Health Promotion Measures Research Articles

The effect of outdoor activities on the medical expenditure of older people: multiple chain mediating effects of health benefits

BackgroundWith the global aging population, attention to the health and medical issues of older adults is increasing. By analyzing the relationship between older people's participation in outdoor activities and medical expenditure, this study aims to provide a scientific basis for improving their quality of life and reducing the medical burden.MethodsData on outdoor activity participation, medical expenditures, and relevant variables were collected through questionnaires and databases. A multi-chain mediation effect model was established to analyze the impact of outdoor activities on the medical expenditure of older people, considering mediation effects and heterogeneity.ResultsResults revealed that increased participation in outdoor activities among older adults correlated with lower medical expenditures. Outdoor activities positively influenced their health by improving mental health, cognition, eating habits, and activities of daily living, resulting in reduced medical expenditures. Robustness tests confirmed the consistent effect of outdoor activities on older people's medical expenditure.ConclusionThese findings contribute to understanding the relationship between outdoor activities, health, and medical expenditure in older people, guiding policy formulation and interventions. Encouraging and supporting older adults in outdoor activities can enhance their quality of life and alleviate medical resource strain. The study's conclusions can also inform health promotion measures for other populations and serve as a basis for future research in this area.

Seafarers’ attitudes and chances to improve the nutrition on merchant ships from the crews’ and cooks’ perspective

BackgroundSeafarers’ diets are often high in fat, sugar and calories, thus contributing to an increased risk of obesity, metabolic syndrome and cardiovascular disease. The multitude of obstacles to healthy eating in the on-board environment on merchant ships makes it essential to find new approaches for health promotion. This study explored seafarers’ attitudes, the status quo of support measures and chances to improve nutrition on merchant ships from the perspective of crews and cooks.MethodsIn the course of the EU-funded project “e-healthy ship”, European and Southeast Asian seafarers (N = 810) and ship cooks (N = 62) were examined by using two questionnaires on 68 ships of two German shipping companies.ResultsAlmost all seafarers (98.8%) considered a healthy diet important for their well-being and the majority of seafarers reported being open-minded about changing their eating habits (88.4%). However, European seafarers were less likely to respond that they are willing to eat less meat [OR 0.11; 95%CI (0.07–0.17); p < .001], more vegetables [OR 0.10; 95%CI (0.02–0.49); p = .005] and more fruits [OR 0.11; 95%CI (0.02–0.61); p = .011] than their Southeast Asian colleagues. On the one hand, 82.3% of the ship cooks reported having taken part in at least one cooking course organized by their employer (1: 33.9%, 2: 25.8%, 3: 14.5%, 4 or more: 8.1%), on the other hand, slightly above half stated that the last of these courses had taken place more than 2 years ago. Furthermore, the ship cooks showed a positive attitude towards the use of a tablet-based digital platform that supports the ship cooks in daily and complex tasks (> 85% agreement).ConclusionsTo improve nutrition on board merchant ships, various parameters need to be adjusted, such as ensuring a demand-oriented food supply on board or supporting seafarers’ healthy food choices through target group-specific nutrition education. Ship cooks would be able to play a crucial role if they receive support. The development of a tablet-based digital platform that supports the ship cooks in their daily tasks, offers training and empowers them to implement health-promoting measures themselves seems to be an accepted and promising approach.

The weight of obesity: a retrospective analysis of the direct costs of hospitalizations due to obesity between 2011 and 2020 for the unified health system in Brazil

Aim: This study aimed to analyze the evolution of obesity-related costs over the past 10 years for Brazil's Unified Health System (SUS) and provide insights for guiding and expanding health management and promotion measures. Methods: An observational and retrospective study was conducted using secondary data from 2011 to 2020, extracted from DataSUS with the ICD-10 code for obesity. Statistical analysis was performed to assess trends in hospitalizations and costs related to obesity. Results: During the analyzed period, there was a substantial increase of 110% in hospitalizations and 167% in obesity-related costs for SUS. Female patients (86%) accounted for the majority of hospitalizations, while males (14%) had lower representation. Predominantly, white individuals (62%) were admitted, whereas indigenous individuals had the lowest representation (0,007%). The Southern region contributed to 46% of total cases, in contrast to the Northern region, which accounted for only 0,9%. Conclusion: The findings of this study indicate a significant rise in hospitalizations and associated costs related to obesity for Brazil's Unified Health System. These results underscore the urgency of implementing health promotion and prevention measures, both in the public and private sectors. There is a need for optimized allocation of human resources, including trained professionals for obesity treatment, to mitigate the burden of obesity-related morbidity and mortality and alleviate the strain on the healthcare system.

