Health Education System Research Articles

Digital Health in Croatia: Key stakeholders’ perspective of societal and institutional readiness

Abstract Background According to the literature, digital health brings an innovative approach to healthcare and an inevitable transformation and disruption. The potential of digital technologies is far-reaching, from preventive medicine to addressing public health challenges. However, the implementation also significantly depends on the social & cultural context. Methods To research Croatia’s expectations, challenges, and readiness for implementing digital health, interviews were conducted with physicians, patients, hospital managers, policymakers, jurists, and engineers (n = 75). Following identifying key themes, a survey was conducted among Croatian medical students (n = 775) at the end of 2022. Results Key stakeholders believe implementation preparedness is demonstrated through institutional and societal readiness. Prominent characteristics of societal readiness include appropriate infrastructure and legal and financial frameworks. Societal readiness is assessed through digital and health literacy and existing social practices within Croatian society. Only 4.6% of medical students believe Croatia’s healthcare system is ready to implement digital technologies. They perceive the highest readiness regarding digital education (63.7%) and the digital literacy of physicians (60.9%) while negatively evaluating healthcare infrastructure, financial resources, and patient literacy. The results highlight numerous aspects that must be addressed for successful implementation, many of which have been neglected in previous periods. Conclusions The research identifies critical aspects of the social context and presents valuable implications for the digital health transformation. Key stakeholders assess that institutional and societal readiness is not at the level required for the sustainable implementation of digital health, thus necessitating specific actions, ranging from governmental bodies and international organisations to the health system, education system, and media. Key messages • It’s crucial to align digital health implementation with the social & cultural context and capabilities. • The prerequisites for successful implementation necessitate engagement across various societal domains beyond the healthcare system.

Health Education in the Bulgarian Schools

The following article focuses on health education in Bulgarian schools. A systematic health education was conducted during on school term among 71 children on current health issues directly related to the health and health behavior of adolescents. The following methods are used: traditional (lectures, conversations, discussions, individual tasks), non-traditional (debate) and interactive (role-playing games, sports activities, educational film and others) pedagogical methods aimed at developing skills in adolescents in order to recognize and avoid health risk factors. The application of non-traditional and interactive methods of health education in schools in accordance with children’s age and interests is effective, which was proved by a comparative analysis of the level of knowledge and point of view of the particular group before and after the education. It is necessary to introduce the methods during the education.

The transformation of Jordan’s healthcare system in an area of conflict

BackgroundThe Jordanian healthcare system has evolved over the past decades expanding its services, technological, and educational resources. A comprehensive view of this system is lacking. The objective of this report is to describe the structure of the Jordanian healthcare system, the challenges facing it, and the current and recommended health policies.Materials and methodsThis study reviewed the current status of the Jordanian healthcare system. The following parameters were analyzed: health indicators, infrastructure, human resources, insurance system, pharmaceutical expense, health education system, and medical tourism. Data were collected from various relevant official institutions and related published literature.ResultsJordan has a young population with a median age of 23.8 years. Life expectancy is 78.8 years for females and 77.0 years for males. The Jordanian healthcare system is divided into three major categories: (1) Governmental Insurance (i.e., the Ministry of Health (MOH), the Royal Medical Services (RMS) and semi-governmental insurance); (2) Private Insurance; and (3) Refugee Insurance, including the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) and the United Nations High Commissioner for Refugees (NHUR). The Governmental Insurance covers 64.30% of the total population. Health expenditure is 6.37% of the gross domestic product (GDP). Pharmaceutical expenses make up 26.6% of the total national healthcare budget. Human resource assessment shows a high ratio of medical staff per 10.000 inhabitants, especially concerning physicians (31.7), dentists (7.9), and pharmacists (15.1). However, the ratio of nursing staff per 10.000 inhabitants is considered low (37.5). The Hospital bed/1000 population ratio is also relatively low (1.4). Healthcare accreditation is implemented through the Joint Commission International (JCI) accreditation which was achieved by 7 hospitals and by the National Health Care Accreditation Certificate (HCAC) achieved by 17 hospitals and 42 primary healthcare centers. Postgraduate medical education covers almost all medical and surgical fields. Medical tourism is currently well-established.ConclusionsAssessment of the Jordanian healthcare system shows high ratios of physicians, dentists, and pharmacists but a low ratio of nursing staff per 10.000 inhabitants. The hospital bed/1000 population ratio is also relatively low. Pharmaceutical expenses are significantly high and medical tourism is well-developed.

