搜索结果：Journal of multidisciplinary healthcare

Pediatric tuberculosis (TB) remains underdiagnosed in high-burden, resource-limited settings. Caregivers' knowledge and perceptions, along with healthcare providers' practices, are crucial for early recognition and timely care-seeking for children with suspected TB. To assess knowledge, perceptions, and care-seeking practices related to pediatric tuberculosis among caregivers and healthcare providers in the Kabondo-Dianda Health Zone, Democratic Republic of the Congo. A descriptive cross-sectional study was conducted in 2024 among 163 caregivers and 27 healthcare providers selected through convenience sampling. Data were collected through face-to-face interviews using a structured questionnaire covering sociodemographic characteristics, knowledge of tuberculosis transmission and prevention, perceptions of tuberculosis transmission, and care-seeking practices. Tuberculosis knowledge was assessed using 11 items related to transmission and prevention, and composite knowledge scores were calculated. Perceptions were assessed through structured items exploring biomedical and non-biomedical beliefs, including perceived transmission through coughing, contact, evil spirits, and domestic animals. Care-seeking practices were assessed by documenting the first point of care, timing of consultation, and reasons for choosing specific care options. Data were analyzed descriptively using frequencies, percentages, mean scores, and group-level comparisons. No inferential statistical tests were performed. Caregivers had a low tuberculosis knowledge score, with a mean of 2.7 ± 1.28 out of 11 and a knowledge index of 24.5/100. Healthcare providers had a higher score, with a mean of 8.3 ± 1.36 and a knowledge index of 75.5/100. Among caregivers, misconceptions were common, including perceived transmission by evil spirits and domestic animals. Only 49.1% of caregivers reported seeking care first at a health facility, while 64.5% reported delayed care-seeking and 50.9% reported informal care-seeking. Among healthcare providers, 70.4% reported health facilities as the first point of care, 48.1% reported delayed consultation, and 29.6% reported informal care-seeking. In descriptive comparisons, healthcare providers showed higher tuberculosis knowledge scores and reported more frequent use of formal health services than caregivers. However, no inferential statistical tests were performed; therefore, these observations should not be interpreted as statistically significant associations. This study identified important gaps in pediatric tuberculosis knowledge, perceptions, and care-seeking practices, particularly among caregivers. The findings suggest the need to strengthen community-based tuberculosis education, culturally appropriate risk communication, and continued capacity-building of frontline healthcare providers, while recognizing the descriptive nature of the study. Given the descriptive design and convenience sampling, the findings should be interpreted cautiously and cannot establish statistical associations or causal relationships.

Sometimes, drug names or their appearances create confusion among healthcare providers. These look-alike or sound-alike (LASA) drugs have the potential to cause medication errors leading to patient harm. Such errors can occur during prescribing, dispensing, and administration of drugs. Therefore, this study was conducted to assess the knowledge, attitudes, and practice of LASA drugs among healthcare providers at a tertiary care hospital in India. This cross-sectional, observational, single-center, questionnaire-based study was conducted among healthcare providers at a tertiary care hospital in India. The study was conducted over a duration of 2 months between November and December 2024. Out of the 400 participants, 81% were doctors, followed by 12.75% nurses, 3.25% pharmacists, and 3% interns. The majority of them were aware of the term LASA drugs. The majority of them were slightly concerned about the risks of LASA drugs. Whereas, only 10% of them had ever reported LASA errors, as the majority of them were unaware about medication error reporting form. This study suggests that lack of awareness about LASA drugs among healthcare providers contributes to medication errors. To address this, solutions can be implemented at different levels via a multidisciplinary approach.

