Healthcare Settings Research Articles (Page 1)

<b>Background:</b> The occurrence of challenges associated with the health of the aged keeps increasing due to the increasing aged population. One of the most common among these is depression. Depression is a prevalent mental illness that is defined by prolonged melancholy, loss of interest in once-enjoyed pursuits, and the inability to carry out everyday tasks for at least two weeks. The study analyzed the contributing factors associated with depression among the ageing population of Ghana.<br /> <b>Method:</b> The study used the World Health Organization’s Study on global AGEing and adult health (SAGE) wave 1 data from Ghana. There were 4,223 participants in the data. Descriptive statistics and logistic regression were used for data analysis. A logistic regression model was developed using the data.<br /> <b>Results:</b> The findings indicated that 52.76% of the elderly suffered depression. The prevalence of depression is higher among older adults with severe or moderate vision issues. Additionally, it was shown that those with medium levels of education experience depression more frequently than those with no education or low levels of education. Again, older people with memory problems are more prone to depression. The logistic regression found difficulty in seeing, highest education level, systolic blood pressure, alcohol intake, and difficulty in remembering as the risk factors associated with depression.<br /> <b>Conclusions:</b> The prevalence of depression among the aged in Ghana is high. Since depressive symptoms are frequently linked to aging, we advise health practitioners to screen depressive symptoms alongside other chronic medical conditions in the elderly population in healthcare facilities and community settings.

People living with human immunodeficiency virus (PLHIV) often navigate complex and vulnerable circumstances shaped by intersecting social identities that influence their experiences with human immunodeficiency virus (HIV) infection, healthcare, and support services. This qualitative study explored how PLHIV in Sweden perceive and experience healthcare and social support. It draws on 32 in-depth interviews conducted in 2019, 2021, and 2024 with participants aged 20-65 years. Three central themes were identified through thematic analysis. The first theme, "Carrying Many Burdens: Multiple Vulnerabilities, Overlapping Conditions, and Socioeconomic Hardship", how overlapping identities, health issues, and financial hardship compound vulnerability. Second, "Varying Attitudes and Practices in Healthcare Settings", reflect inconsistent and sometimes problematic encounters with healthcare systems. The third theme, "Nongovernmental Organizations Support is Valuable but Limited", emphasizes the importance of support while revealing its inadequacy in reaching everyone and meeting all needs. These findings highlight the multifaceted vulnerabilities faced by PLHIV in Sweden and point to significant gaps in both healthcare and social support systems. Addressing these challenges calls for coordinated efforts across the structural, institutional, and individual levels.

ABSTRACT This study aimed to explore how students reflect on their caring encounter with a patient. For this purpose, the research has a reflective lifeworld and, as such phenomenological approach, utilizing individual written narratives as data. Before data collection, the students were educated in an approach to caring communication, supported by a life-world perspective. The students were offered a supplementary training session on the communication approach. Emphasis is placed on adopting an attitude that regards the patient as a subject with unique lived experiences. The participants were recruited from the Primary Health Care Specialist program. During the students’ clinical training, they encountered a patient and reflected upon the encounter afterwards. A reflective lifeworld research perspective was used to analyze the students’ narratives. It was found that students engaging in life-world-led encounters with patients presented various challenges, primarily in maintaining an open and flexible approach by bridling their own preunderstandings, attentively listening to patients’ narratives without interruption were highlighted as significant challenges. Remaining fully present in the moment to actively engage with patients’ descriptions was regarded by the students as both demanding and rewarding. The findings suggest the need for teachers to actually engage in reflective teaching in their professional contexts.