Regional differences and trends in healthy life expectancy in Germany

Against the background of increasing life expectancy, the question arises in which state of health the additional years of life are spent. The aim of this study is to assess for the first time regional differences in healthy life expectancy for Germany. The concept of healthy life expectancy allows for the combination of regional differences in health status and mortality in asingle measure. This article uses the concept of partial healthy life expectancy. We use official data on deaths and population numbers to calculate abridged life tables. Data from the Socio-Economic Panel (SOEP) are used to determine the age- and sex-specific prevalences of health status. Regional differences are analyzed from 2002 to 2019 by dividing Germany into four regions (North, South, East, West). The regional differences in healthy life expectancy in Germany are greater than differences in life expectancy, and trends in healthy life expectancy partly differ from the corresponding trends in mortality. These differences over time also vary according to age: while healthy life expectancy has tended to stagnate and, in some cases, decline among the population aged between 20and 64, the number and proportion of years in good health has increased among older adults up to the age of79. There are striking regional differences and trends in the distribution of expected years in good health in Germany. The timely identification of regionally divergent developments could facilitate the implementation of targeted health-promoting measures.

Prevention and health promotion in dermatology

The term prevention includes measures that are used to avoid illnesses or damage to health as well as to reduce the risk of illness or to delay its occurrence. Preventive measures can be classified based on various criteria: temporal differentiation (primary, secondary, and tertiary prevention), context (behavioral and relational prevention), and recipient (general and individual prevention). Health promotion is used when appropriate measures are intended to strengthen and increase human health potential and resources. This includes, among other things, measures to develop health-promoting behavior (empowerment) and measures regarding the planning and implementation of health-promoting behavior (participation). One goal of these measures is generally to increase health literacy. This article describes examples of prevention and health promotion measures for occupational skin cancer (counseling approach for individual sun protection for outdoor workers; "individuelle Lichtschutzberatung" [ILB]) as well as occupational hand eczema within the meaning of German occupational disease number 5101 (outpatient and inpatient individual prevention measures). These are supplemented by the example of outpatient age-adapted small group trainings for patients with atopic dermatitis according to the multicenter evaluated concept of AGNES e. V. ("Arbeitsgemeinschaft Neurodermitisschulung") and ARNE ("Arbeitsgemeinschaft Neurodermitisschulung im Erwachsenenalter"). These examples also address aspects of sustainability and digitalization (eHealth, eLearning) in the areas of prevention and health promotion.

A review of Ayurvedic measures for preventing COVID-19 and promoting health during pregnancy

Abstract With the fourth year of the pandemic under its belt, the SARS-CoV-2 virus (COVID-19) disease is no longer deemed a public health emergency, but rather a persistent health issue. COVID-19 is one among the many diseases caused by severe acute respiratory syndrome coronavirus-2. Two waves of COVID-19 infections have recently emerged in India, with 2.8 million confirmed cases and 1,95,123 fatalities as of April 26, 2021. Typically, individuals have symptoms such as fever, dry cough, and malaise, which usually subside within a few days. However, in rare instances, these symptoms can escalate to respiratory distress, organ failure, and ultimately death. According to the World Health Organization, pregnant women are at a higher risk of contracting COVID-19 and may experience more severe symptoms than the general population. This is owing to their adaptive physiological changes and weakened immunological condition. Additionally, there is an elevated risk of premature delivery. Susceptible populations require special attention, efforts, and care to protect them from the coronavirus. No specific drug has been discovered for pregnant women (COVID-19) to date. Thus, preventive actions are the primary focus worldwide. Considering the current COVID-19 crisis, strengthening one’s immune system is very crucial, and in recent weeks, there has been much interest in Ayush practices that boost immunity. This article describes numerous Rasayana medicines, both single and compound, as well as preventive measures. This study primarily aims to understand the Ayurvedic perspective of COVID-19 during pregnancy and to offer Ayurvedic measures for immune regulation, health promotion, and prevention. By adopting Ayurvedic measures, the immunity of pregnant women can be enhanced, and COVID-19 will be prevented well, which will lessen the burden of the disease worldwide.