Examining fundamental nursing textbooks for inclusivity and exclusivity content: A directed qualitative content analysis

BackgroundGrowing awareness of social inequities and injustices in education highlights the urgent need to address harmful mechanisms, policies, and norms within health education curricula and systems. PurposeThis study examines inclusivity and exclusivity content in four fundamental nursing textbooks and contributes to the broader discourse on fostering equitable health education. MethodsA Directed Qualitative Content Analysis on 32 chapters from four fundamental nursing textbooks was systematically conducted. Seven codes within inclusivity and exclusivity themes were deductively developed from the literature. Inclusivity codes included equity language and contextualized race-based prevalence. Exclusivity codes included normalizing Whiteness in assessment, stigmatizing and negative descriptors, race-based prevalence without context, cisgenderism, and othering. Two trained analysts independently reviewed the chapters, assigning texts to these codes. Discrepancies were resolved by team consensus. ResultsA total of 118 inclusivity instances: equity language (n = 109) and race-based prevalence with context (n = 9). Exclusivity codes were more prevalent (n = 642), including normalizing Whiteness (n = 398), stigmatizing descriptors (n = 106), cisgenderism (n = 59), and othering (n = 32). ConclusionThe study highlights inclusive language in fundamental nursing textbooks but reveals significant exclusive language perpetuating negative generalizations, including marginalized identities and race prevalence without context. This content undermines person-centered care and hinders understanding the complex interplay between intersectionality, social justice, and social determinants of health.

"What got you here, won't get you there": Students as leaders of the change we need.

Lack of access, system inequities, and inefficiencies plague our current healthcare system. With a challenge this complex, no one intervention is sufficient; all will be necessary. The primary care system needs a strong health workforce prepared in bold new ways. Students represent an important voice, given their role as future leaders of health education and healthcare. For students to lead, educators must leverage education paradigms that position current students as leaders of transformation. Yet, in current health education systems, students are often seen as passive recipients of knowledge and skill. Transformative education seeks to foster critical reflection (an ongoing process of questioning unhelpful assumptions and power relations) and informed action in students to enable them to challenge and change norms and change practices, structures, and society. This article highlights the value of transformative education in cultivating thoughtful change agents and provides one tangible example of a new education/practice model that puts this paradigm into action.

특수형태근로종사자의 안전보건교육실태와 개선방안에 관한 연구

In order to protect special types of workers, the government is requiring safety and health education for special types of workers by revising the Enforcement Decree of the Industrial Safety And Health Act. But the actual effect of education is insufficient due to the lack of educational infrastructure and the characteristics of the occupation such as the diversity of labor provision for special types of workers and easy job change. This study is a basic study on measures to revitalize safety and health education to protect special types of workers, and improvements were derived based on a fact-finding survey. A survey was conducted on the status and awareness of safety and health education completion for 300 workers in each occupations and problems with the current system and areas for improvement were identified through frequency analysis. The survey results were subjected to frequency analysis to identify problems and areas for improvement in the current system. As a result of the survey, excessive completion of overlapping training and limited supply of training were identified as factors that reduce the effectiveness of safety and health education according to the occupational characteristics of special types of workers. Accordingly, as a way to improve the problem of overlapping completions a cross-recognition plan for training completion with other laws and a training completion certification system were proposed. In addition, as a way to improve the problems caused by the limited supply of education, a plan to diversify education and improve quality by easing some of the registration requirements for private educational institutions was presented. As the results of this study focus on the opinions of workers, it is judged that additional verification of the effectiveness of educational measures should be conducted. If the results are supplemented through future system analysis and improvement research centered on safety and health education experts, it is believed that it will be possible to contribute to the protection of special types of workers through a more specific and effective safety and health education system.

