Introduction The use of health services expanded during the pandemic and became a regular part of healthcare. There is not a lot of information about how these services are used over the long term and how patients engage with them. This study examined how patients used telemental health services at King Abdulaziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia, from 2019 to 2025. Objectives To evaluate how telemental health services were used and how patients engaged with them during the time before the pandemic, during the pandemic, and after the pandemic. The study also compared how many appointments were completed and the characteristics of patients who had virtual appointments versus in-person appointments. Methods This was a retrospective, repeated cross-sectional census study of electronic health record data on all scheduled mental health appointments, virtual and in-person, at KAMC from January 1, 2019, to December 31, 2025. All eligible encounters and unique patients across 12 facilities were included using total enumeration rather than sampling. Data were cleaned and analyzed in Python using Google Colab. Descriptive statistics were used to summarize appointment and patient characteristics. Chi-square tests were used to compare categorical variables, including appointment completion by encounter type, and the Mann-Whitney U test was used to compare patient age between virtual and in-person appointments. A binary logistic regression model was used to identify factors associated with appointment completion, including encounter type, pandemic period, and patient demographics. Results The study included 479,643 appointments with 51,323 patients at 12 facilities. Overall, 9% of the appointments were virtual. In 2019, there were no appointments, but their use increased during the pandemic and then stayed steady at around 11% to 12% per year after 2021. Overall, 55% of appointments were completed. Virtual appointments had a higher completion rate than in-person appointments, with 60% of virtual appointments being completed compared to 54% of in-person appointments. We also found that patients who had virtual appointments were substantially older and that virtual appointments were mostly used for follow-up visits rather than new patient appointments.  Conclusion Telemental health services went from being an emergency solution during the pandemic to a part of mental health services at the facility. The study found that virtual appointments were associated with patient engagement, which means that patients were more likely to complete their appointments. These findings support the continued use of a hybrid of in-person and virtual mental health services. The findings provide information to support the planning and development of telemental health services. Telemental health services are a part of the healthcare system, and they can be an effective way to deliver the services.
Objectives: Psychological disorders are prevalent medical conditions that can negatively affect oral health. Due to the increase in the elderly population, and higher risk of psychological conditions in this age group, this study assessed the association of mental health evaluated by the 28-Item General Health Questionnaire (GHQ-28) and oral health in the elderly patients. Materials and Methods: Overall, 150 elderly patients aged 60 years and higher presenting to the dental clinic of School of Dentistry, Tehran University of Medical Sciences in 2019 participated in this cross-sectional study. Oral and dental examinations were conducted to assess the dental caries status using the decayed, missing, and filled teeth (DMFT) index, number of existing teeth, and self-reported dry mouth. Sociodemographic status, oral hygiene behaviors, and medical history of the participants were also recorded. The GHQ-28 was used to assess their mental health. Data were analyzed by SPSS version 25 using the correlation tests (alpha=0.05). Results: Of all the participants, 64 (42.7%) were females, and the age range was 60 to 90 years (mean age: 67.56±6.42 years). The mean total GHQ score was 4±3.8. The DMFT score and number of teeth had significant associations with severe depression and social dysfunction (P<0.05). Dry mouth was directly associated with the total GHQ score and anxiety (P<0.05). Conclusion: Elderly people with severe depression suffered from poor oral health. Comprehensive oral and dental examination and paying close attention to mental health aspects should be considered in regular dental check-ups and oral health promotion programs for the elderly.
This paper critically examines Florence Nightingale's legacy and its ongoing relevance to contemporary patient safety. Drawing on Notes on Nursing, the study highlights Nightingale's emphasis on hygiene, cleanliness, environmental factors, and systematic care as foundational to reducing harm and improving patient outcomes. Her insights laid the groundwork for infection prevention and control practices that remain central to modern nursing and healthcare safety protocols. Nightingale's principles align closely with current patient safety frameworks and global initiatives, such as the World Health Organization's Global Action Plan, emphasizing the social responsibility of healthcare professionals. Despite scientific advances and evolving healthcare systems, her legacy continues to influence nursing practices by reinforcing systematized, ethical, and patient-centered care. This enduring relevance underscores the critical role of nursing in safeguarding health and promoting safety in diverse clinical settings. This study advocates for ongoing recognition and integration of Nightingale's principles to enhance patient safety and care quality in modern healthcare. Her legacy remains an epistemological and practical resource for advancing nursing theory, patient-centered care, and critical reflection in healthcare. Trial Registration: Not applicable.