PATHFINDER-CHD: prospective registry on adults with congenital heart disease, abnormal ventricular function, and/or heart failure as a foundation for establishing rehabilitative, prehabilitative, preventive, and health-promoting measures: rationale, aims, design and methods

BackgroundAdults with congenital heart defects (ACHD) globally constitute a notably medically underserved patient population. Despite therapeutic advancements, these individuals often confront substantial physical and psychosocial residua or sequelae, requiring specialized, integrative cardiological care throughout their lifespan. Heart failure (HF) is a critical challenge in this population, markedly impacting morbidity and mortality.AimsThe primary aim of this study is to establish a comprehensive, prospective registry to enhance understanding and management of HF in ACHD. Named PATHFINDER-CHD, this registry aims to establish foundational data for treatment strategies as well as the development of rehabilitative, prehabilitative, preventive, and health-promoting interventions, ultimately aiming to mitigate the elevated morbidity and mortality rates associated with congenital heart defects (CHD).MethodsThis multicenter survey will be conducted across various German university facilities with expertise in ACHD. Data collection will encompass real-world treatment scenarios and clinical trajectories in ACHD with manifest HF or at risk for its development, including those undergoing medical or interventional cardiac therapies, cardiac surgery, inclusive of pacemaker or ICD implantation, resynchronization therapy, assist devices, and those on solid organ transplantation.DesignThe study adopts an observational, exploratory design, prospectively gathering data from participating centers, with a focus on patient management and outcomes. The study is non-confirmatory, aiming to accumulate a broad spectrum of data to inform future hypotheses and studies.ProcessesRegular follow-ups will be conducted, systematically collecting data during routine clinical visits or hospital admissions, encompassing alterations in therapy or CHD-related complications, with visit schedules tailored to individual clinical needs.AssessmentsBaseline assessments and regular follow-ups will entail comprehensive assessments of medical history, ongoing treatments, and outcomes, with a focus on HF symptoms, cardiac function, and overall health status.Discussion of the designThe design of the PATHFINDER-CHD Registry is tailored to capture a wide range of data, prioritizing real-world HF management in ACHD. Its prospective nature facilitates longitudinal data acquisition, pivotal for comprehending for disease progression and treatment impacts.ConclusionThe PATHFINDER-CHD Registry is poised to offer valuable insights into HF management in ACHD, bridging current knowledge gaps, enhancing patient care, and shaping future research endeavors in this domain.

Influential Social Determinants of Adherence to Preventive and Health Promotion Activities during Pregnancy and the First Year of Life: Systematic Review.

Effective monitoring throughout pregnancy and the first year of life is a crucial factor in achieving lower rates of maternal and infant mortality. Currently, research on socioeconomic factors that influence the lack of adherence to preventive and control measures during pregnancy and the first year of life is limited. The objective of this review is to examine the available evidence on social determinants that influence participation in health promotion and preventive activities throughout the pregnancy journey and in infants during their first year of life. We performed a systematic review of the literature searching in the major scientific databases (PubMed, Scopus, EMBASE, WOS, and Cochrane Library) for articles from February 2017 to May 2023 containing information on health inequities that impact participation in health promotion and preventive measures from pregnancy through the first year of an infant's life. A total of 12 studies were selected; these studies were performed in ten different countries on five different continents. The selected studies cover preventive measures during maternal care, vaccination, and immunization during pregnancy and the first year of life, newborn screening, and follow-up of the first 12 months of life. The social factors associated with low adherence to health promotion activities during pregnancy and the first year of life include education, income, ethnicity, place of residence, and family characteristics. Despite the diverse geographical distribution, it is observed that there are common social factors linked to a decrease in the adherence to preventive measures during pregnancy and in the early years of life.

