Quality Of Care Research Articles

The Impact of Environmental Health Factors on Rates of Hospital Readmission

Introduction: readmissions to the hospital are a key indicator of both the quality of care and how much it costs. However, external health factors that affect return rates have not been studied much. This study tries to fill in that gap by looking at how certain surrounding factors affect how often people have to go back to the hospital.Method: a retrospective cohort study was done using data from 10,000 hospital patients over five years. Environmental data, such as air quality, water quality, and population density, were combined with hospital discharge records. Multivariable logistic regression models were used to account for factors that could affect the results, such as age, gender, illnesses, and the reason for the first hospitalisation.Findings: the results show a strong link between bad air quality and more people having to go back to the hospital (OR=1,45, 95 % CI 1,22-1,73). In the same way, lower water quality was linked to a higher chance of being readmitted, especially for heart and lung diseases. Different health results were not always affected by the amount of people living in cities.Conclusion: environmental health issues, especially the quality of the air and water, have a big impact on the number of times people have to go back to the hospital. These findings show how important it is for healthcare policies to include environmental health knowledge and measures to lower avoidable readmissions. This will improve patient results and lower the cost of running healthcare systems.

Factors That Influence Satisfaction in the Emergency Unit of A Healthcare Center

Objective: The objective of the study is to demonstrate the influence of the factors of compliance with procedures, knowledge about the health condition and perception of recovery on patient satisfaction in an emergency unit of a health center. Theoretical Framework: The main concepts on quality of health care are considered, the Donabedian Model and its components such as structure, process and results that provide a solid basis to understand the context of the research. Method: The methodology includes a non-experimental design, with a quantitative approach, the data collection instrument is a questionnaire with a Likert scale, which was applied to the sample of 170 individuals. For the statistical analysis, an exploratory factor analysis and partial least squares structural equation modeling (PLS-SEM) were used. Results and Discussion: The results obtained indicate that the knowledge that the patient has about his health condition has a greater influence on his satisfaction, followed by compliance with procedures, and lastly perceived recovery. Research Implication: The research has the implication of demonstrating the need for health institutions to focus on improving the efficiency of processes, doctor-patient communication and the perception of patient recovery in order to increase their satisfaction. Originality/Value: The originality of this study lies in its multifactorial approach and in the use of a data collection instrument appropriate for this purpose.

A new Bayesian method for the estimation of emergency nurses’ thresholds and agreement in the context of telephone triage

IntroductionTriage is the process aimed at ensuring that patients receive a level and quality of care matching the urgency of their conditions. The present study focuses on telephone triage. We discuss the application of a new decision-making model to the task of telephone triage.MethodsThe model allows to estimate the nurse’s Belonging Threshold (BT), which quantifies the minimum level of severity of an emergency scenario that leads the nurse to activate a rescue vehicle with emergency devices. The BT can be used as an index of the possible tendency of the nurse to systematically over-or under-triage. The model also provides accurate estimations of the level of agreement between different nurses, and between the nurses and reference experts, net of the noise due to the possible differences between the nurses’ BTs.Results and discussionThe model and the related experimental procedure were applied to a sample of 21 emergency nurses at the SUEM 118 Operations Center in Venice. We discuss how the model can be useful to identify nurses who would benefit from a training to improve the consistency of their application of the protocol, as well as to identify specific emergency scenarios for which the assignment of priority codes was most problematic.

Improve quality of care in hospital-at-home by implementing medication reconciliation on admission: a retrospective observational study

ObjectivesMedication reconciliation (MR) has been identified by the French High Health Authority (HHA) as an advanced criterion for improving the quality of care. Although this activity has been widely developed...

The analysis of factors influencing patient choice of healthcare providers between tertiary hospitals and community clinics