Stroke remains a leading cause of disability worldwide, and hemiplegia is a common sequela that greatly affects patients' quality of life. Electroacupuncture, which combines traditional acupuncture with modern electrotherapy, has been applied in stroke rehabilitation, but its use among healthcare professionals is uneven. This study aimed to assess healthcare professionals' knowledge, attitudes, and practices (KAP) regarding electroacupuncture in post-stroke hemiplegia management. A cross-sectional survey was conducted at Wuxi Secondary Chinese Medicine Hospital during 2023-2024 using a validated questionnaire covering demographics and KAP domains. Of 311 valid responses, 200 participants (64.31%) were physicians, and 188 (60.45%) had prior electroacupuncture experience. Mean knowledge, attitude, and practice scores were 17.77±7.21, 41.05±4.63, and 33.03±11.39, respectively, indicating insufficient knowledge, favorable attitudes, and moderate practice. Structural equation modeling (SEM) analysis revealed that knowledge was positively associated with practice both directly and indirectly through attitude. Notably, the direct associations of knowledge with attitude (β = 0.37 vs β = 0.26) and practice (β = 0.58 vs β = 0.55) were stronger among participants with prior electroacupuncture experience compared to the inexperienced group. Healthcare professionals demonstrated insufficient knowledge yet generally favorable attitudes towards electroacupuncture. While knowledge significantly improved attitudes and practices, these relationships were markedly stronger among participants with prior clinical experience. Targeted, competency-based educational interventions combining theory with clinical mentorship must be prioritized to promote evidence-based integration in stroke rehabilitation.

Diet is closely associated with the onset, progression, and prognosis of inflammatory bowel disease (IBD). In the absence of specific dietary and nutritional guidelines, nutritional management for IBD patients is fraught with challenges and uncertainties. Existing research indicates that artificial intelligence (AI) has great potential for application in the nutritional management of patients with chronic diseases; however, current research on its use in IBD patients is limited. This scoping review was reported in strict accordance with the PRISMA-ScR checklist. A systematic search was conducted across 11 databases, including PubMed, Web of Science, and Scopus, covering the period from the inception of each database to February 2026, focusing on studies investigating the application of AI in the nutritional management of IBD patients. Of the 4,560 records initially screened, 16 studies met the inclusion criteria. The results indicate that AI applications primarily focus on: dietary pattern recognition, such as using clustering algorithms to identify an association between plant-based diets and lower inflammation risk; treatment response prediction, with machine learning models predicting the success rate of total parenteral nutrition and achieving 90% accuracy in distinguishing between Crohn's disease and ulcerative colitis; personalized information support, where conversational AI such as ChatGPT answered nutritional questions with 83.0% accuracy, and smartphone apps can influence patients' dietary behaviors; identifying patient needs, where Natural Language Processing and Latent Dirichlet Allocation (LDA) topic modeling identified key patient concerns such as treatment experiences, dietary advice, and psychological burden. Key technologies encompass traditional machine learning, deep learning, natural language processing, and multi-omics integrated analysis. AI applications have preliminarily demonstrated the ability to reduce inflammatory markers and improve gut microbiota; fecal metabolites have been confirmed as reliable indicators of disease. AI holds promise for the nutritional management of IBD and has shown preliminary success in pattern recognition, prediction of treatment efficacy, and patient empowerment. However, existing studies are often limited by small sample sizes and insufficient generalizability, and the evidence remains preliminary and heterogeneous. Future efforts should focus on large-scale studies and multidisciplinary collaboration to advance AI from proof-of-concept to clinical practice.

The growing complexity of healthcare systems requires the development of creativity and innovation among health professionals. These competencies are essential for professional growth and entrepreneurial thinking. Problem-Based Learning (PBL) and Multidisciplinary approaches have been recognized as effective strategies to foster such skills. This study aimed to evaluate the effectiveness of Multidisciplinary Problem-Based Learning (MPBL) in promoting creativity and innovation among medical sciences students. This pre-post interventional study was conducted in 2024 with 70 students from various medical disciplines at Hamadan University of Medical Sciences. Participants engaged in three 4-hour MPBL workshops (12&#xa0;hours total) featuring clinical scenarios on sepsis, cardiac arrest, and multiple trauma. The intervention incorporated higher-order thinking activities, structured group discussions, and debriefing sessions. Creativity was assessed using the abbreviated figural version of the Torrance Tests of Creative Thinking (TTCT), and innovation was measured using an adapted version of the Research and Innovation Competency Measure Questionnaire (RIC-MQ). Satisfaction was also evaluated. Data were analyzed using SPSS version 24. Participants had a mean age of 21.83 years, with 66.2% female. Overall, creativity and innovation scores increased significantly post-intervention (p < 0.05), except for innovation in the medical group and creativity in the midwifery group. High satisfaction was reported by 58.6% of participants. Although some changes reached statistical significance, the short intervention period limits the ability to infer sustained or educationally meaningful learning; thus, findings are presented as proof-of-concept. MPBL may be associated with short-term improvements in creativity and innovation among medical sciences students. However, the pre-post design precludes causal attribution, and results should be interpreted as preliminary. Observed variations across disciplines underscore the need for further research with larger, more diverse samples and controlled designs to assess broader applicability.

