Cross-sectional Survey Research Articles

Clinical staff attitudes towards opt-out consent for blood-borne virus screening in emergency departments in England.

Opt-out screening for blood-borne viruses (BBVs) in emergency departments (EDs) has been established in areas with a high prevalence of HIV diagnoses in England. This multi-site study explored the attitudes of healthcare workers (HCWs) towards BBV screening in EDs post-implementation. This was a cross-sectional electronic survey of HCWs. Between November 2023 and February 2024, HCWs across 33 EDs in England participating in opt-out BBV screening were invited to complete a survey about the feasibility and acceptability of screening, including the opt-out consent process. Factors independently associated with acceptability of opt-out screening were identified using multivariable logistic regression. Free-text responses were analysed thematically. Responses from 610 HCWs in 19 EDs were provided: 50.4% were nurses, 43.1% doctors, and 6.5% other healthcare professionals. Acceptability of the screening programme and opt-out consent was high (90.3% and 77.7%, respectively), with some variation between EDs. Acceptability of opt-out consent was greater among doctors than among other HCWs, and among HCWs who proactively discussed screening further with patients who opted out. However, 50.8% of HCWs felt that patients should be verbally reminded at blood draw, and 44.3% of HCWs wanted more training in discussing opt-out screening with patients. Free-text answers suggested changes to test-ordering systems, including simple integration of tick boxes to document whether patients opted out and to block repeated testing. There was substantial support from ED HCWs for routine opt-out ED BBV screening, including opt-out consent. Key areas suggested for improvement included changes to test-ordering systems and additional training for HCWs. Frequent preference for verbal reminders at the point of blood draw suggests continued HIV testing exceptionalism.

Cross sectional survey of maternal and newborn quality of care in Niger: Selected findings, lessons learned and recommendations.

Comprehensive assessments of quality of care (QoC) are essential for monitoring progress towards meeting global and national maternal and newborn health (MNH) targets. Liverpool School of Tropical Medicine (LSTM) and the Niger Ministry of Public Health adapted a 2014 WHO QoC tool to cover antenatal care (ANC) and postnatal care (PNC) and include client voices through exit interviews. The objectives of the study were to assess quality of MNH care in Niger and to document lessons learnt from implementing the LSTM QoC tool. Quality of Care (QoC) was assessed using five tools: health facility survey (using register and official record data), partograph reviews, healthcare provider knowledge assessment, exit interviews with clients, and observation of antenatal and postnatal care. A nationally representative sample of 110 public healthcare facilities at three levels (integrated health centres, district hospitals and mother-child hospitals) and 2153 women were included. Descriptive analysis with 95% confidence intervals was presented. The health facility survey showed variable access to electricity (63% [53-72]), water (72% [62-81]), and transportation (40% [31-50]). Tests and treatment for HIV, TB, and malaria were found in more than 90% of relevant facilities. During observation of first ANC visit, 62% [48-74] women were tested for HIV; 13% [5-30] for pre-eclampsia and 22% [12-36] for anaemia. Observation of PNC showed much lower rates of screening (15% [7-27] tested for HIV and 4% [0;11] for malaria). Partographs were used in 86% of deliveries with inconsistent completion. At client interviews, respectful care indicators were variable, with providers not always explaining results to clients (59% [50-67]). Targeted allocation of resources and training could impact on QoC and reduce missed opportunities for prevention, screening and management of diseases among pregnant women and babies. The QoC assessment tool proved capable of offering a comprehensive overview of priorities in MNH, while maintaining feasibility in the Nigerien context.

Specialty choices among new generation of doctors - insights from a Polish survey study.