Medial opening wedge high tibial osteotomy (MOWHTO) and unicompartmental knee arthroplasty (UKA) are established treatments for knee osteoarthritis (KOA). This study compared their effects on mental health outcomes. A retrospective cohort study was conducted on patients who underwent MOWHTO or UKA between 2019 and 2023 at a single tertiary institution. The primary outcome measure, the Short Form-36 mental component score (SF-36 MCS), was recorded at baseline, six months and two years post-procedure. Secondary outcomes included the SF-36 physical component score (PCS) and the Oxford knee score (OKS). A total of 105 MOWHTO and 89 UKA procedures were performed. Propensity score matching accounted for preoperative scores, age, gender and body mass index, yielding 51 patients per group. Multivariable regression was used to examine associations between preoperative MCS and postoperative outcomes. Baseline predictors of postoperative MCS were analysed. The level of significance was set at P < 0.05. At six months postoperatively, the UKA group demonstrated better PCS (MOWHTO 42.0 vs UKA 49.6, P < 0.001) and OKS (MOWHTO 23.0 vs UKA 18.8, P = 0.002). At two years, both groups achieved similar improvements in SF-36 MCS, SF-36 PCS and OKS. Preoperative MCS showed a moderate association with postoperative MCS and weak associations with postoperative PCS and OKS. Preoperative MCS was the only baseline factor independently associated with postoperative MCS. In patients with KOA, MOWHTO and UKA achieved similar improvements in mental health scores at two years. Preoperative mental health is an important determinant of postoperative mental health, highlighting its importance in preoperative assessment and counselling.
This cross-sectional survey aimed to assess oral health in patients with inflammatory bowel diseases (IBD) living in Austria. Data collection was conducted with an online questionnaire, including when possible validated tools, covering general medical history, socioeconomic factors, IBD-related parameters, and various oral health parameters, that is, tooth loss rate, prevalence of severe periodontitis, oral health-related quality of life (OHRQoL), and presence of oral lesions. The questionnaire was disseminated to the members of the Austrian Crohn's Disease/Ulcerative Colitis Association. The analysis included the responses of 327 patients (68% female; average age 46 years), 134 with ulcerative colitis (UC) or IBD unclassified, and 193 with Crohn's disease (CD). Based on self-reported data, about 85% of the patients reported intake of an IBD-related medication and about two thirds of the responders reported some IBD activity in the past 12 months. Approximately 24% of the patients had < 20 remaining teeth, 34% had severe periodontitis, and 7% reported poor OHRQoL. IBD diagnosis did not affect the odds for having < 20 teeth or self-reported severe periodontitis, but patients with CD presented more frequently with poor OHRQoL. In addition, patients with CD received more frequently information from their physician on the possibility of oral lesions due to IBD; however, > 50% of all patients indicated not having any problems with oral lesions. Oral health remains inadequately addressed in patients with IBD despite the significant need for dental care. Hence, treating physicians should motivate patients with IBD to inform their dentist about their diagnosis and to maintain regular dental checkups.
Disease outbreaks are non-random public health phenomena attributed to known or idiopathic human, animal, and animal-based factors; a realm referred to as the One Health concept; a new global public health order for control and prevention of epidemics, endemics, and pandemics. These are diseases of viral, prion, bacterial, fungal, and parasitic origin, transmitted between vertebrate animals and humans and vice versa. Emergence and re-emergence of zoonotic diseases such as rabies, Ebola, COVID-19, monkeypox, avian influenza, anthrax, brucellosis, leptospirosis, and Lyme disease continue to affect populations across the world, pointing to unexpected budget impacts of the affected countries.
