review and proposed reporting checklist.","authors":"Cara Ghiglieri, Benjamin McCullough, Rebecca H McLeese, Brenda O'Neill, Emily Bannister, Bronwen Connolly, Judy M Bradley","doi":"10.1186/s12913-026-15616-6","DOIUrl":"10.1186/s12913-026-15616-6","url":null,"abstract":"<p><strong>Background: </strong>The Theoretical Framework of Acceptability (TFA) assesses how interventions are perceived by those who deliver and receive them. However, there has been no systematic mapping of how the framework is conceptualised, operationalised, and reported in healthcare intervention research.</p><p><strong>Aim: </strong>To examine how the TFA is used to assess acceptability in healthcare intervention research.</p><p><strong>Methods: </strong>A scoping review was conducted using JBI methodology and reported in accordance with PRISMA-ScR. Searches were undertaken across MEDLINE, EMBASE, CINAHL, Cochrane Library, ClinicalTrials.gov and ISRCTN from 2017 to July 2025. Empirical studies, trial registrations, and published protocols were included if they applied the TFA to assess the acceptability of patient-facing healthcare interventions. Data were extracted and synthesised using descriptive and narrative approaches.</p><p><strong>Results: </strong>Use of the TFA has increased over time and spans diverse clinical contexts. When findings were aggregated across source types, acceptability was most commonly assessed, or planned to be assessed, using questionnaires and was typically positioned as a post-intervention outcome. Assessments were predominantly conducted with patients or service users at a single time point. Sensitivity analysis restricted to empirical studies showed that assessment was predominantly qualitative and interview-based, while outcome positioning and post-intervention timing remained common. Non-specification of TFA constructs was concentrated among trial registrations. In the overall sample, the TFA most frequently informed data collection, whereas among empirical studies it was most often applied during analysis, reporting and interpretation.</p><p><strong>Conclusion: </strong>Despite widespread adoption, application of the TFA remains variable and reporting does not always provide sufficient detail to support appraisal and comparison. This limits the ability to compare acceptability across studies, identify key drivers, or use findings to inform intervention development and implementation. Greater transparency in how acceptability is conceptualised, assessed and reported may enhance the utility of the TFA. A reporting checklist may support more consistent interpretation, clearer appraisal of framework use, and improved comparability across studies.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036511","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 importance of \"being seen\": a qualitative interview study of patient and clinician experiences of virtual and face-to-face TIA clinics in one region of England.","authors":"Jacob Heath, Carol Dumelow, Maeve Moran, Sara E Shaw, Sarah Brown, Gary A Ford, Catherine Pope","doi":"10.1186/s12913-026-15470-6","DOIUrl":"10.1186/s12913-026-15470-6","url":null,"abstract":"<p><strong>Background: </strong>Most NHS trusts introduced virtual clinics for managing transient ischaemic attack (TIA) during the Covid-19 pandemic. Some continue to use virtual clinics, whilst others returned to face-to-face or implemented hybrid clinics. There has been limited evaluation of the effectiveness and experience of patients and healthcare professionals (HP) of virtual TIA clinics.</p><p><strong>Methods: </strong>A rapid insights evaluation of the effectiveness of virtual TIA clinics took place in South East England. This paper focuses on findings from one part of the evaluation, which conducted qualitative interviews with 15 patients and 12 HPs across 6 NHS trusts to explore their views and experiences of different TIA clinic care models. Patient participants were identified by clinicians at first consultation with the TIA clinic. Telephone or video interviews were recorded and analysed using thematic analysis.</p><p><strong>Results: </strong>HPs reported that virtual clinics worked well for some patients (e.g., those not needing MRI/MRA imaging, older patients with co-morbidities/poor mobility, young working people, people living in rural areas) but not all. Most patients placed great importance on 'being seen' by a HP in a face-to-face consultation during their TIA care pathway. We identified two key themes which represent different yet complementary dimensions of the importance of 'being seen', highlighting the perceived value of face-to-face consultations over virtual TIA clinics: (1) Greater opportunities for communication; and (2) Feeling looked after and listened to by a multidisciplinary team.</p><p><strong>Conclusions: </strong>Virtual TIA clinics were perceived more positively by HPs than patients, who particularly valued face-to-face consultations. Yet HPs also identified distinct benefits of face-to-face consultations. Whilst further research is needed, our findings indicate that TIA service model design should consider how HPs interact with patients during assessment and diagnosis. A hybrid model of TIA clinic care may offer the greatest potential benefits to patients and clinicians. Offering choice of TIA clinic modality could be a priority, along with improved referral that reflects which patients are best suited to virtual or face-to-face care.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058223","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":"Development and preliminary evaluation of a German questionnaire assessing attitudes toward hearing aids and behavioral intention.","authors":"Corinna Mathern, Katrin Reimann, Rainer M Weiß, Johanna R Rusche, Boris A Stuck, Kruthika Thangavelu","doi":"10.1186/s12913-026-15549-0","DOIUrl":"10.1186/s12913-026-15549-0","url":null,"abstract":"<p><strong>Background: </strong>Hearing aid uptake remains suboptimal despite well-established clinical benefits, suggesting that psychosocial factors influence hearing rehabilitation decisions. This study aimed to develop and perform a preliminary psychometric evaluation of a German-language questionnaire assessing attitudes toward hearing aids and behavioral intention toward hearing aid use.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among German-speaking adults with and without self-reported hearing loss. An existing English-language questionnaire was substantially adapted for the German healthcare system through expert review, psychometric evaluation, and pilot revision before final administration. Preliminary psychometric evaluation included assessment of internal consistency and exploratory factor analysis. Associations between attitudes, behavioral intention, and hearing aid use were examined using correlation and regression analyses.