Interventions In Health Care Settings Research Articles

Managing no-shows in healthcare: insights from an urban Health District in Northern Italy

Abstract Background Non-attendance at healthcare appointments, known as no-show, poses significant challenges to healthcare systems, disrupting patient care continuity, exacerbating waiting times, and straining resources. Addressing this issue is crucial for optimizing health care delivery and containing costs. This study explores the phenomenon of patient no-shows and aims to identify factors associated in a densely populated healthcare district in Turin, Northern Italy. Methods Data were extracted from the healthcare management system covering outpatient care appointments in the health district in 2022 and 2023. The analysis included various patient and service-related variables. Missing information on key variables were managed with listwise deletion. Descriptive statistics provided an overview of missed appointment rates, while multivariate analysis explored various patient and service-related variables. Results A 5.1% (n = 6198) no-show rate was observed out of 120,405 records. The total cost incurred due to missed appointment fees amounted to €127,244. Several factors were associated with a significantly increased likelihood of no-show (p < 0.05), including initial visit (OR = 1.11), deferred priority (OR = 1.22), non-exempt status from healthcare co-payments (OR = 1.36), exemption based on income (OR = 1.82), age under 18 (OR = 2.46) and under 65 (OR = 2.32), male gender (OR = 1.17), residency outside the Piedmont Region (OR = 1.31) and outside Italy (OR = 2.46), and longer waiting time (OR = 1.01). Conclusions This study sheds light on the widespread issue of patient no-shows and its economic implications. It provides clear direction for implementing tailored interventions in healthcare settings. As a response to these findings, a telephone recall project was launched. Its efficacy will be evaluated in subsequent assessments to determine if it can effectively alleviate the burden of no-shows, thus enhancing healthcare efficiency and ensuring continuity of care for patients. Key messages • The no-show phenomenon has important implications both organizationally and economically. • The magnitude and major determinants of patient no-shows must be recognized to guide the deployment of tailored interventions in a real-world setting.

Abstract A090: Comparing baseline knowledge and attitudes towards tobacco use and cessation among providers at substance use treatment centers and medical healthcare centers in rural and/or medically underserved areas of Texas

Abstract Introduction: Tobacco use intervention in healthcare settings is consistent with best practice guidelines and has been shown to facilitate tobacco cessation. Such intervention is particularly important in rural and medically underserved areas (MUAs), where tobacco use is elevated, as is cancer mortality. Providers’ knowledge and attitudes about the danger of tobacco use and their role in mitigating the same may play a role in whether their patients receive guideline-compliant care. This study investigates knowledge and attitudes toward tobacco use and cessation care delivery among providers at substance use treatment centers (SUTCs) and medical healthcare centers (MHCs; e.g., Federally Qualified Health Centers) in rural and/or MUAs of Texas to identify modifiable barriers to effective tobacco cessation treatment. Methods: Providers from healthcare centers (12 SUTCs, 9 MHCs) participating in a tobacco-free workplace program responded to a baseline solicitation assessing, among other things, their interest in receiving tobacco cessation care training and resources. In total, 347 providers from SUTCs (n=174) and MHCs (n=173) serving 49.6% of Texas’ counties responded to face-valid items assessing their knowledge and attitudes about tobacco use and provision of tobacco cessation care. Generalized or linear mixed models were used to analyze differences between SUTCs and MHCs. Results: More SUTC than MHC providers accurately identified that adults with mental health and/or non-nicotine substance misuse disorders are 2x more likely to smoke cigarettes than the general population (69% vs. 57%, p<0.008) and that quitting smoking can improve associated mental health symptomatology/substance misuse (61% vs. 54%, p<0.05), but also that patients’ tobacco product use is a personal decision that does not concern the direct service provider (30% vs. 19%, p<0.03). Conversely, more MHC than SUTC providers agreed that smoking cessation counseling is an important part of their job (66% vs. 41%, p<0.001), that their patients who smoke want to quit (38% vs. 21%, p<0.002), that providers should advise patients to quit even if it is not the reason for the visit (65% vs. 43%, p<0.001), that counseling by a provider motivates tobacco product users to quit (68% vs. 50%, p<0.005), and that providers should make appointments to specifically help patients quit tobacco product use (59% vs. 39%, p<0.003). Overall, only 48.4% of providers felt somewhat or completely prepared to help patients quit (56% MHC vs. 41% SUTCs, p<0.03). Conclusion: Addressing tobacco use in rural and/or MUAs of Texas where patients receive healthcare is critical to cancer prevention and achieving health equity. Responding SUTC and MHC providers evinced a need for training to enhance their understanding of tobacco use and to elevate the importance of cessation care provision. This is particularly the case in SUTCs, where providers primarily treat addiction. Findings will inform workplace interventions and their adaptation for use in each setting to facilitate guideline-compliant care provision. Citation Format: Sriya N. Kakarla, Brian J. Carter, Ammar D. Siddiqi, Maggie Britton, Tzuan A. Chen, Isabel Martinez Leal, Teresa Williams, Kathleen Casey, Hector Sanchez, Lorraine R. Reitzel. Comparing baseline knowledge and attitudes towards tobacco use and cessation among providers at substance use treatment centers and medical healthcare centers in rural and/or medically underserved areas of Texas [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A090.