Protein supplements have gained popularity among gym users in Saudi Arabia. This study aimed to collect data from adults in Saudi Arabia focusing on six components related to protein supplements: demographic characteristics of participants, health and physical activity information, knowledge and attitudes, use, health beliefs, and safety concerns. This study was a cross-sectional, observational online survey targeting adults in Saudi Arabia. Participants included males and females aged 18 and older. Participants who did not complete the survey, as well as pregnant or breastfeeding women, were excluded. Ethical approval was obtained from the Deanship of Scientific Research at Qassim University. Data were analyzed by gender using SPSS version 25, with descriptive statistics and chi-square tests. A total of 358 participants completed the online questionnaire, while two participants did not complete it between March 29, 2024 and December 31, 2024. Regarding knowledge and attitudes, about 68.2% of participants (including both users and non-users of protein supplements) were aware of protein supplements, with males (81.3%) showing significantly higher awareness than females (63.7%). Additionally, 64.8% of participants (both male and female) were unaware of the risks associated with protein supplements. Of all participants, 56% of males and 39.3% of females did not believe that natural protein sources are enough for muscle building, indicating a significant difference. About 127 participants (35.5%) reported using protein supplements either currently or in the past, with no significant difference between males and females. Of those who reported using protein supplements, 11.8% experienced some side effects and were significantly less knowledgeable about the amount of protein they should consume from food and how much protein is enough for their needs. The majority of protein supplement users (48.8%) did not know if protein powders could contain doping agents, with females reporting significantly higher responses than males. Regarding safety concerns, only 43.3% of protein supplement users looked for protein supplements marked with NSF Certified for Sport® on the package, with no significant difference between males and females. Finally, 78% of protein supplement users expressed a need for more information on how to select the best protein supplements, with the highest need found in females and participants who exercise regularly, who showed significantly higher needs for additional guidance. There remains a significant need for increased education about the proper use of protein supplements to minimize potential side effects and increase understanding of their health risks and safety concerns.
Patient safety remains a major concern in hospital-based settings because of adverse events, medication errors, communication failures, delayed recognition of clinical deterioration, and inconsistent adherence to safety protocols. Digital health technologies are increasingly used to support patient safety, but their contribution may depend on integration with standardized protocols and multidisciplinary workflows. This scoping review aimed to map evidence on the integration of digital health technologies and standardized protocols for supporting patient safety in hospital-based settings. This scoping review followed the Arksey and O'Malley framework, further refined by Levac et al, and was guided by PRISMA-ScR. PubMed, Scopus, CINAHL, Web of Science, and IEEE Xplore were searched for English-language studies published from 2006 to June 2025. Eligible studies examined digital health technologies integrated with standardized protocols in hospital-based care and reported patient safety-related outcomes. Data were synthesized using descriptive content analysis and thematic synthesis. Twenty studies were included. Four themes were identified: algorithm-based early warning systems for patient deterioration and sepsis risk; barcode medication administration, electronic medication reconciliation, and clinical decision support systems for medication safety; standardized handoff protocols and digital checklists for clinical communication and workflow adherence; and electronic monitoring systems and digital safety toolkits for hand hygiene and fall prevention. Included studies reported study-specific outcomes related to mortality, length of stay, medication errors, adverse drug events, communication accuracy, protocol adherence, hand hygiene compliance, and fall-related outcomes. Digital health technologies may support patient safety when aligned with standardized protocols and embedded in multidisciplinary workflows. Because no formal critical appraisal or quantitative synthesis was conducted, findings should be interpreted as evidence mapping rather than definitive evidence of effectiveness. Future studies should examine implementation quality, alert fatigue, staff training, workflow integration, sustainability, and transferability across hospital contexts.