Emergency department (ED) nurses and allied health professionals (AHPs) face persistent occupational stressors that threaten workforce sustainability. Burnout prevalence exceeds 50% among ED nurses, and post-traumatic stress disorder (PTSD) prevalence among paramedics ranges from 11% to 37%. Despite growing research interest, the team-based and organisational resilience-enhancement strategies targeting both ED nurses and AHPs have not been comprehensively reviewed. This narrative review synthesises current evidence on team-based and organisational resilience-enhancement strategies targeting ED nurses and AHPs in emergency and acute care settings globally. A systematic search informed by JBI scoping methodology and reported in line with PRISMA 2020 was conducted across three databases (Scopus, PubMed, Web of Science) for studies published between January 2016 and March 2026. Search terms combined three concept blocks-emergency care personnel (eg, "emergency nurs*", "paramedic*", "allied health professional*"), resilience constructs (eg, "resilien*", "coping", "hardiness", "post-traumatic growth"), and emergency/acute care context (eg, "emergency department*", "prehospital", "ambulance service*")-using Boolean operators. The Population-Concept-Context (PCC) framework guided eligibility. Studies scoring &#x2265;70% on JBI critical appraisal checklists were included; a sensitivity analysis examined the effect of relaxing this threshold to &#x2265;50%. Data were charted using a standardised JBI extraction form and synthesised narratively. From 766 identified records, 160 duplicates were removed, 606 titles/abstracts were screened, and 196 full texts were assessed. Forty-nine empirical studies met the inclusion criteria; one record initially retrieved was a registered trial protocol with no outcome data and was excluded from synthesis. Of the 49 studies, 32 (65.3%) focused on ED nurses, 12 (24.5%) on AHPs/paramedics, and 5 (10.2%) on mixed teams. Five intervention categories were identified: organisational support (n=17, 34.7%), system-level reforms (n=12, 24.5%), structured training programmes (n=11, 22.4%), peer/team-based support (n=7, 14.3%), and leadership development (n=2, 4.1%). Controlled intervention studies reported positive effects: a three-arm randomised controlled trial (RCT) demonstrated significant improvement in psychological resilience (p<0.05), and a violence-coping programme produced a large effect on resilience (F=59.41, p<0.001). The Cochrane meta-analysis included reported a moderate pooled effect on resilience (standardised mean difference [SMD]=0.45) and stress (SMD=-0.61). Cross-sectional studies reported moderate-to-strong associations between perceived organisational support and resilience (eg, r=0.549). This narrative review identified five intervention categories addressing resilience in emergency care teams, with organisational support and system-level reforms most frequently reported. Controlled studies, although few, consistently reported positive effects. Critical gaps exist in leadership-focused strategies (4.1%) and AHP-specific research (24.5%). Future studies should prioritise longitudinal designs, standardised resilience outcome measures, and culturally adapted interventions. Why was this review done? Emergency departments are high-pressure workplaces where nurses and other health professionals regularly face traumatic events, heavy workloads, and emotional exhaustion. More than half of emergency nurses (over 50 in every 100) experience burnout, and many consider leaving their jobs. This can lead to staff shortages and poorer patient care. We wanted to bring together what is known about strategies that hospitals and teams&#x2014;rather than individuals alone&#x2014;have used to help these frontline workers cope and stay in their jobs. What did we do? We searched three major research databases for studies published between 2016 and 2026. We used search words covering three ideas: the workers (such as emergency nurses and paramedics), resilience and coping, and the emergency-care setting. After careful screening, we included 49 studies from 19 countries. What did we find? The 49 studies described five main types of strategies. We counted how many studies looked at each type: workplace support from managers and organisations (17 of 49 studies), system-wide changes such as better staffing levels (12 of 49 studies), formal training programmes (11 of 49 studies), peer support among colleagues (7 of 49 studies), and leadership development (only 2 of 49 studies). The small number of well-controlled trials reported positive results. For example, one randomised trial showed a meaningful improvement in resilience, and a structured coping programme produced a large improvement. What does this mean? Most strategies focus on what organisations and systems can do, rather than on individual workers alone. However, very few studies tested leadership training, and few focused on paramedics and other allied health professionals. More high-quality, long-term studies are needed, especially for these under-studied groups.

