bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telemonitoring activities of daily living in home healthcare services to support aging in place
Authors: Aboujaoude A , Lussier M , Filiou R-P , Couture M , Kenfack Ngankam H , Giroux S , Paré G , Bottari C , Da Cunha Belchior P , Bier N 
Published: October 2024

Abstract

Context
Assessing older adults’ abilities to carry out their activities of daily living (ADLs) is a key determinant in the provision of homecare services for aging in place. Amidst a growing aging population and lack of human resources, continuous remote monitoring technology appears promising to support health and social care professionals (HSCPs) in identifying service needs. However, implementation studies conducted in real-life settings are lacking. This study is part of an on-going action design research project aimed at developing an ambient telemonitoring system monitoring ADLs to support clinical decision making. It focused on the initial step of implementation and aimed to understand 1) which HSCPs would want to use the system, 2) for which care recipient they requested it, and 3) for which reasons.

Methods
A multiple embedded case study utilizing mixed methods was conducted across 3 healthcare establishments in Quebec, Canada. Descriptive statistics from surveys and medical records was conducted to describe the profile of HSCPs and their care recipients. An inductive qualitative analysis was carried out through interviews with 23 HSCPs, in charge of 31 care recipients, to deepen our understanding of the reasons why they requested the system.

Results
HSCPs were primarily women (89%) occupational therapists (43%). Home care recipients were also primarily women (74%), with documented refusal of homecare services (65%), diagnosed with cognitive decline (94%), and living in a single-family home or apartment (68%). Overall, interviews revealed HSCPs challenges in getting the necessary information to assess their care recipients needs, despite the presence of in-home services and other strategies in place (e.g. informal carer support). Moreover, the telemonitoring system was perceived as promising for risk management.

Conclusions
There is an interest for the use of ADL telemonitoring technology in the delivery of home healthcare services for aging in place.

Key messages
• To facilitate its integration in practice, we explored the need for, and value of, ADLs telemonitoring technology by health and social care professionals (HSCPs) in real-life contexts.
• By studying the integration of innovative technologies in home healthcare practices, such as ADLs telemonitoring, we aim to support HSCPs practice in fulfilling older adults desire to age in place.
Workplace health promotion measures and use of medical services in the German Federal Armed Forces
Authors: Seeland U , Hauck M , Roehle R , Dickob C , Ucar J , Arnold L , Willich S N , Reinhold T , Ludwig S , Roy R 
Published: October 2024

Abstract

Introduction
Workplace health promotion measures (WHPM) are among recommended options for maintaining employees health, important for the German Federal Armed Forces as an employer. In order to detect associations between WHPM and health care utilization, we recorded the number of outpatient visits and hospital stays, differentiated according to gender, military or civilian activity.

Methods
Prospective longitudinal observational substudy with cross sectional analysis of items regarding use of medical services at T0 (6-9/2022). Analysis for T1 (2023) and T2 (2024) follow. Data were obtained with a web-based employee survey to record self-reported endpoints. A total of about 224.000 employees by the German Armed Forces were addressed.

Results
Survey participation rate was 10.5% (n = 23.568) of all employees in T0, 29.1% were women and 0.3% reported being diverse, 43.2% of the participants were &lt;40 years of age. Independently of taking part in WHPM, we did not detect differences in the proportion of male soldiers receiving treatment in hospitals of the German Federal Armed Forces. Among female soldiers without WHPM, 37.5% stayed in hospitals and with WHPM 30.5%. Higher % of women (84%) than men (78%) presented to the military - or family physician (w: 81%, m: 73%), independent of participation in WHPM and assignment for civil or military. In last 4 weeks, more women (81.3%) than men (65.6%) were prescribed medication. Female employees in civilian w.p.(84.8%) took more medications than those in military w.p (77.7%). Oral contraception was used by 20% of women in both civilian and military w.p.

Conclusions
There are no gender differences nor difference for civilian or military employees concerning the number of days staying in hospital. More women than men recieved regular outpatient medical care and more women than men take medication regularly.
*Ludwig S and Roy R share last authorship

Key messages
• There are no gender differences nor difference for civilian or military employees concerning the number of days staying in hospital.
• More women than men recieved regular outpatient medical care and more women than men take medication regularly.
The trajectory of frailty index among spousal caregivers: longitudinal evidence from China
Authors: Pikhart H , Peasey A 
Published: October 2024

Abstract

Background
Very few studies have investigated the association between providing unpaid caregiving to a spouse and the frailty of caregivers. This study aims to examine the impact of providing spousal care on frailty among the middle aged and older Chinese population.