The choice of medical specialty for future doctors is a multidimensional issue, associated with many factors. This study aimed to explore the factors influencing the specialty choices of doctors entering the Polish healthcare system. A nationwide cross-sectional survey was conducted from May until August 2023. The data was gathered via an online nationwide survey among recent medical school graduates. We explored respondents' preferences regarding medical specialties (in two categories: surgical and non-surgical), and the factors that drive their choices. The U-Mann Whitney test was used to compare the distribution of 19 analysed factors, and the chi-squared test was used if a trend was not observed. 737 responses were collected, and 698 were included in the study. The respondents (60.5% female) preferred non-surgical specialties over surgical ones. The main factors influencing doctors' choices were remuneration, the ability to maintain work-life balance, interest in the medical field, the ability to start a private practice, skills possessed, and doctor-patient interactions. Doctors pursuing a career in surgical fields are driven by slightly different factors than those who chose a non-surgical specialty. The youngest generation values a healthy work-life balance, and their non-professional life remains crucial.

Trends in the practice environment of Chinese healthcare professionals from 2008 to 2023: an age period cohort analysis.

Healthcare practice environment plays a vital role in evaluation and the development of health sector in China. However, there are few comprehensive reviews and studies focusing on its state and changing trends. This study aimed to examine the dynamic trends in Chinese healthcare professionals' perceptions of their practice environment from 2008 to 2023 using age period cohort (APC) analysis. Four national cross-sectional surveys of healthcare professionals were conducted in 2008, 2013, 2018, and 2023. APC analysis was performed to distinguish effects of age, period and cohort. Covariates like gender, department, job satisfaction, and doctor-patient relationships were also analyzed. Between 2008 and 2023, healthcare professionals' perceptions of their practice environment first declined and then improved. Those aged 28-38 during 2013-2018 and born between 1978 and 1988 had the most negative perceptions. After 2018, perceptions improved, peaking in 2023. Those under 23 and over 43 exhibited larger age effects. Birth cohorts after 1993 also had more positive effects. Controlling for covariates attenuated APC effects. Females, those in obstetrics and emergency medicine, nurses, technicians, and administrators perceived better environments. Higher job satisfaction and doctor-patient relationship harmony are also associated with more positive perceptions. Income matching efforts and perceptions of promotion fairness had positive impacts, while increasing severity of physical fatigue and psychological anxiety negatively influenced perceptions of the practice environment. The APC analysis provided nuanced insights into evolving practitioner perceptions amid healthcare reforms in China. Tailored policies focused on career stage and generation are needed to address disruptions and sustain improvements. Monitoring feedback on reforms and changes is essential for optimizing the practice environment over time.

Assessment of Practice Preparedness among Novice Nurses in Private Hospitals: A Cross-sectional Study

Background. The crop of novice nurses who are currently employed is a product of flexible learning who had limited contact hours with actual patients, which is contrary to those who graduated from traditional learning modalities. Hence, it is essential to evaluate how the impact of flexible learning modality has affected the practice preparedness levels of novice nurses in the hospital setting. Objective. This study aimed to determine the level of practice preparedness and its associated factors among novice nurses who work in private hospitals. Methods. The study utilized a cross-sectional survey design. Data was gathered from a total enumeration of ninetyfour novice staff nurses who graduated from the flexible learning curriculum and are currently employed in private hospitals in Baguio City and La Trinidad. The tool used was a questionnaire in two parts. Part 1 consisted of questions related to demographic information and factors related to practice preparedness, and part 2 included the Nursing Practice Readiness Scale, with validity and reliability scores of >0.924 and 0.90, respectively. The data was analyzed using the SPSS V27 trial version. The protocol was approved by the Saint Louis University Research Ethics Committee. Results. Findings reveal that more novice nurses in private hospitals perceived themselves as well-prepared across all domains of practice preparedness: “Collaborative Interpersonal Relationship” (n = 94, 100%); “Patient Centeredness” (n = 92, 97.90%); “Self-regulation” (n = 90, 95.70%); “Clinical Judgment and Nursing Performance” (n = 78, 83.00%); and “Professional Attitudes” (n = 76, 80.90%). There is a significant association between practice preparedness and the following factors: “Attended more than one Training/Seminars per year” (p = 0.02), “Graduated from Private Schools” (p = 0.03), and “Assigned in Regular Wards” (p = 0.05).On the other hand, no significant association was found between practice preparedness and the following factors: “Sex” (p = 0.61) and “Membership in Professional Organizations” (p = 0.73). Conclusion. In agreement with existing studies, practice preparedness is multifactorial. However, what this study contributes are new factors that are favorable in making novice nurses more confident in performing their roles and responsibilities. These include being a graduate of private schools, being assigned to regular wards, and attending professional training/seminars more than once annually. Advantageously, these factors that promote practice preparedness are modifiable.

