Objectives:People living with severe mental illness have a reduced life expectancy when compared to the general population largely due to physical health comorbidities.Exercise is a valuable,evidence-based component o...Objectives:People living with severe mental illness have a reduced life expectancy when compared to the general population largely due to physical health comorbidities.Exercise is a valuable,evidence-based component of mental healthcare,with positive effects on physical health,mental health,and quality of life.However,to date,there is limited evidence regarding the implementation of varied styles of supported exercise therapy within outpatient,transdiagnostic mental health services.This protocol paper outlines the methods for a hybrid effectiveness-implementation trial implementing two styles of supported exercise within an outpatient mental health hospital.Methods:Participants will be allocated to either in-person supervised exercise sessions,or independent,remotely supported exercise programs.Both intervention arms will have the target of 150 minutes of moderate intensity exercise per week across the 12-week intervention period,along with a 12-week maintenance period following the intervention periods.Assessments will be conducted at intake,intervention midpoint(i.e.,week 6–7),intervention conclusion(i.e.,week 13),and at follow-up(i.e.,week 25).Results:The evaluation of the exercise interventions will consist of implementation and effectiveness outcomes during the intervention and at follow-up.Conclusions:The outcomes from this trial will add to the ever-increasing evidence for the incorporation of exercise within care for severe mental illness.This trial will report on the implementation and effectiveness of varied levels of support in exercise therapy for consumers with severe mental illness,which may in turn guide the future implementation and improve provision of exercise therapy in hospital mental health services.展开更多
<div style="text-align:justify;"> <strong>Background</strong> <span "="">The use of health services by the adult population is related to cardiovascular risk and its st...<div style="text-align:justify;"> <strong>Background</strong> <span "="">The use of health services by the adult population is related to cardiovascular risk and its stratification. Cardiovascular risk (CVR) stratification should be a tool for the assessment of the patients and the appropriate control during the process of medical care and utilization of health services for the adults. <b>Objective </b>Evaluate the association between cardiovascular risk (CVR) in adults and the utilization of health services. <b>Material and Methods </b>A secondary analysis</span> was performed of the data from the National Health and Nutrition Survey (ENSANUT) 2018-2019. <span "="">The CVR classification (risk score) was obtained in 43,070 adults with a previous diagnosis (self-report) and 1,237 adults newly diagnosed. Independent, risk factors and the association between groups of CVR and utilization of preventive, outpatient and hospital services were analyzed. <b>Results </b>More than 85% of adults interviewed have some degree of CVR. Almost half of them have low CVR (48.2%). Older adults with social security predominate in the group with high and very high CVR. Seventy-five percent of adults recently diagnosed have low CVR. In both, there is very little utilization of health services. For adults previously diagnosed CVR, the higher the CVR, the greater the likelihood of utilization of outpatient, preventive and hospital services, in contrast to adults without CVR independent of the marital status, sex, health institution and socioeconomic level. <b>Conclusion </b>The results give evidence of areas of opportunity for improvement in the quality of health services. The evaluation of CVR in primary care and promotion and prevention of CVR should be strengthened.</span> </div>展开更多
Objective:Gender-specific integrated health services have long existed in the arena of women’s health care,but men’s health centers(MHCs)have only recently emerged as a novel practice model.Here,we seek to evaluate ...Objective:Gender-specific integrated health services have long existed in the arena of women’s health care,but men’s health centers(MHCs)have only recently emerged as a novel practice model.Here,we seek to evaluate the prevalence and format of MHCs found in the leading academic medical centers in the United States.Methods:The US News&World Report’s Top 50 Ranked Hospitals for Urology was used as our cohort.Data were gathered on the presence of MHCs and types of providers and conditions treated.An equivalent search was performed for women’s health centers(WHCs).Results:Sixteen of 50(32%)promoted some type of MHC,compared to 49 of 50(98%)offering a WHC.Eight of the top 15 ranked institutions(53%)had an MHC compared to eight of 35(23%)remaining programs.Six of 16 MHCs incorporated providers from a variety of medical disciplines,including urologists,internists,endocrinologists,cardiologists,and psychologists,while another six of 16 MHCs were staffed solely by urologists.Eight of 16 provided services for exclusively urologic issues,four of 16 offered additional services in treatment of other medical conditions,and four of 16 did not specify.展开更多
Objectives: It is to determine the prevalence of familial hypercholesterolemia (FH) among adult Filipino patients with dyslipidemia at Universidad de Santa Isabel Health Services Department in one year. Methods: An ob...Objectives: It is to determine the prevalence of familial hypercholesterolemia (FH) among adult Filipino patients with dyslipidemia at Universidad de Santa Isabel Health Services Department in one year. Methods: An observational descriptive prospective study involves Filipino patients, aged 19 years and older, with dyslipidemia. The Dutch Lipid Network (DLN) Criteria was used to diagnose FH. Prevalence data and categorical variables were expressed as percentages, while continuous variables were reported as mean and standard deviations. Results: 529 patients were included in the study. 302 were females, and 227 were males. 180 (34%) scored Unlikely, 100 (19%) scored Probable, 185 (35%) scored Possible, and 64 (12%) were classified under Definite Familial Hypercholesterolemia. Most of the patients diagnosed with definite FH did not have diabetes, cerebrovascular disease (CVD), and coronary artery disease (CAD). The diagnosis was not affected by gender, BMI, smoking, and alcohol consumption. Hypertension was significantly correlated to the diagnosis of FH, as most of them were already hypertensive at diagnosis. It was noted that hypertension, diabetes, CVD, and CAD were seen at an earlier age among patients with definite FH. Conclusion: The prevalence of heterozygous FH at 12% among dyslipidemia patients and 1.3% among the general population was described for the first time in our region. This result should raise the awareness of our healthcare providers that FH, which is a major risk factor for premature CAD and CVD, exists, and early detection and management are important.展开更多
Introduction:Risk assessment for high-risk populations is critical for preventing Type 2 Diabetes Mellitus(T2DM).Although China’s public health services have continuously contributed to early grassroots diagnosis of ...Introduction:Risk assessment for high-risk populations is critical for preventing Type 2 Diabetes Mellitus(T2DM).Although China’s public health services have continuously contributed to early grassroots diagnosis of diabetes for years,universally applicable tools for identifying latent high-risk elderly populations urgently need to account for heterogeneity,robustness,and generalizability.Therefore,this study developed and validated the integrated Chinese Adapted Risk Evaluation for Diabetes Mellitus(iCARE-DM)model for elderly Chinese individuals.Methods:The iCARE-DM model was developed based on pooled effect estimates from a meta-analysis of cohort studies that identified T2DM risk factors in East Asian populations and validated in three multicenter Chinese populations.Predictive performance was evaluated using area under the curve(AUC),sensitivity,specificity,accuracy,log-rank tests,and compared with the guideline-recommended model(i.e.,New Chinese Diabetes Risk Score,NCDRS)as well as four machine learning(ML)models.Results:The iCARE-DM model achieved AUC values of 0.741,0.783,and 0.766,outperforming the NCDRS model by at least 12%.Although the bestperforming ML model achieved AUC values comparable to the iCARE-DM model,its performance varied significantly across populations(with a range as high as 9%).Subgroup analyses of the iCARE-DM model confirmed consistent performance across age,gender and rural-urban groups.Conclusion:The iCARE-DM model demonstrated higher accuracy than the NCDRS model and exhibited superior robustness and generalizability compared to the ML models.The iCARE-DM model provides a robust,culturally adapted tool for T2DM risk assessment in elderly Chinese individuals.展开更多