BackgroundThe uneven distribution of medical resources in China has led to persistently low utilization rates of primary healthcare institutions. The tiered healthcare delivery system aims to optimize resource allocation and strengthen primary care, yet patient preferences for tertiary hospitals hinder its effective implementation. Understanding the factors influencing healthcare-seeking behaviors is crucial for improving policies and promoting system efficiency.ObjectiveTo analyse the factors influencing patient choices between a tertiary hospital and a community health service center in Chengdu and provide recommendations for advancing the tiered healthcare system.MethodsA random sampling method was used in August 2023 to survey patients at a tertiary hospital (Group A) and a community health service center (Group B). The survey assessed demographics, health status, factors influencing provider choice, and awareness of the family doctor system. Chi-square, t-tests, or Wilcoxon rank-sum tests were used for group comparisons, while logistic regression identified factors associated with primary care visits.ResultsAmong 865 valid responses (Group A: 420; Group B: 445; 92.02% response rate), Group A had significantly higher education levels and household incomes (p < 0.001), while Group B had higher chronic disease prevalence and family doctor contract rates (71.5% vs. 59.3, 44.5% vs. 25.5%; both p < 0.01). Positive factors for choosing community healthcare included better equipment and medication availability (46.9%), lower costs with higher reimbursement (45.0%), and convenient transport (41.2%). Negative factors included distrust in community care quality (39.1%) and limited familiarity with family doctors (32.8%). Logistic regression indicated that being over 60 years old (OR: 1.94, CI: 1.02–3.69) and awareness of the tiered healthcare system (OR: 2.48, CI: 1.56–3.96) were significant factors for seeking primary care.ConclusionPatients with higher education and income prefer tertiary hospitals, while chronic disease patients are more likely to utilize community care. Low family doctor contract rates and trust in community healthcare quality remain barriers. Strengthening community resources and promoting the tiered healthcare system could improve patient participation and alleviate pressure on tertiary hospitals.

Telemedicine Offers Solutions for the Rural Disparities in Infectious Disease (ID) Care Delivery

Abstract In the US, there is a growing shortage of infectious diseases (ID) physicians that highlights disparity between rural versus urban ID expertise resulting in a healthcare gap with significant consequences for patients unable to have ID directed care available to them. Telemedicine is a crucial modality of healthcare that can be used to bridge that gap by providing quality care consistent with outcomes for inpatient ID service models, while also serving as a tool for much greater geographic coverage by a single ID physician. As a specialty, we must embrace telemedicine for the good of our patients, whose local communities may not have access to ID care, and to create the incentive of broader community impact for potential entrants into the ID field.

Using maternal sepsis patient journeys to map and prioritise barriers to quality maternal healthcare in Malawi: a multidisciplinary stakeholder consultation workshop

ABSTRACT Background Malawi has made progress in improving access to maternity care services, shifting the focus to quality of care as an essential determinant of maternal health outcomes. However, no effective mechanisms exist to use patients’ experiences of care at health facilities to inform and improve the quality of maternal healthcare. Objective To use maternal sepsis patient journeys in a workshop with maternal health stakeholders to identify and prioritise barriers in care and recommend interventions to improve maternal healthcare quality in Malawi. Methods In February 2024, in Blantyre, Malawi, using a modified nominal group technique, 28 stakeholders reviewed the patient journeys of three women hospitalised at Queen Elizabeth Central Hospital, who had sepsis after childbirth. Patient journeys narrate events experienced within a healthcare system in the patient’s words. In a multiframework approach (Four Delays, Respectful Maternity Care, and WHO Quality of Care), stakeholders identified and prioritised barriers to care and recommended interventions to improve the quality of maternal healthcare. Content analysis of the workshop data linked barriers with stakeholders’ suggested interventions. Results Nineteen barriers identified included various delays in receiving care, mistreatment by healthcare providers, and suboptimal quality of care. Stakeholders found patient journeys valuable and insightful for identifying gaps in the quality of care and promoting sepsis awareness among healthcare workers and the public. Conclusions Patient journeys are a novel tool for capturing the experience of care in Malawi. They have the potential to guide strategic improvements in maternal healthcare quality and ultimately reduce maternal morbidity and mortality.

Evaluation of care and clinical outcomes after the implementation of an electronic medical record system for type 1 diabetes management in Rwanda