Prospective Discussion on December-Month Introduction of Voice Nursing and Health Education System.

A cross-sectional study was conducted on the 12th month of using the voice nursing and health education system. Work sampling method was used to observe for 120 hours, and 39 satisfaction questionnaires were collected. The results showed that the usage rate of voice health education system accounted for 14.3% of nursing guidance tools. Pearson analysis showed that user satisfaction and usage efficiency had the greatest impact (p < .001). When the system's ease of operation and stability meet expectations, the care guidance process can be improved.

The Effectiveness of On-Demand Health Education Systems in Assisting the Nursing Workload.

This article explores the "On-Demand Health Education System" in healthcare, highlighting its role in enhancing nursing efficiency and quality. Using a database, it allows nurses to provide tailored education via QR codes for patients and families. Key findings show its positive impact on education quality and efficiency, though improvements are needed in user interface and accessibility for certain groups like the elderly. Future enhancements should focus on user experience and expanding accessibility, acknowledging the potential of such systems in medical education with technological advancement.

Development of an Intelligent Health Education System Based on Large Language Model for Elderly Pulmonary Aspiration Prevention.

As the aging process accelerates, the incidence of chronic diseases in the elderly is rising. As a result, it is crucial to optimize health education for the elderly. Pulmonary aspiration and aspiration pneumonia are significant concerns endangering the health of the elderly. The health education paradigm now in use to prevent pulmonary aspiration in the elderly has numerous flaws, including a lack of home-based health education and the digital divide. Large language model (LLM), an example of artificial intelligence technology, is anticipated to bring a chance to address these issues and offer easily comprehensible health information for the prevention of pulmonary aspiration in the elderly. Our multidisciplinary research team fully understood the needs from the perspective of physicians, nurses and patients, built a knowledge graph (KG), and developed an intelligent Health EducAtion system based on LLM for the prevention of elderly Pulmonary Aspiration (iHEAL-ePA system).

Evaluation of the Implementation of Integrated Primary Care for Patients with Type 2 Diabetes and Hypertension in Belgium, Cambodia, and Slovenia.

Integrated care of chronic patients improves quality of their management, but there is scarce evidence of its implementation in different healthcare settings. With this article, we wanted to determine the level of integrated care implementation in the management of T2D (diabetes) and HT (hypertension) in three different settings: Belgium, Slovenia, and Cambodia. This was an observational study with integrated approach. It was conducted in primary health care organisations in three countries. In each primary health care organisation, we aimed to include primary care workers that worked with Type 2 Diabetes (T2D) and hypertension (HT) patients. Data was collected with the Integrated Care Package (ICP) grid (consisting of six elements: identification, treatment, health education, self-management, caregiver collaboration, and care organisation). ICP is almost completely implemented without major differences within Slovenia. There is a considerable variability across practice types in Belgium. Implementation is constrained by health system resources in Cambodia. Some elements, especially identification, are better implemented then others, across health systems. Countries can enhance integrated care for chronic diseases by implementing central policies, standardized protocols, and local adaptation, addressing resource constraints, promoting systematic screening and health education, and providing training for healthcare workers, tailored to community needs, to improve patient outcomes and healthcare delivery.