Objective：To assess the evidence of the use and efficacy for complementary and alternative medicine（CAM） in inflammatory bowel disease（IBD）. Methods：A systematic literature search in MEDLINE was performed for ra...Objective：To assess the evidence of the use and efficacy for complementary and alternative medicine（CAM） in inflammatory bowel disease（IBD）. Methods：A systematic literature search in MEDLINE was performed for randomized controlled trials（RCTs） in Crohn＇s disease and ulcerative colitis.Moreover,a selective literature search for health services research studies on the use of CAM in patients with IBD was performed.Results：Health services research studies showed a high use of CAM in adult and pediatric patients with IBD worldwide.In contrast to the high use among IBD patients,there was a lack of high-quality data for many of the used CAM methods.Although most of the studies showed positive results,the methodological quality of most studies was rather low;therefore,the results had to be interpreted with caution.While there were many studies for probiotics and fish oil,RCTs for the highly used method homeopathy, for most herbal products,and for traditional Chinese medicine methods apart from acupuncture RCTs were completely lacking.Conclusions：The lack of high-quality studies might be the consequence of the problems associated with the funding of clinical trials involving CAM.However,having the high user rates in mind,high-quality studies assessing efficacy and safety of those methods are urgently needed.Furthermore,there is a need for better representation of CAM in undergraduate and postgraduate medical education.展开更多
Objective:To investigate the stress perceptions of nurses serving in home healthcare services during COVID-19.Methods:This study was qualitative research with a phenomenological design.Data were collected and recorded...Objective:To investigate the stress perceptions of nurses serving in home healthcare services during COVID-19.Methods:This study was qualitative research with a phenomenological design.Data were collected and recorded through in-depth interviews with 6 nurses working in MuşState Hospital,Home Healthcare Services Unit using a form consisting of 12 questions on an online platform between May 2021 and July 2021.The audio recordings were transcribed by the researcher and content analysis was performed by creating codes,categories,and themes.Results:The interviews yielded 10 categories and 59 sub-codes.These codes were addressed under the theme of"COVID-19 pandemic".Under this main theme,nurses expressed the problems they experienced in issues such as stress,support mechanisms,and family and social problems during COVID-19.They mentioned that they experienced high stress in this process,as well as social isolation and negative thoughts of society about them and that they could not spare time for themselves and their families.Conclusions:Nurses working in home healthcare services frequently express negativities such as high stress,isolation from society,and increased workload.Therefore,actions should be taken to raise awareness of society on these issues,increase the number of personnel,conduct more research,and share the results with the public.展开更多
Objectives: Examining consumers’ healthcare behavior can help in the design of ways to ensure better access to health and the quality of care. Health-seeking behavior is viewed as the varied response of individuals t...Objectives: Examining consumers’ healthcare behavior can help in the design of ways to ensure better access to health and the quality of care. Health-seeking behavior is viewed as the varied response of individuals to states of ill-health, depending on their knowledge and perceptions of health, socioeconomic constraints, adequacy of available health services and attitude of healthcare providers. This study examines health-seeking behavior of university students, their use of healthcare services in the community and barriers to seeking help at the university health centre. Method: Structured questionnaires were validated and administered on a random sample of university students spread over different academic disciplines in a large institution. The sample consisted of 1608 undergraduate students attending the public university in southwesternNigeria. The demographic profile reflects the national university student population. Relevant information was collected on preferred health services consulted by the undergraduates such as barriers to seeking adequate medical attention and their experiences with salient aspects of service delivery. Responses were weighted and the average was taken to be representative. Results: Students consulted their peers (37.5%) in health related academic disciplines rather than seek treatment at the university health centre. Some students (24.7%) preferred community pharmacies while others took personal responsibilities for their health or abstained from medical care for religious reasons (16.8%). Significant barriers to seeking medical attention at the health centre were cost of care, protracted waiting time, inadequate health information, unfriendly attitude of healthcare workers and drug shortage. Conclusions: Students sought help from community pharmacies (ease of access) and from peers in health related academic programmes rather than from physicians at the health centre. Health-seeking behavior of the students was influenced, essentially, by the nature of ailment, waiting time in the health facility and attitude of healthcare professionals. Implications for policy, practice or delivery: The findings of this research identified the relative use of available health services within the university. Initiatives to improve student access to the university health centre should address significant barriers of patient delays, the need for attitudinal change and continuing professional development of relevant workers in the health facility. Promotional activities may be necessary to inform and educate students on rational use of medicines and access to treatment at the health centre.展开更多
Objective The aim of this study was to describe health services utilisation and responsiveness in East Azerbaijan province,Iran.Design A cross-sectional household study as part of a larger research on primary healthca...Objective The aim of this study was to describe health services utilisation and responsiveness in East Azerbaijan province,Iran.Design A cross-sectional household study as part of a larger research on primary healthcare system.setting We carried out the study in East Azerbaijan Province,northwest Iran from July to September 2015.Participants A total of 1318 households were included.results Most of the participating households had social security health insurance.Heart failure or hypertension care,general outpatient care and arthritis care were the most used services.High services cost and inadequate medicine and medical equipment were introduced to be the main barriers to health services utilisation in Tabriz and province representative sample(PRS),respectively.Health system responsiveness mean score(the maximum is 100)was 33.71±16.15(95%CI 32.45 to 34.97)in Tabriz and 32.02±14.3(95%CI 30.9 to 33.13)in PRS,which showed significant difference(p≤0.02).Conclusions Differences in the utilisation and responsiveness of health services and distribution of health resources were observed between Tabriz and PRS.Evidently,health system responsiveness in both Tabriz and PRS was at low level.The results demonstrate the need for changing resource distribution policies and employing reactive health policies to response the public health.展开更多