To describe the development, implementation, and feasibility of a novel training program for community pharmacists transitioning to clinical ambulatory care positions. A primary care-focused ambulatory care pharmacist training program was initiated in an integrated healthcare system in Utah in response to community pharmacy closures. The program aimed to transition community pharmacists into clinical ambulatory care positions utilizing a competency framework designed to cultivate skills in applying clinical knowledge, communication, managing clinic workflow, and professional development. Nine pharmacists in the program (trainees) were each paired with 1 to 2 pharmacists (mentors) with robust experience in ambulatory care practice. Trainees participated in independent study, didactic instruction, and hands-on experiences tailored to their roles as either embedded or telehealth pharmacist trainees. They worked toward meeting clinical skills and professional engagement objectives outlined in a competency framework, with the goal of progressing to independent practice within 6 to 12 months. While these objectives guided development, completion timelines were adapted in response to evolving roles and operational challenges. Embedded pharmacist trainees completed 70% of the clinical skills objectives after 6 months and 74% of the professional engagement objectives after 12 months. Telehealth pharmacist trainees completed 100% of the clinical skills objectives after 6 months and 56% of the professional engagement objectives after 12 months. Trainees reported increased confidence in most clinical skills areas but less motivation for professional engagement activities at 6 months. Mentors found the program design suitable but suggested a higher mentor-to-trainee ratio to manage workload. This program served as a novel, practice-based approach to train and transition community pharmacists into clinical ambulatory care positions. Its successful implementation demonstrates a feasible strategy for workforce redeployment, offering a model that may inform future training initiatives in evolving healthcare settings.

Black birthing people experience disproportionately high rates of adverse maternal and infant health outcomes. Doula support is associated with improved birth outcomes and can help reduce racial disparities, yet culturally congruent doulas face hurdles practicing in the healthcare setting. This quality improvement project aimed to understand the experiences of Black doulas in Nebraska to enhance integration into healthcare systems. Three group-based interviews were conducted as part of a quality improvement project in August 2023 with six Black doulas practicing in Nebraska. Participants were recruited through community organizations and snowball sampling. Semi-structured interviews explored doula practices, barriers, motivations, and sources of support. Transcripts were analyzed using thematic analysis. Three main themes emerged: (1) Barriers inhibiting Black doulas in the healthcare setting, (2) Facilitators of a doula-friendly clinical environment, and (3) Coping strategies. Doulas described facing resistance, stereotypes, and a lack of understanding about their role from some healthcare staff, contrasted with client advocacy. Self-care strategies and peer support networks were critical for sustainable practice. Despite systemic barriers, Black doulas play a vital role in supporting Black families and addressing inequities. Recommendations include implementing doula-friendly policies, addressing bias, fostering an inclusive environment in healthcare facilities, and enhancing the integration of culturally concordant doula support to improve outcomes for Black birthing people.

Pulsed field ablation (PFA) is an emerging non-thermal catheter ablation (CA) modality for the treatment of atrial fibrillation (AF), PFA has shown a relatively similar success rate but offers improved safety compared to thermal approaches such as radiofrequency ablation (RFA) and cryoballoon ablation (Cryo). Although its clinical benefits are well established, comparative data on its economic impact remain limited. This systematic review aimed to compare the cost profiles of PFA versus thermal ablation strategies in patients with AF. We systematically searched PubMed, Embase, and Scopus through April 2025 for studies reporting cost analyses comparing PFA with RFA or Cryo. Extracted data included per-patient cost, procedural time, and, when available, cost-effectiveness metrics such as quality-adjusted life years (QALYs) and net monetary benefit (NMB). Four studies met the inclusion criteria. Despite variability in health care settings and costing approaches, three of the four studies demonstrated that PFA was cost-saving compared to thermal ablation, with per-patient differences ranging from $520 to $2387. One study reported higher costs for PFA, with an excess of $2447 compared to Cryo. PFA was consistently associated with shorter procedural times, suggesting potential efficiency gains for high-volume centers. Only one study reported a formal cost-effectiveness analysis, in which PFA demonstrated both lower total costs and higher QALYs, resulting in an NMB of $2947 at a willingness-to-pay threshold of $100,000 per QALY. PFA shows a favorable cost profile compared to RFA and Cryo, driven by reduced procedural time and lower long-term costs.

The emergence of multidrug-resistant organisms (MDROs) represents a significant challenge for global healthcare systems. The Netherlands maintains one of the lowest antimicrobial resistance rates in the world, attributed to prudent antibiotic use and effective infection prevention and control policies in healthcare settings. This report presents an updated national guideline for the infection prevention and control of MDROs in hospitals, developed by the Dutch Collaborative Partnership for Infection Prevention Guidelines (SRI). Using a multidisciplinary approach and evidence-based frameworks such as AGREE-II and GRADE, the guideline addresses the definition of MDRO, risk assessment and recommendations for MDRO screening, isolation and infection prevention measures, source and contact tracing, discontinuation of isolation measures, and organization of care. It incorporates new evidence, and other aspects such as patient perspectives, sustainability, costs, and organizational factors, providing practical recommendations to mitigate MDRO transmission. This update aims to strengthen national infection control practices and sustain the Dutch low antimicrobial resistance levels.