Methods
Data were derived from the 2011, 2013, 2015, and 2018 waves of China Health and Retirement Longitudinal Study (CHARLS) including 4,008 participants aged 50 and above. Frailty was assessed using a composite mean score based on 41 indicators according to Rockwood frailty criteria, including self-reported health, medically diagnosed conditions, medical symptoms, functional activities assessment, Activities of Daily Living (ADLs), and Instrumental Activities of Daily Living (IADLs). A growth curve model was employed to investigate the differences in frailty among caregivers and non-caregivers.

Results
Compared to non-caregivers, spousal caregivers were more likely to have a higher frailty when adjusted for all covariates (Beta=0.010, SE = 0.003, p &lt; 0.001). Furthermore, female caregivers exhibited a higher rate of change of frailty index over time (Beta=0.002, SE = 0.001, p &lt; 0.05) compared to female non-caregivers, while no such effect was found in males.

Conclusions
The findings of this study reveal that providing unpaid care to a spouse is associated with an increase in the frailty index over time particularly among female caregivers. These insights underline the necessity for Chinese policymakers to develop and implement targeted interventions aimed at reducing burden on spousal caregiving, thereby preventing an increase in frailty among these caregivers. Such measures would also align with the broader objective of promoting healthy ageing.

Key messages
• Chinese policymakers need to develop and implement targeted interventions to reduce the burden on female spousal caregivers and prevent increased frailty.
• Focusing on the frailty of female spousal caregivers is crucial for promoting healthy aging.
Core set of indicators to evaluate healthcare workers support programmes: a consensus-based approach
Authors: Guerra-Paiva S , Carrillo I , Mira J J , Fernandes J , Strametz R , Gil-Hernández E , Sousa P 
Published: October 2024

Abstract

Objectives
Considering the widespread implementation of support programmes for healthcare workers (HCWs), there is an urgent need to establish a standardised set of indicators for their ongoing assessment. This study seeks to develop a consensus framework for evaluating interventions aimed at supporting HCWs affected by patient safety incidents (PSIs) or other distressing situations, commonly referred to as second victims (SVs). Having a core set of indicators it is crucial for facilitating comparative analyses across different organisations and time periods.

Methods
A qualitative study was conducted from June 2023 to March 2024. The study involved a multidisciplinary group of members part of the European Researchers Network Working on Second Victims. The consensus-building process utilised insights from a scoping review (phase 0) and a nominal group technique (phase 1) to develop a questionnaire for Delphi Rounds (phase 2). Indicators were rated on a scale of 1-5, with consensus reached if over 70% of participants rated an indicator as both feasible and sensitive scoring above 4. A consensus conference was subsequently organised.

Results
From an initial pool of 91 indicators, 55 were rated online, with 35 progressing to the Delphi rounds. A total of two Delphi rounds were performed and achieved response rates exceeding 60% and 80% respectively, resulting in consensus on 11 indicators for evaluating SV’ support programmes. These indicators encompass various aspects such as awareness and activation of the programmes, organisational processes and structures, institutional training provisions and assessment of the impact of the programme in the SVs.

Conclusions
This study endeavors to provide guidance for future SVs’ programs namely in the critical areas of programme’s awareness and activation, structural and process enhancements, and programme’s impact on SVs. Moreover, these indicators are suitable for multiple healthcare contexts and levels of implementation.

Key messages
• The priorities for evaluation of second victim programmes’ include their impact on healthcare workers, awareness and activation, organisational processes and structures and institutional training.
• Utilizing a multidisciplinary consensus approach, we defined a set of indicators that are adaptable to diverse contexts that provide care and varying levels of second victim support implementation.
Racism in inpatient settings in Germany: professionals’ perspectives
Authors: Tezcan-Güntekin H , Stüwe E , Papadopoulou S , Meshkova K , Merz S 
Published: October 2024

Abstract

Background
Experiences of racial discrimination during healthcare encounters have increasingly been recognised as a source of health inequity. Narrative accounts by racialised healthcare users have dominated research in the field but it is equally important to capture the perceptions and practices of professionals to understand how racism operates in healthcare provisioning. This presentation asks: how does racism manifest in the German inpatient healthcare system (hospitals, rehabilitation facilities), and are there areas or phases of healthcare provisioning where racism is observed more frequently?

Methods
Problem-centred expert interviews (Döringer 2021) with 20 healthcare professionals from medicine, nursing, and therapeutic professions working in hospitals or rehabilitation facilities across three German federal states. Data were analysed using documentary method (Bohnsack 2002).

