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Managing Metabolic Dysfunction-Associated Steatotic Liver Disease: Protocol for a Scoping Review of Patient Perceptions, Barriers, and Facilitators

2026-04-13T00:31:42Z

Title: Managing Metabolic Dysfunction-Associated Steatotic Liver Disease: Protocol for a Scoping Review of Patient Perceptions, Barriers, and Facilitators Authors: Park, Sikyeong; Park, Yu Shin; Hong, Dahye; Kang, Bada; 박유신 Abstract: Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD), is a major global health concern, affecting over 30% of adults worldwide. Closely associated with metabolic comorbidities such as obesity, type 2 diabetes, and dyslipidemia, MASLD relies heavily on health behavior modification for effective management. However, sustaining healthy behaviors remains challenging, particularly due to the disease's asymptomatic nature in its early stages and low perceived severity among patients. Thus, understanding patient perceptions and identifying barriers and facilitators are essential for developing effective, patient-centered interventions. Objective: This scoping review protocol aims to systematically map the existing literature on patients' perceptions of MASLD and to identify barriers and facilitators that influence disease management and patient engagement. Methods: This scoping review will follow the Joanna Briggs Institute scoping review methodology and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A systematic search will be conducted in PubMed, CINAHL, Cochrane Library, and PsycINFO by using MeSH terms and keywords such as "MASLD," "NAFLD," "perception," "awareness," "attitude," "barriers," and "facilitators." Two independent reviewers will screen studies, extract data using a standardized charting form, and resolve discrepancies through discussion or consultation with a third reviewer. Eligible studieswill include adults with MASLD/NAFLD and will focus on patient perceptions, health beliefs, behaviors, or barriers and facilitators to management. Data synthesis will be guided by the socioecological model to categorize findings across individual, interpersonal, organizational, community, and public policy levels. Results: The research protocol was finalized in January 2026. This study received no external funding. A preliminary literature search was conducted by January 30, 2026, and formal screening of titles and abstracts is scheduled to begin in February 2026. Data extraction and synthesis are expected to be completed by April 2026. The final results are anticipated to be submitted for publication in the summer of 2026. Conclusions:This scoping review will offer a comprehensive overview of patients' perceptions of MASLD, as well as the barriers and facilitators that influence its management. The results will inform the development of patient-centered strategies aimed at improving care delivery and reducing disease impact. International Registered Report Identifier (IRRID): DERR1-10.2196/81404

Dynamic Relationship Between Sleep Patterns and Behavioral and Psychological Symptoms of Dementia: Longitudinal Observational Study

2026-04-13T00:52:02Z

Title: Dynamic Relationship Between Sleep Patterns and Behavioral and Psychological Symptoms of Dementia: Longitudinal Observational Study Authors: Cho, Eunhee; Hwang, Sinwoo; Yang, Minhee; Kim, Eunkyo; Cho, Jungwon; Park, Chang; 양민희 Abstract: Background: A higher prevalence of behavioral and psychological symptoms of dementia is associated with a greater caregiver burden and increased mortality in people with dementia. Considering the possibility of a reciprocal relationship between sleep disturbances and these symptoms, time series analyses are necessary to explore the associated temporal dynamics. Objective: This study aimed to examine dynamic interdependencies between sleep disturbances and behavioral and psychological symptoms of dementia in older adults. Methods: Daily interactions between sleep patterns and behavioral and psychological symptoms of dementia were analyzed over a 14-day period using a panel vector autoregressive model. Data were collected from June 2018 to June 2020 in community and institutional settings. A total of 154 older adults with dementia wore wrist actigraphy devices continuously for 2 weeks for sleep data, and caregivers recorded behavioral and psychological symptoms of dementia in a daily symptom diary. Results: Using a panel vector autoregressive model, we analyzed data from 154 older adults living with dementia and their caregivers. The results showed unidirectional Granger causality running from the number of awakenings on the previous day to irritability (P=.03) and appetiteor eating disorders (P=.04) on the following day. Conversely, some of the previous day's behavioral and psychological symptoms of dementia temporally preceded subsequent changes in sleep patterns. Specifically, delusions had a Granger-causality effect on total sleep time (P<.001), wake after sleep onset (P=.01), and the number of awakenings (P=.006), while irritability had a Granger causality effect on the number of awakenings (P=.007). Notably, bidirectional Granger causality was observed between irritability and the number of awakenings. Conclusions: This study demonstrates that the relationship between the behavioral and psychological symptoms of dementia and sleep patterns is dynamic and forms a vicious cycle. Consequently, early intervention to alleviate symptoms is imperative, and strategies to enhance sleep quality and address sleep disturbances should be prioritized.