Caring is commonly described as the ethical core of nursing and as a fundamentally human way of relating to others. As social assistive robots are increasingly introduced into healthcare, questions emerge regarding the role these technologies can play in caring practices. Drawing on Katie Eriksson's theory of caritative caring, this paper examines how social assistive robots may be understood in caring and discusses the ethical boundaries that should guide their use. Caritative caring, grounded in Caritas, emphasizes human dignity, the care relationship, invitation, responsibility, virtue, obligation or duty, and ethical freedom. It presupposes an ethical orientation and relational openness that robots cannot possess as ethical subjects. Social assistive robots may simulate relational behaviors and support certain aspects of care, but they lack the moral agency and compassionate intentionality required for caritative caring in its full sense. At the same time, this does not mean that robots have no place in healthcare. When designed and used within a value-sensitive and care-oriented framework, social assistive robots may complement caregivers by supporting safety, autonomy and routine care tasks. Caritative caring theory thus offers a framework for clarifying the ethical boundaries of robot use in healthcare, not as substitutes for human compassion and responsibility, but where social assistive robots may support the conditions for human caring without replacing the relation and ethical responsibilities of caregivers.
暂无摘要（点击查看详情）
暂无摘要（点击查看详情）
Trans and gender diverse people experience persistent inequities across healthcare systems, including discrimination in care, barriers to access, and poorer mental and physical health outcomes. While nurses are well placed to influence the quality and inclusivity of healthcare encounters, responses to these inequities have often focused primarily on improving clinical knowledge. Such an emphasis, while important, is insufficient to account for the relational, ethical, and structural conditions that shape care for trans and gender diverse communities. This paper draws on Carper's patterns of knowing, extended through Chinn and Kramer's emancipatory knowing, to reconsider authentic allyship in nursing. Using the patterns of empirical, aesthetic, personal, ethical, and emancipatory knowing, the paper argues that allyship is not reducible to technical competence, respectful intention, or symbolic inclusion. Rather, it requires the integration of evidence-based understanding, compassionate and contextually attuned care, critical self-reflection, moral responsibility, and structural awareness. Through this framework, the paper examines how nursing responses to trans and gender diverse health inequities can move beyond fragmented or individualised approaches towards a more reflective, socially responsive praxis. The paper further considers implications for nursing education, professional leadership, and organisational practice, arguing that authentic allyship must be embedded across curricula, clinical environments, and disciplinary commitments to social justice. Integrating patterns of knowing provides nursing with a multidimensional framework for practice that is not only clinically competent but also affirming, ethically grounded, and attentive to the structural conditions that shape health and healthcare.
Healthcare systems worldwide face mounting pressure to deliver high-quality care while enhancing efficiency and sustainability. Nurse-led interventions have emerged as promising strategies to optimize care delivery, particularly within value-based health systems. However, a comprehensive understanding of their clinical impact and economic value remains limited. This systematic review conducted following PRISMA guidelines, searched nine international databases to identify and synthesize formally evaluated nurse-led interventions, programs, and strategies. Twenty-eight studies were included, encompassing diverse care settings and patient populations. Most studies reported improvements in clinical outcomes, including reduced hospital readmissions, enhanced quality of life, and improved chronic disease management. Several interventions analyzed effectiveness, particularly those involving advanced nursing roles such as nurse practitioners and case managers. Findings suggest that clinical effectiveness does not necessarily translate into increased professional authority: nurse-led interventions consistently generate value across patient, organizational, and systemic dimensions, yet nursing leadership remains structurally subordinate within healthcare governance. A systematic agenda for rigorous economic evaluation embedded in nursing research programs is urgently needed, alongside structural reforms that redistribute authority-not merely develop competencies-within healthcare organizations.