</p><p><strong>Results: </strong>The overall attitude scale demonstrated acceptable internal consistency (Cronbach's α = 0.77), whereas the behavioral intention scale demonstrated good internal consistency (α = 0.86). Exploratory factor analysis supported a four-factor structure, although several items demonstrated cross-loadings, suggesting that further refinement of the questionnaire is warranted. The study included 159 adults (18-96 years), of whom 48.4% reported hearing loss. General attitude was strongly associated with behavioral intention (r = 0.63, p < 0.001) and explained approximately 40% of its variance (R² = 0.40). Among attitudinal domains, expected benefit and effort (r = 0.66) and stigma (r = 0.65) showed the strongest associations with behavioral intention. Participants with hearing loss who used hearing aids demonstrated significantly more favorable attitudes and stronger behavioral intention than non-users (both p < 0.001).</p><p><strong>Conclusions: </strong>This study describes the development and preliminary psychometric evaluation of a German-language questionnaire assessing attitudes toward hearing aids and behavioral intention. The findings provide preliminary evidence supporting the questionnaire's reliability and structural validity while highlighting the need for further psychometric validation in independent populations. Stigma-related beliefs and expectations regarding hearing aid benefit emerged as the attitudinal domains most strongly associated with behavioral intention and may represent important targets for interventions to improve hearing aid uptake.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975635","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":"Managers' experiences of collaboration and individual participation in integrated healthcare and social services for adults with complex needs: a focus group study.","authors":"Markus Hjelm, Veronica Plessen, Anna Andersson, Ulrika Harris","doi":"10.1186/s12913-026-15602-y","DOIUrl":"10.1186/s12913-026-15602-y","url":null,"abstract":"<p><strong>Background: </strong>Adults with long-term mental, cognitive, and physical conditions experience a substantial disease burden and have complex health needs. The co-occurrence of mental health problems, substance use, and social vulnerabilities further underscores the need for integrated and coordinated healthcare and social services. Such integration requires close collaboration among involved actors; however, this is often constrained by legislative barriers and challenges in coordinating complex care. Coordination adapted to complexity, individualised care planning, and interprofessional collaboration depend on effective leadership and governance to support the development and sustainability of integrated care. Therefore, this study aimed to explore managers' experiences of facilitators and barriers to collaboration and individual participation in managing healthcare and social services for adults with complex needs.</p><p><strong>Methods: </strong>A descriptive qualitative design was employed using three focus group interviews with a total of 13 participants to explore managers' experiences. Data were analysed using qualitative content analysis.</p><p><strong>Results: </strong>The analysis resulted in three categories: (1) organisational prerequisites for the sustainable improvement of integrated care, (2) prerequisites for interprofessional collaboration in addressing individuals' needs, and (3) supporting individual change through relational and needs-based approaches. These categories included eight subcategories.</p><p><strong>Conclusions: </strong>Interprofessional collaboration in the care of adults with complex needs is influenced by relational, structural, and contextual factors. Although managers express awareness of and ambition towards person-centred and integrated care, a gap remains between intention and implementation. Addressing this gap may require strengthening trust, clarifying structures and governance, and supporting organisational continuity to enhance sustainable collaboration and individual participation.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975712","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-reported experience measures (PREMs), coercion, and mental health outcomes in psychiatric inpatient care: a national mixed-methods study comparing immigrant and majority populations.","authors":"Lina Harvold Ellingsen-Dalskau, Øyvind Bjertnæs, Marte Karoline Råberg Kjøllesdal, Hilde Hestad Iversen","doi":"10.1186/s12913-026-15511-0","DOIUrl":"10.1186/s12913-026-15511-0","url":null,"abstract":"<p><strong>Background: </strong>Immigrants are at increased risk of mental health problems but underutilize specialist services and may face barriers to high-quality care. Evidence regarding their experiences in psychiatric inpatient settings remains limited. This study examined differences in patient experiences, coercion, and change in mental health between immigrant groups and the majority population and considered challenges in measuring and comparing patient-reported experiences across groups.</p><p><strong>Methods: </strong>A national survey was conducted across Norwegian psychiatric inpatient institutions from January 2020 to June 2022. The Psychiatric Inpatient Patient Experience Questionnaire - Continuous Electronic Measurement (PIPEQ-CEM) was used with demographic, coercion, and mental health indicators. Linear regression examined associations between region-of-birth and key outcomes. Additionally, 390 comments from immigrant patients and 125 from Norwegian-born patients were thematically analyzed.</p><p><strong>Results: </strong>Data from 8,184 patients (89.5% Norwegian-born) revealed few group differences in overall patient experience scores. However, some immigrant groups rated aspects-including initial welcome, privacy, and treatment benefit-lower than the majority population, in addition to higher levels of coercion and less improvement in mental health. Thematic analysis revealed immigrant-specific experiences related to expectations and prior knowledge of psychiatric care, belonging and trust, communication, and access to information.</p><p><strong>Conclusions: </strong>While overall patient experience scores were largely similar, some immigrant groups reported higher coercion and less favorable mental health trajectories. Qualitative findings highlighted contextual factors that may shape how patients experience and report care. These results underline the importance of culturally sensitive psychiatric care delivery and culturally appropriate measurement of patient experiences across diverse populations.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058262","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}