Understanding the challenges and successes of implementing ‘hybrid’ interventions in healthcare settings: findings from a process evaluation of a patient involvement trial

Introduction‘Hybrid’ interventions in which some intervention components are fixed across sites and others are flexible (locally created) are thought to allow for adaptation to the local context while maintaining fidelity....

Reducing anxiety and enhancing satisfaction in thyroid patients with DietLens application during radioactive iodine therapy: A quasi-experimental study

Hyperthyroidism and thyroid cancer significantly impact health, and often require Radioactive Iodine (RAI) therapy. Anxiety is common in patients undergoing RAI, particularly related to dietary compliance. This study aimed to assess the effectiveness of the mobile health application, DietLens in reducing anxiety and increasing satisfaction in patients preparing for RAI therapy, focusing on low-iodine diet (LID). A quasi-experimental study was conducted in a Singapore tertiary hospital outpatient department from March 13, 2019 to March 27, 2020, involving patients scheduled for their first RAI treatment. Participants were divided into a control group receiving standard care and an intervention group using DietLens alongside standard care. Anxiety levels were assessed using the Zung Self-Rating Anxiety Scale, and satisfaction levels were measured through self-reported questionnaires. In the study, 56 participants were initially divided into control (n = 28) and intervention (n = 28) groups. After accounting for dropouts, 50 participants finished the study, with each group comprising 25 individuals. Anxiety levels were similar between groups pre-intervention. Post-intervention, the intervention group displayed a significant decrease in anxiety levels compared to the control group (independent t-test: t (48) = 2.50, p = 0.02). The multivariate linear regression analysis indicated that being in the intervention group was significantly associated with a decrease in post-intervention anxiety score (β = −4.03, 95 % CI: −7.33 to −0.72, p = 0.02). Fisher's Exact Test revealed a borderline significant difference in satisfaction with educational materials and the overall treatment process, with 100 % of the intervention group expressing satisfaction compared to 80 % in the control group, resulting in a p-value of 0.052 in both instances. DietLens was effective in reducing anxiety and enhancing satisfaction related to RAI therapy preparation, particularly in managing a LID, highlighting a beneficial role for digital interventions in healthcare settings.

A Realist Review Protocol into the Contexts and Mechanisms That Enable the Inclusion of Environmental Sustainability Outcomes in the Design of Lean Healthcare Improvement Interventions.

Healthcare makes a significant contribution to the social, economic and environmental benefits of communities. It is correspondingly a significant employer and consumer of both energy and consumables, often at high costs. Lean, a quality improvement methodology focuses on the elimination of non-value add (NVA) activities (steps that do not add value from the perspective of the customer) to improve the flow of people, information or goods. Increasingly, Lean thinking is evolving from its initial focus on eliminating NVA to a more holistic approach that encompasses sustainability. However, little work has been undertaken intentionally, including environmental sustainability outcomes in Lean healthcare interventions. Realist review methodology facilitates an understanding of the extent to which an intervention works, for whom, in what context, why and how, and has proven useful in research relating to Lean interventions in healthcare settings. This protocol provides details for a realist review that will enable an understanding of the specific contexts in which certain mechanisms are activated that enable the inclusion of environmental sustainability outcomes in the design of Lean healthcare improvement interventions.

