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Adults with Tourette syndrome (ATS) face increased risks of self-injury behaviours (SIBs) and suicidality, yet research has largely focused on biological factors. Despite stigma being a known contributor to these outcomes in marginalised groups, its role in ATS remains unexplored. This study aims to address this gap by examining the impact of stigma on SIBs and suicidality in ATS.
This study analysed adult data from the Tourette Association of America’s 2022 Impact Survey, conducted online via convenience sampling. Stigma was assessed via six items, generating scores ranging from 1.0 to 4.0, with higher scores indicating greater stigma. The outcomes included lifetime self-harm, past-year suicidal ideation and suicide attempts. Owing to missing data, a Heckman selection model with a probit link function was used to examine the relationships between stigma and these outcomes, adjusting for demographic and clinical factors.
The study included 601 US ATS, with moderate to high stigma levels. Among the participants, 58% reported lifetime self-harm, 43% had past-year suicidal ideation and 27% had attempted suicide at least once in the past year. The Heckman selection model confirmed a significant association between stigma and all three outcomes.
This sample of ATS, on average, endures medium–high levels of stigma, which significantly contributes to their risk of self-injury, suicidal ideation and suicidal behaviours. Given this heightened risk, it is crucial to integrate stigma reduction interventions into health and mental health services for this vulnerable population.
To examine the relationships among social support, eHealth literacy and eHealth technology acceptance among patients with chronic illnesses, and investigate whether eHealth literacy plays a mediating role.
A cross-sectional correlational study.
A total of 202 patients with chronic illnesses were recruited from outpatient clinics and communities in Taiwan. Data were collected via structured questionnaires and analysed using SPSS and PROCESS macro with 1000 bootstrap samples.
eHealth literacy was the strongest predictor of technology acceptance. Although social support was positively associated with eHealth literacy, it did not directly predict technology acceptance after controlling for eHealth literacy, indicating a full mediation effect.
eHealth literacy is a crucial mechanism through which social support influences health technologies acceptance. Interventions to improve eHealth literacy, particularly those integrated with social support strategies based on different cultural backgrounds, enhance digital engagement among chronic illnesses.
Healthcare professionals and policy-makers should design literacy-sensitive interventions that leverage social networks and involve significant others to promote meaningful eHealth engagement in disease management.
eHealth literacy fully mediates the relationship between social support and eHealth technology acceptance, proving that social support alone does not directly increase adoption without improving eHealth literacy. eHealth literacy is the strongest predictor of eHealth technology acceptance, emphasising its central role in bridging the gap between social support and eHealth engagement.
This study followed the STROBE checklist guideline.
No patient or public involvement.
To explore how adults with congenital heart disease (ACHD) experience and express grit in the workplace.
Qualitative study using Husserl's descriptive phenomenology.
Between March 2022 and June 2023, semi-structured interviews were administered to 18 ACHD recruited from two medical centre outpatient departments. The collected data underwent analysis utilising Colaizzi's 7-step analysis method, coupled with Lincoln and Guba's framework, to ensure credibility and trustworthiness.
The analysis revealed five prominent themes derived from the data: (a) career choices amid constraints; (b) adjustments to one's work environment for reasons of fatigue; (c) crises in the workplace arising from exceeding one's physical limits; (d) supportive networks for better health and job stability; (e) resilience at work for balance and fulfilment in life.
Grit significantly influences life satisfaction and job performance among adults with congenital heart disease, highlighting its profound impact on their experiences. Patients exhibit perseverance in job pursuits, adapt work methods to manage physical fatigue, confront challenges during work crises, value family and societal support and aim for self-satisfaction. These findings highlight the impact of grit and mental health on ACHD's lives and work, providing insights for better psychological support and interventions.
This study clarifies the need for healthcare professionals to incorporate workplace grit training and assessment into ACHD care.
Recognising grit as a key factor in ACHD patients' lives informs holistic care, workplace inclusivity and policies that enhance their long-term well-being.
This study was performed in accordance with the COREQ guidelines.
No patient or public involvement.
Hypertension is a major health challenge imposing substantial economic and health burdens worldwide. This study compared treatment outcomes and costs between cost-intensive and non-cost-intensive pharmacotherapies, defined by prescribing intervals and the type of drugs, using electronic health record (EHR) data from multiple healthcare facilities, focusing on the type of antihypertensive drug and prescribing patterns.
A retrospective cohort study. A mixed-effects Cox proportional hazards model was used to investigate the association between cardiovascular events and healthcare resource use.
EHRs from 34 primary care facilities in Japan.
Patients prescribed either angiotensin receptor blockers (ARBs) alone or calcium channel blockers (CCBs) alone were included.
During 6629 person-years of follow-up, 71 events were observed. Model diagnostics confirmed the proportional hazards assumption and substantial inter-clinic heterogeneity. The type of drug (ARBs or CCBs) had no statistically significant impact on the incidence of cardiovascular events (HR 0.999, 95% CI 0.603 to 1.655). Similarly, shorter prescribing intervals (less than 36 days) were not significantly associated with the outcome (HR 1.724, 95% CI 0.906 to 3.279). The mean annual medical cost per patient for the cost-intensive (ARB with short prescribing intervals) and non-cost-intensive (CCB with long prescribing intervals) groups was Japanese yen (JPY) 137 023 and JPY 85 911, respectively. Sensitivity analysis using different time windows yielded similar results, confirming the robustness of the findings.
No apparent reduction in cardiovascular events associated with the use of ARBs or shorter prescribing intervals was observed despite the elevated cost caused by intensive pharmacotherapy and frequent clinic visits.
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