Research in Health Science (RHS) is an international, double-blind peer-reviewed, open-access journal which is published by Scholink. The journal aims to promote excellence through dissemination of high-quality research findings, specialist knowledge, and discussion of professional issues that reflect the diversity of this field. We would welcome scholars and researchers engaging in the related field to submit your manuscripts which are complete unpublished and original works and not under review in any other journals to Research in Health Science. Both of online submission and E-mail submission (rhs@scholink.org) are acceptable. The scopes of the journal include the following topics: public health health psychology community health health information mental health behavioral health environmental health healthcare nursing nutrition health policy health services health economics health protection health education The journal is included in: Academic Journal Articles Bielefeld Academic Search Engine (BASE) CiteFactor CNKI Scholar CrossRef Directory of Research Journals Indexing (DRJI) Electronic Journals Library (EZB) Globethics.net Journalseek JournalTOCs OCLC- WorldCat Open J-Gate Publons Refseek academic search engine ResearchBib Scientific Indexing Service (SIS) The Scientific Literature Database (Scilit) Standard Periodical Directory WZB Library Open access: Research in Health Science is available online to the reader "without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself". Peer review: Research in Health Science takes peer review policy. Peer review is the evaluation of work by one or more people of similar competence to the producers of the work (peers).
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Influencing Factors of the Long-term Care Needs of Disabled Elderly People in Urban and Rural Areas in China
As the population ages, the long-term care needs of elderly people with disabilities are becoming increasingly urgent. This study examines urban-rural differences in long-term care needs and their key determinants among older adults in China. Using data from the 2020 China Health and Retirement Longitudinal Study, we analyzed a sample of 8,533 individuals aged 60 and above with disabilities. A generalized ordered logistic regression model was applied to both the full sample and urban-rural subsamples. Results show that individuals aged 80 and above and those with four or more chronic diseases have significantly higher care needs, while better self-assessed health is associated with lower demand. Rural elderly individuals exhibit greater long-term care needs than their urban counterparts, especially those aged 80 and above, whose needs are 1.23 times higher. Chronic disease has a stronger effect on care needs in rural areas, and the protective effects of education and social participation are weaker. These findings highlight the importance of age, health status, and chronic disease burden in shaping long-term care demand and underscore significant urban-rural disparities. It is recommended that long-term care insurance be integrated into basic medical systems, prioritizing coverage for severely disabled rural populations and gradually expanding to include those with mild to moderate disabilities.
Copyright (c) 2026 Xinrui Li, Xinjuan Zhou, Haiyi Chen http://creativecommons.org/licenses/by/4.0
Systematic Diagnosis and Treatment Management of Vaginal Foreign Bodies in Prepubertal Girls: Experience with 120 Cases of Vaginoscopy
Objective: To develop a systematic diagnosis and treatment management strategy for vaginal foreign bodies (VFBs) in prepubertal girls and to evaluate the core clinical value of vaginoscopy in this approach. Methods: A retrospective analysis was conducted on clinical data of 120 prepubertal girls with vaginal foreign bodies admitted to our hospital from January 2015 to December 2024. The systematic management pathway was summarized in four key components: risk identification, imaging evaluation, minimally invasive intervention, and health education. Results: All girls successfully underwent diagnostic vaginoscopy using a hysteroscope under intravenous anesthesia, and the foreign bodies were smoothly removed. No serious postoperative complications occurred. This systematic management pathway achieved whole‑process quality control from accurate diagnosis and non‑invasive treatment to effective prevention. Conclusion: A systematic diagnosis and treatment management system based on hysteroscopy/vaginoscopy offers significant advantages for vaginal foreign bodies in prepubertal girls, including high diagnostic accuracy, minimal trauma, few complications, and excellent long‑term outcomes. It is worthy of clinical promotion and application.