Work-family conflict and job stress as predictors of quality of work-life among nurses

This study investigated predictors of quality of work life among nurses in Ipokia Local Government Area in Ogun State, Nigeria. A cross-sectional survey design was adopted to collect data using the Quality of Life Scale, Work-Family Conflict Scale, and Job Stress Scale. A purposive sampling technique was used to select 182 nurses (Females: 123; Males: 59). Data were analyzed using multiple regression analysis, t-test of independent mean, and one-way analysis of variance. Three hypotheses were generated and tested at a 0.001 level of significance. The result revealed that work-family conflict and job stress jointly predicted the quality of work-life among nurses [R2 = 286, F (2,181) = 37.648, p = .002). Also, job stress independently predicted the quality of work-life among nurses (β = .543, p = .001). However, work-family conflict did not independently predict the quality of work-life among nurses (β =-.001, p >.05). It was concluded that work-family conflict was a significant factor when combined with job stress but not an independent predictor of quality of work-life among nurses. Therefore, the Chief Medical Director and Human Resource Department of hospitals should monitor the stress levels of their nurses to ensure continuous productivity and avoid unnecessary breakdown of nurses at Work and home.

Trends in hypertension prevalence, awareness, treatment, and control in the Thai population, 2004 to 2020.

Under Thailand's universal health coverage every citizen has access to primary care including free hypertension treatment. This study describes temporal trends in hypertension prevalence, awareness, treatment, and control in Thailand. Data were analyzed from four survey cycles of Thailand's National Health Examination Survey (NHES), between 2004 and 2019-2020. The NHES is a nationally-representative cross-sectional survey conducted every five years using a multistage probability sample. Hypertension was defined as systolic blood pressure > = 140 or diastolic blood pressure > = 90 mmHg or currently taking antihypertensive medicines; blood pressure control was defined as < 140/90 mmHg for patients without diabetes and < 130/80 mmHg for those with diabetes. In 2019-2020, age-standardized hypertension prevalence in Thailand was 25.7% (24.6% females, 26.8% males). Among people with hypertension, 51.5% were aware of their diagnosis, 47.9% were treated, and 22.7% had controlled blood pressure. Age-standardized hypertension prevalence remained relatively unchanged in Thai adults from 2004 to 2019-2020, however trends varied by age group. Hypertension control increased from 8.8% in 2004 to a peak of 30% in 2014 but dropped to 22.7% by 2019-2020. Hypertension awareness increased from 30.7 to 55.8% between 2004 and 2014, but decreased to 51.5% by 2019-2020. Hypertension prevalence in Thailand has remained high over the past 15 years. Despite universal health coverage, hypertension awareness has not improved and blood pressure control has decreased in the past five years. An urgent and concerted public health response is needed to improve diagnosis and control of hypertension to prevent avoidable cardiovascular disease.

Nurse Leader Perspectives and Experiences on Caregiver Support Following a Serious Medical Error

OBJECTIVE This study explored nurse leaders' perspectives and experiences in supporting nurses following a serious medical error. BACKGROUND Appropriate support is crucial for nurses following an error. Authentic leadership provides an environment of psychological safety and establishes a patient safety culture. METHODS A cross-sectional survey research design was conducted to determine nurse leader's (NLs') perspectives on supporting nurses following a medical error. RESULTS NL training on handling serious medical errors varied. NLs indicated experiencing a variety of formal support programs: peer support, education, error examination, employee assistance, and just culture. Following an error, NLs reported these interventions were helpful, including education/retraining, psychological safety, time off the unit, identifying system failures, nurse involvement in disclosure, and peer support. CONCLUSION This study illuminates how NLs support nurses following an error. It provides insight into the education of NLs on assisting nurses and the need to implement formal caregiver support programs.