Transgender and gender diverse (TGD) individuals undergoing gender-affirming mastectomy (GAM) face unique challenges related to breast cancer risk assessment and screening. This study aimed to identify factors that influence healthcare professionals' (HCPs) integration of cancer risk evaluation, including genetic assessment, within the context of GAM and pre-surgical planning. We conducted semi-structured qualitative interviews with 20 healthcare professionals - including six primary care providers, five cancer genetic counselors, six oncologists, and three plastic surgeons - experienced in caring for TGD patients considering or undergoing GAM. Using a social constructivist framework, we applied reflexive thematic analysis to explore HCP perspectives and generate key themes. We conceptualized five key themes: (1) HCPs perceive no clear ownership for care integration of breast cancer risk assessment; (2) conflicting guidelines force HCPs to rely on their own judgment, resulting in inconsistent practice; (3) care pathways are driven by individual HCP champions rather than standardized protocols; (4) GAM frequently occurs at young ages prior to age of population cancer risk screening initiation, complicating risk discussions; and (5) structural failures in care delivery compromise patient safety. Improving cancer risk assessment for TGD patients undergoing GAM demands clear institutional accountability, harmonized evidence-based guidelines, standardized care pathways, and genetic counseling embedded into multidisciplinary gender-affirming care teams. These coordinated structural efforts are critical to integrate equitable, personalized, and patient-centered cancer prevention with gender-affirming surgical care.

Good-quality care in the intrapartum and early postnatal period are critical to ensuring maternal, fetal and newborn survival and well-being. There is currently no standardised approach to assess the quality of intrapartum and early postnatal care provided in health facilities, women's experiences of that care, and whether the services provided are aligned with the latest WHO recommendations. The Global Maternal and Newborn Health Platform (GMP) aims to establish and sustain a multi-country network of health facilities providing childbirth services, to measure and improve the quality of intrapartum and early postnatal care. The main objectives of this Platform are (i) to measure coverage of key intrapartum and early postnatal care practices and their alignment with WHO recommendations, (ii) to describe women's experiences of care, (iii) to measure key maternal and newborn health outcomes. GMP will use periodic, cross-sectional, observational data collection in a multi-country network of health facilities from up to 63 low- and middle-income countries (LMICs). In the first wave, GMP is being implemented in 74 facilities in 10 Asia-Pacific countries. In participating facilities data will be collected at level of the individual woman/baby, maternal and newborn health providers, and facility. This multi-country initiative aims to assess the quality of intrapartum and early postnatal care in health facilities, with a "person-centred" approach that emphasizes women's experiences during birth and postnatal admission. In its first wave, data will be collected from over 100,000 women and their babies, alongside nearly 30,000 pre-discharge surveys on care experiences, complemented by responses from over 2,000 healthcare providers across 74 facilities in 10 Asia-Pacific countries. The resulting dataset will enable multi-country, country-specific, and facility-level analyses to identify actionable priorities for improving maternal and newborn health outcomes. GMP's tools and methods are developed using an evidence-based approach and foster multidisciplinary networks among healthcare professionals, researchers, and policymakers. GMP provides a robust, scalable approach for periodic and standardised data collection, informing evidence-based policy and practice to enhance care quality. GMP will provide global situational analyses on intrapartum and early postnatal care quality to address the Sustainable Development Goals (SDG) and will help to addresses the WHA 77.5 resolution to accelerate progress towards reducing maternal, newborn and child mortality, including stillbirths.