Digital health technology has the potential to increase access to home-based reablement programmes for people living with dementia (PLwD) or mild cognitive impairment (MCI) to support everyday living. Digital Voice Assistants (DVAs) offer a possible solution to overcome usability issues with traditional technologies due to associated cognitive, motor and visual impairments. This paper describes the co-design of a personalised reablement programme to be delivered via DVA. PLwD or MCI (n = 9), their care partners (n = 9) and health professionals (n = 8) participated in the co-design via online workshops and semi-structured interviews. Phases 1-7 of the IDEAS (Integrate, Design, Assess and Share) framework guided this iterative process to develop a product for future feasibility testing. Consensus on essential functions and features was facilitated using the MoSCoW prioritisation method. Transcripts were analysed using a modified thematic framework to inform the reablement programme. Thematic requirements of a cognitive reablement program to be delivered via DVA included (1) Daily Living (self-care, household and cooking), (2) Activity Participation (leisure activities, home hobbies and ad hoc appointments), (3) Emotional Well-being (social connection and coping strategies) and (4) technical requirements (activation, adaptable content, adherence, auditory processing, awareness and training). The IDEAS framework successfully facilitated meaningful engagement from PLwD or MCI, their care partners, and health professionals to integrate user insights and feedback to co-design a personalised reablement program via DVA for subsequent pilot feasibility testing. PLwD and/or MCI, and their care partners contributed by sharing lived experiences for researchers to gain insights; collaboratively identifying behaviours requiring support; creating ideas for solutions; feeding back on prototypes and prioritising program features and functions. Health professionals fed back improvements on prototypes, identifying potential barriers and solutions to implementation of the program.
Healthcare-related incidents affect both patients and professionals involved. The impact on these professionals, known as "second victims," is one of the major hidden burdens of harm. To analyze the concept of the "second victim" from Rodgers' evolutionary perspective. This study conducted a concept analysis based on Rodgers' evolutionary perspective, using a scoping review to identify attributes, antecedents, consequences, surrogate terms, and related concepts associated with the "second victim" concept. The attributes of the "second victim" concept involve persistent physical, emotional, and psychological consequences. Antecedents include a punitive culture and a lack of institutional and peer support. Consequences include sleep disorders, anger, fear, sadness, shame, intrusive memories, anxiety, depression, isolation, absenteeism, and leaving the profession. Related terms include patient safety and mental health, while surrogate terms include the "second victim phenomenon" and "second victim syndrome". Punitive environments exacerbate negative impacts, undermine patient safety, promote error concealment, and increase underreporting, thereby hindering organizational learning and the correction of failures. The "second victim" concept refers to healthcare workers, scholars, and administrative or support staff who are directly or indirectly involved in patient care and who, when involved in an unintentional healthcare-related incident, manifest physical, emotional, and psychological reactions with repercussions across biopsychosocial, ethical, and legal dimensions. Without adequate and timely support, these reactions can become chronic and, eventually, pathological. Los incidentes en la atención sanitaria no solo afectan a los pacientes, sino también a los profesionales involucrados, conocidos como “segundas víctimas”. El impacto sobre estos profesionales se considera una de las principales cargas ocultas del daño. Analizar el concepto de“segunda víctima” desde la perspectiva evolutiva de Rodgers. La investigación consiste en un análisis de concepto basado en la visión evolutiva de Rodgers, utilizando una revisión de alcance para identificar atributos, antecedentes, consecuencias, términos sustitutos y conceptos relacionados con el concepto de “segunda víctima”. El concepto de “segunda víctima” incluye repercusiones físicas, emocionales y psicológicas duraderas. Los antecedentes incluyen la cultura punitiva y la falta de apoyo institucional y de pares. Las consecuencias abarcan trastornos del sueño, ira, tristeza, ansiedad, depresión, aislamiento, absentismo y abandono profesional. Los términos relacionados son seguridad del paciente y salud mental, mientras que los sustitutos incluyen “fenómeno” y “síndrome” de la segunda víctima. Los entornos punitivos agravan los impactos negativos, desmotivan la seguridad del paciente, promueven que se oculte errores y que no se reporten, dificultando el aprendizaje organizacional y la corrección de errores. El concepto de“segunda víctima”se refiere a los trabajadores de la salud, académicos y personal administrativo o de apoyo, involucrados directa o indirectamente en la atención al paciente, quienes, al verse involucrados en un incidente involuntario relacionado con la atención en salud, manifiestan experimentar reacciones físicas, emocionales y psicológicas, con repercusiones