Perspectives, Experiences, and Practices of Healthcare Professionals and Patients Towards Herb-Drug Interaction: A Systematic Review of Qualitative Studies.

The aim of the study was to understand healthcare professionals, pharmacists, and patients perspectives and experiences on clinical practice of herb-drug interactions (HDIs). A systematic review of qualitative studies was conduct. 10 electronic databases were searched from inception through September 2023. Qualitative studies, mixed-method studies, and unstructured or semi-structured cross-sectional surveys focused on healthcare professionals, pharmacists and patients' perspectives, attitudes, clinical practice behaviors, and information needs regarding HDI were included. Thematic synthesis employed Nvivo 12 software. Of 6655 studies identified, 1267 full-text articles were retrieved. Of these, 18 studies conducted in 11 countries/regions were eligible for inclusion, involving 1273 patients, 302 healthcare professionals, and 230 pharmacists. Five over-arching explanatory themes were identified: perspectives, attitudes, practices, experiences, expectations, and information needs. Complementary and alternative (CAM) physicians, pharmacists, and general practitioners were considered by patients to possess the ability or responsibility to assess potential HDIs. Pharmacists yet encountered difficulties due to conflicting information sources and inadequate training. Healthcare professionals, including pharmacists, usually only assessed HDIs when they were deemed to cause serious adverse effects. Regarding expectations and information needs, patients were particularly concerned about the risk of adverse HDIs, the severity of HDIs, and the appropriate intervals between drug doses. They would like to receive relevant HDI alerts. Results suggest that government, policy makers, healthcare professionals, and the education system should give attention to HDIs and improve health professional-patient communication. Further research should also be conducted on the understanding and practices of CAM practitioners in China. Trial Registration: CRD42022324777 (https://www.crd.york.ac.uk/PROSPERO/#recordDetails).

Knowledge, attitude, and practice regarding tuberculosis in a labor-intensive industrial district

BackgroundIn China, tuberculosis (TB) is a major contributor to deaths caused by infectious diseases, with a significant number of cases remaining undetected. Lack of knowledge could heighten the chances of infecting TB. Due to the lack of information on the knowledge, attitudes, and practices (KAP) related to TB among labor-intensive businesses, the study aimed to evaluate the TB KAP within this demographic.MethodsA descriptive cross-sectional survey was conducted among 1,007 participants from March 1 to 28, 2023. A survey was created for assessing knowledge, attitudes, and practices related to tuberculosis, and was sent to employees within the company. We utilize t-tests, ANOVA, and multiple linear regression to investigate the relationship between TB knowledge, attitudes, and practices and various influencing factors.ResultsThe mean good scores rate for TB KAP were 43.5, 23.5, and 75.3%, respectively. Native, female, and workers living in their own houses had a higher score in TB knowledge. Native, non-operators, and workers with a history of TB contact had higher scores in TB practice. Regarding the multivariable linear regression analysis, sex, seniority, birthplace, marital status, and sources of information were associated with greater knowledge; monthly income categories were associated with greater attitude; and position, birthplace, and contact history were associated with greater practice.ConclusionThe survey results lead to the assumption that the level of KAP toward TB is not high among manufacturing workers in Songjiang district. Therefore, it is crucial to enhance tuberculosis knowledge, attitudes, and practices within this demographic.

Academic Physician and Trainee Occupational Well-Being by Sexual and Gender Minority Status.