In Mecklenburg-Western Pomerania, multidisciplinary round tables bring together stakeholders from the healthcare sector to jointly develop and advance solutions for regional care challenges on a semi-annual basis. In a sparsely populated state with distinct structural and service-related difficulties, these collaborative formats play a key role in improving discharge management. Against this backdrop, the present study explores the main fields of action required to enhance discharge processes in rural areas of Mecklenburg-Western Pomerania. It aims to prioritise the key challenges, objectives, and measures that can contribute to a more efficient and patient-centred continuum of care following hospital discharge. Guideline-based group discussions were conducted at the round tables in Demmin, Pasewalk, Parchim and Ueckerm&#xfc;nde and analysed using qualitative content analysis. To prioritise key topics and measures, a dialogue-based structural mapping method (Strukturlegetechnik) was applied. This approach enables the reconstruction of participants' subjective theories through consensus-oriented discussions and visual mapping of conceptual relationships. In four focus group discussions involving a total of 30 participants, three main areas for action were emphasised: the expansion of networks and binding coordination structures, the use of digital tools such as online platforms and telemedicine, and the development of tailored support services for vulnerable groups. In addition, prevention, health education, citizen participation and public relations were highlighted as essential cross-cutting tasks. To ensure sustainable healthcare provision in rural areas, it is essential to establish stable networks that meet on a regular basis and have reliable funding. The targeted expansion of telemedicine, digital communication platforms and capacity monitoring systems should be pursued to strengthen cross-sector collaboration and reduce gaps in service delivery. In Mecklenburg-Vorpommern bestehen Runde Tische, an denen Akteur*innen des Gesundheitswesens multidisziplin&#xe4;r zusammenkommen, um halbj&#xe4;hrlich gemeinsame L&#xf6;sungsans&#xe4;tze f&#xfc;r regionale Versorgungsprobleme zu entwickeln und deren Umsetzung zu begleiten. Gerade in einem Fl&#xe4;chenland mit geringer Bev&#xf6;lkerungsdichte und spezifischen Versorgungsherausforderungen kommt diesen Strukturen eine zentrale Rolle f&#xfc;r die Weiterentwicklung des Entlassmanagements zu. Vor diesem Hintergrund untersucht der Beitrag, welche Handlungsfelder f&#xfc;r eine Verbesserung des Entlassmanagements in l&#xe4;ndlichen Regionen Mecklenburg-Vorpommerns relevant sind, und zielt darauf ab, zentrale Herausforderungen, Zielsetzungen und Ma&#xdf;nahmen zu priorisieren, um eine effizientere und st&#xe4;rker patient*innenzentrierte Versorgung nach dem Krankenhausaufenthalt zu f&#xf6;rdern. Es wurden leitfadenbasierte Gruppendiskussionen an den Runden Tischen in Demmin, Pasewalk, Parchim und Ueckerm&#xfc;nde durchgef&#xfc;hrt, welche inhaltsanalytisch ausgewertet wurden. Zur Priorisierung zentraler Themen und Ma&#xdf;nahmen wurde die Strukturlegetechnik eingesetzt, ein dialogkonsensbasiertes Verfahren zur Rekonstruktion subjektiver Theorien. In vier Fokusgruppendiskussionen mit insgesamt 30 Teilnehmenden wurden vor allem drei Handlungsfelder betont: der Ausbau von Netzwerken und verbindlichen Koordinationsstrukturen, der Einsatz digitaler Instrumente (z.B. Portale, Telemedizin) sowie passgenaue Unterst&#xfc;tzungsangebote f&#xfc;r vulnerable Gruppen. Erg&#xe4;nzend wurden Pr&#xe4;vention, Aufkl&#xe4;rung, B&#xfc;rgerbeteiligung und &#xd6;ffentlichkeitsarbeit als zentrale Querschnittsaufgaben hervorgehoben. F&#xfc;r eine nachhaltige Gesundheitsversorgung in l&#xe4;ndlichen Regionen sind stabile, regelm&#xe4;&#xdf;ig tagende Netzwerke und eine gesicherte Finanzierung essenziell. Die Integration von Telemedizin, digitalen Kommunikationsplattformen und Kapazit&#xe4;tsmeldesystemen sollte gezielt vorangetrieben werden, um die sektor&#xfc;bergreifende Zusammenarbeit zu st&#xe4;rken und Versorgungsl&#xfc;cken zu schlie&#xdf;en.