Primary Health Care Services Sector (PHCSS) of Dubai Health Authority (DHA) provides many services dedicated to seniors. However, there have been no studies to date that consulted the seniors themselves regarding thes...Primary Health Care Services Sector (PHCSS) of Dubai Health Authority (DHA) provides many services dedicated to seniors. However, there have been no studies to date that consulted the seniors themselves regarding these services. Thus, this study was conducted to investigate the age-friendliness of outpatient clinic’s services provided in PHCSS from perspective of elderly service recipients. Methods: Three focus groups were designed. The focus groups included receivers of care (senior patients and caregivers for senior patients) and healthcare providers (physicians, nurses, administrators and medical record officers). The discussed topics in the focus groups were based on WHO’s recommended three domains of improvement for an age-friendly Primary Health Care (PHC): Information, education and training, community-based health care management systems, and the physical environment.展开更多
Background and Objectives: The ultimate goal of the health system is to improve the health status of people. To achieve this goal and meet the needs and expectations of people in the field of health, different strateg...Background and Objectives: The ultimate goal of the health system is to improve the health status of people. To achieve this goal and meet the needs and expectations of people in the field of health, different strategies have been designed, one of which is the family physician. Therefore, the main aim of this study was to evaluate management and performance of the family physician in the diagnosis, treatment and prevention of diabetes in the Counties of Gilan Province. Materials and Methods: This is a cross-sectional study, which was carried out descriptively. In this study 320 patients with diabetic records were selected from among 1900 using simple random selection. Results: There is a significant difference between the number of visits, the number of referrals to specialists and the number of tests with the expected rate. In addition, 68.8% of patients were diagnosed by the family physician for the first time. According to comparisons made on the number of referrals, visits and request for blood tests, there was a significant difference between two Counties (p Conclusion: The results of the present study indicate that there is a fundamental weakness in terms of diagnosis, control, care of patients, referral, completion of health records and eventually preventing diabetes complications in the northern villages of Iran. In general, family physician program has relatively good performance in Iran after several years, but has not been able to reach the determined goals and standards.展开更多
Diabetes is highly prevalent among the elderly worldwide,with the highest number of diabetes cases in China.Yet,the management of diabetes remains unsatisfactory.Recent advances in digital health technologies have fac...Diabetes is highly prevalent among the elderly worldwide,with the highest number of diabetes cases in China.Yet,the management of diabetes remains unsatisfactory.Recent advances in digital health technologies have facilitated the establishment of smart wards for diabetes patients.There is a lack of smart wards tailored specifically for older diabetes patients who encounter unique challenges in glycemic control and diabetes management,including an increased vulnerability to hypoglycemia,the presence of multiple chronic diseases,and cognitive decline.In this review,studies on digital health technologies for diabetes in China and beyond were summarized to elucidate how the adoption of digital health technologies,such as real-time continuous glucose monitoring,sensor-augmented pump technology,and their integration with 5th generation networks,big data cloud storage,and hospital information systems,can address issues specifically related to elderly diabetes patients in hospital wards.Furthermore,the challenges and future directions for establishing and implementing smart wards for elderly diabetes patients are discussed,and these challenges may also be applicable to other countries worldwide,not just in China.Taken together,the smart wards may enhance clinical outcomes,address specific issues,and eventually improve patient-centered hospital care for elderly patients with diabetes.展开更多
BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T...BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T2DM).Based on conven-tional nursing methods,community home care has important clinical significance in controlling blood sugar and disease progression.AIM To explore the impact of community public health nursing on treatment effect,health cognition,and self-management in patients with T2DM.METHODS One hundred patients with T2DM were selected as the research subjects.The patients were divided into either a conventional nursing group or community nursing(CN)group using the random number table method.The conventional nursing group(50 cases)received routine care,while the CN group(50 cases)received community public health care in addition to routine care as that for the conventional nursing group.The rate of excellent and good blood glucose control,fasting blood glucose before and after care,2-h postprandial blood glucose,health cognition,and self-management ability,and patient satisfaction were compared between the two groups.RESULTS The CN group had a higher rate of excellent blood sugar control than the conventional nursing group(88%vs 70%,P<0.05).Before care,there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients(P>0.05).After nursing,fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups,and both blood glucose levels in the CN group were lower than those of the conventional nursing group(P<0.05).Compared with the scores before care,the cognitive level score for diabetes and self-management ability score improved after care in both groups.The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group(P<0.05).The overall satisfaction of the CN group was better than that of the conventional nursing group(98%vs 86%,P<0.05).CONCLUSION Community public health care based on conventional care of T2DM can achieve better blood sugar control,and improve patients’health cognitive level and self-management ability.展开更多
Objective: To explore the application effect of optimizing the nursing model in community health centers for elderly health examinations, providing a reference for enhancing the management level of elderly health at t...Objective: To explore the application effect of optimizing the nursing model in community health centers for elderly health examinations, providing a reference for enhancing the management level of elderly health at the grassroots level. Methods: A total of 300 elderly individuals who underwent health examinations at our center from January 2024 to December 2024 were selected as the study subjects. They were randomly divided into a control group and an observation group, with 150 cases in each group. The control group underwent the conventional health examination nursing process, while the observation group adopted an optimized community nursing model, which included stratified education and appointment scheduling before the examination, full-time accompaniment and safety care during the examination, and the establishment of electronic medical records and continuous follow-up after the examination. Differences in health management awareness rates and satisfaction with health examination services between the two groups of elderly individuals were compared. Results: The health management awareness rate in the observation group was 94.67%, significantly higher than that in the control group (78.00%;p < 0.001). The satisfaction rate with health examination services in the observation group was 96.00%, also significantly higher than that in the control group (82.00%;p < 0.001). Conclusion: The optimized community nursing model can effectively enhance the health awareness level and service satisfaction of elderly individuals during health examinations, demonstrating strong practicality and promotion value. It contributes to achieving continuity and precision in grassroots elderly health management.展开更多