Few studies have explored the association between sexual and gender minority (SGM) status and occupational well-being among health care workers. To assess the prevalence of burnout, professional fulfillment, intent to leave, anxiety, and depression by self-reported SGM status. This cross-sectional survey study collected data from October 2019 to July 2021, from 8 academic medical institutions participating in the Healthcare Professional Well-Being Academic Consortium. The survey, including questions on SGM status, was administered to attending physicians and trainees. Statistical analyses were performed from June 1, 2023, to February 29, 2024. SGM status was determined via self-reported sexual orientation and gender identity. Primary outcomes measured were the Professional Fulfillment Index (burnout and professional fulfillment), intent to leave, and self-reported anxiety and depression using the Patient-Reported Outcomes Measurement Information System short-form 4-item measure. Of 20 541 attendings and 6900 trainees, 8376 attendings and 2564 trainees responded and provided SGM status. Of these respondents, 386 attendings (4.6%) and 212 trainees (8.3%) identified as SGM. Compared with their non-SGM peers, SGM attendings had a lower prevalence of professional fulfillment (133 of 386 [34.5%] vs 3200 of 7922 [40.4%]) and a higher prevalence of burnout (181 of 382 [47.4%] vs 2791 of 7883 [35.4%]) and intent to leave (125 of 376 [33.2%] vs 2433 of 7873 [30.9%]) (all P < .001). Compared with their non-SGM peers, SGM trainees had a lower prevalence of professional fulfillment (63 of 211 [29.9%] vs 833 of 2333 [35.7%]) and a higher prevalence of burnout (108 of 211 [51.2%] vs 954 of 2332 [40.9%]) (both P < .001). After adjusting for age and race and ethnicity, SGM attendings had higher odds of burnout than their non-SGM peers (adjusted odds ratio, 1.57 [95% CI, 1.27-1.94]; P < .001). Results for burnout were similar among the SGM trainees compared with their non-SGM peers (adjusted odds ratio, 1.47 [1.10-1.96]; P = .01). In this cross-sectional survey study of academic physicians and trainees, SGM attendings and trainees had higher levels of burnout and lower levels of professional fulfillment. SGM attendings had greater intent to leave than their non-SGM peers, but trainees did not. These disparities represent an opportunity for further exploration to retain SGM health care workers.

The Association Between Healthy Lifestyle Behaviors and Polypharmacy in Older Adults: The Loma Linda Longevity Study

Polypharmacy—defined as taking numerous medications that may not be clinically necessary—is becoming a significant concern among the older adult population. This study examined the associations between lifestyle behaviors and the number of prescribed medications in older adults (75 years and older) living in the counties of San Bernardino and Riverside. This study employed a cross-sectional survey to assess lifestyle behaviors and medication use in 611 older adults aged 75 or over. Bivariate correlation and linear regression analyses were used to assess potential relationships between lifestyle behaviors and the number of prescribed medications. Fruit consumption ( P = 0.005), mild physical activity per week ( P &lt; .001), and lifestyle index ( P = 0.003) had a highly significant inverse association with the number of prescribed medications. Fat consumption had a direct positive relationship with the number of prescribed medications ( P = 0.02). Higher fat intake was directly linked to an increased need for medications, while regular physical activity, a higher fruit intake, and a healthy overall lifestyle were all associated with a lower likelihood of polypharmacy. Future research can explore the mechanisms linking these behaviors with medication usage.

The role of motivation and knowledge in promoting green consumer behavior in Saudi Arabia and Pakistan

This research explores the factors influencing consumers’ intentions and behaviors toward purchasing green products in two culturally and economically distinct countries, Saudi Arabia and Pakistan. Drawing on Ajzen’s Theory of Planned Behavior (TPB), the study examines the roles of altruistic and egoistic motivations, alongside environmental knowledge, in shaping green consumer behavior. Altruistic motivation, driven by concern for societal well-being and environmental sustainability, is found to have a stronger impact on green purchase intention and behavior in both countries, particularly in Pakistan. Egoistic motivation, which focuses on personal benefits like health and cost savings, also contributes but with a lesser influence. The research employs a cross-sectional survey design, collecting data from 1000 respondents (500 from each country) using a stratified random sampling technique. The collected data were analyzed using structural equation modeling (SEM) to examine the relationships between variables and test the moderating effects of environmental knowledge. The results reveal that environmental knowledge significantly moderates the effect of both altruistic and egoistic motivations on green purchase intention, enhancing the likelihood of eco-friendly consumption. These findings underscore the importance of environmental education in promoting sustainable consumer behavior. The originality of this study lies in its comparative analysis of green consumerism in two distinct contexts and its exploration of motivational factors through the TPB framework. Practical implications suggest that policymakers and marketers can develop strategies that appeal to both altruistic and egoistic drivers while enhancing consumer knowledge of environmental issues. The study contributes to the literature by expanding TPB to include the moderating role of environmental knowledge in understanding green consumption behavior across diverse cultures.