The COVID-19 pandemic and digital transformations have led to a significant expansion of remote work in healthcare settings. This longitudinal, multicenter study evaluated personal and organizational coping strategies employed by remote hospital staff (including doctors, nurses, engineers, and administrative personnel) in Lahore and Karachi, Pakistan. The study assessed the effectiveness of these strategies in maintaining mental health. Over a 12-month period, we surveyed approximately 800 participants across 5 hospitals in each city. Validated tools (the Patient Health Questionnaire-9 [PHQ-9] for depression and the Generalized Anxiety Disorder-7 for anxiety) were administered at baseline, 6 months, and 12 months. Additionally, the brief COPE inventory was used to assess coping mechanisms. Ethical approval and informed consent were obtained in accordance with the Declaration of Helsinki. Descriptive statistics were used to characterize demographic and mental health profiles, while multivariable mixed-effects models examined associations between coping strategies and symptom trajectories over time. At baseline, 30% of participants reported moderate-to-severe depressive symptoms. Common personal coping practices included family support, positive thinking, prayer, physical exercise, and mindfulness. Organizational strategies included flexible work schedules, IT assistance, and regular supervisor check-ins. Over time, regular physical activity, virtual social support, and effective time management were significantly associated with lower PHQ-9 and Generalized Anxiety Disorder-7 scores. In contrast, excessive news consumption and workaholism were linked to worse mental health outcomes. For instance, individuals who reported engaging in daily physical activity experienced a 20% reduction in depressive symptom trajectories (P < .01). In conclusion, both personal and organizational strategies were effective in mitigating stress. These findings highlight the importance of institutional policies that promote such coping mechanisms (such as structured support programs and balanced workloads) to sustain staff well-being in remote and hybrid work environments.

Selecting patient-reported outcome measures (PROMs) that accurately reflect the unmet needs of cancer survivors (CSs) remains a challenge in oncology, as current processes lack a structured methodology. This study aimed to develop and test the feasibility of a replicable, patient-centred framework for PROM selection, ensuring alignment between survivors' lived experiences and standardised outcome measures across diverse healthcare settings. Our methodology integrated qualitative and quantitative approaches, mapping patient-expressed unmet needs onto the International Classification of Functioning, Disability, and Health (ICF). The process involved three steps: (1) identifying survivors' needs through focus groups, interviews and questionnaires, (2) linking these needs to ICF categories using validated methodologies and (3) systematically evaluating existing PROMs based on their coverage of these categories. To demonstrate feasibility, we conducted a feasibility study involving 35 CSs and seven caregivers within the Italian healthcare context. Among the 14 PROMs analysed, the Cancer Rehabilitation Evaluation System (CARES) covered 94.3% of ICF-linked needs, emerging as the most suitable option. The framework's adaptability allows clinicians and researchers to identify context-specific PROMs for diverse populations and healthcare systems. This study provides a robust, evidence-based methodology for optimising PROM selection, bridging the gap between patient narratives and standardised measurement. This feasibility study demonstrates the framework's practical applicability in clinical practice, with potential for broader implementation across diverse healthcare contexts. Its global applicability ensures that survivorship care remains patient-centred, data-driven and contextually relevant. By facilitating the selection of tailored PROMs, this framework enhances patient-centred survivorship care, ensuring that outcome assessments remain relevant to survivors' experiences and improving care quality across different settings. ClinicalTrials.gov Identifier: NCT06236373.