Introduction:Despite the well-documented benefits of exercise for adolescents’physical and mental health,exercise remains an underutilized strategy for improving the health of trans adolescents.This is notable becaus...Introduction:Despite the well-documented benefits of exercise for adolescents’physical and mental health,exercise remains an underutilized strategy for improving the health of trans adolescents.This is notable because,compared to their cisgender peers,trans adolescents experience greater health challenges and systemic barriers to being physically active.To date,no research has evaluated an evidence-based exercise service within specialist paediatric gender services in Australia.Methods:The study is a non-randomised type 2 effectivenessimplementation hybrid trial for adolescents engaged with Child and Adolescent Health Service Gender Diversity Service at Perth Children’s Hospital,Western Australia.The participant group will receive the intervention alongside standard care.The design of the program has incorporated input from the GENder idenTity Longitudinal Experience(GENTLE)Cohort Consumer Advisory group;trans young people,families,and health professionals;guidelines for commonmedical presentations within paediatric gender services and international physical activity guidelines for adolescents.Program implementation and feasibility(i.e.,participant engagement,perceptions and experiences of the intervention),as well as preliminary effectiveness of the targeted exercise programon health outcomes(i.e.,quality of life,wellbeing and markers of physical health),will be evaluated as part of a pilot trial.Discussion:This project addresses a significant gap in research and healthcare and aims to enhance service delivery by integrating exercise into standard care for specialist paediatric gender services in Australia.Anticipated impacts include shaping current and future practices by defining safe,effective exercise for trans adolescents while laying the groundwork for larger scale implementation and research on long-term health benefits.展开更多
This article systematically reviews the research progress on health literacy in lung cancer patients,covering the core definition and multidimensional assessment system of health literacy,epidemiological characteristi...This article systematically reviews the research progress on health literacy in lung cancer patients,covering the core definition and multidimensional assessment system of health literacy,epidemiological characteristics,mechanisms of its impact on clinical outcomes and quality of life,as well as targeted intervention strategies.Research indicates that health literacy significantly improves patient prognosis through pathways such as enhancing treatment adherence,optimizing doctor-patient communication,and strengthening self-management capabilities.This review also points out that future research needs to focus on developing cross-cultural assessment tools,exploring neurocognitive mechanisms,integrating digital technologies,and promoting policy translation to address the new challenges in the era of chronic disease management for lung cancer.展开更多
To the editor:Peer workers-people with personal experiences of using mental health services,trained to provide support to others currently using similar services--are increasingly integrated into the workforce of ment...To the editor:Peer workers-people with personal experiences of using mental health services,trained to provide support to others currently using similar services--are increasingly integrated into the workforce of mental health systems internationally.展开更多
Background Higher accelerometer-assessed volume and intensity of physical activity(PA)have been associated with a longer life expectancy but can be difficult to translate into recommended doses of PA.We aimed to:(a)im...Background Higher accelerometer-assessed volume and intensity of physical activity(PA)have been associated with a longer life expectancy but can be difficult to translate into recommended doses of PA.We aimed to:(a)improve interpretability by producing UK Biobank age-referenced centiles for PA volume and intensity;(b)inform public-health messaging by examining how adding recommended quantities of moderate and vigorous PA affect PA volume and intensity.Methods 92,480 UK Biobank participants aged 43-80 years with wrist-worn accelerometer data were included.Average acceleration and intensity gradient were derived as proxies for PA volume and intensity.We generated sex-specific centile curves using Generalized Additive Models for Location Scale and Shape(GAMLSS)and modeled the effect of adding moderate(walking)or vigorous(running)activity on the combined change in the volume and intensity centiles(change in PA profile).Results In men,volume was lower as age increased while intensity was lower after age 55;in women,both volume and intensity were lower as age increased.Adding 150 min of moderate PA weekly(5×30 min walking)increased the PA profile by 4 percentage points.Defining moderate PA as brisk walking approximately doubled the increase(9 percentage points)while 75 min of vigorous PA weekly(5×15 min running)trebled the increase(13 percentage points).Conclusion These UK Biobank reference centiles provide a benchmark for interpretation of accelerometer data.Application of our translational methods demonstrate that meeting PA guidelines through shorter duration vigorous activity is more beneficial to the PA profile(volume and intensity)than longer duration moderate activity.展开更多
Objective: To analyze the effectiveness of musculoskeletal ultrasound in diagnosing rotator cuff injuries. Methods: A total of 80 patients with suspected rotator cuff injuries who were admitted and diagnosed between J...Objective: To analyze the effectiveness of musculoskeletal ultrasound in diagnosing rotator cuff injuries. Methods: A total of 80 patients with suspected rotator cuff injuries who were admitted and diagnosed between January 1, 2020, and December 31, 2024, were selected. Musculoskeletal ultrasound was performed on these patients, and the diagnostic efficacy of musculoskeletal ultrasound was evaluated by comparing the results with those of MRI. Results: The detection rates of musculoskeletal ultrasound for the location and extent of injury were similar to those of MRI (p > 0.05). Based on the MRI diagnosis results, the diagnostic accuracy rate of musculoskeletal ultrasound was 92.50%, with a sensitivity of 93.06% and a specificity of 87.50%. The morphological and signal characteristics, as well as ultrasound indicators, of patients with positive musculoskeletal ultrasound results differed significantly from those of patients with negative results (p < 0.05). Conclusion: Musculoskeletal ultrasound can effectively detect the location and extent of rotator cuff injuries, comprehensively assess the damage, and demonstrate high diagnostic efficacy. Furthermore, the morphological and signal characteristics, as well as ultrasound indicators, of musculoskeletal ultrasound can serve as diagnostic criteria for rotator cuff injuries, improving disease detection efficiency.展开更多
Background:Bullying during adolescence is shaped by numerous psychosocial factors such as family dynamics,attachment,and peer relationships.This study aims to examine parental acceptance-rejection,attachment styles,an...Background:Bullying during adolescence is shaped by numerous psychosocial factors such as family dynamics,attachment,and peer relationships.This study aims to examine parental acceptance-rejection,attachment styles,and social exclusion factors as key psychosocial variables predicting bullying behavior in adolescents.Methods:In a cross-sectional study conducted with 349 high school students in Hakkari,Türkiye.Data were collected using the Olweus Bullying Scale,the Parental Acceptance-Rejection Scale,the Social Exclusion Scale,and the Three-Dimensional Attachment Styles Scale.Independent samples t-tests,one-way ANOVAs,Pearson correlations,and hierarchical regression analyses were performed.Results:Research findings reveal that peer bullying varies significantly according to gender,class level,parents’educational level,and socio-economic status.Furthermore,our findings indicate that social exclusion(β=0.506,p<0.01)and avoidant attachment(β=0.162,p<0.01)positively predict peer bullying,while secure attachment(β=−0.205,p<0.01),maternal(β=−0.385,p<0.01)and paternal(β=−0.217,p<0.01)acceptance/rejection negatively predict bullying.The final regression model explains approximately 55%of the variance in bullying.Conclusion:Our findings indicate that social exclusion,parental acceptance/rejection,and secure or avoidant attachment patterns may be associated with bullying behaviour in adolescents.These findings emphasise the necessity of family-and peer-focused interventions to combat bullying.展开更多
基金sponsored by the University of Western Australia with first author CM completing this protocol paper and the associated research while receiving an Australian Commonwealth Government Research Training Program stipendwith research support and funding received from the University of Western Australia.