Speech and neuroimaging effects following HiCommunication: a randomized controlled group intervention trial in Parkinson's disease.

Speech, voice and communication changes are common in Parkinson's disease. HiCommunication is a novel group intervention for speech and communication in Parkinson's disease based on principles driving neuroplasticity. In a randomized controlled trial, 95 participants with Parkinson's disease were allocated to HiCommunication or an active control intervention. Acoustic analysis was performed pre-, post- and six months after intervention. Intention-to-treat analyses with missing values imputed in linear multilevel models and complimentary per-protocol analyses were performed. The proportion of participants with a clinically relevant increase in the primary outcome measure of voice sound level was calculated. Resting-state functional MRI was performed pre- and post-intervention. Spectral dynamic causal modelling and the parametric empirical Bayes methods were applied to resting-state functional MRI data to describe effective connectivity changes in a speech-motor-related network of brain regions. From pre- to post-intervention, there were significant group-by-time interaction effects for the measures voice sound level in text reading (unstandardized b = 2.3, P = 0.003), voice sound level in monologue (unstandardized b = 2.1, P = 0.009), Acoustic Voice Quality Index (unstandardized b = -0.5, P = 0.016) and Harmonics-to-Noise Ratio (unstandardized b = 1.3, P = 0.014) post-intervention. For 59% of the participants, the increase in voice sound level after HiCommunication was clinically relevant. There were no sustained effects at the six-month follow-up. In the effective connectivity analysis, there was a significant decrease in inhibitory self-connectivity in the left supplementary motor area and increased connectivity from the right supplementary motor area to the left paracentral gyrus after HiCommunication compared to after the active control intervention. In conclusion, the HiCommunication intervention showed promising effects on voice sound level and voice quality in people with Parkinson's disease, motivating investigations of barriers and facilitators for implementation of the intervention in healthcare settings. Resting-state brain effective connectivity was altered following the intervention in areas implicated, possibly due to reorganization in brain networks.

What is known about the role of external facilitators during the implementation of complex interventions in healthcare settings? A scoping review

ObjectiveTo synthesise current knowledge about the role of external facilitators as an individual role during the implementation of complex interventions in healthcare settings.DesignA scoping review was conducted. We reviewed original...

The Effectiveness of ACT and DBT-Based Interventions with and without Exercise on Pain Outcomes and Desire for Treatment in Substance-Dependent Patients with Chronic Pain

Background: Managing chronic pain outcomes and addressing the desire for addiction treatment can be crucial for recovery from substance dependence and chronic pain. Objectives: This study aimed to control pain outcomes and enhance the desire for treatment using interventions based on acceptance and commitment therapy (ACT), Dialectical Behavior Therapy (DBT), and physical exercise. Methods: This quasi-experimental study employed a pre-test-post-test design with a two-month follow-up period and included a control group. Seventy-five voluntary patients undergoing addiction treatment in 2021 at Taban, Hayate Pak, and Omid addiction treatment centers in Zahedan with chronic pain participated. Participants were selected through purposive sampling and randomly assigned to five groups (ACT and DBT groups with and without exercise, and a control group). Data were collected using the Pain Outcomes Questionnaire-VA (POQ-VA) (Clark, Gironda, & Young, 2003) and the Stages of Change Readiness and Treatment Eagerness scale (SOCRATES) (Miller & Tonigan, 1996). Acceptance and Commitment Therapy intervention (eight sessions), DBT intervention (eight sessions), and aerobic exercise (24 sessions) were conducted only for the intervention groups over two months. Data were analyzed using repeated measures analysis of variance (ANOVA) and Bonferroni's post hoc test with SPSS-26 software at a significance level of 0.05 (P < 0.05). Results: Repeated measures ANOVA revealed significant changes for ACT and DBT interventions with and without exercise in the intragroup effect (time) for pain outcomes and the desire for treatment across the pre-intervention, post-intervention, and follow-up stages (P ≤ 0.001), as well as for time-group interaction (P ≤ 0.001). Furthermore, the three groups exhibited significant differences in pain outcomes and the desire for treatment across the three evaluation stages (P ≤ 0.01). Notably, compared to other interventions, ACT intervention with exercise was more effective in managing pain outcomes and enhancing the desire for treatment (P ≤ 0.001). Conclusions: The findings suggest that ACT intervention with exercise, while controlling pain outcomes and increasing the desire for treatment, can contribute to successful addiction cessation and serve as an effective intervention in healthcare settings.

