OBJECTIVE: This study explores and understands community members\' resilience in outpatient clinics, considering various dimensions and types of resilience.
METHODS: A cross-sectional study.
METHODS: This study was conducted in Saudi outpatient clinics from September to December 2023 and included 384 individuals chosen through systematic random sampling. Various tools were used, such as Social Cohesion and Trust Scale, Community Resilience Assessment Tool, Community Assessment of Psychic Experiences, Environmental Resilience Assessment, Economic Resilience Index, Connor-Davidson Resilience Scale, Brief Resilience Scale, Resilience Scale for Adults and Healthcare Resilience Index.
RESULTS: Participants displayed a robust overall resilience level, as indicated by Total Connor-Davidson Resilience Scale score of 63.0 ± 9.0. Additionally, they demonstrated commendable levels of resilience in Total Brief Resilience Scale (56.04 ± 8.6), Resilience Scale for Adults (82.5 ± 7.2) and Healthcare Resilience Index (45.8 ± 5.5). These findings offer significant insights into psychological and emotional well-being of the study population, highlighting their adaptive capacities and coping mechanisms across various life domains.
CONCLUSIONS: This study provides valuable insights into the multidimensional nature of resilience in outpatient settings. The cross-sectional design sets the groundwork for future longitudinal investigations, highlighting the need for a holistic approach to understanding and promoting resilience.
CONCLUSIONS: This study holds immediate implications for participants and their communities. It underscores the adaptive capacities and coping mechanisms prevalent in the outpatient population by revealing commendable resilience levels. This insight enhances individuals\' psychological and emotional well-being, contributing positively to the overall resilience and communal strength. Additionally, this study sheds light on how resilience among community members in Saudi Arabia relates to international advanced nursing communities, providing insight into their work.
UNASSIGNED: Patients who have received outpatient services in the past 6 months were purposively chosen to ensure a diverse representation across age, gender and socio-economic backgrounds in this study.

Systematic reviews of observational studies can be affected by biases that lead to under- or over-estimates of true intervention effects. Several tools have been reported in the literature that attempt to characterize potential bias. Our objective in this study was to determine the extent to which study-specific bias may have influenced intervention impacts on total costs of care (TCOC) in round 1 of the Health Care Innovation Awards.
We reviewed 82 statistical evaluations of innovation impacts on Medicare TCOC. We developed five risk-of-bias measures and assessed their influence on TCOC impacts using meta-regression.
The majority of evaluations used propensity score matching to create their comparison groups. One third of the non-randomized interventions were judged to have some risk of biased effects due largely to the way they recruited their treatment groups, and 35% had some degree of covariate imbalance remaining after propensity score adjustments. However, in the multivariable analysis of TCOC effects, none of the bias threats we examined (comparison group construction method, risk of bias, or degree of covariate imbalance) had a major impact on the magnitude of HCIA1 innovation effects. Evaluations using propensity score weighting produced larger but imprecise savings effects compared to propensity score matching.
Our results suggest that it is unlikely that HCIA1 TCOC effect sizes were systematically affected by the types of bias we considered. Assessing the risk of bias based on specific study design features is likely to be more useful for identifying problematic characteristics than the subjective quality ratings used by existing risk tools.

Indigenous health is becoming a top priority globally. The aim is to ensure equal health opportunities, with a focus on Indigenous populations who have faced historical disparities. Effective health interventions in Indigenous communities must incorporate Indigenous knowledge, beliefs, and worldviews to be culturally appropriate.

Although issues pertaining to infertility affect both males and females, women often become victims of stigmatization and rejection, making them susceptible to emotional pain and suffering. Due to these psychosocial problems, they require not only biomedical treatment, but also psychological, social, and spiritual support. Unfortunately, many women with infertility are not treated holistically. The aim of this review was to retrieve existing evidence of holistic healthcare interventions for women with infertility. Global databases were searched for articles published anywhere in the world between 2010 to 2018 that explored holistic healthcare interventions for women diagnosed with infertility. A total of 18 articles meeting the inclusion criteria were assessed, and data extraction was performed. Findings revealed that interventions adopted in managing infertile women alongside the bio-medical management included: counseling; cognitive behavioral therapy; acceptance and commitment therapy; educational interventions; spiritual interventions; emotionally focused therapy/intervention and integrative body-mind-spirit interventions. The results of this review have implications for healthcare professionals to ensure holistic care of women diagnosed with infertility in Ghana and Africa at large.