文摘Objectives:People living with severe mental illness have a reduced life expectancy when compared to the general population largely due to physical health comorbidities.Exercise is a valuable,evidence-based component of mental healthcare,with positive effects on physical health,mental health,and quality of life.However,to date,there is limited evidence regarding the implementation of varied styles of supported exercise therapy within outpatient,transdiagnostic mental health services.This protocol paper outlines the methods for a hybrid effectiveness-implementation trial implementing two styles of supported exercise within an outpatient mental health hospital.Methods:Participants will be allocated to either in-person supervised exercise sessions,or independent,remotely supported exercise programs.Both intervention arms will have the target of 150 minutes of moderate intensity exercise per week across the 12-week intervention period,along with a 12-week maintenance period following the intervention periods.Assessments will be conducted at intake,intervention midpoint(i.e.,week 6–7),intervention conclusion(i.e.,week 13),and at follow-up(i.e.,week 25).Results:The evaluation of the exercise interventions will consist of implementation and effectiveness outcomes during the intervention and at follow-up.Conclusions:The outcomes from this trial will add to the ever-increasing evidence for the incorporation of exercise within care for severe mental illness.This trial will report on the implementation and effectiveness of varied levels of support in exercise therapy for consumers with severe mental illness,which may in turn guide the future implementation and improve provision of exercise therapy in hospital mental health services.
文摘<div style="text-align:justify;"> <strong>Background</strong> <span "="">The use of health services by the adult population is related to cardiovascular risk and its stratification. Cardiovascular risk (CVR) stratification should be a tool for the assessment of the patients and the appropriate control during the process of medical care and utilization of health services for the adults. <b>Objective </b>Evaluate the association between cardiovascular risk (CVR) in adults and the utilization of health services. <b>Material and Methods </b>A secondary analysis</span> was performed of the data from the National Health and Nutrition Survey (ENSANUT) 2018-2019. <span "="">The CVR classification (risk score) was obtained in 43,070 adults with a previous diagnosis (self-report) and 1,237 adults newly diagnosed. Independent, risk factors and the association between groups of CVR and utilization of preventive, outpatient and hospital services were analyzed. <b>Results </b>More than 85% of adults interviewed have some degree of CVR. Almost half of them have low CVR (48.2%). Older adults with social security predominate in the group with high and very high CVR. Seventy-five percent of adults recently diagnosed have low CVR. In both, there is very little utilization of health services. For adults previously diagnosed CVR, the higher the CVR, the greater the likelihood of utilization of outpatient, preventive and hospital services, in contrast to adults without CVR independent of the marital status, sex, health institution and socioeconomic level. <b>Conclusion </b>The results give evidence of areas of opportunity for improvement in the quality of health services. The evaluation of CVR in primary care and promotion and prevention of CVR should be strengthened.</span> </div>
文摘Objective:Gender-specific integrated health services have long existed in the arena of women’s health care,but men’s health centers(MHCs)have only recently emerged as a novel practice model.Here,we seek to evaluate the prevalence and format of MHCs found in the leading academic medical centers in the United States.Methods:The US News&World Report’s Top 50 Ranked Hospitals for Urology was used as our cohort.Data were gathered on the presence of MHCs and types of providers and conditions treated.An equivalent search was performed for women’s health centers(WHCs).Results:Sixteen of 50(32%)promoted some type of MHC,compared to 49 of 50(98%)offering a WHC.Eight of the top 15 ranked institutions(53%)had an MHC compared to eight of 35(23%)remaining programs.Six of 16 MHCs incorporated providers from a variety of medical disciplines,including urologists,internists,endocrinologists,cardiologists,and psychologists,while another six of 16 MHCs were staffed solely by urologists.Eight of 16 provided services for exclusively urologic issues,four of 16 offered additional services in treatment of other medical conditions,and four of 16 did not specify.
文摘Objectives: It is to determine the prevalence of familial hypercholesterolemia (FH) among adult Filipino patients with dyslipidemia at Universidad de Santa Isabel Health Services Department in one year. Methods: An observational descriptive prospective study involves Filipino patients, aged 19 years and older, with dyslipidemia. The Dutch Lipid Network (DLN) Criteria was used to diagnose FH. Prevalence data and categorical variables were expressed as percentages, while continuous variables were reported as mean and standard deviations. Results: 529 patients were included in the study. 302 were females, and 227 were males. 180 (34%) scored Unlikely, 100 (19%) scored Probable, 185 (35%) scored Possible, and 64 (12%) were classified under Definite Familial Hypercholesterolemia. Most of the patients diagnosed with definite FH did not have diabetes, cerebrovascular disease (CVD), and coronary artery disease (CAD). The diagnosis was not affected by gender, BMI, smoking, and alcohol consumption. Hypertension was significantly correlated to the diagnosis of FH, as most of them were already hypertensive at diagnosis. It was noted that hypertension, diabetes, CVD, and CAD were seen at an earlier age among patients with definite FH. Conclusion: The prevalence of heterozygous FH at 12% among dyslipidemia patients and 1.3% among the general population was described for the first time in our region. This result should raise the awareness of our healthcare providers that FH, which is a major risk factor for premature CAD and CVD, exists, and early detection and management are important.
基金Supported by the National Key R&D Program of China(2022YFC3600600)Sichuan Science and Technology Program(2024ZYD0102,2025YFHZ0069)+1 种基金Chengdu Science and Technology Program(2024-YF05-01784-SN)Sichuan Preventive Medicine Association(SYYXH202403).