Progress in Studying Theoretical Models of NSSI Behavior in Adolescents

Non-suicidal self-injury, NSSI refers to the individual in subjective without suicide intention, a series of not for the purpose of death, directly, intentionally, repeatedly hurt their organs and tissues, and objectively will not cause death, but cause mild or moderate damage, such as the skin cutting, friction, needles, scratch, this behavior can not be accepted by recognition or society. NSSI has become a serious impact on adolescent psychosomatic health worldwide public health problems, NSSI behavior is an important factor predicting suicide, the incidence of adolescent NSSI in China, the physical and mental health is closely related to its personal future development, about the family, social and national harmony and stability, should cause the attention of the whole society. NSSI may be related to many factors, such as psychological problems, family environment, campus atmosphere, and social relations. This paper summarizes the shortcomings of NSSI behavior theory model and analyzes the good understanding of the mechanism of adolescent NSSI behavior, provides the theoretical basis for adolescent NSSI research, provide the theoretical basis for NSSIR prevention, intervention program and policy formulation for health departments, education system and schools in China.

Continuous Assessment of Active-Duty Army Special Operations and Reconnaissance Marines Using Digital Devices and Custom Software: The Digital Comprehensive Operator Readiness Assessment (DcORA) Study.

Continuous exposure to extreme and chronic stress from uncontrollable events has been linked to increased psychological and physiological reactivity. Prolonged, frequent deployments may test coping skills over time, ultimately rendering Servicemembers vulnerable to mental health problems and suicide. This study develops a methodology for accurately collecting holistic health measures from Servicemembers using digital tools, including custom-built phone software and body-worn sensors. The secure research platform and mobile app continuously collect multiple health measures and, after data analysis, deliver continuously updated summary data back to the Servicemember. This system provides novel insights into the relationships between the measures while helping individuals track their progress toward self-established goals. Participants were given an iPhone (including the study app) and an Apple Watch. Participants tracked their data for more than 6 months and responded to baseline, daily, and weekly questions and assessments. Physiologic, psychologic, and cognitive assessment data across the Preservation of the Force and Family program (POTFF) domains were collected, displayed to the individual, and analyzed in aggregate. When coupled with custom-built software, this hardware can be elevated from a fitness tracker to a user-facing health monitoring, educational, and delivery system. This wearable system measured vital factors associated with the health and human performance of Servicemembers. In real-time, it engaged Servicemembers in health and human performance optimization practices to achieve a goal of prevention of physical or mental injury.

Organization of PhD studies at the Faculty of Public Health of the Slovak Medical University in the context of practice.

The Slovak Medical University (SMU) holds a unique position in the health education system in Slovakia. It has a direct connection to the health sector, allowing health education to reflect the actual needs in this field. Because of increasing importance of public health in the last decades, more attention must be given to disease prevention and the promotion of healthy lifestyles. We aim to highlight the main characteristics of health higher education at one of the specialized health universities in Slovakia, with a particular focus on public health and its practical impacts. We analysed the available legal regulations for postgraduate studies in Slovakia and the officially valid documents of the Faculty of Public Health (FPH) and the Slovak Medical University in accordance with the accredited study programme in Public Health. Archived data from the Department of Science, Research, and Doctoral Studies of the Faculty over the past 10 years were used for the analysis of postgraduate studies (2013-2023). PhD studies in Slovakia are conducted in accordance with Act No. 131/2002 Coll. on Higher Education Institutions and on amendments to certain acts. There are two forms of PhD study in Slovakia: full-time and external. The evaluation of study results is based on the credit system. The doctoral study programme proceeds according to an individual study plan under the guidance of the advisor. The PhD study concludes with the defence of the dissertation, which serves as the final thesis. A total of 97 students have graduated at FPH SMU in Public Health in the last 10 years. The majority of graduates were females (68% vs. 32% males) and studied in the external form of study (80.4% vs. 19.6% in the full-time programme). The most frequent research topics at FPH SMU in the last 10 years included Epidemiology and Prevention of Non-communicable (21.7%) and Infectious Diseases (11.3%), Health Management and Policy (17.5%), Environmental Health (15.5%), as well as Occupational Health (13.4%). High-quality and innovative postgraduate education in public health plays a crucial role in this field, preparing experts for the public health services. From a quality perspective, it is substantial to share experiences with various study programmes across the European region, as well as with other universities. Graduates of the Faculty of Public Health are highly sought-after professionals with diverse career opportunities not only in Slovakia but also within the European Union, other countries, and various important international institutions.