Impact of sleep quality on health-related quality of life domains and the mediating effects of symptoms in people with multiple sclerosis.

Many people living with multiple sclerosis (PwMS) experience poor sleep, which is associated with diminished overall health-related quality of life (HRQoL). We quantified associations between sleep quality and HRQoL domains and examined the extent to which other MS symptoms could account for these associations. In this cross-sectional survey of 1,717 Australians with MS, we used Assessment of Quality of Life (AQoL) 8D and Pittsburgh Sleep Quality Index (PSQI) to assess HRQoL and sleep quality, respectively. Total, direct, and indirect effects of sleep quality on HRQoL domains were determined using mediation regression analysis. Poor sleep quality was significantly associated with all domains of HRQoL, with strongest associations seen for mental health (β=-0.08) and pain (β=-0.11), and weaker associations for independent living (β=-0.05) and senses (β=-0.03). Poor sleep quality had the largest direct effect on mental health (60.8%), happiness (48.7%), and pain (49.7%). MS symptom clusters mostly contributing to indirect effects were "feelings of anxiety and depression" for psychosocial, and "pain and sensory symptoms" for physical HRQoL super dimensions. Improving sleep could lead to substantial improvements in all HRQoL domains and the improvement in HRQoL could be partially achieved through indirect improvements in sleep on MS symptoms.

One-year impact of behavioural interventions on schistosomiasis-related knowledge, attitude and practices of primary schoolchildren in Pemba, Tanzania.

Elimination of schistosomiasis as a public health problem and interruption of transmission in selected areas are goals set by the World Health Organization for 2030. Behaviour change communication (BCC), coupled with other interventions, is considered an essential measure to reduce the transmission of Schistosoma infection. Focusing on elimination, we assessed the 1-year impact of BCC interventions on schistosomiasis-related knowledge, attitude and practices (KAP) of schoolchildren in hotspot schools versus low-prevalence schools that did not receive the interventions. School-based cross-sectional surveys were implemented in 16 schools on Pemba Island, Tanzania, in 2020 and 2022, respectively. The schistosomiasis-related KAP were assessed in children attending grades 3-5, using pre-tested questionnaires. Between the surveys, in 2021, children from hotspot schools were exposed to BCC interventions. The difference in mean knowledge and attitude scores, respectively, between schoolchildren from hotspot and low-prevalence schools during the survey in 2022 was determined with a linear mixed-effect model. In the five hotspot schools that received BCC interventions, 315 children participated in the survey in 2020 and 349 in 2022. There was a 21.0% increase in children withmoderate knowledge and a 13.8% decrease in no knowledge; a 8.3% increase in good attitude and a 19.2% decrease in poor attitude; 3.4% and 3.2% fewer children reported to use waterbodies for washing clothes or body, respectively. In the 11 low-prevalence schools without BCC interventions, 778 children participated in 2020 and 732 in 2022. The percentage of children withpoor knowledge (56.4% and 63.1%) and poor attitude (55.3% and 53.1%) remained relatively stable from 2020 to 2022, but 4.9% and 3.0% less children reported to use waterbodies for washing clothes or their body, respectively. In 2022, the difference in mean knowledge scores was 0.8 [95% confidence interval (CI): 0.5-1.1] and the difference in mean attitude scores was 0.6 (95% CI: 0.4-0.7) between children in hotspot compared with low-prevalence schools. After one year of implementation, the BCC interventions markedly improved the KAP of exposed children. Complemented by improved access to clean water and sanitation, BCC holds promise to contribute successfully to the achievement of schistosomiasis control and elimination targets. Trial registration ISRCTN, ISRCTN91431493. Registered 11 February. 2020, https://www.isrctn.com/ISRCTN91431493 .