Understanding “danger signs” in healthcare: A concept analysis

Introduction: Danger signs are specific indicators signaling potential serious or life-threatening health conditions, crucial for prompt intervention in healthcare settings. Recognizing these signs can be challenging due to variations in cultural perceptions and individual interpretations. Additionally, danger signs are context-dependent, requiring awareness and contextual analysis. This complexity is amplified when dealing with abstract or non-physical signs. Understanding and consistently applying the concept of danger signs is essential for effective healthcare delivery. Method: This paper utilized Walker and Avant's eight-step concept analysis method, offering a systematic and structured approach for defining and understanding concepts. The method promotes clarity, precision, and thorough exploration of the concept's relationships with others, enhancing comprehensive understanding within its context. Result: Conceptually, danger signs represent a broad array of indicators signaling potential harm or imminent risk. Through analysis, this paper defines danger signs operationally as objective, measurable cues that are context-dependent, indicating the presence of a potential negative outcome. Conclusion: This paper contributes to existing knowledge by identifying danger sign attributes, reducing ambiguity and facilitating clearer application in health specialties training. The enhanced clarity also allows for the development of more precise tools to assess competence in danger sign identification.

The Impact of Integrated Patient Education on Short-Term Revisit Rates in Healthcare Settings: A Quality Improvement Project.

Patient education plays a critical role in healthcare, influencing outcomes and resource utilization. However, effectively integrating patient education into clinical practice remains challenging due to time constraints and inconsistencies in information delivery. Enhancements in Electronic Health Records (EHR) offer potential solutions by facilitating customized, quality education delivery. This study investigates the impact of an EHR-enhanced patient education intervention on short-term revisit rates to healthcare facilities. A quasi-experimental, pre-test/post-test design without a control group was employed at the International Medical Center in Riffa, Bahrain. The intervention consisted of modifications to the EHR system to support patient education, along with staff training on effective education delivery. Patient revisit rates within seven days post-consultation were compared before and after the intervention using chi-square tests and logistic regression, adjusting for potential confounders. A total of 1,239 patients participated in the study, which was divided into two groups: 754 patients in the pre-intervention group and 485 patients in the post-intervention group. A significant change was observed in the patient revisit rates: in the pre-intervention group, 53.32% of patients (402 out of 754) returned within seven days, compared to 41.44% of patients (201 out of 485) in the post-intervention group, with a p-value < 0.01. Enhancements to EHR systems, combined with comprehensive staff education on patient education, can lead to significant reductions in short-term patient revisits. This underscores the importance of integrating technological and educational interventions in healthcare settings to improve patient outcomes and efficiency.

Linking patient-centered communication with cancer information avoidance: The mediating roles of patient trust and literacy

ObjectivesThis study, drawing on the pathway mediation model developed by Street and his colleagues (2009) that links communication to health outcomes, explores how patient-centered communication affects cancer information avoidance. MethodsData was gathered through online access panel surveys, utilizing stratified sampling across Germany, Switzerland, the Netherlands, and Austria. The final sample included 4910 non-cancer and 414 cancer patients, all receiving healthcare from clinicians within the past year. ResultsThe results demonstrated that patient-centered communication is directly associated with reduced cancer information avoidance, especially among cancer patients. Additionally, this association is indirectly mediated through patient trust and healthcare literacy. ConclusionThe findings provide empirical evidence that reveals the underlying mechanism linking clinician-patient communication to patient health information behavior. Practice implicationsThe potential of clinician-patient communication in addressing health information avoidance is highlighted by these findings. Future interventions in healthcare settings should consider adopting patient-centered communication strategies. Additionally, improving patient trust and literacy levels could be effective in reducing cancer information avoidance.