Results
Racism occurs widely in German inpatient settings. It manifests both structurally, e.g. in the absence of professional translators for healthcare users with limited German skills, and interpersonally, e.g. in the form of microaggressions and stereotyping but also the witholding of treatment and verbal abuse. Targets of racism are both patients and staff, especially internationally recruited healthcare workers. Respondents thereby identify night shifts, psychiatric settings and the emergency ward as contexts where racism is more likely to occur. The hierarchical nature of and pervasive power asymmetries in hospitals thereby prevent effective interventions against racial discrimination.

Conclusions
Racism in German healthcare institutions requires multiscalar public health interventions, particularly at the level of the institutions themselves. These include the establishment of a robust and low-threshold complaints structure, spaces for self-reflection for professionals, and mandatory anti-racism training rather than a focus on diversity-sensitive competence.

Key messages
• In future research approaches, structurally determined reproductions of racism should be investigated using a multi-method approach.
• Experiences of powerlessness are reported by both those affected by racism and those professionals who observe racism and should be addressed by the institutions.
The association between cancer literacy and cancer screening behaviours: a systematic review
Authors: Isonne C , Pistollato A , Sinopoli A , Iera J , Sciurti A , Marzuillo C , Villari P , Baccolini V 
Published: October 2024

Abstract

Background
This study aimed at investigating the association between cancer literacy (CL) and adherence to cancer screening programs.

Methods
PubMed, Scopus and Web of Science were searched. Any study, published until March 2024, that investigated the associations between CL and cancer screening intention or uptake in any target population were eligible. For CL measurement, both validated and ad hoc tools were considered. For each outcome, articles were grouped according to the type of cancer investigated and results were narratively synthesized.

Results
A total of 3426 records were retrieved. After deduplication and screening process, six studies were included. Population enrolled was heterogeneous as well as the tool used to measure CL. Four studies explored the relationship between CL and screening uptake, one focused solely on screening intention and another investigated both intention and uptake. Significant association was found between CL and screening intention in the two studies included, with higher literacy levels correlating to increased intent for screening. A significant association between higher CL and skin cancer screening uptake was reported, while the uptake of prostate cancer screening was not significantly associated with CL levels. By contrast, mixed results were obtained investigating breast, cervix and colorectal screening uptake.

Conclusions
Higher levels of cancer literacy appeared to be associated with screening intention, while its association with screening uptake was found barely significant for any screening type, suggesting that other factors influence the actual screening uptake. However, the scarce number of studies, along with the absence of validated tools and the heterogeneity of target populations, limits the generalizability of the results. Further research, differentiating screening types and timelines and using multivariate models, is needed to clarify the role of CL in screening behaviours.

Key messages
• Higher levels of cancer literacy appear to be associated with screening intention, suggesting its importance in promoting motivation for early cancer detection.
• Association between cancer literacy and screening uptake was found barely significant for any screening type, suggesting that other factors influence actual screening uptake, urging further research.
How to measure the general Environmental Health Literacy
Authors: Lopez Lumbi S , Masciangelo L , Liebig-Gonglach M , Duda A , Rodenkirchen J , Hoyer A , Hornberg C , Mc Call T 
Published: October 2024

Abstract

Background
Many environmental factors, both natural or man-made, are associated with health risks. To make informed decisions about these potential risks, certain skills and competencies are necessary. The concept of Environmental Health Literacy (EHL) which integrates aspects of Science Literacy, Health Literacy and Environmental Literacy encompasse these competencies. To assess to what extent individuals or groups are environmental health literate, a general Environmental Health Literacy Scale is necessary. To the best of our knowledge, there is no validated instrument to measure general EHL.

Methods
Two phases of scale construction were conducted: 1) Item development with deductive methods which includes a literature review and assessment of existing scales resulting in two suitable studies for scale construction. Included items were translated to German language. 2) Scale development with pre-testing of items followed by applying potential items (n = 38) to a sample of of 454 students. Internal consistency (Cronbach’s alpha), Kaiser-Meyer-Olkin Criterion (KMO), Bartlett’s test, Velicer’s minimum average partial (MAP) test for number of underlying factors and Exploratory Factor Analysis using Principal Component Analysis with oblimin rotation and stepwise item reduction were assessed.

Results
Velicer’s MAP identified 3 factors, Cronbach’s alpha = .92, KMO = .92, Bartlett’s Test revealed significant correlation. Seven items were removed from the scale due to low factor loadings (&lt; .3). Factor 1 (access) explains 18% of variance, factor 2 (knowledge) 12% and factor 3 (reflection) 10%, respectively. Overall, the model explains 40% of variance. Model fit represented by RMSEA index = .05.