Peer support workers (PSWs) are trained behavioral health professionals with lived experience of substance use disorders. PSWs are employed by behavioral health agencies to increase uptake of and retention in treatment and recovery services. As their presence in these settings grows, it remains unclear how well PSW job functions align with their unique skills and personal experiences. To fill this gap, a content analysis of online job postings for PSW roles in Missouri across geographic regions and types of behavioral healthcare settings (i.e., treatment facilities, recovery housing, recovery community centers, hospitals, criminal justice settings) posted between April 2023 and September 2024 was conducted and analyzed to assess how they reflect role expectations and the distinct value PSWs contribute to the system. Job tasks were organized into categories and classified as authentic (utilizing PSWs' experience and training, e.g., mentoring, recovery goal setting, and peer advocacy) or generic (not specific to peer roles, e.g., administrative duties, transportation, maintaining relationships with external stakeholders). Results showed that PSWs are expected to perform a near even split of authentic (49.8%) and generic (50.2%) tasks. These findings suggest a lack of consistency in how agencies define and implement the PSW role, potentially contributing to job dissatisfaction and turnover. As organizations continue to employ PSWs in greater numbers, it will be important for agencies to prioritize job clarity and satisfaction, as well as determine the optimal balance of tasks for a more consistent system-level understanding of how to best utilize PSWs in the workplace.

To explore how chief nursing officers perceive and enact their leadership within bureaucratic healthcare systems, with a particular focus on patient safety, strategic responsibilities and the advancement of nursing care quality. A qualitative study design was used. Semistructured interviews were conducted between October 2023 and May 2024 with nine female Chief Nursing Officers, representing diverse regional healthcare settings across Sweden. The interviews were analysed using reflexive thematic analysis, which was informed by the theory of bureaucratic caring to support interpretation. Chief nursing officers described navigating hierarchical and bureaucratic systems while promoting person-centred care and professional governance. Their work involved balancing strategic mandates with ethical imperatives, advocating for workforce development and fostering a culture of proactive safety. The analysis generated four interrelated themes: (1) grappling with complexity and power structures; (2) guided by ethics, compassion and purpose; (3) empowering the nursing workforce to provide improved care; and (4) shaping quality care through innovation, evidence and technology. Chief Nursing Officers can act as key agents of transformation at the intersection of structure and care. Their leadership extends beyond administrative functions to encompass strategic influence, ethical advocacy and system-level improvement. The findings underscore the need to further formalise and institutionalise the role, ensuring it is equipped with the mandate and structures required to lead across organisational levels. Strengthening such roles calls for leadership models that foster collaboration, support shared governance and enable flatter organisational hierarchies-structures designed to enhance participation, distribute decision-making and promote professional autonomy. This study followed reporting standards for qualitative research by adhering to the EQUATOR Network guidelines and using the COREQ checklist. Only health care staff participated in this study. This study highlights the strategic, ethical and relational dimensions of chief nursing officers' leadership and its impact on patient safety, quality improvement and workforce development. The findings demonstrate that they can play a pivotal role in embedding ethical perspectives into healthcare leadership-bridging professional nursing values with structural and strategic priorities. This underscores the importance of enabling nurses to shape care systems in ways that promote safety, professional governance and person-centredness.

Tuberculosis continues to represent a major occupational risk in healthcare environments, particularly for healthcare workers who have persistent contact with patients who may be infectious. Despite the high occupational burden of tuberculosis among healthcare workers, there remains a lack of focused reviews that comprehensively evaluate preventive interventions across all levels of prevention within healthcare settings. In this literature review, effective preventive interventions relevant to tuberculosis transmission have been examined. Primary preventive interventions seek to diminish exposure through protective interventions such as respirators, improvements in ventilation systems, and implementation of educational programs regarding infection control protocols. Secondary preventive interventions target early diagnosis and routine screening with efforts to detect cases and latent infections early, before they progress to active disease. Enhancements in diagnostic technology have improved both the accuracy and speed of detection, further aiding the efforts of controlling nosocomial transmission. Tertiary preventive interventions target enhancing compliance with treatment protocols, managing complications of active infection, and controlling resistant strains through individualized follow-up and interventions. Barriers like stigma and lack of resources, however, often impede such interventions’ effectiveness in many cases. This narrative literature review highlights the imperative for strengthened workplace policies, an expansion of educational programs, and continued research in new and emerging interventions like new vaccine and diagnostics technology development. All these factors aim to optimize intervention effectiveness for tuberculosis and protect the health and welfare of workers in the medical field.