Predictors of adherence in Austrian employees during the COVID-19 pandemic: results of an online survey.

Since the beginning of the pandemic in December 2019, Coronavirus disease 2019 (COVID-19) has been a significant challenge to health care systems throughout the world. The introduction of measures to reduce the incidence of infection had a significant impact on the workplace. Overall, companies played a key and adaptive role in coping with the pandemic. Cross-sectional data from an online-survey of 1,183 employees conducted during the COVID-19 pandemic in spring 2021 in Austria were used in the analyses. The influence of health beliefs (e.g., perceived severity), modifying factors (e.g., age) and time-dependent factors (e.g., corona fatigue) on individual adherence were evaluated. The conception of the questionnaire was based on the health belief model. The majority of respondents were female (58.3%), worked in companies with more than 250 employees (56.6%) and had been to an academic secondary school or had a university degree (58.3%). Overall, employees were adherent to most of the measures at their company (>80%), except for wearing FFP-2 masks when they were travelling in a car with coworkers (59.3, 95%CI 51.3-66.7%). Overall adherence was associated with high ratings for the meaningfulness of testing (OR: 2.06 95%CI: 1.00-4.22; p = 0.049), the extent to which social norms govern behavior (OR: 6.61 95%CI: 4.66-9.36; p < 0.001), lower perceived difficulties associated with the adoption of health-promoting measures (OR: 0.37 95%CI: 0.16-0.82; p = 0.015) and lower corona fatigue (OR: 0.23 95%CI: 0.10-0.52; p < 0.001). Adherence to four single measures was influenced by different predictors. The most important predictors (important for the adherence to three out of four single measures) were social norms and corona fatigue. The importance attached to testing and social norms, as well as lower perceived barriers to health-promoting measures and low levels of corona fatigue all increase overall adherence to Covid-19 protective measures in companies. Strategies to improve adherence should be adapted depending on the aim (to raise overall adherence or adherence to individual measures) and on the group of persons that is being targeted.

Pattern of multimorbidity in middle-aged and older-aged people with mild intellectual disability in Australia.

Non-communicable diseases (NCDs), also known as chronic diseases, now constitute a major proportion of ill-health across most adult and older populations including in people with intellectual disability. The current paper is a comparative analysis of prevalence of NCDs across mid-aged and older-aged people with mild intellectual disability. Comparative data comes from two cross-sectional surveys using similar methodology and timeframes. The analysis sample comprises mid-aged group (30-50 years, N = 291) and older-aged group (≥60 years, N = 391). People with mild intellectual disability start developing NCDs in early to mid-adulthood and increases with age. The mean number of NCDs in mid-aged group was 0.86 (SD, 0.84) compared to 3.82 in older group (SD, 2.67). There needs to be early identification and management of NCDs using relevant health promotion and preventative measures at optimal intervention points. The training of healthcare professionals needs improvement.

Health Promotion Measures: Correct Usage of Facemask and Practices of Hand Hygiene

Health Promotion Measures: Correct Usage of Facemask and Practices of Hand Hygiene

Positive mental health and sense of coherence among emergency medical service professionals.