文摘Introduction:Risk assessment for high-risk populations is critical for preventing Type 2 Diabetes Mellitus(T2DM).Although China’s public health services have continuously contributed to early grassroots diagnosis of diabetes for years,universally applicable tools for identifying latent high-risk elderly populations urgently need to account for heterogeneity,robustness,and generalizability.Therefore,this study developed and validated the integrated Chinese Adapted Risk Evaluation for Diabetes Mellitus(iCARE-DM)model for elderly Chinese individuals.Methods:The iCARE-DM model was developed based on pooled effect estimates from a meta-analysis of cohort studies that identified T2DM risk factors in East Asian populations and validated in three multicenter Chinese populations.Predictive performance was evaluated using area under the curve(AUC),sensitivity,specificity,accuracy,log-rank tests,and compared with the guideline-recommended model(i.e.,New Chinese Diabetes Risk Score,NCDRS)as well as four machine learning(ML)models.Results:The iCARE-DM model achieved AUC values of 0.741,0.783,and 0.766,outperforming the NCDRS model by at least 12%.Although the bestperforming ML model achieved AUC values comparable to the iCARE-DM model,its performance varied significantly across populations(with a range as high as 9%).Subgroup analyses of the iCARE-DM model confirmed consistent performance across age,gender and rural-urban groups.Conclusion:The iCARE-DM model demonstrated higher accuracy than the NCDRS model and exhibited superior robustness and generalizability compared to the ML models.The iCARE-DM model provides a robust,culturally adapted tool for T2DM risk assessment in elderly Chinese individuals.
文摘Objective：To assess the evidence of the use and efficacy for complementary and alternative medicine（CAM） in inflammatory bowel disease（IBD）. Methods：A systematic literature search in MEDLINE was performed for randomized controlled trials（RCTs） in Crohn＇s disease and ulcerative colitis.Moreover,a selective literature search for health services research studies on the use of CAM in patients with IBD was performed.Results：Health services research studies showed a high use of CAM in adult and pediatric patients with IBD worldwide.In contrast to the high use among IBD patients,there was a lack of high-quality data for many of the used CAM methods.Although most of the studies showed positive results,the methodological quality of most studies was rather low;therefore,the results had to be interpreted with caution.While there were many studies for probiotics and fish oil,RCTs for the highly used method homeopathy, for most herbal products,and for traditional Chinese medicine methods apart from acupuncture RCTs were completely lacking.Conclusions：The lack of high-quality studies might be the consequence of the problems associated with the funding of clinical trials involving CAM.However,having the high user rates in mind,high-quality studies assessing efficacy and safety of those methods are urgently needed.Furthermore,there is a need for better representation of CAM in undergraduate and postgraduate medical education.
文摘Objective:To investigate the stress perceptions of nurses serving in home healthcare services during COVID-19.Methods:This study was qualitative research with a phenomenological design.Data were collected and recorded through in-depth interviews with 6 nurses working in MuşState Hospital,Home Healthcare Services Unit using a form consisting of 12 questions on an online platform between May 2021 and July 2021.The audio recordings were transcribed by the researcher and content analysis was performed by creating codes,categories,and themes.Results:The interviews yielded 10 categories and 59 sub-codes.These codes were addressed under the theme of"COVID-19 pandemic".Under this main theme,nurses expressed the problems they experienced in issues such as stress,support mechanisms,and family and social problems during COVID-19.They mentioned that they experienced high stress in this process,as well as social isolation and negative thoughts of society about them and that they could not spare time for themselves and their families.Conclusions:Nurses working in home healthcare services frequently express negativities such as high stress,isolation from society,and increased workload.Therefore,actions should be taken to raise awareness of society on these issues,increase the number of personnel,conduct more research,and share the results with the public.
文摘Objectives: Examining consumers’ healthcare behavior can help in the design of ways to ensure better access to health and the quality of care. Health-seeking behavior is viewed as the varied response of individuals to states of ill-health, depending on their knowledge and perceptions of health, socioeconomic constraints, adequacy of available health services and attitude of healthcare providers. This study examines health-seeking behavior of university students, their use of healthcare services in the community and barriers to seeking help at the university health centre. Method: Structured questionnaires were validated and administered on a random sample of university students spread over different academic disciplines in a large institution. The sample consisted of 1608 undergraduate students attending the public university in southwesternNigeria. The demographic profile reflects the national university student population. Relevant information was collected on preferred health services consulted by the undergraduates such as barriers to seeking adequate medical attention and their experiences with salient aspects of service delivery. Responses were weighted and the average was taken to be representative. Results: Students consulted their peers (37.5%) in health related academic disciplines rather than seek treatment at the university health centre. Some students (24.7%) preferred community pharmacies while others took personal responsibilities for their health or abstained from medical care for religious reasons (16.8%). Significant barriers to seeking medical attention at the health centre were cost of care, protracted waiting time, inadequate health information, unfriendly attitude of healthcare workers and drug shortage. Conclusions: Students sought help from community pharmacies (ease of access) and from peers in health related academic programmes rather than from physicians at the health centre. Health-seeking behavior of the students was influenced, essentially, by the nature of ailment, waiting time in the health facility and attitude of healthcare professionals. Implications for policy, practice or delivery: The findings of this research identified the relative use of available health services within the university. Initiatives to improve student access to the university health centre should address significant barriers of patient delays, the need for attitudinal change and continuing professional development of relevant workers in the health facility. Promotional activities may be necessary to inform and educate students on rational use of medicines and access to treatment at the health centre.
基金This research was done under the support of health vice-chancellor of TUOMS and was funded by Tabriz Health Services Management Research Center,Tabriz University of Medical Science,Tabriz,IranThe study was approved by the Ethical Committee of Tabriz University of Medical Sciences(TUOMS)(TBZMED.REC.1394.35).
文摘Objective The aim of this study was to describe health services utilisation and responsiveness in East Azerbaijan province,Iran.Design A cross-sectional household study as part of a larger research on primary healthcare system.setting We carried out the study in East Azerbaijan Province,northwest Iran from July to September 2015.Participants A total of 1318 households were included.results Most of the participating households had social security health insurance.Heart failure or hypertension care,general outpatient care and arthritis care were the most used services.High services cost and inadequate medicine and medical equipment were introduced to be the main barriers to health services utilisation in Tabriz and province representative sample(PRS),respectively.Health system responsiveness mean score(the maximum is 100)was 33.71±16.15(95%CI 32.45 to 34.97)in Tabriz and 32.02±14.3(95%CI 30.9 to 33.13)in PRS,which showed significant difference(p≤0.02).Conclusions Differences in the utilisation and responsiveness of health services and distribution of health resources were observed between Tabriz and PRS.Evidently,health system responsiveness in both Tabriz and PRS was at low level.The results demonstrate the need for changing resource distribution policies and employing reactive health policies to response the public health.