ABSTRACT Background Electronic medical record (EMR) systems are increasingly used to improve disease management. However, the impact on data quality, quality of care and clinical outcomes for type 1 diabetes (T1D) in sub-Saharan Africa (SSA) has not yet been explored. Objective The aim was to evaluate the effect of implementing an EMR system on the quality of care and clinical outcomes for T1D individuals in Rwanda. Methods The Rwanda Diabetes Association collected data during quarterly district hospital visits. We evaluated the effect of a newly developed and implemented EMR system by assessing differences in clinical attendance and outcomes 2 years before (pre-EMR: February 2020-February 2022) and after (post-EMR: February 2022–February 2024) the deployment of the EMR system. Results We found an increase in the number of individuals examined and the number of consultations conducted post-EMR. There was an increase in data completeness on all parameters; however, we also found that more people did not monitor their blood glucose post-EMR. We found a significant increase in clinical attendance, and a reduction in median HbA1c levels from 81.4 mmol/mol pre-EMR to 63.9 mmol/mol post-EMR (p < 0.001). Conclusion Several quality and clinical indicators improved after the integration of the EMR system in T1D management. To the best of our knowledge, this is the first study evaluating the impact of using an EMR system on the quality of care and clinical outcomes for T1D individuals in an SSA context. The long-term effect and implications are yet to be explored.

Legal Protections for Patients with Medical Conditions in Online Health Consultations

Legal protections in telemedicine protect patients' rights, privacy, and care quality, but research often overlooks patients' perspectives. Therefore, understanding evolving legislation and patient-centered legal concepts improves patient care. This article aims to explore legal protections for patients with medical conditions in online health consultations. This study used a systematic literature review (SLR) approach to examine articles related to legal protections for patients, medical conditions, and online health consultations. We searched the Scopus and PubMed databases for articles in three categories: legal protections for patients, medical conditions, and online health consultations over the last five years (2019-2024). Using the Publish and Perish and Mendeley Reference Manager applications, we selected 389 papers from the Scopus database and 46 from the PubMed database based on specific criteria. Therefore, we conducted a PRISMA analysis on the 59 full-text research articles that we included. The results show that legal protections for patients in online health consultations include confidentiality, informed consent, licensure, data protection, emergency response protocols, professional standards, telemedicine compliance, care quality, and redress mechanisms. Solutions include streamlining licensing processes and enhancing cross-border regulations. The study emphasizes the need for patient advocacy, legal protection, data protection, and ethical compliance in online medical consultations, addressing barriers like dissatisfaction and lack of funds.

End-of-life care quality for American Indians with cancer.

American Indians (AI) experience disparities in cancer outcomes. Little is known about the quality of end-of-life (EOL) care in AI patients with cancer. We retrospectively analyzed EOL care for North Carolina patients who died (decedents) diagnosed with any cancer (2003-2018) using the Cancer Information and Population Health Resource. Measures of EOL care quality were informed by existing literature and included in-hospital death, hospice use and other healthcare utilization within the last 30 days of life. Associations between race/ethnicity and EOL outcomes were evaluated to estimate adjusted risk ratios (aRRs). Because within group heterogeneity can influence health outcomes and intervention effectiveness, we also evaluated associations among AI individuals only. We identified 163,285 (1,769 AI and 161,516 White) decedents. The majority (60%) of AIs lived in a geographic area characterized by non-federally recognized tribes. AI decedents had greater proportions of rural residence than White decedents (54.5% AI vs 30.4% White) and dual Medicaid/Medicare enrollment (37.4% AI vs 17.7% White). Compared with White decedents, AI decedents had increased hospital admission (aRR, 1.10, 95% confidence interval [CI], 1.06-1.15), ICU admission (aRR, 1.21; 95% CI, 1.11-1.32), and >1 ED visit (aRR, 1.31; 95% CI, 1.20-1.44) in the last 30 days of life. We observed significant within-group variation in EOL care quality among AI patients. Structural barriers to care and rurality may contribute to lower quality EOL care among AI decendents, when compared with White patients. High-quality, culturally appropriate EOL care will require a better understanding of care decision-making and access.