Conclusions
A new general EHL scale has been developed and proven to be suitable for a students sample. This marks the first step towards a validated tool for multiple purposes. Cultural adaptation as well as multiple language validations are in process.

Key messages
• The process towards a general Environmental Health Scale has started.
• The development of a validated EHL scale will improve understanding on whether the general population or subgroups are able to gain, understand and act upon information regarding environmental health.
Measuring Vaccine Literacy in Switzerland: How is the situation after COVID-19?
Authors: Jaks R , De Gani S M 
Published: October 2024

Abstract

Background
Vaccinations are one of the most effective medical health interventions and one of the most important preventive measures. However, the population is often unsure about vaccination, and the roles and responsibilities of the key actors seem often unclear. To adequately protect the population against vaccine-preventable diseases, the Swiss Confederation, the Cantons and other stakeholders have developed the National Vaccination Strategy and an associated action plan. For its implementation, studies on the population’s knowledge, attitudes, skills, and vaccination behavior are crucial. Thus, the Swiss Federal Office of Public Health launched a study to assess vaccine literacy and its relation to vaccination readiness and behavior in the adult population in Switzerland.

Methods
A representative sample of 2,500 people living in Switzerland will be surveyed in summer 2024. The online questionnaire will include validated instruments, e.g. the HLS19-VAC Instrument to measure vaccine literacy or the 7C Vaccination Readiness Scale, as well as questions on correlates of vaccine literacy, vaccination readiness and behavior.

Results
The results of the survey will be presented, with a focus on vaccine literacy, vaccination readiness and behavior and their correlates. Specifically, differences among the three main language regions and between specific population groups will be shown. Further, a comparison with data from previous studies will be presented.

Conclusions
Despite having an advanced healthcare system, to date Switzerland has only partially reached its objectives in terms of vaccination, both for individual protection and collective immunity. New data on vaccine literacy, vaccination readiness and behavior as well as on the influencing factors are needed, especially after the pandemic, to guide effective future actions and measures to improve the vaccine coverage and public health in Switzerland.

Key messages
• Due to the COVID-19 pandemic the topic of vaccination in general has received increasing attention and may has changed people’s knowledge and attitudes towards vaccination.
• Newest data on vaccine literacy, vaccination readiness and behavior are necessary to inform future, targeted actions and increase vaccine uptake.
Development of a tool for generating comprehensible, individualized and digitalized outpatient letter
Authors: Jaks R , Nicca D , Künzler-Heule P , Brülke B , Jonietz A , Post R , De Gani S M 
Published: October 2024

Abstract

Background
Patients often remember little from a medical consultation or a conversation with a doctor. A comprehensible, individual patient letter summarizing the consultation can support, as a German project which successfully implemented a digital tool to generate such a letter in inpatient care showed. Based on this, our aim is to develop a tool for letters in outpatient care in Switzerland, to support understanding of the consultation and increase patient’s health literacy (HL).

Methods
The development of the tool was conducted participatively with targeted health professionals (HP) and patients with a chronic disease to 1) identify specific patient groups and situations, 2) confirm eligibility and receive concrete input regarding structure and content, and 3) to ensure the technical practicality and usability by the target groups. Concretely, several expert and patient interviews, a focus group and consultation observations were performed. Further workshops and usability tests are planned.

Results
We first defined 8 criteria to identify situations suitable for the development of the letter (e.g. high information need) and interviewed 5 experts on selected topics. Based on this, chronic back pain was chosen for a deeper feasibility analysis: A focus group interview (n = 4 HP) and 5 telephone interviews with patients confirmed the eligibility and provided information on the structure and content of the letter. Observations of 5 consultations provided further insights. Then, a first concept for the letter’s content was developed and is currently being finalized. It consists of: 1) summary; 2) background; 3) diagnosis; 4) treatment; and 5) next steps and includes infoboxes and a glossary.

Conclusions
The tool for patient letters can be adapted to other diseases (e.g. chronic back pain) and settings (outpatient care). In a next phase, the letter will be piloted in an outpatient clinic and evaluated with HP and patients. The effect on HL will also be assessed.

Key messages
• Comprehensible, individualized, and digitalized patient letters can help patients to deal with health information and take better decisions for their health and well-being.
• The developed patient letter and the corresponding tool should be easily adaptable for other diseases and settings.