Positive mental health (PMH) is a construct used to define and evaluate health from a positive perspective. Healthcare professionals in the emergency ambulance service are more likely to experience mental health disorders than the overall population. The demographic and occupational variables and Sense of Coherence (SOC) can act as predictors of PMH and can serve as protective elements against stress and demanding situations in the work environment. This study aimed to evaluate PMH and its relationship with demographic and occupational variables and determine if SOC is a predictive variable for PMH in health professionals working in the emergency ambulance service. A descriptive, cross-sectional, and correlational study was conducted with a sample of 406 healthcare professionals from the emergency ambulance service in eight health regions of Catalonia, Spain. The following variables were analyzed: Age, biological sex, household members, dependents family members, professional category, type of contract, job satisfaction and sense of collaboration with other institutions. The following assessment instruments were used: Positive Mental Health Questionnaire and Sense of Coherence scale. High scores were obtained in Positive Mental Health (PMH). Study participants who reported feeling completely satisfied in their work also showed a significant relationship with all PMH factors: greater satisfaction with their personal life, in their helpful prosocial attitude toward others, in their capability to deal effectively with stress and navigate conflict scenarios, in their ability to solve problems and self-realization, greater empathy and ability to understand the feelings of others, greater ability to establish interpersonal relationships. Comprehensibility, as a dimension of SOC, was identified as a predictor for some factors of PMH: a greater personal satisfaction, self-control, autonomy, interpersonal skills and total PMHQ. More than 43% of positive mental health in health professionals is explained by higher Meaningfulness and Comprehensibility values of the SOC, the absence of dependent family members and having a non-graduate background. Healthcare workers in the emergency ambulance service had high PMH. Meaningfulness (ME) and Comprehensibility (C), dimensions of SOC, were identified as model predictors of greater PMH, showing higher scores in most of PMH factors. To enhance SOC as a mental health promotion measure, resilience programs should be implemented to help professionals develop skills to face and overcome adverse situations. Educating in stress management thought networks are key elements to strengthen SOC. Managers in emergency medical services play a key role in transforming healthcare work environments to promote positive outcomes in the mental health of their healthcare workers.

Decentralized Health Promotion in Nuremberg according to the Prevention Bill: Assessment of results and experiences of the project "Health for Everyone in the District"

The project "Health for Everyone in the District" was implemented in Nuremberg from May 2017 to October 2022 as part of the law passed to strengthen health promotion and disease prevention with funding from Public Health Insurance, Bavaria. The aim was to implement health promotion measures through a decentralized system in four deprived parts of the city and thus promote health equity on site. Among other aspects, program loyalty, project scope, and acceptance, as well as continuity and establishment of permanent structures underwent external assessment. As part of the evaluation, quantitative data from the paper-and-pencil feedback forms of the measures (n=580), four qualitative focus group interviews with participants of the project (n=20), and an in-depth partially standardized predominantly quantitative online survey of participants and course instructors from the districts (n=67) were conducted. The programs were accepted by those most in need, namely women, elderly people and those with a migration background. Women, senior citizens and people with a migration background were well reached by the measures. The very high level of satisfaction with the measures showed that there were opportunities for implementation of health promotion measures into daily life taking into consideration the local environment and deprived target groups. The specifications of the guidelines for prevention, however, represented a hurdle for the long-term establishment of the measures in these districts. The project "Health for Everyone in the District " represents a local low-threshold approach to social situation-related health promotion in the municipal setting and is suitable for reaching deprived target groups with health-promoting measures. Adjustments to the guidelines for prevention could help create permanent structures on a broader scale.

Job satisfaction and work stress among physicians in Norway and Germany-A cross-sectional study.

Physicians' health and wellbeing are important albeit often neglected quality indicators of health care systems. The aims of the study were to compare job satisfaction and work stress among doctors in Germany and Norway, and to identify predictors for job satisfaction. All active physicians in Schleswig-Holstein, Germany (N = 13,304) and a nationwide sample of Norwegian physicians (N = 2,316) were surveyed in a cross-sectional design in 2021. Response rates of German and Norwegian physicians were n = 4,385 (33%) and n = 1,639 (70.8%), respectively. In addition to age, sex, and work-hours, the main outcome measures were the validated Job Satisfaction Scale (JSS) and the short form of the Effort-Reward Imbalance Questionnaire (ERI). There were significant differences between Norwegian and German physicians in job satisfaction but with small effect sizes. All effort scores of German physicians were significantly higher and four of seven reward scores significantly lower than for their Norwegian colleagues. The proportion of German physicians in the state of a gratification crisis was significantly higher (67%) than in their Norwegian colleagues (53%). In both countries, physicians with a gratification crisis scored significantly lower on all items of job satisfaction. There were only minor gender differences in job satisfaction and effort-reward balance. Age, effort, and reward accounted for 46% of the explained variance of job satisfaction. Lower job satisfaction and reward in some areas and higher perceived effort of physicians in Germany than in Norway are still in favor of Norwegian working conditions, but the differences seem to diminish. The high proportions of gratification crises in both countries warrants appropriate measures for prevention and health promotion.