Associations between muscle dysmorphia symptomatology and sleep duration and difficulty in the Canadian Study of Adolescent Health Behaviors

ObjectivesPrior research has shown links between mental health symptomatology and poor sleep. However, associations between muscle dysmorphia symptomatology and poor sleep remain unknown, which was the aim of this study. MethodsData from the Canadian Study of Adolescent Health Behaviors (2021-2022) were analyzed (N = 912). Multinomial logistic regression analyses and logistic regression analyses were used to determine the association between muscle dysmorphia symptomatology and average sleep duration (5 hours or less, 6 hours, 7 hours, and 8 or more hours) and difficulty falling or staying asleep over a 2-week period. ResultsFindings indicated significant associations between muscle dysmorphia symptomatology and shorter sleep duration and greater sleep difficulty in both cross-sectional and prospective analyses. ConclusionsThe findings from this study underscore poor sleep as a correlate of muscle dysmorphia symptomatology among adolescents and young adults, emphasizing the need for screening and interventions in healthcare settings.

A multilevel intervention in pediatric primary care for youth tobacco control: Outcomes of implementing an Ask, Advise, and Connect model.

Multilevel interventions in healthcare settings (e.g. Ask, Advise, and Connect; AAC) can reduce tobacco product use among adult patients: their effectiveness in pediatric practice is largely unknown. We implemented an AAC model in pediatric primary care to deter children's tobacco use, and evaluated its effectiveness in a single-arm trial. At wellness visits, young patients (ages 12-17) completed a tablet-based assessment (Ask) of lifetime and current tobacco use. These data were made available within the electronic health record to pediatric primary care providers for preventive counseling (Advise). Providers then referred patients to an e-health evidence-based tobacco control intervention (Connect). Tobacco control outcomes were examined in the clinic population (N = 2219) and in a sample of patients (N = 388, 62% female, 39% non-White, M age = 15) over time, along with intervention engagement. Population use of tobacco products decreased following introduction of AAC (more than 2-fold). At the patient level, most children (80.9%) engaged with the intervention: those who were Black or African American, who never used tobacco products/were not susceptible to use, and who used fewer non-cigarette tobacco products were more likely to engage, but only after multiple prompts versus a single prompt. Engagement was positively associated with lowering children's susceptibility to using tobacco at follow-up. A pediatric AAC model holds promise in deterring youth tobacco use, including among historically marginalized populations who may require additional support.

Construct Validity and Test-Retest Reliability of Questionnaires to Assess Workplace Violence Risk Factors (QAWRF): A Tripartite Perspective of Worksite-Specific Determinants in Healthcare Settings.

Among available workplace violence (WPV) interventions, only data-driven, worksite-based, and risk-based approach WPV interventions had moderate evidence for effectiveness in decreasing the risk of WPV. The Questionnaires to Assess Workplace Violence Risk Factors (QAWRF) had been previously developed to determine the level of WPV risk factors in each healthcare setting based on the tripartite perspective of key stakeholders to enable effective WPV interventions. This study aimed to determine the construct validity and test-retest validity of QAWRF. QAWRF, a three-component instrument consisting of QAWRF-Administrators, QAWRF-Workers, and QAWRF-Clients, had previously undergone content validation, face validation, and internal consistency reliability testing. 965 respondents were recruited to examine the construct validity of QAWRF, and a subset of these (n = 90) were retested again at an interval of three weeks to assess its test-retest reliability. Confirmatory factor analysis (CFA) was performed, and fitness indices, average variance extracted, correlation coefficient, composite reliability, and intraclass correlation coefficient were determined. QAWRF-Administrator, QAWRF-Worker, and QAWRF-Client had acceptable factor loadings (≥0.6), absolute fit (Root Mean Square Error of Approximation > 0.1), incremental fit (Confirmatory Fit Index and Tucker Lewis Index > 0.9), parsimonious fit (Chi-square/degree of freedom < 5), correlation coefficient between construct (≤0.85), discriminant validity index, and construct reliability (≥0.6). CFA supported a four-factor model for QAWRF-Administrator and QAWRF-Worker, and a two-factor model for QAWRF-Client. QAWRF holds good construct validity and test-retest reliability. By using QAWRF, healthcare managers can identify specific WPV risk factors that are perceived by stakeholders as prevalent at a particular workplace, and these findings can contribute towards data-driven, worksite-specific, and targeted WPV interventions in healthcare settings that are expected to be resource-efficient and more effective than general WPV interventions.