Analysis of influencing factors of orthopedic nurses' spiritual care competencies based on structural equation model

PurposeTo comprehensively understand the spiritual care competencies of orthopedic nurses and analyze the factors that affect them.MethodsThis study employed convenience sampling to conduct a cross-sectional survey among orthopedic nurses at Hefei First People's Hospital. Data was collected utilizing a general information questionnaire, alongside the Chinese versions of the Spiritual Care Competence Scale, the Spiritual Care Perspective Scale, the Professional Identity Assessment Scale, and the Hospital Ethical Climate Scale. Guided by the Person-Environment Fit theory and the Triadic Reciprocal Determinism theory, a structural equation model was utilized to analyze the influencing factors and pathways related to the spiritual care competence of orthopedic nurses.ResultsA total of 112 valid questionnaires were obtained, yielding an overall score of 68.92 ± 11.03 for orthopedic nurses' spiritual care competencies, with an average score of 3.14 ± 0.50 per item. The results of the Pearson correlation analysis revealed a significant positive correlation (all P &amp;lt; 0.01) between spiritual care competence and the scores for spiritual care perspective, professional identity assessment, and hospital ethical climate. The spiritual care perspective, professional identity, and hospital ethical climate emerged as the influencing factors of orthopedic nurses' spiritual care competence, exhibiting total effects of 0.30, 0.53, and 0.85, respectively. Notably, the hospital ethical climate exerts an indirect influence on spiritual care competence through the mediation of spiritual care perspective and professional identity, with the indirect effect accounting for 61.18% of the total effect.ConclusionThere remains significant potential for enhancing the spiritual care competencies of orthopedic nurses. The hospital's ethical climate not only has a direct and positive impact on spiritual care competence but also indirectly influences it through the lens of nurses' spiritual care perspectives and professional identity assessments. Hospital administrators may wish to consider strategies for bolstering the hospital's ethical climate, fostering a deeper spiritual care perspective and heightened professional identity among nurses, and ultimately improving their spiritual care competence.

Characteristic of mental health app usage: a cross-sectional survey in the general population.

Mental health apps (MHA) have gained popularity in recent years. Most freely available apps are of low quality and lack evidence for effectiveness. Yet, download rates indicate high usage. MHA are potentially beneficial for individuals with no/low symptom severity as prevention, or as an option to reach underserviced populations. However, currently very little is known about the characteristics of MHA users in the general population, about the kind of MHA used, or the motivation behind MHA usage. We collected survey-data from N = 1,247 individuals from the general population to investigate MHA usage. Descriptive statistics revealed that 41% had used MHA in the past 12 months; prescription app-use however was low (1.5% of MHA users). Mindfulness, moodtracking, and relaxation were the most popular categories of MHA. Perceived helpfulness, fun, and availability were the top reasons for MHA usage. Non-users reported distrust, lack of perceived need, and data security concerns as usage barriers. MHA users and non-users did not differ regarding sociodemographic variables. Multiple regression analyses revealed that sub-threshold symptoms of psychological disorders as well as higher levels of anxiety and stress were linked to higher probability of MHA usage. Higher levels of depression were associated with lower likelihood of MHA usage in general, but increased likelihood of usage of self-help apps specifically for depression. It follows that MHA use is common in the general population independent of sociodemographic characteristics. MHA can reach people who might benefit, but more awareness and better structure of the market is needed to reduce distrust, increase usage of high-quality MHA, and improve the fit between app and user.