en las dimensiones biopsicosocial, ética y jurídica. Sin un apoyo adecuado y oportuno, estas reacciones pueden volverse crónicas y, con el tiempo, patológicas. Incidentes na assistência à saúde afetam tanto os pacientes quanto os profissionais envolvidos. O impacto sobre esses profissionais, conhecidos como "segundas vítimas", é um dos principais fardos ocultos do dano. Analisar o conceito de “segunda vítima” sob a perspectiva evolucionária de Rodgers. A pesquisa realiza uma análise de conceito fundamentada na visão evolucionária de Rodgers, utilizando uma revisão de escopo para identificar atributos, antecedentes, consequentes, termos substitutos e conceitos relacionados ao conceito de “segunda vítima”. Os atributos do conceito de “segunda vítima” envolvem repercussões físicas, emocionais e psicológicas duradouras. Os antecedentes incluem cultura punitiva e falta de apoio institucional e de pares. Os consequentes, destacam distúrbios do sono, raiva, medo, tristeza, vergonha, memórias intrusivas, ansiedade, depressão, isolamento, absenteísmo e abandono da profissão. Os termos relacionados abrangem segurança do paciente e saúde mental, enquanto termos substitutos incluem “fenômeno” e “síndrome” da segunda vítima. Ambientes punitivos agravam os impactos negativos, desestimulam a segurança do paciente, promovem a ocultação de erros e aumentam as subnotificações, dificultando o aprendizado organizacional e a correção de falhas. O conceito de “segunda vítima” refere-se aos trabalhadores de saúde, acadêmicos e colaboradores administrativos ou de apoio, envolvidos direta ou indiretamente no cuidado ao paciente, que ao implicarem-se em um incidente relacionado à assistência à saúde de natureza não intencional, manifestam reações físicas, emocionais e psicológicas, com repercussões nas dimensões biopsicossociais, éticas e legais. As reações sem o suporte adequado e oportuno, podem se tornar crônicas e, eventualmente, patológicas.
Workplace violence against nurses and midwives intensified during the COVID-19 pandemic, exposing and amplifying longstanding structural marginalization in health systems across Latin America. This study analyzes how different forms of violence were experienced and described by nursing professionals during this period. A secondary qualitative analysis was conducted using text-based responses from an international online survey developed by the Global Consortium, which included 3860 nurses and midwives from 18 Latin American and Caribbean countries. Data were examined through Descending Hierarchical Classification using IRaMuTeQ, followed by reflective thematic analysis for interpretive integration. The analysis identified five lexical classes, reorganized into three interconnected themes: direct violence related to care delivery and system collapse; stigma, fear, and disruption of social belonging; and ethical-political suffering associated with structural blame, moral suffering, and moral injury. Despite contextual differences across countries, narratives revealed recurring patterns of emotional overload, professional delegitimization, and exposure to multiple forms of violence. These findings position violence against nursing professionals during the pandemic as a structural and multifaceted phenomenon rooted in historical inequities and institutional fragility, underscoring the need for sustained policies that strengthen workforce protection, ethical accountability, and institutional support in both routine healthcare settings and future public health emergencies.
sensitive disease surveillance is essential for global health security, yet fragile, conflict-affected settings like Somalia face critical human resource and capacity challenges. District and regional surveillance officers are frontline personnel whose competencies in epidemiology, outbreak investigation, and data analysis directly influence early detection, rapid response, and containment of public health threats. a descriptive cross-sectional study was conducted from 1st to 30th April 2025 among all 90 active surveillance officers (72 District Surveillance Officers, 18 Regional Surveillance Officers) across Somalia's Federal Member States. A structured, self-administered questionnaire assessed demographic characteristics, training history (IDSR, FETP, outbreak investigation, rapid response, scientific reporting), and self-reported competencies in core surveillance domains. of 90 invited officers, 68 completed the survey (response rate 75.6%). Participants were predominantly male (86.8%) and aged 20-39 years (95.6%), with 95.6% holding bachelor's or master's degrees. IDSR training coverage was high (96.6%), yet only 10.3% of district officers participated in FETP. Outbreak investigation experience was highest for cholera (54.4%) and measles (47.1%), but low (<20%) for AFP, malaria, diphtheria, and respiratory infections. Technical skills in Excel were widespread (≥75%), whereas GIS (25%) and Power BI (<5%) proficiency were limited. Geographic distribution was uneven, with 27.9% of officers based in Banadir and underrepresentation in peripheral regions. critical gaps in advanced epidemiological skills, specialized outbreak experience, and workforce equity among Somali surveillance officers undermine national disease detection and response. Prioritizing surveillance officers on FETP, targeted refresher training, technical upskilling in GIS and data visualization, and motivation are recommended.