Term stillbirths in Eastern Uganda: a community-based prospective cohort study

ABSTRACT Background Every year, 1.9 million stillbirths occur worldwide, of whom 1.5 million occur in sub-Saharan Africa (SSA) and Southeast Asia. Objectives This study aims to determine the incidence and risk factors and to describe underlying causes for term stillbirths in Eastern Uganda. Methods This was a cohort study of pregnant women enrolled at 34 weeks of gestation or more and followed to birth between January 2021 and January 2024. Enrolment and follow-up were done in the community by trained midwives. Using structured questionnaires, details of maternal health, pregnancy and birth were captured. Results We enrolled 6101 participants and analysed 5496 for incidence of term stillbirth and 5296 for risk factors. Of the participants, 4913/5296 (92.8%) were between 14 and 35 years, and 4456/5296 (84.1%) had a health facility birth. There were 101 term stillbirths (61 were intrapartum and 40 antepartum). The incidence of term stillbirth was 18.4 per 1000 births (95% CI 14.8 to 22.9). The most common underlying causes of stillbirth were prolonged or obstructed labour 32/101 (31.7%) and malaria 20/101 (19.8%). The factors associated with term stillbirths were caesarean birth (aRR 3.3; 95% CI 2.00 to 5.4), intimate partner violence (aRR 1.8; 95% CI 1.1 to 2.8) and maternal age above 35 years (aRR 2.2; 95% CI 1.2 to 3.9). Conclusion Eastern Uganda has a high rate of term stillbirths with more than half occurring during labour. Efforts are needed to improve the quality of birth care and to prevent intimate partner violence.

Possibilities of using telemedical interventions in the framework of providing specialized endocrinological care to the population

Telemedicine is the use of telecommunication systems to provide medical care to the population at a distance. It has the potential to improve patient outcomes, access to care, and reduce health care costs. As telemedicine consultation applications continue to evolve, it is important to understand in which clinical situations and settings of care a telemedicine intervention is appropriate and can ensure that patients receive quality care. Objective: to assess the acceptability, effectiveness and safety of using TMC in the provision of specialized endocrinological care to patients. Search strategy: review of the most relevant studies published in the electronic databases Medscape, PubMed, PubMed Central, MEDLINE, Scopus, eLibrary, CyberLeninka. The selection criterion was scientific articles published up to March 2024 inclusive. Search keywords: telemedicine, virtual care, endocrinology, diabetes. Conclusions. The results of currently published studies have shown that telemedicine interventions can have a beneficial effect on the outpatient management of patients with chronic non-communicable diseases, in particular diabetes mellitus, and improve the self-management of glycemic parameters in patients. However, many questions remain unresolved regarding the choice of the optimal strategy for monitoring, treating and providing quality medical care to patients with endocrine pathology. Findings to date indicate significant promise for implementing telemedicine interventions within health care delivery. The advisability of their use in each specific case must be approached individually and solely as another, additional tool for improving the quality and accessibility of medical care.

Ethical and Legal Implications of Healthcare Worker Shortages

The chronic shortage of healthcare workers presents significant ethical and legal challenges, particularly regarding the quality of patient care and safety. This paper explores the implications of healthcare worker shortages, focusing on their impact on labor cost, compromised patient care, increased medical errors, and rising malpractice claims. Healthcare institutions face legal risks when they fail to meet mandated staffing ratios, which can result in penalties, fines, and lawsuits. Furthermore, overworked staff, often subject to extended hours and excessive workloads, raise concerns about labor law violations, including non-compliance with mandatory rest periods and fair overtime compensation. The increased reliance on contract workers to fill staffing gaps also introduces legal challenges related to contract disputes, working conditions, and patient safety. Addressing these shortages is critical to preventing further harm to patients and mitigating legal liabilities for healthcare systems. This paper proposes a set of solutions, including legal mandates for minimum staffing ratios in critical care areas and incentives for recruitment and retention in underserved regions. These measures aim to reduce turnover, protect patient safety, and minimize legal risks. A holistic approach to workforce planning and policy reform is necessary to sustain safe staffing levels and ensure ethical standards of care are maintained across the healthcare system. Ultimately, addressing healthcare worker shortages is both a legal requirement and an ethical imperative to safeguard the future of patient care and the well-being of healthcare professionals.

The integration of hospital pharmacists into primary care settings in Shenzhen, China: a qualitative study

BackgroundIntegrating hospital pharmacists into primary care settings can enhance the quality of patient care. However, the challenges vary across countries. China has piloted such collaborations between hospital pharmacists and primary care practitioners in recent years, but research on this subject is limited. This study aims to examine the integration of hospital pharmacists into primary care settings in Shenzhen, China, and identify the perceived barriers and facilitators.MethodsFrom May 1 to November 30, 2022, a qualitative study gathered key informant interviews and on-site observations at three community health centers (CHCs) in Shenzhen. Two researchers collected the data, and all interviews were audio-recorded, transcribed verbatim, and analyzed using a thematic approach.ResultsSeventeen key informants were recruited (eight hospital pharmacists, six GPs, and three health administrators), most of whom were women (n = 11). Hospital pharmacists mainly conduct medication reviews and consultations in clinics or pharmacies of CHCs and engage in home visits with GPs in a few cases. Barriers to their integration include pharmacists’ inadequate competency, a lack of patient recognition, GPs’ resistance, and insufficient technological support. Patient needs, incentive systems, administrative leadership, social media use, and colocation were identified as facilitators of integration.ConclusionWhile unique opportunities may exist for primary care settings to improve patient care by integrating hospital pharmacists, it is essential to address the barriers stemming from individuals and the health system. Efforts should focus on the targeted training of pharmacists’ practical skills, strategic campaigns to raise awareness among the public and healthcare providers, and policy-led efforts to foster technological progress.