Teen pregnancy involvement among African, Caribbean and Black adolescent boys and girls: A scoping review

ObjectivesThis study aims to investigate the incidence, associated factors and interventions to address teen pregnancy involvement (TPI) among African, Caribbean and Black (ACB) adolescents in North America.DesignWe conducted a scoping...

Father�s involvement in the development, care, and upbringing of a child with autism spectrum disorder in Kazakhstan: Results of a comprehensive study

Relevance. The full and harmonious upbringing of a child with autism spectrum disorder requires the active joint efforts of the mother and father. Given the prevalence of traditional family relationships in Kazakhstani society, it is relevant to study the degree of father�s involvement in the educational process aimed at the development and maintenance of a child with autism spectrum disorder. Purpose. The aim of the research is to study the factors that influence the involvement of fathers in the care and nurturing, upbringing and education of children with autism spectrum disorders (ASD) in order to provide recommendations for supporting families and children by specialists of health care, social protection and education systems. Methodology. For detailed empirical disclosure of the issues, a sociological survey, in-depth interview, expert interview and focus group discussion were used. Results. The study recorded, firstly, the presence of adequate and correct understanding by fathers of their child�s diagnosis. But at the same time, this was the result of a complex process of realization, as most fathers were unaware of autism prior to their child�s diagnosis, which caused them stress and susceptibility to stereotypical thinking. The perception of the child�s diagnosis was romanticized or marginalized. Secondly, it was empirically confirmed that the traditional model was the main form of paternal involvement in parenting, where the father predominantly fulfils the function of providing for the family and the mother is responsible for all educational processes. Conclusions. The findings of the study show that over half of mothers spend all their time with their child, while less than one-fifth of fathers do the same. This study on father involvement in the care and upbringing of children with ASD in Kazakhstan is valuable for developing programs to improve family relations and promote equal caregiving. Keywords: awareness of the diagnosis; inclusive parenting; parenting practices; distribution of roles between spouses; social stereotypes

Lifestyle in Breast Care and Evaluation of Health Education Effects

This paper discusses the effect evaluation of lifestyle and health education in breast care. It emphasized the importance of health education in improving patient quality of life, reducing complications, improving the ability to perform activities of daily living, and relieving patient negative emotions and improving functional exercise compliance. The implementation methods of health education are introduced in detail, including the systematic health education plan, the application of the causal real cause introduction of health education promotion activities, and the effect of continuous health education. Lifestyle adjustments were discussed, including healthy eating habits, regular exercise, wearing suitable underwear, etc. The importance of psychological and social support, including the reduction of psychological stress, improving endocrine function and the effects of peer supportive health education. Finally, the readability of the breast cancer-related health education materials was assessed. These strategies and methods help to improve individual health awareness and behavior and promote health level.

Knowledge, Attitude, and Perceived Barriers of Arteriovenous Fistula among Chronic Kidney Disease Patients Attending a Tertiary Care Center