Estimating the return on investment of selected infection prevention and control interventions in healthcare settings for preparing against novel respiratory viruses: modelling the experience from SARS-CoV-2 among health workers

Insufficient infection prevention and control (IPC) practices in healthcare settings increase the SARS-CoV-2 infection risk among health workers. This study aimed to examine the level of preparedness for future outbreaks. We modelled the experience from the COVID-19 pandemic and assessed the return on investment on a global scale of three IPC interventions to prevent SARS-CoV-2 infections among health workers: enhancing hand hygiene; increasing access to personal protective equipment (PPE); and combining PPE, with a scale-up of IPC training and education (PPE+). Our analysis covered seven geographic regions, representing a combination of World Health Organization (WHO) regions and the Organisation for Economic Co-operation and Development (OECD) countries. Across all regions, we focused on the first 180 days of the pandemic in 2020 between January 1st and June 30th. We used an extended version of a susceptible-infectious-recovered compartmental model to measure the level of IPC preparedness. Data were sourced from the WHO COVID-19 Detailed Surveillance Database. In all regions, the PPE+intervention would have averted the highest number of new SARS-CoV-2 infections compared to the other two interventions, ranging from 6562 (95% CI 4873-8779) to 38,170 (95% CI 33,853-41,901) new infections per 100,000 health workers in OECD countries and in the South-East Asia region, respectively. Countries in the South-East Asia region and non-OECD countries in the Western Pacific region were poised to achieve the highest level of savings by scaling up the PPE+intervention. Our results not only support efforts to make an economic case for continuing investments in IPC interventions to halt the COVID-19 pandemic and protect health workers, but could also contribute to efforts to improve preparedness for future outbreaks. This work was funded by WHO, with support by the German Federal Ministry of Health for the WHOResearch and Development Blueprint for COVID-19.

Development and implementation of the Specialist Palliative Care in Aged Care (SPACE) Project across Queensland.

There is an urgent and unmet need for specialist palliative care services in residential aged care. The Specialist Palliative Care in Aged Care (SPACE) Project aimed to improve palliative and end-of-life care for older people living in residential aged care facilities in Queensland. A representative working group developed a series of service principles around palliative care practice in aged care (comprehensive resident-focused care, streamlined service, and capacity building). Funding was allocated by population to the health services in Queensland to adapt and implement models of care aligned with these principles. SPACE successfully implemented a variety of decentralised models of care across Queensland. The critical elements for the success of SPACE were the use of an expert working group to define the core innovation, networking and implementation support from the central project team and community of practice, and adaptable models of care led by local facilitators. Lessons learned from this real-world case study could be adopted to guide and ensure the successful implementation and sustainability of future complex interventions in healthcare settings, both nationally and internationally.

Navigating Cultural Entropy: Leadership Strategies and Organizational Dynamics in Higher Education Institutions

This study aims to explore cultural entropy in higher education institutions, with a focus on understanding its impact on employee performance and organizational dynamics. The research investigates factors influencing cultural entropy, the relationship with leadership, and parallels with healthcare settings. Conducted as a systematic literature review, this research employs a bottom-up approach, reviewing articles from Scopus, Emerald, and Google Scholar (2010-2023). The analysis includes factors contributing to cultural entropy, leadership styles, and the impact on organizational performance in higher education. The findings reveal that cultural entropy in higher education is influenced by factors such as bureaucratic excess, unclear communication, and limited employee engagement. Transformational leadership emerges as a crucial factor in addressing cultural entropy, emphasizing the need for leaders who can instigate positive change and foster a culture of continuous learning. The research is limited by the relatively small body of literature on cultural entropy in higher education. Further research is needed to explore tailored approaches for diverse academic contexts and to develop specific interventions for mitigating cultural entropy in educational settings. The study underscores the importance of proactive leadership in managing cultural entropy. Higher education institutions can benefit from strategies inspired by successful interventions in healthcare settings. Implementing policies and supports to address employee stress and cultural entropy can contribute to a more balanced and sustainable work environment. This study contributes to the limited body of literature on cultural entropy within educational institutions, shedding light on its unique manifestations and challenges. The exploration of parallels between healthcare and academia provides a novel perspective, emphasizing the distinct dynamics at play in educational settings. The study encourages further investigation into tailored approaches for addressing cultural entropy in diverse academic contexts.