Strengthening teamwork and respect (STAR) in maternity units: developing a health system intervention in South Africa

ABSTRACT Disrespect and abuse in maternity services in South Africa has been described over several decades and are rooted in the country’s complex socio-political landscape and unequal health system which places strain on public sector health professionals. Strategies to improve the quality of health care typically involve once-off didactic teaching or outside technical consultants focused on improving specific health programmes. These approaches fail to encourage self-reflection or to establish learning cultures. Participatory learning processes, embedded in routine service delivery, are a potentially powerful way to improve ownership and accountability for health system performance. We describe the process followed to develop the Strengthening Teamwork and Respect (STAR) intervention which is being implemented in nine district hospitals in two rural districts of KwaZulu-Natal. The intervention approach draws on a conceptual framework for learning health systems, with intervention strategies informed by participatory learning and action theory. The intervention design was an iterative process informed by literature reviews, formative data collection, consultation with provincial, district and hospital management stakeholders, expert reviewer inputs and piloting of proposed activities. This process produced the STAR intervention approach and toolkit, consisting of: identification and training of champions, creation of STAR teams, convening of learning sessions to work through STAR toolkit activities, identification, implementation and monitoring of change projects, and onsite and virtual mentorship from the STAR development team. Endline cross-sectional surveys and a parallel process evaluation will advance the evidence base for interventions to improve respectful care and cultures of teamwork and learning within maternity units in rural low- and middle-income settings.

Analysis of quality criteria in endoscopic retrograde cholangiopancreatography in a tertiary care center.

There is a growing concern about ensuring quality in patient care, particularly in high-risk procedures such as Endoscopic Retrograde Cholangiopancreatography (ERCP). We present the results of the evaluation of our performance in ERCP based on the quality measures proposed by the European Society of Gastrointestinal Endoscopy (ESGE) in 2018. This study aims to serve as an internal audit and the first of its kind in our center.

Defining familiarity in nursing homes providing care for residents with dementia: a scoping review

ObjectiveThis study explores the underpinning definitions associated with familiarity in the context of dementia inclusive design and nursing home environment.BackgroundEnvironmental design in nursing homes impacts the quality of life and care of residents with dementia. One of the key principles of design is the need for the environment to achieve a sense of familiarity. However, there are divergent perspectives regarding the term “familiarity.” Inconsistent definitions are challenging to understand, and they continue to impact the implementation of good design. To that end, this scoping review examines the definitions and associated with familiarity, dementia, and the design of nursing home environments.MethodsThe Arksey and O'Malley methodological framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews ensure the rigor of the scoping review. Searches were conducted using six databases for peer-reviewed publications in English from 1991 to 2023. Search terms included “dementia,” “nursing home,” “long-term care,” “familiar,” “familiarity,” and “environments.”ResultsThe searches yielded 245 publications. Of those, 46 studies from 19 countries were included in this review. The review uncovered three central themes and compelling evidence citing the inclusion of homelike environments. Emphasis on design considerations includes the wellbeing of the designated population and the need to embrace multisensory integration in the design process.ConclusionsA strong link exists between familiarity and key design considerations, such as a homelike environment, wellbeing, and multisensory integration. These considerations can enhance the effectiveness of the design of familiar environments.

Development of clinical decision support for patients older than 65 years with fall-related TBI using artificial intelligence modeling.