Smartphone addiction and postural alterations in the cervical region in adolescents.

To evaluate smartphone addiction and postural alterations in the cervical region in adolescents. A cross-sectional study with 281 adolescents (15 to 19 years old), attending the 1st to the 3rd grades of High School, carried out between September and October 2019 in the city of Fortaleza, Ceará, Brazil. Data collection took place in two stages. In the first, they answered four self-administered questionnaires: sociodemographic questionnaire, health conditions and smartphone use, Nordic Musculoskeletal Symptom Questionnaire (NMQ), Self-Report Questionnaire (SRQ-20) and the Smartphone Addiction Inventory (SPAI-BR). In the second stage, they were submitted to photogrammetry using the Postural Assessment Software (SAPO) and anthropometric assessment (weight and height). The software SPSS Statistics version 23.0 was used for data analysis. Of the total number of adolescents, 63.3% (n=178) showed smartphone addiction, using it for 5.8 hours (±3.5) during the week and 8.7 (±4.0) hours on the weekend. When analyzing postural alignment in the anterior view, a significant reduction in the lateral head tilt was observed when typing on the smartphone (p=0.002) compared to the anatomical position (baseline). In the lateral view, an increase in head anteriorization was observed during smartphone use (p<0.05). There was an association between smartphone addiction and head anteriorization (p<0.05). The use of the smartphone in the typing position causes postural alterations in the cervical region, especially in adolescents with smartphone addiction. Therefore, health promotion measures that alert adolescents to the adverse effects caused by prolonged smartphone use are necessary.

A Dataset on Population Activity Patterns in Typical Regions of North China

This data article describes the "Typical Regional Activity Patterns" (TRAP) dataset, which is based on the Tackling Key Problems in Air Pollution Control Program. In order to explore the interaction between air pollution and physical activity, we collected activity patterns of 9,221 residents with different occupations and lifestyles for three consecutive days in typical regions (Jinan and Baoding) where air pollutant concentrations were higher than those in neighboring areas. The TRAP dataset consists of two aspects of information: demographic indicators (personal information, occupation, personal habits, and living situation) and physical activity pattern data (activity location and intensity); additionally, the exposure measures of physical activity patterns are included, which data users can match to various endpoints for their specific purpose. This dataset provides evidence for exploring the attributes of activity patterns of residents in northern China and for interdisciplinary researchers to develop strategies and measures for health education and health promotion.

Assessing seniors' satisfaction with local government activities in physical activity promotion: a comparative analysis.

The aging population in Poland poses significant challenges to social and health systems. By 2050, the percentage of people over 65 in Poland is projected to reach 32.7%. Promoting physical activity among seniors is crucial for preventing chronic diseases, improving quality of life, and reducing healthcare burdens. Local governments play a pivotal role in implementing health-promoting measures. The study aims to analyze seniors' satisfaction with local government activities in promoting physical activity and to identify the best activities and future needs of seniors in the Silesia, Mazovia, and Pomerania regions of Poland. The survey, conducted between May 2023 and May 2024, utilized the Computer Assisted Web Interviewing (CAWI) method to gather data from 1,500 seniors aged 65 and above across the Silesia, Mazovia, and Pomerania regions. The study population was carefully selected to ensure representativeness in terms of gender, age, education, and place of residence. Data analysis included chi-square tests and logistic regression to assess satisfaction levels and identify influencing factors. The survey revealed regional differences in satisfaction levels. Seniors in the Mazovia region exhibited the highest satisfaction (74% positive ratings), followed by the Silesian (64%) and Pomeranian (56%) regions. Factors influencing satisfaction included gender, age, education, and place of residence. Women, older seniors, those with higher education, and urban residents reported higher satisfaction levels. The most appreciated local government activities were related to sports infrastructure and sports programs. Future needs emphasized the demand for more sports programs and better infrastructure, with regional variations in preferences. Seniors' satisfaction with local government activities in promoting physical activity varies significantly across regions. Tailoring activities to regional preferences and continuous evaluation of programs are essential for enhancing effectiveness and satisfaction. Increased funding and support for physical activity programs are necessary, especially in less developed regions.