Skeletal muscle aging is associated with increased lipid accumulation, or myosteatosis, leading to lipotoxicity and loss of muscle function. Here, we report that loss of the lactate receptor GPR81 in cellular and progeroid models of muscle aging is associated with impaired lipid oxidation and enhanced lipid accumulation. Knockdown of GPR81 in young healthy myoblasts led to an increase in senescence hallmarks such as DNA damage, accumulation of reactive oxygen species (ROS), impaired mitochondrial activity, and autophagy. Conversely, treatment of senescent myoblasts with GPR81 agonists enhanced lipid oxidation, leading to a decrease in lipid accumulation, ultimately resulting in decreased DNA damage, ROS accumulation, and enhanced ability to form myotubes. In agreement with our in vitro findings, we observed significant improvement in muscle regeneration and overall health of progeric mice that were treated with GPR81 agonists. Our findings suggest that GPR81 plays a key role in skeletal muscle lipid metabolism, and agonists of GPR81 might play a promising role in reversing age-associated lipid accumulation and loss of muscle function.
According to epidemiological data from Hungary, cardiovascular diseases cause the greatest loss of health among the population and are responsible for a significant proportion of premature deaths. This reinforces the health policy position that cardiovascular prevention, including improving medication adherence, must be given top priority in patient care. Long-term survival in patients who have experienced acute coronary syndrome depends heavily on medication adherence, particularly regarding statins and anticoagulants; however, domestic surveys indicate deficiencies in the use of preventive medications. The aim of our study was to compare the attitudes and beliefs regarding antiplatelet agents and cholesterol-lowering drugs among patients in the secondary prevention group who underwent percutaneous coronary intervention and those in the primary prevention control group, using the Beliefs about Medicines Questionnaire (BMQ). A cross-sectional, questionnaire-based study included 162 secondary prevention patients and 136 primary prevention patients who had undergone percutaneous coronary intervention. Medication attitudes were measured using the specific and general dimensions of the BMQ, and SPSS 27.0 was used for statistical analysis. Among patients in the secondary prevention group, both drug groups were characterized by lower levels of concern and more accepting attitudes, whereas in the primary prevention group, sceptical (p<0.05) and ambivalent attitudes were more common (p<0.001). Based on the analysis of respondents by attitude group and the examination of the BMQ's general subscales, percutaneous coronary intervention significantly influenced beliefs regarding medications. This change was clinically significant in terms of treatment adherence (p<0.001) Discussion and conclusion: Patients who have undergone percutaneous coronary intervention have more favourable attitudes toward medication, which highlights the role of targeted education and psychoeducation in improving adherence in the non-intervention population. However, adherence in the secondary prevention group cannot be considered optimal either, therefore further targeted education is warranted in this patient group as well. Orv Hetil. 2026; 167(31): 1238-1247. Bevezetés: Magyarországi epidemiológiai adatok alapján a cardiovascularis betegségek okozzák a legnagyobb egészségveszteséget a lakosság körében, és az idő előtti halálozás jelentős részéért is felelősek. Ez megerősíti azt az egészségpolitikai álláspontot, hogy a cardiovascularis prevenciónak, beleértve a gyógyszeres terápiahűség javítását, kiemelt prioritást kell kapnia a betegellátásban. Az akut coronaria szindrómán átesett betegek hosszú távú túlélése nagymértékben függ a gyógyszeres terápiahűségtől, különösen a sztatinok és véralvadásgátlók tekintetében, ugyanakkor hazai felmérések a preventív gyógyszerek szedésének hiányosságaira utalnak. Célkitűzés: Vizsgálatunk célja a percutan coronariaintervención