The Mediating Role of Religious Health Fatalism and Modesty on the Association Between Religiosity and Mammography Screening Behavior Among Saudi Women

2026-01-16T05:57:28Z

Title: The Mediating Role of Religious Health Fatalism and Modesty on the Association Between Religiosity and Mammography Screening Behavior Among Saudi Women Authors: Alahmari, Reem Abstract: Introduction: Breast cancer is the most prevalent malignancy among Saudi women, yet mammography screening rates remain low despite government-funded initiatives. Socioreligious factors may influence mammography screening behaviors, but their roles remain underexplored. This study examines the direct effect of religiosity on mammography screening and the mediating roles of religious health fatalism (RHF) and modesty.Method: A cross-sectional study was conducted among 86 Saudi women. Data were collected through self-administered questionnaires measuring religiosity, RHF, modesty, and mammography screening behavior. Hierarchical logistic regression and mediation analyses were performed using SPSS and Hayes's PROCESS macro.Results: Religiosity positively influenced screening behavior (p = .006). However, RHF (p = .015) and modesty (p = .027) mediated this relationship, reducing screening likelihood. Physician recommendations were the strongest predictor (p < .001).Discussion: While religiosity may encourage screening, RHF and modesty create barriers. Culturally sensitive interventions and physician engagement are crucial to improving screening uptake.

Nurses' Perceptions and Behaviours Regarding Climate Change and Health: A Quantile Regression Analysis

2026-03-11T01:25:14Z

Title: Nurses' Perceptions and Behaviours Regarding Climate Change and Health: A Quantile Regression Analysis Authors: Park, Min Kyung; Baek, Seoyoung; Jeong, Da Woon; Kim, Gwang Suk Abstract: AimsThe aim of this study is to identify the factors associated with nurses' perceptions and behaviours related to climate change and health (PBCH) according to their PBCH levels.DesignA cross-sectional study was used.MethodsThis study included a sample of 499 Korean nurses and adhered to the STROBE checklist. Data were collected from March 23 to May 10, 2023. Quantile regression analysis was performed, and PBCH levels were measured using the Korean version of the Climate Health and Nursing Tool.ResultsAcross all quantile groups, the experience of extreme weather events and awareness of climate change-coping facilitators were associated with PBCH. Differences were observed in factors associated with PBCH levels. Significant associations with PBCH were observed within the 75th percentile group, for having a religion, household income, and workplace climate friendliness. In the 25th percentile group, having a child, the number of sources for climate change-health-related information, and experience in setting climate change-health goals and strategies significantly influenced PBCH.ConclusionWe propose a differentiated strategy by elucidating the factors associated with high and low quantiles of PBCH levels.ImplicationsBy verifying specific factors associated with PBCH levels, nurses can enhance their preparedness to respond to the health risks posed by climate change in their clients.ImpactIdentifying common factors associated with all quantiles of nurses is important for establishing universal PBCH characteristics. Recognising the distinctions between high and low PBCH levels can aid in developing tailored nursing strategies to enhance PBCH among nurses.Reporting MethodThis study adhered to the STROBE guidelines.Patient or Public ContributionNo Patient or Public Contribution.