This retrospective study aims to compare the efficacy of doctor-nurse therapist integrated rounds versus traditional rounds during the perioperative period of cervical spondylotic myelopathy (CSM). A total of 95 patients with CSM, treated between April 2018 and April 2021, were divided into a test group and a control group. The study compared preoperative and postoperative cervical Japanese Orthopaedic Association (JOA) scores, Neck Disability Index (NDI) scores, postoperative complications, and satisfaction levels among doctors, nurses, therapists, and patients. There were no significant differences in JOA and NDI scores between the two groups (P>0.05). A statistically significant difference in JOA and NDI scores was observed pre- and post-surgery (P<0.05). The test group exhibited a lower incidence of postoperative complications compared to the control group (P<0.05). Additionally, satisfaction levels among healthcare professionals, including doctors, nurses, and therapists, were higher in the test group than in the control group (P<0.05). Notably, patient satisfaction was significantly greater in the test group compared to the control group (P<0.01). Integrated roundsIntegrated doctor-nurse-therapist rounds significantly reduce postoperative complications and improve satisfaction among healthcare providers and patients in CSM surgery, but they do not lead to superior functional recovery (JOA/NDI). This model is recommended for improving perioperative safety and patient-provider experience.

Pediatric feeding disorder is a prevalent, impactful diagnosis for children and their families. This diagnosis is heterogenous in presentation and requires the care of a multidisciplinary team of providers. Existing research suggests providers are underprepared to assess and treat pediatric feeding disorder, therefore more information on training and clinical practice is needed. This study conducted focus groups to describe the training journey of providers across all four pediatric feeding disorder domains (medical, nutrition, feeding skill, psychosocial). Seven focus groups (total of 25 providers) were conducted and analyzed using thematic analysis. Four themes were identified: differences in academic preparation, workplace infrastructure and access, desire for comprehensiveness and feasibility, and value of the family perspective. Overall, results point to opportunities to improve provider training and therefore patient care including academic exposure to pediatric feeding disorder and multi-disciplinary collaboration practices, increased access to mentorship, training, and evidenced-based resources, and enrichment of the research to practice pipeline with a focus on family-centered care.

Rare diseases affect a small percentage of the population but collectively impact millions worldwide. In the Middle East, the challenges are intensified by regional factors such as high rates of consanguinity, sociocultural stigma, limited diagnostic capacity, and inadequate healthcare infrastructure. These challenges often lead to delayed diagnoses, restricted access to treatment, and poor quality of life for affected individuals and their families. The Rare Advocacy Council conducted two 1.5-hour virtual expert panels involving 14 regional and international stakeholders (5 clinicians, 4 patient advocates, and 5 international academic experts) to identify and prioritize the challenges of managing rare diseases in the Middle East region. Discussions were organized across four domains: disease recognition and diagnosis, the patient journey and continuum of care, access to timely diagnostics, and access to adequate treatment, followed by structured online voting (involving only clinicians and patient advocates; n&#x2009;=&#x2009;9), discussions focused on prioritization, and a descriptive follow-up survey to identify the most critical barriers and propose actionable solutions. Key challenges identified included the lack of national disease registries, limited public awareness, underrepresentation of patient voices in decision-making, fragmented multidisciplinary care, and restricted access to diagnostics and advanced therapies. Top priorities included developing national registries, enhancing media-driven education, strengthening collaboration among care providers, and improving treatment accessibility through policy reforms. Effective management of rare diseases in the Middle East requires a coordinated, patient-centered approach. Strengthening health system infrastructure, investing in education, and aligning policy with patient needs are essential for sustainable improvement. Collaborative action among policymakers, healthcare providers, and advocacy groups can significantly advance care delivery and improve outcomes for individuals living with rare diseases.

Robotic-assisted surgery has transformed minimally invasive surgery worldwide, offering improved precision, visualization, and dexterity. However, evidence describing program implementation and perioperative outcomes in low- and middle-income countries remains limited. This study describes the initial institutional experience of a multidisciplinary robotic-assisted surgery program in Peru. A retrospective cohort study included consecutive adult patients undergoing robotic-assisted surgery during the early implementation phase (December 1, 2024 to March 31, 2026) at a national referral center in Peru. Demographic, clinical, procedural, and perioperative outcomes were collected. Multivariable linear regression identified independent predictors of operative time. A total of 398 robotic-assisted procedures were analyzed. Mean age was 49.8&#x2009;&#xb1;&#x2009;17.2 years, and 68.2% of patients were female. Most procedures were performed for benign disease (64.8%), followed by malignancy (29.4%) and complex/reconstructive indications (3.8%). Cholecystectomy (18.1%) and hysterectomy (17.6%) were the most common procedures. Mean operative time was 236.8&#x2009;&#xb1;&#x2009;152.1 min. The conversion rate was 7.5%, postoperative complications occurred in 10.3% of patients, mean length of stay was 7.68&#x2009;&#xb1;&#x2009;8.17 days, 30-day readmission was 2.5%, and no postoperative mortality occurred. Increasing age (&#x3b2;&#x2009;=&#x2009;0.85 min/year; p&#x2009;=&#x2009;0.032), male sex (&#x3b2;&#x2009;=&#x2009;52.3 min; p&#x2009;=&#x2009;0.011), and higher ASA classification (&#x3b2;&#x2009;=&#x2009;8.7 min/category; p&#x2009;<&#x2009;0.001) independently predicted longer operative time. The model explained 54% of operative-time variability (R&#xb2;=0.54). Early implementation of a multidisciplinary robotic-assisted surgery program in a Peruvian public referral hospital demonstrated broad procedural adoption, acceptable perioperative outcomes, and predictable variation in operative duration. These findings provide an implementation benchmark for robotic-assisted surgery in resource-limited healthcare systems.