Changing the “Meaning of Place” Within a Hospital: The Impact of Establishing an Art Gallery on Esthetic Experience, Restorativeness, Affective Commitment, and Work Engagement of Healthcare Personnel

For a long time, care environments have been characterized as "inhuman," with their place meaning linked to illness and suffering. This study aims to analyze the shift in the meaning of the hospital space, investigating the impact of a permanent art gallery in a hospital's Gynecology Department on employees' well-being. Employing a quasi-experimental design, a final sample of 116 hospital employees (81 in the control group and 74 in the experimental group) completed self-report measures before and after the installation. Three self-report measurements were conducted at approximately 45-day intervals. The intervention resulted in an immediate increase in aesthetic experience, confirming an emotional involvement. Additionally, the art gallery demonstrated delayed positive effects on restorativeness after 45 days, positively affecting affective commitment and work engagement. These findings highlight the potential of art interventions in healthcare settings to enhance employees' well-being, suggesting implications for organizational design and employee satisfaction.

Implementation and Impact of Health Care Gardens: A Systematic Scoping Review.

Background: In community and school settings, gardens and garden interventions have been shown to confer several psychosocial, physiological, and nutritional benefits. However, little is known about the implementation and impact of health care gardens on patients, visitors, and staff health and well-being. The primary aim of this review is to identify and describe the types of gardens and common design elements implemented in health care settings and the impact these gardens have on the health and well-being of patients, visitors, and staff. A secondary aim is to assess the quality of available evidence. Methods: PubMed, CINAHL, EMBASE, and PsycINFO were systematically searched on October 28, 2022. Primary qualitative and quantitative studies (excluding case reports and studies) were eligible for inclusion if they described the types of gardens and common design elements implemented in health care settings (hospitals, aged care, rehabilitation facilities, and medical centers) and/or assessed the impact of garden interventions on the health and well-being of patients, visitors, and staff. Review, selection, and data extraction were conducted by two independent researchers, with findings synthesized and presented in narrative form. Articles were critically appraised using the mixed methods appraisal tool (MMAT). Results: Eighteen articles were included. Eight studies provided detailed descriptions of the types of gardens implemented in health care settings (healing [n = 3], therapeutic [n = 2], sensory [n = 2], children's fairy gardens [n = 1], and enriched [n = 1] gardens). Studies examining the psychosocial impacts of gardens were most frequently reported (n = 16), followed by physical (n = 4) and nutritional (n = 2). A wide range of positive outcomes, predominantly relating to patients (n = 12), were reported, including improvements in stress, quality of life (QOL), cognitive function, physical activity, and fruit and vegetable intake. The evidence was heterogeneous and low-medium quality. Conclusions: The findings suggest that implementing gardens and garden interventions in health care settings may positively impact the health and well-being of patients, visitors, and staff. Most studies related to the impact of gardens on patients' mental health and QOL, indicating the need for further research to explore physical and nutritional outcomes, as well as health outcomes of staff and visitors. Findings also suggest the need for high-quality study designs (e.g., cluster control trials) and standardized measurement tools.

Abstract P348: Utilizing A Whatsapp Community To Enhance Hypertension Control And Address Misconceptions Among Patients With High Blood Pressure

A prospective intervention study was conducted, involving patients diagnosed with hypertension and exhibiting misconceptions regarding the condition. The study explored the impact of a WhatsApp community in promoting knowledge exchange, peer support, and adherence to hypertension management strategies. A total of 3000 patients were enrolled in the study, all of whom had been diagnosed with high blood pressure and displayed misconceptions surrounding hypertension. The WhatsApp community provided a platform for these patients to interact, share experiences, and receive guidance from healthcare professionals. The community facilitated the exchange of accurate information regarding hypertension, its causes, risk factors, and effective management strategies. Among the population, 30% were below 40 years of age and predominantly male (70%). About 18% were not on active treatment and a further 12% had switched themselves onto alternative medicines for fear of prescription medicines. Through active participation in the WhatsApp community, patients gained a deeper understanding of hypertension (formative assessment through quizzes), dispelled misconceptions (direct question and answer sessions), and received valuable support from peers facing similar challenges. This real-time communication fostered a sense of empowerment and accountability among the patients. These findings highlight the potential of utilizing technology-based platforms, such as WhatsApp communities, as effective tools for improving hypertension control and addressing misconceptions among patients. Implementing similar interventions in healthcare settings can lead to enhanced patient education, improved adherence, and ultimately better health outcomes for individuals with hypertension.