Risk Factors for Human Contact with Bats in Northern Tanzania

Background: Environmental changes impact bat–human interactions, heightening concerns of pathogen spillover and highlighting the need to understand human–bat interactions in the context of ecosystems. The objective of this study was to assess factors associated with human contact with bats in communities living near bat roosts in Northern Tanzania. Methods: A cross-sectional survey was used to investigate the factors associated with human contact with bats. Utilizing a standardized questionnaire administered through face-to-face interviews, relevant data were collected from respondents living in or near regions characterized by high bat density. Descriptive analyses followed by bivariate and multivariate analyses were performed to assess the association between the investigated factors and the outcome variable of interest, contact with bats. Results: Data were collected from 325 respondents. Of the respondents, 57.5% (187/325) reported bat contact, and only 4% believed bats can transmit rabies. The following factors were significantly associated with human–bat contact: being unaware that bats can transmit diseases like rabies (AOR = 8.63, CI = 1.04, 71.43, p = 0.045), feeling safe to handle bats with bare hands (AOR = 3.47, CI = 1.71, 7.05, p &lt; 0.001), not washing hands thoroughly after bat bite or scratch (AOR = 2.43, CI = 1.29, 4.59, p = 0.006), using water from ponds, rivers or wells (AOR = 5.58, CI = 3.17, 9.79, p &lt;0.001), age &gt; 45 years (AOR = 1.77, CI = 1.0, 3.14, p = 0.047) and a low level of education (AOR = 5.86, CI = 2.97, 11.57, p &lt;0.001). Conclusion: The study findings highlight the key factors to be targeted when developing strategies aimed at improving the community’s knowledge of the potential risks of zoonotic infectious diseases associated with bats and reducing the likelihood of human–bat contact and the related public health risks in communities living near bat roosting sites in Tanzania.

Physical activity, leisure-time management, perceived barriers to physical activity and mental well-being among Turkish university students.

This study examined the relationship between physical activity (PA) level, free time management, mental well-being, and perceptions of barriers to PA among university students. A cross-sectional survey was conducted with 723 Turkish university students, which included four questionnaires to assess participants' PA levels, conditions of mental well-being, free time management, and perceived barriers to PA. Multivariate linear regression was performed to identify factors associated with the participants' PA level. The study found that 216 (29.9%) of participants were inactive, 325 (45%) were minimally active, and 182 (25.1%) were health-enhancing active. While 25.23% of males were inactive, 42.02% were minimally active, and 31.45% were health-enhancing active, these rates were 31.4, 45.98, and 22.62% for females, respectively. These findings highlight that 3/4 of university students have inadequate PA levels. Changes in barriers to PA (p < 0.001), free time management (p = 0.040), and mental well-being (p < 0.001) were associated with PA levels. According to the regression analysis, only increased barriers to PA was a significant predictor of PA (p < 0.001). Given the role of health science students in public health, this study could help policymakers develop new strategies to promote healthy living and address barriers to PA, such as students' free time and mental health.

Dietary Habits, Nutritional Knowledge, and Their Impact on Thyroid Health in Women: A Cross-Sectional Study

Background: The thyroid gland plays a crucial role in regulating metabolism and various bodily functions through hormone production. Women are particularly susceptible to thyroid disorders such as hypothyroidism and Hashimoto’s disease, with associated symptoms affecting overall well-being. Prior research has inadequately addressed the influence of dietary habits and nutritional knowledge on thyroid health, especially in women. Objective: This study aimed to evaluate the dietary habits and nutritional awareness of women aged 18–45 with diagnosed thyroid disorders, emphasizing the effects of education level on knowledge and dietary practices. Material and Methods: A cross-sectional survey was conducted with 297 women diagnosed with thyroid conditions. The survey assessed demographics, comorbidities, hydration habits, and knowledge about nutrient intake critical for thyroid health. Chi-square tests, ANOVA, and correlation analyses were performed to evaluate associations. Results: Hypothyroidism and Hashimoto’s disease were most prevalent among younger women (18–25 years). A significant association was observed between higher education and knowledge of protein and carbohydrate roles in managing thyroid health (p &lt; 0.01). Women with higher educational backgrounds more frequently used healthier cooking methods and were more informed about beneficial nutrients, including vitamin D and omega-3. A chi-square test indicated that low water intake was significantly associated with comorbid conditions, including insulin resistance and cardiovascular disease (p &lt; 0.01). Conclusions: Significant gaps remain in dietary knowledge, particularly concerning protein intake and nutrient–drug interactions, indicating a need for targeted dietary education. Women with higher education demonstrated greater dietary awareness, emphasizing the importance of tailored educational interventions to enhance thyroid disorder management.