Copyright (c) 2026 Miaomiao Du, Guifang Gong, Yali Zhu, Jingying Xie http://creativecommons.org/licenses/by/4.0
The Impact of Outpatient Pooling Reform on Patients’ Out-of-Pocket Burden: Evidence from China
Objective: This study systematically evaluates the financial burden on outpatient visits following implementation of the outpatient pooling reform among Urban Employee Basic Medical Insurance enrollees in Chongqing. The research focuses on the evaluation of the degree to which the policy reduces the burden of outpatient expenses. In addition, through the analysis of the heterogeneity of chronic diseases and the elderly group, the institutional effectiveness of the policy in accurately guaranteeing the newly-needed population is further explored. Methods: This study is based on comprehensive outpatient claims data from a large tertiary hospital in Chongqing, covering the period from January 2023 to December 2024. The dataset comprises approximately 600,000 insured individuals and 1.67 million outpatient visit records, forming a high-frequency micro-level panel dataset. First, an interrupted time series (ITS) model is employed to identify macro-level trends and immediate structural breaks at the time of policy implementation, with Newey–West heteroskedasticity and autocorrelation consistent standard errors applied to correct for serial correlation. Second, a two-way fixed effects (TWFE) model is constructed to track within-individual behavioral changes before and after policy implementation, controlling for individual heterogeneity and seasonal effects to identify the net micro-level impact of the policy. Finally, robustness checks are conducted through placebo tests using pseudo-policy implementation dates and by replacing the age threshold used to define elderly status. Results: The empirical analysis yields the following core findings. In the cost burden dimension, the policy showed a significant and robust burden reduction effect, and the ITS showed that the proportion of out-of-pocket payment decreased by 12.5 percentage points (95% CI: -0.169, -0.080); the TWFE model showed that the proportion of out-of-pocket expenses of the same patient decreased by 24.2 percentage points on average, and the total amount of absolute out-of-pocket expenses decreased by more than 58%. Heterogeneity analysis confirmed that the policy had significant skewed protection characteristics for high-need populations, and the decrease of absolute total out-of-pocket payments for patients with chronic diseases and the elderly was 5.3% and 5.1% more than that of the baseline group, respectively. Conclusion: This study shows that the outpatient pooling reform of medical insurance for workers in Chongqing significantly reduced patients’ cost burden. Through the intervention of the pooling fund, the policy has reduced the outpatient out-of-pocket expenses of the insured, especially the burden reduction effect of the elderly and the chronic disease group.
Copyright (c) 2026 Xinjuan Zhou http://creativecommons.org/licenses/by/4.0
Exploring the Link between Green Spaces and Digestive System Diseases: Observational and Genetic Perspectives
Purpose: To explore the epidemiological and genetic link between green spaces and digestive system diseases. Methods: The current study includes two main parts. The first part is a comprehensive meta-analysis of epidemiological findings, subsequently, two-sample epigenetic Mendelian randomization (MR) analysis is conducted to explore the genetic associations between green spaces and digestive system diseases. Results: The meta-analysis part included seven studies, with six cohort studies and one ecological study. After pooling up all the data, we found that green space was not significantly associated with the overall risk of digestive system diseases (OR=0.97, 95% CI=0.92 to 1.01, P=0.17, I²=90.09%). Subgroup analysis showed that green space was associated with reduced risk of liver diseases (OR=0.93, 95% CI=0.88 to 0.99, P=0.02, I²=79.76%). In the MR analysis, genetic evidence suggested significant causal effects between green spaces-associated DNA methylation and digestive system diseases. Specifically, the PRSS23 gene and CpG site cg10916494 were strongly associated with ulcerative colitis, indicating potential biological pathways linking green spaces and digestive system diseases. Conclusion: Our findings suggested that while epidemiological evidence did not strongly indicate that green spaces were associated with digestive system diseases. However, MR analysis indicated that significant causal effects between green spaces-associated DNA methylation and digestive system diseases existed.
Copyright (c) 2026 Can Tan, Yong Cheng http://creativecommons.org/licenses/by/4.0
Fall Risk and Its Determinants in Community-Dwelling Older Adults with Type 2 Diabetes: A Cross-Sectional Study
Objective: To quantify fall risk among community-dwelling older adults with type 2 diabetes and to identify its associated factors. Methods: A cross-sectional study was conducted among 370 older adults with type 2 diabetes recruited from a community health service center in Shenzhen, China, from January to August 2024. Data were collected using standardized instruments, including the Fall-Risk Self-Assessment Questionnaire (FRQ), the Berg Balance Scale (BBS), the Generalized Anxiety Disorder Scale (GAD-7), and the Geriatric Depression Scale (GDS-15). Multivariable linear regression was performed to identify independent predictors. Results: Overall, 43.2% of participants were classified as being at risk of falling. Fall risk scores differed significantly across demographic, clinical, and psychological variables. Multivariable analysis identified age (β=0.177), visual status (β=0.149), hypoglycemia in the past year (β=0.124), falls in the past year (β=0.287), anxiety (β=0.163), depression (β=0.119), and balance ability (β=−0.389) as independent predictors (all P < 0.05). Balance ability showed a moderate negative correlation with fall risk (r = −0.592, P < 0.001). Conclusion: Fall risk is highly prevalent among older adults with type 2 diabetes in community settings. Both physiological and psychological factors contribute to this risk, highlighting the need for a multidimensional assessment and targeted interventions.