átesett másodlagos prevenciós és a kontrollcsoportba tartozó elsődleges prevenciós betegek thrombocytaaggregáció-gátlókkal és koleszterinszint-csökkentőkkel kapcsolatos hozzáállásának és hiedelmeinek összehasonlítása volt a Beliefs about Medicines Questionnaire (BMQ) segítségével. Módszerek: Keresztmetszeti, kérdőíves vizsgálatban 162 percutan coronariaintervención átesett másodlagos prevenciós és 136 elsődleges prevenciós beteg vett részt. A gyógyszerattitűdök mérése a BMQ speciális és általános dimenziói mentén történt, a statisztikai elemzéshez az SPSS 27.0 programcsomagot alkalmaztunk. Eredmények: A másodlagos prevenciós betegek esetében elmondható, hogy mindkét gyógyszercsoport esetében kisebb aggodalomszint és elfogadóbb hozzáállás volt jellemző, míg az elsődleges prevenciós csoportban gyakoribb volt a szkeptikus (p<0,05) és az ambivalens hozzáállás (p<0,001). A válaszadók attitűdcsoportok szerinti elemzése, valamint a BMQ általános alskáláinak vizsgálata alapján a percutan coronariaintervencióhoz társulóan szignifikáns különbségek voltak megfigyelhetők a gyógyszerekkel kapcsolatos hiedelmeket illetően. Ez a változás a gyógyszeres terápiahűséggel összefüggő attitűdök szempontjából jelentős volt (p<0,001). Megbeszélés és következtetés: A percutan coronariaintervención átesett betegek kedvezőbb gyógyszerattitűdökkel rendelkeznek, ami kiemeli a célzott edukáció és pszichoedukáció szerepét a nem intervención átesett populáció terápiahűségének javításában. Ugyanakkor a terápiahűség a másodlagos prevenciós csoportban sem tekinthető optimálisnak, ezért ebben a csoportban is indokolt a további célzott betegoktatás alkalmazása. Orv Hetil. 2026; 167(31): 1238–1247.
Children and young people with intellectual and developmental disability have long been known to suffer from inequities in accessing safe and quality health care. These challenges are most felt within the emergency department due to its busy, crowded, and overstimulating environments with staff that are not trained to provide reasonably adjusted care. The study is an evaluation using qualitative and quantitative methods of a continuing education and quality improvement programme designed to increase the knowledge, skills, and confidence of healthcare staff in providing reasonable adjustments to children and young people with intellectual disability in hospitals. This study evaluated the Motivated for Change programme, which uses Behavioural change, Adult Learning, and Quality Improvement strategies to drive practice change and service improvement. A hundred and thirty-one and 89 staff participated in a pre- and post-intervention survey. Interviews were conducted with parents of children and young people with intellectual and developmental disability attending the emergency department. Observational studies were also conducted in the pre- and post-intervention phase. These were transcribed, categorised, and coded with themes derived. Consensus was reached through meetings with the research team. The Motivated for Change programme has demonstrated significant increases in staff knowledge, skills, and experience in providing safe and quality care for these children and young people. Evidence of change is reflected in the parent and staff interview and observational study themes. In addition, staff were further motivated to undertake quality improvement projects, develop an in-house training programme to provide ongoing training for new staff, and make further improvements in the department. The Motivated for Change programme has demonstrated its efficacy in enabling changes in the practice of reasonable adjustments and the emergence of local champions for sustained efforts for ongoing improvements in safety and quality of care. The development of the research question and outcome measures was informed by data from previous research publications involving parents and staff. We sought input from a parent advisory committee in the design of the study. Parents were not involved in the recruitment and conduct of the study. Results were presented to the parent advisory at the end of the study.