Programa de garantías explícitas en salud en Chile para Cáncer gástrico: análisis de mortalidad y cambios estructurales

Objective: To analyze the variation in gastric cancer mortality rates in Chile following the implementation of the Explicit Health Guarantees Program within the Chilean Healthcare System, from its introduction in 2006 to 2022. Metodology: A quantitative, analytical, retrospective cross-sectional study was conducted. A secondary analysis of gastric cancer mortality rates between 2000 and 2022 was performed. The technique used involved time series analysis with structural changes, using Chow statistical test. All deaths with gastric cancer as the primary cause were included. Results: A structural change in the time series of standardized mortality due to gastric cancer in the population was identified through annual observations from 2000 to 2022, with a Chow test = 25.62; p-value of 1.572e-5; at a significance level of 0.05. It was identified in the year 2012. Conclusion: Following the implementation of the Explicit Health Guarantees Program in 2006, a structural change in mortality analysis was observed, specifically related to gastric cancer, in the year 2012. Screening, coverage, access, and health promotion measures contributed to the reduction in mortality between 2012 and 2022.

Injury as a Threat To Health, Experiences of Falling From Trees in Farmers: A Qualitative Study

Background: Falling is a significant cause of occupational injuries and fatalities among farmers, and falling from trees is one of the most common causes of injury resulting in a high number of visits to health centers. Despite this, there is limited evidence on the factors associated with falling from walnut trees. Therefore, this study aimed to identify the factors that contribute to falling from walnut trees from the perspective of farmers and farmworkers. Methods: This qualitative study was conducted using conventional content analysis. Data were collected through semi-structured interviews with 20 farmers and farmworkers who had experienced falling from walnut trees as recorded in the National Accidents Record Program from September to October 2017 in Tuyserkan county, Iran. Participants were selected through purposive sampling. Moreover, data rigor was ensured through participant and external checks. All interviews were recorded and analyzed using content analysis methods. Results: Data analysis led to the extraction of six themes, including psychological factors, physical factors, behavioral and habitual factors, economic factors, factors related to walnut trees, and atmospheric agents, along with 18 subthemes for behavioral, human, and environmental factors. Conclusion: The findings of this study suggest that with appropriate interventions and training, farmers and farmworkers can be guided and assisted so as to prevent the occurrence of falling from walnut trees. In addition to educational interventions, health promotion measures such as providing safety equipment and insurance coverage can be essential in reducing injuries.

“Always Look at the Clock”: Psychosocial Working Conditions in Outpatient Care—A Qualitative Study

Background: In view of demographic change, there is a growing need for qualified nursing professionals. More and more people in need of care prefer to be cared for at home. A shortage of skilled workers and constantly changing and increasing professional requirements are some of the consequences. The aim of this study is to generate further insights into work-related psychosocial stress factors and the resources of outpatient caregivers in their subjective perceptions to derive approaches for possible health-promoting interventions for practice and research that promote healthier and more sustainable work. In addition, coping strategies and needs should be inquired about in order to determine support offers. Methods: Using a semi-structured interview guide, thirty outpatient nursing professionals in Germany were interviewed in 2022. The subject of this interview was the psychosocial working conditions and resources in outpatient care. The collected data were evaluated by means of the Kuckartz qualitative content analysis. Results: This qualitative study identified work-related job demands and resources in outpatient care. The way nurses are treated in the companies they work for and the appreciation of patients were explored as important resources. Physical demands, the time factor, and dealing with personal fates are primarily mentioned as stress factors. The learning effect plays an important role in dealing with these. Conclusion: This study contributes to a better understanding of current job strain and resources as well as job satisfaction in outpatient care. In any case, it became clear that the nursing staff love their profession, which they see more as a vocation. Future quantitative studies are necessary to build on these findings. First ideas of implications for health promotion measures in research and practice have already been derived.