Abstract Introduction: Chronic kidney disease (CKD) affects 11% of the adult population worldwide. Hemodialysis (HD) therapy can be through either arteriovenous fistula (AVF), arteriovenous graft, or central venous catheter. Although AVF has better outcomes, many factors are responsible for its underutilization. Materials and Methods: A cross-sectional study was conducted in a tertiary care hospital among all adult patients diagnosed with CKD registered in the nephrology outpatient department for 3 months. The patients were subjected to a structured questionnaire. The questionnaire consisted of four parts, namely sociodemographic details, patients’ knowledge regarding AVF, attitude toward AVF, and perceived barriers toward the procedure. Data were analyzed using SPSS V-21. Demographic and knowledge data were summarized by calculating means and standard deviation. Attitudes and perceived barriers were analyzed as categorical variables. Association between categorical variables was done using the Chi-square test. Results: The mean age of the study participants was 52.24 (±15.47) years. The major cause of end-stage renal disease was hypertension (35.3%). Adequate knowledge was found to be among 79.8% of patients; which was significantly associated with patients who had dialysis session &gt;150 times and who underwent AVF. 65.5% of patients would recommend AVF to others who are undergoing HD. Fear of needles (18%) was found as a major barrier to undergoing AVF. Conclusion: A systematic health education regarding the advantages of AVF over other VA methods can be done before initiating HD which can reduce the perceived barriers. This will aid in increasing the acceptance of AVF procedure among CKD patients.

On the Structure and Practice of Mental Health Education System in Vocational Colleges’ Integration of Five-Domain Education—— Take Shenzhen Polytechnic University as an Example

Mental health education plays a key role in the vocational colleges’ talent training system and has become the core of ideological and political work. This study started with the mental health education in secondary colleges of Shenzhen Polytechnic University and discussed the practical way of constructing the five-domain education system. This paper sorted out the unique practices and made an in-depth analysis of the mental health education system of “four-heart education”, aiming to implement mental health education, improve the physical and mental health of students, maintain harmony and stability on the campus, and provide a useful reference for the mental health education in colleges and universities in China.

Research on the Integrated Development of Psychological Health Education in Colleges and Universities, Middle Schools and Primary Schools to Construct High-Quality Development Path: From the Perspective of the Concept of “Three Complete Education”

The integrated development of psychological health education is an important part of the construction of the integrated development of ideological education. Guided by the concept of "three complete education", and following the law of continuity and stage of students' physical development, it is of vital significance to cultivate the good psychological quality of colleges and universities, middle schools and primary school students and promote their all-round and harmonious physical and mental development. Despite the integrated development of psychological health education in colleges and universities, middle schools and primary school, there is a lack of overall planning and top-level organizational design in the implementation of the integrated development of psychological health education. In addition, there is a serious disconnect in the teaching content of each stage. Therefore, it is of great research value to construct an effective integrated psychological health education system and realize the scientific connection from the stage to the continuity of psychological health education. This paper adopts the method of literature analysis, deeply analyzes the connotation of the integrative development of psychological health education in colleges and universities, middle schools and primary schools. It also analyzes the current situation and problems in the construction of the integrative development of psychological health education, and puts forward some construction paths, so as to realize the high-quality development of the integrative development of psychological health education in colleges and universities, middle schools and primary schools.

Telemedicine-medical "snack community"-PHS ecosystem: Insights into the double-edged sword role of telemedicine in clinical practice and medical education during the COVID-19 pandemic and beyond.

Telemedicine has gained tremendous development during the COVID-19 pandemic. With deblocking and opening, telemedicine accelerates the evolvution of the medical "snack community" and undermines the perception of medical students and staff, which promotes the incidence of psychosocial-related disorders. Moreover, the inconsistent telemedicine adaptability between medical workers and patients aggravates the doctor-patient conflict due to the aging population and COVID-19 squeal. Telemedicine is colliding with the national healthcare system, whose synchronization with conventional medical service is crucial to coordinate the relationship among medical payment, patient privacy and qualifications of clinicians. This study puts more emphasis on the double-edged sword role of telemedicine in clinical practice and medical education during the COVID-19 pandemic and beyond. Overall, while telemedicine has demonstrated its utility in health care throughout the COVID pandemic, it is pretty critical to continue evaluating the efficacy and limitations of telemedicine in order to maintain equal access to medical service and high-quality medical education. A new concept as telemedicine-medical "snack community"-PHS ecosystem, where the psychological health education system and partners healthcare system with enough bandwidth, especially 5G technology, could optimize the effect of telemedicine on medical practice and education, is proposed.