Copyright (c) 2026 Feng Li, Yonghong Jiang http://creativecommons.org/licenses/by/4.0
Hydrometeorological Disasters and Climate-Sensitive Disease Burden in Pacific Island Countries: Evidence on Disease-Specific and Temporal Heterogeneity from a Multi-Database Panel Study
Background: Pacific Island countries are highly vulnerable to hydrometeorological disasters, but comparable quantitative evidence on how such disasters affect climate-sensitive disease burden across countries remains limited. This study examined whether disaster-related health associations varied across diseases, outcome dimensions, and lag structures. Methods: We conducted an ecological country-year panel study of 11 Pacific Island countries from 2000 to 2023 using data from the Global Burden of Disease Study, EM-DAT, the World Development Indicators, the Global Health Expenditure Database, and the ND-GAIN Country Index. Two-way fixed-effects models with country-clustered standard errors were used to estimate associations of disaster occurrence and disaster count with aggregate and disease-specific disease burden outcomes, with alternative incidence and death outcomes, lag terms, supplementary sensitivity analyses, wild cluster bootstrap tests for selected coefficients, and interaction models involving health expenditure and ND-GAIN readiness. Results: No stable short-term average association was observed between hydrometeorological disasters and the aggregate climate-sensitive age-standardized DALY rate. In fully adjusted models, the coefficients for disaster occurrence and disaster count were 17.56 (95% CI: −12.43 to 47.54) and 9.39 (95% CI: −9.46 to 28.25), respectively. Disease-specific analyses revealed marked heterogeneity. The most robust finding was a delayed positive association between disaster occurrence and protein-energy malnutrition burden, with coefficients of 10.68 (95% CI: −0.13 to 21.49) at a 1-year lag and 13.65 (95% CI: 0.73 to 26.56) at a 2-year lag; both remained significant in wild cluster bootstrap tests (p = 0.026 and p = 0.032). By contrast, diarrheal disease signals were weaker and not robust under stricter inference. Disaster-related signals were more evident for the aggregate climate-sensitive incidence rate than for the aggregate death rate, although the incidence association remained borderline under bootstrap testing. Conclusions: Hydrometeorological disasters were not associated with a stable short-term increase in the aggregate climate-sensitive DALY burden in Pacific Island countries, but their health effects showed clear disease-specific and time-dependent heterogeneity. The most robust evidence was concentrated in delayed nutrition-related burden, suggesting that climate-resilient health strategies in the Pacific should extend beyond emergency response to include stronger nutritional resilience, surveillance capacity, and cross-sector coordination.
Copyright (c) 2026 Xinglian Liu http://creativecommons.org/licenses/by/4.0
Life-course Trajectories of Work Productivity and Multidimensional Health: A Longitudinal Study of Childhood Socioeconomic Conditions in Aging Adults
Background: Maintaining work productivity and good health is essential for healthy aging; however, their long-term co-developmental patterns remain insufficiently understood. This study aimed to identify the joint longitudinal trajectories of work productivity and multidimensional health among middle-aged and older adults and to examine their associations with childhood socioeconomic status. Methods: A group-based dual trajectory model was employed to identify joint trajectories of work productivity and multidimensional health. Multinomial logistic regression was used to examine the associations between childhood socioeconomic status and trajectory membership. Results: Three distinct trajectories of work productivity were identified: low, decreasing, and high. Multidimensional health trajectories were classified as decreasing, moderate, and high. Individuals with persistently high productivity were more likely to follow a high health trajectory. Notably, some individuals with low productivity trajectories also maintained high health trajectories. Childhood socioeconomic indicators, including parental occupation and primary residence, were significantly associated with a decreasing productivity trajectory in later life. Conclusions: Work productivity and multidimensional health demonstrate distinct yet interconnected developmental trajectories across middle and later adulthood. Early-life socioeconomic circumstances play a significant role in shaping these long-term patterns. These findings underscore the importance of a life-course perspective in designing policies and interventions to support healthy and productive aging.