Cervical dysplasia is preventable through screening methods and Human Papillomavirus (HPV) vaccination. Cervical cancer (CC) mortality is disproportionately higher in low-and-middle-income nations, which lack a population-based screening program. Health professionals should promptly counsel and educate females about cervical dysplasia prevention. this work aimed to determine the level of knowledge, attitudes, and practices of female health professionals about cervical cell dysplasia. As well as addressing the potential barriers against routine cytological screening tests. A cross-sectional multicentric study at two tertiary hospitals; Tanta and Menoufia University Hospitals, recruited 1300 women (physicians, nurses, pharmacists, and dentists) via a multistage stratified random sampling technique. A self-administered questionnaire consisting of 4 sections was used to collect the relevant data. Across all professions, 25% and 49.2% respectively had good knowledge levels and positive attitudes regarding cervical dysplasia. The majority had not been vaccinated against HPV nor undergone a Pap smear. Older age, urban residence, and positive family history were significant predictors of negative attitudes towards screening, p < 0.0001, beta 95%(CI) = -0.8 ( -0.1,-0.05), -0.9 (-1.2,-0.6), -0.2 (-0.8,0.4)) respectively. The most encountered barriers opposing screening included lack of awareness about health facilities providing CC screening and the belief that there is no need so far, no complaints (72.6%,73%). Female health professionals possessed acceptable knowledge and relatively positive attitudes regarding CC prevention, while their practices were discouraging. Believing that CC is a curse was the main culprit of refraining screening. It is pivotal to enhance accessibility to cervical screening services in various healthcare settings and boost the knowledge of health practitioners as they are key promoters of public health.

Background: Healthcare systems worldwide face growing challenges in anticipating and managing patient surges, particularly in times of public health crises, natural disasters, or seasonal peaks. The ability of healthcare organisations to forecast and respond to such demand fluctuations—referred to as organisational readiness for patient capacity surge—has become a critical determinant of service continuity and patient outcomes. Despite the urgency, there remains a lack of consolidated evidence on how healthcare authorities measure, evaluate, and operationalise this readiness. This systematic review aims to identify and synthesise existing literature that presents case studies, methodologies, and strategic frameworks used to evaluate organisational preparedness for patient surge capacity. It also explores resource allocation mechanisms, hospital capacity planning algorithms, and temporary facility strategies documented in healthcare settings. Methods: The review was conducted across two major scientific repositories, i.e., PubMed and Web of Science (WoS). A set of four structured search queries were formulated to capture the breadth of the topic, focusing on demand forecasting, hospital capacity planning, workforce models, and resource management within the context of healthcare surge demand. The search was limited to publications from the last 10 years (2014–2024) to ensure the inclusion of contemporary practices and technologies. Resutls: A total of 142 articles were selected for detailed analysis. The articles were categorised into six thematic groups: (i) empirical case studies on healthcare surge management; (ii) hospital resources and capacity scaling; (iii) ethical frameworks guiding surge response; (iv) IT-driven algorithms and forecasting tools; (v) policy evaluations and actionable lessons learned; and (vi) existing systematic reviews in related domains. Notably, several articles provided evidence-based frameworks and simulation models supporting predictive planning, while others highlighted real-world implementation of temporary care facilities and staff redeployment protocols. Conclusions: The review underscores the fragmented yet growing body of literature addressing the multidimensional nature of surge preparedness in healthcare. While algorithmic forecasting and capacity modelling are advancing, gaps remain in standardising metrics for organisational readiness and incorporating ethical considerations in surge planning. Limitations of this review include potential selection bias and the subjective categorisation of articles. Future research should aim to develop integrative frameworks that couple technical, operational, and ethical readiness for patient surge scenarios.

The increasing demand for effective Arabic communication in Malaysian healthcare settings shows a significant challenge for public relations officers. As healthcare services are increasingly globally, the ability to communicate proficiently in Arabic is essential for attending Arab patients who are coming to Malaysia seeking for treatments. However, the scarcity of resources and technological tools tailored for this specific communication need has hindered effective public relations efforts. In this study, H-PRACOM platform, an integrated digital solution is introduced to bridge this gap by integrating multiple interactive platforms such as AI Chatbot, Padlet, Wordwall, and Google Sites with various multimedia elements including text, audio, and video animation into a unified resource for Arabic healthcare communication. By utilizing advanced digital tools, H-PRACOM empowers the efficiency and cultural aspects of public relations interactions, enhancing healthcare communicators to provide better support and engagement with Arab patients. This innovative digital solution not only addresses current communication challenges but also lays the essential works for future advancements for Arabic communication in healthcare public relations setting.