文摘Primary Health Care Services Sector (PHCSS) of Dubai Health Authority (DHA) provides many services dedicated to seniors. However, there have been no studies to date that consulted the seniors themselves regarding these services. Thus, this study was conducted to investigate the age-friendliness of outpatient clinic’s services provided in PHCSS from perspective of elderly service recipients. Methods: Three focus groups were designed. The focus groups included receivers of care (senior patients and caregivers for senior patients) and healthcare providers (physicians, nurses, administrators and medical record officers). The discussed topics in the focus groups were based on WHO’s recommended three domains of improvement for an age-friendly Primary Health Care (PHC): Information, education and training, community-based health care management systems, and the physical environment.
文摘Background and Objectives: The ultimate goal of the health system is to improve the health status of people. To achieve this goal and meet the needs and expectations of people in the field of health, different strategies have been designed, one of which is the family physician. Therefore, the main aim of this study was to evaluate management and performance of the family physician in the diagnosis, treatment and prevention of diabetes in the Counties of Gilan Province. Materials and Methods: This is a cross-sectional study, which was carried out descriptively. In this study 320 patients with diabetic records were selected from among 1900 using simple random selection. Results: There is a significant difference between the number of visits, the number of referrals to specialists and the number of tests with the expected rate. In addition, 68.8% of patients were diagnosed by the family physician for the first time. According to comparisons made on the number of referrals, visits and request for blood tests, there was a significant difference between two Counties (p Conclusion: The results of the present study indicate that there is a fundamental weakness in terms of diagnosis, control, care of patients, referral, completion of health records and eventually preventing diabetes complications in the northern villages of Iran. In general, family physician program has relatively good performance in Iran after several years, but has not been able to reach the determined goals and standards.
基金Supported by Post-Subsidy Funds from the National Clinical Research Center,Ministry of Science and Technology of China,No.303-01-001-0272-08Beijing Municipal Administration of Hospitals Incubating Program,No.PX2022032Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(PWD&RPP-MRI),No.JYY2023-13.
文摘Diabetes is highly prevalent among the elderly worldwide,with the highest number of diabetes cases in China.Yet,the management of diabetes remains unsatisfactory.Recent advances in digital health technologies have facilitated the establishment of smart wards for diabetes patients.There is a lack of smart wards tailored specifically for older diabetes patients who encounter unique challenges in glycemic control and diabetes management,including an increased vulnerability to hypoglycemia,the presence of multiple chronic diseases,and cognitive decline.In this review,studies on digital health technologies for diabetes in China and beyond were summarized to elucidate how the adoption of digital health technologies,such as real-time continuous glucose monitoring,sensor-augmented pump technology,and their integration with 5th generation networks,big data cloud storage,and hospital information systems,can address issues specifically related to elderly diabetes patients in hospital wards.Furthermore,the challenges and future directions for establishing and implementing smart wards for elderly diabetes patients are discussed,and these challenges may also be applicable to other countries worldwide,not just in China.Taken together,the smart wards may enhance clinical outcomes,address specific issues,and eventually improve patient-centered hospital care for elderly patients with diabetes.
文摘BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T2DM).Based on conven-tional nursing methods,community home care has important clinical significance in controlling blood sugar and disease progression.AIM To explore the impact of community public health nursing on treatment effect,health cognition,and self-management in patients with T2DM.METHODS One hundred patients with T2DM were selected as the research subjects.The patients were divided into either a conventional nursing group or community nursing(CN)group using the random number table method.The conventional nursing group(50 cases)received routine care,while the CN group(50 cases)received community public health care in addition to routine care as that for the conventional nursing group.The rate of excellent and good blood glucose control,fasting blood glucose before and after care,2-h postprandial blood glucose,health cognition,and self-management ability,and patient satisfaction were compared between the two groups.RESULTS The CN group had a higher rate of excellent blood sugar control than the conventional nursing group(88%vs 70%,P<0.05).Before care,there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients(P>0.05).After nursing,fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups,and both blood glucose levels in the CN group were lower than those of the conventional nursing group(P<0.05).Compared with the scores before care,the cognitive level score for diabetes and self-management ability score improved after care in both groups.The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group(P<0.05).The overall satisfaction of the CN group was better than that of the conventional nursing group(98%vs 86%,P<0.05).CONCLUSION Community public health care based on conventional care of T2DM can achieve better blood sugar control,and improve patients’health cognitive level and self-management ability.
文摘Objective: To explore the application effect of optimizing the nursing model in community health centers for elderly health examinations, providing a reference for enhancing the management level of elderly health at the grassroots level. Methods: A total of 300 elderly individuals who underwent health examinations at our center from January 2024 to December 2024 were selected as the study subjects. They were randomly divided into a control group and an observation group, with 150 cases in each group. The control group underwent the conventional health examination nursing process, while the observation group adopted an optimized community nursing model, which included stratified education and appointment scheduling before the examination, full-time accompaniment and safety care during the examination, and the establishment of electronic medical records and continuous follow-up after the examination. Differences in health management awareness rates and satisfaction with health examination services between the two groups of elderly individuals were compared. Results: The health management awareness rate in the observation group was 94.67%, significantly higher than that in the control group (78.00%;p < 0.001). The satisfaction rate with health examination services in the observation group was 96.00%, also significantly higher than that in the control group (82.00%;p < 0.001). Conclusion: The optimized community nursing model can effectively enhance the health awareness level and service satisfaction of elderly individuals during health examinations, demonstrating strong practicality and promotion value. It contributes to achieving continuity and precision in grassroots elderly health management.
基金funded by a NHMRC Investigator Grant(#2010063)the MRFF-funded Australian Research Consortium for Trans Youth and Children(ARCTYC,MRF2032119).