Ensuring high-quality care during pregnancy, childbirth, postpartum, and the newborn period is essential for reducing maternal and neonatal morbidity and mortality. In Mexico, a significant gap exists in comprehensive, culturally relevant instruments to assess quality of care (QoC) across these critical stages. This study aimed to develop robust, context-specific instruments to evaluate key dimensions of maternal and neonatal care, including patient experience, clinical processes, and hospital infrastructure. Using a modified Delphi method, we conducted two national workshops with 78 unique national experts, including academic researchers, healthcare decision-makers, and maternal health advocates. In Workshop 1, 45 experts identified 1,162 QoC indicators, which our research team subsequently reduced to 521 through a systematization process. Workshop 2 engaged 62 experts-approximately 20% of whom had also participated in Workshop 1-who discussed and rated the 521 indicators. Based on these expert ratings, our research team conducted a subsequent systematization, which further reduced the list to 489 QoC indicators. The final 489 indicators were categorized into five core QoC domains (i.e., Woman, Care Processes, Health Personnel, Infrastructure, and Supplies and Medications) and used to develop three instruments (1) a Semi-Structured Interview Guide to explore women's care experiences; (2) a Childbirth Observation Instrument to assess QoC during labor and immediate postpartum care, including sociodemographic details, facility characteristics, clinical processes, and adherence to best practices, and (3) a Hospital Information Instrument to gather data on infrastructure, personnel, supplies, medications, and service utilization. These instruments offer a rigorous, context-specific framework for evaluating maternal and neonatal QoC in Mexico, helping identify gaps, guide improvements, and promote health equity. They address a critical need by providing tailored tools with strong potential to inform practice and improve outcomes.

To analyze the patient experience during the transition of care, at hospital discharge, in light of clinical management. This is a qualitative study conducted with 31 patients at a public university hospital in the Central-West region of Brazil. Data were collected through interviews, mediated by the critical incident technique. The information was processed using IRaMuTeQ&#xae; software and subjected to content analysis. The main categories were: challenges in transition and in the logistics of care within the Health Care Network; interpersonal relationships and clinical follow-up in care; and perception of care and satisfaction in the recovery process. Experiences related to the presence of consistent therapeutic bonds, clear communication, a welcoming environment, and coordinated action by multidisciplinary teams were associated with greater satisfaction and trust in care, while communication failures and lack of follow-up were frustrating. The findings highlight the need to improve coordination between healthcare services, especially in logistical and communication aspects. In this context, clinic management emerges as an opportune strategy to promote the integration of care practices, contributing to more effective, continuous, and patient-centered care throughout their journey at different levels of care.