Older persons comprise most traumatic brain injury (TBI)-related hospitalizations and deaths and are particularly susceptible to fall-induced TBIs. The combination of increased frailty and susceptibility to clinical decline creates a significant ongoing challenge in the management of geriatric TBI. As the population ages and co-existing medical conditions complexify, so does the need to improve the quality of care for this population. Utilizing early hospital admission variables, this study will create and validate a multinomial decision tree that predicts the discharge disposition of older patients with fall-related TBI. From the National Trauma Data Bank, we retrospectively analyzed 11,977 older patients with a fall-related TBI (2017-2021). Clinical variables included Glasgow Coma Scale (GCS) score, intracranial pressure monitor use, venous thromboembolism (VTE) prophylaxis, and initial vital signs. Outcomes included hospital discharge disposition re-categorized into home, care facility, or deceased. Data were split into two sets, where 80% developed a decision tree, and 20% tested predictive performance. We employed a conditional inference tree algorithm with bootstrap (B = 100) and grid search options to grow the decision tree and measure discrimination ability using the area under the curve (AUC) and calibration plots. Our decision tree used seven admission variables to predict the discharge disposition of older TBI patients. Significant non-modifiable variables included total GCS and injury severity scores, while VTE prophylaxis type was the most important interventional variable. Patients who did not receive VTE prophylaxis treatment had a higher probability of death. The predictive performance of the tree in terms of AUC value (95% confidence intervals) in the training cohort for death, care, and home were 0.66 (0.65-0.67), 0.75 (0.73-0.76), and 0.77 (0.76-0.79), respectively. In the test cohort, the values were 0.64 (0.62-0.67), 0.75 (0.72-0.77), and 0.77 (0.73-0.79). We have developed and internally validated a multinomial decision tree to predict the discharge destination of older patients with TBI. This tree could serve as a decision support tool for caregivers to manage older patients better and inform decision-making. However, the tree must be externally validated using prospective data to ascertain its predictive and clinical importance.

The challenge of calculating EUSOMA quality indicators with administrative data – A pilot study in Belgium

Introduction: The study aimed to assess the feasibility of calculating the European Society of Breast Cancer Specialists (EUSOMA) quality indicators (QIs) using Belgian cancer registry data coupled to administrative health data, and to provide national results. Methods: Women diagnosed with ductal carcinoma in situ (DCIS) or invasive breast cancer (IBC) in 2014-2018 were selected from the cancer registry. Fourteen EUSOMA QIs were chosen to assess the quality of care. Results: Overall, 46,035 patients with IBC and 3,973 patients with DCIS were included. Most QIs had to be rephrased so that they could be calculated with the available data. None of the selected QIs on systemic treatment could be calculated due to a lack of reliable receptor status information. For some QIs there is ample room for improvement in Belgian clinical practice: cTNM stage reporting, multidisciplinary team meetings, sentinel lymph-node biopsy only in IBC with clinically negative lymph nodes. The result was 1-5% lower than the target for mammography and breast ultrasound, pTNM reporting, start of treatment, single breast surgery in DCIS, and no axillary clearance in DCIS. For histological or cytological assessment, receptor status assessment, start of radiotherapy, and single breast surgery in IBC, the results were at or above the target. Conclusion: Several EUSOMA QIs can be calculated with routinely collected data, while for several important aspects of care additional data collection is indicated so that its quality can be assessed. The validity of the obtained results depends on the reporting accuracy.

The Effect of Online Infant Care Education and Postpartum Counseling Based on Meleis's Transition Theory on Mothers' Self-Esteem and Infant Health: A Randomized Controlled Trial.

The aim of this research was to assess the effects of online infant care education and postnatal counseling, based on Meleis's transition theory, on maternal self-esteem and infant health. The randomized controlled trial was conducted between November 2022 and May 2023 with 102 mothers and their infants, n = 52 in the intervention and n = 50 in the control. The intervention group received training across two sessions between 32 and 38 weeks of gestation and counseling support for 3 months postbirth. The control group was shared with additional educational materials in PDF format in addition to their usual care. In the intervention group, the subdimension and total score mean of the Karitane Parental Self-Confidence Scale during pregnancy, postpartum, first, second, and third months were higher than the control group (p = 0.001). The proportion of exclusive breastfeeding in the third month was higher in the intervention group than in the control group (p = 0.001). Newborn nurses' care on Meleis' transition theory will increase the quality of care and newborn health. In our study, Meleis's transition theory provides a strong foundation for understanding mothers' psychological and physical transitions in the postpartum period. Trial Registration: NCT05812833.