文摘Introduction:Despite the well-documented benefits of exercise for adolescents’physical and mental health,exercise remains an underutilized strategy for improving the health of trans adolescents.This is notable because,compared to their cisgender peers,trans adolescents experience greater health challenges and systemic barriers to being physically active.To date,no research has evaluated an evidence-based exercise service within specialist paediatric gender services in Australia.Methods:The study is a non-randomised type 2 effectivenessimplementation hybrid trial for adolescents engaged with Child and Adolescent Health Service Gender Diversity Service at Perth Children’s Hospital,Western Australia.The participant group will receive the intervention alongside standard care.The design of the program has incorporated input from the GENder idenTity Longitudinal Experience(GENTLE)Cohort Consumer Advisory group;trans young people,families,and health professionals;guidelines for commonmedical presentations within paediatric gender services and international physical activity guidelines for adolescents.Program implementation and feasibility(i.e.,participant engagement,perceptions and experiences of the intervention),as well as preliminary effectiveness of the targeted exercise programon health outcomes(i.e.,quality of life,wellbeing and markers of physical health),will be evaluated as part of a pilot trial.Discussion:This project addresses a significant gap in research and healthcare and aims to enhance service delivery by integrating exercise into standard care for specialist paediatric gender services in Australia.Anticipated impacts include shaping current and future practices by defining safe,effective exercise for trans adolescents while laying the groundwork for larger scale implementation and research on long-term health benefits.
基金Supported by National Natural Science Foundation of China(71774049).
文摘This article systematically reviews the research progress on health literacy in lung cancer patients,covering the core definition and multidimensional assessment system of health literacy,epidemiological characteristics,mechanisms of its impact on clinical outcomes and quality of life,as well as targeted intervention strategies.Research indicates that health literacy significantly improves patient prognosis through pathways such as enhancing treatment adherence,optimizing doctor-patient communication,and strengthening self-management capabilities.This review also points out that future research needs to focus on developing cross-cultural assessment tools,exploring neurocognitive mechanisms,integrating digital technologies,and promoting policy translation to address the new challenges in the era of chronic disease management for lung cancer.
基金funded by National Institute for Health Research(NIHR)(RP-PG-1212-20019)。
文摘To the editor:Peer workers-people with personal experiences of using mental health services,trained to provide support to others currently using similar services--are increasingly integrated into the workforce of mental health systems internationally.
基金supported by the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre and NIHR Applied Research Collaboration East Midlands (ARC EM, (IS-BRC-1215-20010))funded by the National Institute for Health and Care Research Bristol Biomedical Research Centre (IS-BRC-1215-20011)supported by a UKRI research grant (EP/X042464/1)。
文摘Background Higher accelerometer-assessed volume and intensity of physical activity(PA)have been associated with a longer life expectancy but can be difficult to translate into recommended doses of PA.We aimed to:(a)improve interpretability by producing UK Biobank age-referenced centiles for PA volume and intensity;(b)inform public-health messaging by examining how adding recommended quantities of moderate and vigorous PA affect PA volume and intensity.Methods 92,480 UK Biobank participants aged 43-80 years with wrist-worn accelerometer data were included.Average acceleration and intensity gradient were derived as proxies for PA volume and intensity.We generated sex-specific centile curves using Generalized Additive Models for Location Scale and Shape(GAMLSS)and modeled the effect of adding moderate(walking)or vigorous(running)activity on the combined change in the volume and intensity centiles(change in PA profile).Results In men,volume was lower as age increased while intensity was lower after age 55;in women,both volume and intensity were lower as age increased.Adding 150 min of moderate PA weekly(5×30 min walking)increased the PA profile by 4 percentage points.Defining moderate PA as brisk walking approximately doubled the increase(9 percentage points)while 75 min of vigorous PA weekly(5×15 min running)trebled the increase(13 percentage points).Conclusion These UK Biobank reference centiles provide a benchmark for interpretation of accelerometer data.Application of our translational methods demonstrate that meeting PA guidelines through shorter duration vigorous activity is more beneficial to the PA profile(volume and intensity)than longer duration moderate activity.
文摘Objective: To analyze the effectiveness of musculoskeletal ultrasound in diagnosing rotator cuff injuries. Methods: A total of 80 patients with suspected rotator cuff injuries who were admitted and diagnosed between January 1, 2020, and December 31, 2024, were selected. Musculoskeletal ultrasound was performed on these patients, and the diagnostic efficacy of musculoskeletal ultrasound was evaluated by comparing the results with those of MRI. Results: The detection rates of musculoskeletal ultrasound for the location and extent of injury were similar to those of MRI (p > 0.05). Based on the MRI diagnosis results, the diagnostic accuracy rate of musculoskeletal ultrasound was 92.50%, with a sensitivity of 93.06% and a specificity of 87.50%. The morphological and signal characteristics, as well as ultrasound indicators, of patients with positive musculoskeletal ultrasound results differed significantly from those of patients with negative results (p < 0.05). Conclusion: Musculoskeletal ultrasound can effectively detect the location and extent of rotator cuff injuries, comprehensively assess the damage, and demonstrate high diagnostic efficacy. Furthermore, the morphological and signal characteristics, as well as ultrasound indicators, of musculoskeletal ultrasound can serve as diagnostic criteria for rotator cuff injuries, improving disease detection efficiency.
文摘Background:Bullying during adolescence is shaped by numerous psychosocial factors such as family dynamics,attachment,and peer relationships.This study aims to examine parental acceptance-rejection,attachment styles,and social exclusion factors as key psychosocial variables predicting bullying behavior in adolescents.Methods:In a cross-sectional study conducted with 349 high school students in Hakkari,Türkiye.Data were collected using the Olweus Bullying Scale,the Parental Acceptance-Rejection Scale,the Social Exclusion Scale,and the Three-Dimensional Attachment Styles Scale.Independent samples t-tests,one-way ANOVAs,Pearson correlations,and hierarchical regression analyses were performed.Results:Research findings reveal that peer bullying varies significantly according to gender,class level,parents’educational level,and socio-economic status.Furthermore,our findings indicate that social exclusion(β=0.506,p<0.01)and avoidant attachment(β=0.162,p<0.01)positively predict peer bullying,while secure attachment(β=−0.205,p<0.01),maternal(β=−0.385,p<0.01)and paternal(β=−0.217,p<0.01)acceptance/rejection negatively predict bullying.The final regression model explains approximately 55%of the variance in bullying.Conclusion:Our findings indicate that social exclusion,parental acceptance/rejection,and secure or avoidant attachment patterns may be associated with bullying behaviour in adolescents.These findings emphasise the necessity of family-and peer-focused interventions to combat bullying.