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BACKGROUND: Data in Electronic Health Records (EHRs) is often poorly structured and standardized, which hampers data reuse. Research described some examples of interventions to increase and improve structured and standardized data, such as guidelines and policies, training and user friendly EHR interfaces. However, little is known about the translation of this knowledge into practical solutions. Our study aimed to specify the most effective and feasible interventions that enable better structured and standardized EHR data registration and described practical examples of successfully implemented interventions.
METHODS: A concept mapping approach was used to determine feasible interventions that were considered to be effective or have been successfully implemented in Dutch hospitals. A focus group was held with Chief Medical Information Officers and Chief Nursing Information Officers. After interventions were determined, multidimensional scaling and cluster analysis were performed to categorize sorted interventions using Groupwisdom™, an online tool for concept mapping. Results are presented as Go-Zone plots and cluster maps. Following, semi-structured interviews were conducted to describe practical examples of successful interventions.
RESULTS: Interventions were classified into seven clusters ranked from highest to lowest perceived effectiveness: (1) education on usefulness and need; (2) strategic and (3) tactical organizational policies; (4) national policy; (5) monitoring and adjusting data (6) structure of and support from the EHR and (7) support in the registration process (EHR independent). Interviewees emphasized the following interventions proven successful in their practice: an enthusiastic ambassador per specialty who is responsible for educating peers by increasing awareness of the direct benefit of structured and standardized data registration; dashboards for continuous feedback on data quality; and EHR functionalities that support (automating) the registration process.
CONCLUSIONS: Our study provided a list of effective and feasible interventions including practical examples of interventions that have been successful. Organizations should continue to share their best practices to learn from and attempted interventions to prevent implementation of ineffective interventions.

UNASSIGNED: Improved survival rates for people with cystic fibrosis have led to increased rates of co-morbidity, of which diabetes is the most common. Cystic fibrosis related diabetes affects 19% of adolescents and up to 50% of adults, although little is known about their experiences of this co-morbidity.
UNASSIGNED: To investigate the experiences of living with and managing cystic fibrosis related diabetes among adolescents and adults.
UNASSIGNED: Systematic review and thematic analysis of qualitative evidence.
UNASSIGNED: Six studies, rated good quality, were included in the review and four main themes emerged from the data: knowledge and understanding; emotional and social impact; balancing both conditions; acceptance and adjustment. Although the main themes reflect adolescent and adult experiences, there were subtle variations in their sub-themes. Participants\' overriding story was of journeying towards acceptance and integration of cystic fibrosis related diabetes into their lives. This included their unpreparedness for the likely onset of cystic fibrosis related diabetes and their struggles to balance the competing demands of living with and managing cystic fibrosis and diabetes.
UNASSIGNED: The diagnosis of cystic fibrosis related diabetes and its incorporation into daily life is challenging for many people with cystic fibrosis. Review findings indicate opportunities for cystic fibrosis related diabetes interventions pre-diagnosis, at diagnosis, and during ongoing management, which need integrating into routine cystic fibrosis care.

Appropriate prioritisation of geographic target regions (TRs) for healthcare interventions is critical to ensure the efficient distribution of finite healthcare resources. In delineating TRs, both \'targeting efficiency\', i.e., the return on intervention investment, and logistical factors, e.g., the number of TRs, are important. However, existing approaches to delineate TRs disproportionately prioritise targeting efficiency. To address this, we explored the utility of a method found within conservation planning: the software Marxan and an extension, MinPatch (\'Marxan + MinPatch\'), with comparison to a new method we introduce: the Spatial Targeting Algorithm (STA). Using both simulated and real-world data, we demonstrate superior performance of the STA over Marxan + MinPatch, both with respect to targeting efficiency and with respect to adequate consideration of logistical factors. For example, by design, and unlike Marxan + MinPatch, the STA allows for user-specification of a desired number of TRs. More broadly, we find that, while Marxan + MinPatch does consider logistical factors, it also suffers from several limitations, including, but not limited to, the requirement to apply two separate software tools, which is burdensome. Given these results, we suggest that the STA could reasonably be applied to help prevent inefficiencies arising due to targeting of interventions using currently available approaches.

BACKGROUND: In the United States, we have a healthcare system crisis with high rates of dissatisfaction among patients and providers. To transform health and healthcare, clinical providers must be proficient in the human-centered approach of design thinking (DT).
OBJECTIVE: To synthesize the human-centered design (HCD) and DT literature for the creation of health interventions.
METHODS: We performed an integrative literature review focused on how HCD and DT are used in the clinical healthcare setting. Four research databases were searched from inception through November 6, 2020. We analyzed the methodology used, who is using the frameworks, and the DT phases included.
RESULTS: Twenty-four articles were included in the final analysis. Of the 24 manuscripts, 6 (25%) were nurse-led and 15 (63%) had interdisciplinary first and last authors (e.g., Nursing and Medicine). Overall, 10/24 (42%) included all DT method. When analyzing the articles by approach or methodology, 12 (50%) stated they were using the HCD approach, 5 (21%) the DT methodology, and 7 (29%) stated they were using both the HCD approach and DT methodology.
CONCLUSIONS: There are inconsistencies in who uses DT and the phases used to create healthcare interventions.