Copyright (c) 2026 Lingna Chen http://creativecommons.org/licenses/by/4.0
Interpretative Phenomenological Analysis of Factors for the Use of Serving Chopsticks and Separate Dining in Sichuan and Chongqing, China
Objectives: To conduct a qualitative phenomenological study exploring factors for using serving chopsticks and separate dining. Methods: Qualitative phenomenological research was conducted via face-to-face, semi-structured interviews. All interview transcripts were analyzed using the seven steps of Colaizzi phenomenological data analysis and were input into the Nvivo12 (qualitative research analysis software) through sentence-by-sentence, word-by-word coding and formed themes. Results: Two main themes and fifteen sub-themes were found. The barriers in implementing serving chopsticks and separate dining include consumers bearing the cost of serving chopsticks and separate dining in the end; long-established dietary habits and culture background of willingness to share food with others by using own chopsticks or eating in one pot; the difficulty for low-end catering to implement the serving chopsticks and separate dining; separate dining bringing challenges to grasping the quantity of meals given each person’s varying preferences; weak public awareness of serving chopsticks and separate dining; their perception that troublesome and embarrassing, separate dining destroys the overall aesthetic of the food; and no sophisticated design of serving chopsticks and separate dining. Suggestions to implement serving chopsticks and separate dining include pioneering the implementation and training of communal chopsticks sharing in the restaurant industry, the collective units implementing the serving chopsticks system, producing highly recognizable serving chopsticks, creating a living atmosphere of serving chopsticks, promoting the comprehensive government system to form a new "food" fashion, conducting serving chopsticks experience activities, guarantee through government mandatory policies starting with teenagers, prioritizing the implementation of serving chopsticks, and gradually promoting the serving chopsticks system. Conclusions: Mandatory government policies and measures, public education on serving chopsticks, creating a good atmosphere for serving chopsticks, the production and sale of recognizable chopsticks and reasonable separate dining design, and the initiative of the catering industry and unit canteens to assume the responsibility of chopsticks sharing are required.
Copyright (c) 2026 Keni Wu, Yaqi Wen, Huiyi Zhang, Ronghua Dai, Yong Zhao, Jun Yuan http://creativecommons.org/licenses/by/4.0
Association of the Zhejiang University index with sleep-related problems in US adults: findings from NHANES 2007-2014
Background: This study aims to investigate the precise relationship between the Zhejiang University index (ZJU index) and sleep-related problems. Methods: This study included 7920 participants from the National Health and Nutrition Examination Surveys conducted between 2007 and 2014. Logistic regression, restricted cubic spline regression, subgroup analyses and receiver operating characteristic (ROC) curve were employed to evaluate the relationship between the ZJU index and sleep-related problems. Results: After adjusting for all included confounders, the odds ratios (ORs) for sleep disorders, self-reported difficulty falling asleep, and short sleep duration were 1.83 (95%CI: 1.55 to 2.15, P < 0.001), 1.24 (95%CI: 1.12 to 1.37, P < 0.001), 1.17 (95%CI: 1.08 to 1.27, P < 0.001), respectively. A U-shaped nonlinear relationship between the ZJU index and sleep disorders (P-nonlinear = 0.001, point= 37.7) was identified through restricted cubic spline analysis. ROC curve analysis revealed that the ZJU index was superior to single indicators and lipid metabolism indicators in predicting sleep-related problems. Furthermore, it had a high predictive value (area under the curve = 0.710) in elderly women whose sleep disorders were diagnosed. Conclusion: The ZJU index is strongly associated with sleep-related problems in US adults. Therefore, focusing on high ZJU index levels is useful for early monitoring of sleep-related problems, especially in elderly women.
Copyright (c) 2026 Ming Sun, Shijun Wang, Sicen Wan, Hongru Li, Xu Zhang, Gang Chen, Xiang Li Jr, Jiahe Wang http://creativecommons.org/licenses/by/4.0