Background: Diabetes mellitus (DM) is a metabolic disease with an increasing global prevalence. It is characterized by chronic and systemic complications. Due to these complications, DM significantly impacts patients' health-related quality of life (HRQoL). One of the most critical complications of DM is diabetic foot ulcers (DFUs), which have serious consequences for patients and healthcare systems. Objective: This study aimed to investigate variables potentially associated with HRQoL in patients with DFUs presenting to our wound care unit. Methods: This prospective cross-sectional study was conducted from February to May of 2023 at the Wound Care Unit of the General Surgery Department at Eski&#x15f;ehir City Hospital. A total of 209 patients who agreed to participate were included in the study. Data were collected via a structured questionnaire developed based on the literature, which included the Diabetic Foot Ulcer Scale-Short Form (DFS-SF). We used the Kolmogorov-Smirnov test, univariate analyses (Mann-Whitney U and Kruskal-Wallis tests), and multiple linear regression. Results: In the multivariate analysis, receipt of foot care education (p < 0.001), frequency of hospital applications due to DFU (p = 0.008), and Wagner classification (p = 0.012) were found to be predictors of HRQoL for DFUs (Adjusted R2 = 0.206, F = 4.365, p < 0.001). Conclusions: To maintain a high HRQoL among DFU patients, they should immediately apply to specialized Wound Care Units, receive education, especially regarding early diagnosis and treatment, and receive multidisciplinary management for DFU.

In middle-income countries, the duration of medical consultations is a key determinant of care quality, particularly given the limited health literacy of part of the population. This study analyzes its impact in Morocco by exploring the perceptions of beneficiaries of Compulsory Health Insurance (AMO). A mixed-methods design combined a literature review with a survey of 240 AMO beneficiaries. Data were collected through a questionnaire focusing on listening, clarity of explanations, consultation length, and patient expectations. Most patients reported feeling listened to and considered the explanations clear. However, a significant proportion expressed unmet needs, especially regarding consultation time and medical jargon. The average consultation duration (15-20 minutes) was considered sufficient by two-thirds of patients, while one-third desired more time. Overall satisfaction reached 80%. Consultation length is a major lever for enhancing doctor-patient communication and perceived quality of care. In resource-limited settings, interventions such as simplifying medical language, training healthcare providers in communication skills, and optimizing consultation time management are crucial. These findings, while grounded in the Moroccan context, provide valuable lessons for middle-income countries facing similar challenges.

Effective evaluation of upper-limb prostheses is essential for guiding clinical care, advancing research, and informing device development. There are numerous clinically validated, task-based assessments of function, in which users complete various activities with their prosthesis. Although these tools provide important insights into the users' upper extremity function, their selection varies widely by professional domain and by the purpose of the assessment. To better understand these differences, we conducted a cross-professional survey of 100 physical and occupational therapists, prosthetists, physicians, and researchers practicing in the upper extremity prosthesis field. Respondents reported their familiarity and use of 25 task-based assessments and ranked the relative importance of test attributes such as administration time, validity, comprehensiveness, and ability to track patient progress. Results revealed both common and varying priorities: validity and the ability to track patient progress were universally emphasized, while researchers placed relatively higher importance on comprehensiveness, and clinicians favored short administration times. The Box and Block Test was the most widely used across professions. These findings highlight the way in which profession, competing priorities and practical constraints influence the choice of tests used to evaluate upper-limb prosthetic function.

With obesity management medications being used more widely, it is important to understand the role of the dietitian in the obesity care pathway. This study examined primary-care dietitians' perspectives on the various phases of the obesity care pathway, from patients living with obesity (PwO) accessing nutritional services through monitoring and referral. In this qualitative study, first-line dietitians in Flanders, Belgium, between March, 2025 and June, 2025, were invited to participate. Participants were interviewed, and data were transcribed and analysed using thematic analysis. The first section of the semi-structured interview guide focused on how PwO typically access nutrition therapy, how dietitians monitor and follow up with PwO, and the criteria they use for referral. Lastly, dietitians were asked about their collaboration with other healthcare professionals involved in the care of PwO. Twelve dietitians were interviewed before data saturation was reached. PwO accessed dietetic care mainly through self-initiative or medical referral, though referrals from general practitioners (GPs) were reported as limited. Monitoring and follow-up varied widely in duration and evaluation tools, while barriers such as limited patient motivation, time constraints, and limited reimbursement for dietetic care hindered continuity of care. Dietitians highlighted the need for referral guidelines, digital tools to support interprofessional communication, educational initiatives on interprofessional collaboration, and a central care coordinator to improve obesity care. This qualitative study examined primary-care dietitians' experiences across the obesity care pathway, from patient access to monitoring and referral. Dietitians highlighted limited referrals from GPs as well as variability in the duration and monitoring practices of nutritional therapy. Clear treat-to-target and referral guidelines could reduce reliance on individual clinical judgement, promote coordinated care and prevent delays in effective multidisciplinary care.