Understanding self-care behaviors in older adults with chronic diseases: The influence of personal views on aging and illness perceptions.

ABSTRACT A recognised and established role for social workers in healthcare is inpatient care in Australian hospitals. Victorian hospitals are experiencing increased patient demand and complexity, necessitating skilled social workers. A triangulated exploratory design enabled both quantitative and qualitative questions through use of tailored questionnaires. The aim of this study was to identify factors that strengthen or pose barriers to the recruitment and retention of social workers in a hospital setting. Responses were obtained from hospital social work managers, social workers, and students. Key findings revealed that factors such as workload, limited career progression, and workplace culture significantly impact recruitment and retention. A multifaceted, systemic approach is essential to address these challenges and strengthen workforce sustainability in healthcare settings. IMPLICATIONS Recruitment and retention of experienced hospital social workers remain problematic in Australian healthcare services. A multidimensional understanding of the broader issues related to recruitment and retention in Melbourne metropolitan hospitals can help strengthen recruitment and retention strategies and policies.

As patient diversity continues to expand, nursing staff are increasingly required to support neurodivergent individuals, particularly in the context of diabetes care. This article explores the principles of neurodiversity and outlines how nurses can provide informed, inclusive support to both patients and colleagues across various healthcare settings. It considers communication techniques, sensory considerations, environmental design, and policy recommendations. A key focus is placed on strategies for behaviour change, managing comorbid conditions, and tailoring diabetes care to individuals with specific learning differences. Consistent communication plans, reasonable adjustments, and multiagency collaboration have been shown to significantly enhance care outcomes. There is a need for increased recognition of neurodiversity within nursing education and practice environments. Embracing neurodiversity fosters more equitable, person-centred care and supports nursing staff in delivering high-quality services.

While Seasonal Malaria Chemoprevention (SMC) has been adopted as a malaria control strategy in regions with seasonal transmission, continued monitoring and evaluation of its effectiveness across diverse ecological, epidemiological, and healthcare settings remain critical for optimizing the intervention. This study aims to assess the ongoing population-level impact of SMC under routine programme conditions by evaluating rates of uncomplicated and severe malaria following four rounds of administration. A pre-post analysis was conducted using real-world surveillance data from clinic visits in 285 villages in Nouna District, Burkina Faso, along with National Malaria Control Programme data on SMC administration. Estimates of the population used for person-time calculations were derived from a census conducted as part of a randomized controlled trial. Malaria rates for children under 5 were analyzed for each epidemiological week in 2021, for each health post in the study area. Negative binomial regression models were used, with person-time at risk used as an offset and standard errors clustered by health post, to obtain incidence rate ratios (IRRs) and rate differences. Changes in diagnoses were estimated from the administration weeks to each of the three weeks post- administration within the same population. Injury rates were used as a negative control outcome to assess potential unmeasured confounding. Although SMC was administered during peak malaria transmission weeks within each cycle, both uncomplicated and severe malaria rates remained high through December, following the fourth and final round of SMC. There was a substantial reduction in infection rates in the 3weeks post SMC, with gradual increases in rates across the three weeks. The rates of uncomplicated and severe malaria per 1000 person-weeks in the administration weeks were 8.5 (95% CI 7.0 to 10.1) and 0.31 (95% CI 0.22 to 0.40), respectively. Uncomplicated malaria rates were lower by 41%, 95%CI (31-50%), 34% (23-43%) and 22% (12-31%) in the first, second and third weeks after administration, respectively. Severe malaria rates declined by 47% (21-64%), 47% (31-59%) and 34% (17-47%) in the three weeks post-administration. Injury rates, the negative control outcome, did not change significantly across the three weeks. In programme settings, at the population level, SMC administration was associated with a substantial reduction in uncomplicated and severe malaria, though this effect was limited to the immediate weeks following administration. The gradual increase in malaria rates by the third week suggests a shorter duration of protection than previously observed. Extending the areas where 5 rounds of distribution occur may be necessary to effectively prevent malaria infections in regions with a longer transmission season. Regular evaluation of local malaria trends and impact of SMC can help further tailor and optimize SMC programmes for specific regional contexts.

A Cross-Sectional Analysis of Body Mass Index With Cholesterol Gallstones in Patients With Cholelithiasis in Tertiary Healthcare Settings