Articles

Identification of Factors Influencing Organizational Citizenship Behavior (OCB) among Healthcare Workers: A Systematic Literature Review

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Organizational Citizenship Behavior (OCB) refers to voluntary behaviors that play an important role in enhancing the effectiveness of healthcare services. However, various work-related pressures in healthcare facilities often lead to a decline in OCB. This study aims to identify factors influencing OCB among health workers using a Systematic Literature Review (SLR) approach following the PRISMA guidelines. Literature searches were conducted through Google Scholar, ScienceDirect, and Garuda databases, covering publications from 2015 to 2025. A total of 16 articles met the inclusion criteria and were analyzed thematically. The findings indicate that OCB is influenced by two main groups of factors: internal individual factors (job satisfaction, organizational commitment, emotional intelligence, optimism, work motivation, and quality of work life) and external organizational factors (transformational leadership, organizational culture and climate, perceived organizational support, leader–member exchange, workload, work stress, and emotional supervisor support). External factors were found to be more dominant than internal factors. These findings underscore the importance of organizational strategies in fostering supportive leadership and a positive work climate to enhance Organizational Citizenship Behavior among health workers.

Service Quality and Patient Satisfaction in Pharmacy Settings: A Systematic Review Using SERVQUAL Dimensions

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Background: Service quality is a fundamental determinant of patient satisfaction in pharmacy services. SERVQUAL, consisting of Tangibles, Reliability, Responsiveness, Assurance, and Empathy, is widely applied; however, the magnitude and consistency of its association with satisfaction vary by context. Objective: To synthesize available evidence on the relationship between SERVQUAL dimensions and patient satisfaction in hospital and community pharmacy settings amid growing digital healthcare adoption. Methods: This systematic review followed PRISMA 2020 guidelines. A total of 8,225 records were screened from Google Scholar and PubMed. Twelve quantitative studies conducted between 2017–2025 met inclusion criteria. The JBI Cross-Sectional Critical Appraisal Checklist was applied to assess methodological rigor. Results: All studies showed positive satisfaction outcomes, but predictive power varied across settings. In community pharmacies, medicine supply, environment, and communication were dominant satisfaction predictors. Meanwhile, reliability, assurance, and empathy were most influential in hospital pharmacies. Several studies reported non-significant effects for responsiveness and tangibles, indicating expectation–performance discrepancies and contextual constraints. Digital service readiness appears to influence patient experience but is rarely assessed using SERVQUAL. Conclusion: SERVQUAL remains a robust predictor of pharmacy service satisfaction; however, its impact is context-dependent. Strategic integration of SERVQUAL into digital transformation processes such as electronic prescriptions, automated dispensing, and digital queue systems will be essential to maintain quality and patient-centered outcomes.

Adverse effects of E-cigarettes or Vapes in otherwise Healthy Young and Middle-aged Adults who have No History of Smoking: A Systematic Review

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Introduction: The use of Electronic cigarettes and Vapes have been widely accepted as a less-harmful means of smoking when compared to cigarettes. While this is true, the adverse effects and harms of E-cigarettes and Vaping are not inconsequential.

Methods: We searched the PubMed database exclusively for Randomized controlled trials, while limiting our search between 2007 – 2023. We initially identified 234 articles from PubMed which were then screened by abstract. Articles were screened for relevance based on the topic of E-cigarettes or Vaping and of adverse effects. Exclusion of 205 studies left 29 full-text articles to assess. Assessing based on our inclusion and exclusion criteria left 6 studies eligible for systematic analysis. Data extraction was performed on each study with focus on baseline demographics and covariates. Using the Jadad-scale, three independent reviewers assessed the methodological quality of each study on a 5 point scale. It was found that 1 study was of poor quality, 4 studies were of moderate quality and 1 study was of good quality.

Results: 6 RCTs were included in the analysis with 4 being performed in the United States, 1 in Italy and 1 in Canada. A total of 137 participants were included in the randomized controlled trials published between 2015 and 2021. Acute vaping indicated a positive correlation and dose-response relationship with an increase in CD14, CD16, T-cells, natural killers and monocytes. Furthermore, the findings from the review suggests that EC usage alters expression of the transcriptome in both small airway epithelium (SAE) and alveolar macrophages (AM).

However, acute electronic cigarette use does not affect lung and heart functions as long as they do not contain nicotine.

Discussion: This systematic review was conducted using Randomized controlled trials, which minimizes bias and adjusts for confounding, with a robust internal validity. Randomization also provides the best means for determining a causal relationship between an intervention and outcome. However the average quality of the included studies are not of good quality and sample size (137 subjects) may be considered quite small and not representative. Database for studies included was limited to only Pubmed. Moreover health-care practitioners must also actively inquire about the recreational use of vapes in youth and adults, as they are becoming popularized due to the misconception of having few harmful effects.

Conclusion: Acute use of electronic cigarettes show a significant increase in inflammatory cell and cytokine release, leading to oxidative stress, potential airway remodeling and DNA damage. It was found that acute E-cigarette usage also decreases FEV1, however these changes were not clinically significant towards pulmonary function and cardiac function tests. While this study only assesses the acute effects of electronic cigarette vape usage, further studies must be conducted on the chronic usage of E-cigarettes and their clinical effects.

Effectiveness of Palliative Care Interventions Offering Coping Skills to Women with Gynecological Cancers: A Systematic Review

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Background and aim: Gynecological cancers, including ovarian, cervical, and uterine cancers, are among the most prevalent malignancies affecting women globally. Patients with these cancers frequently encounter substantial physical, psychological, and social challenges. This systematic review aims to evaluate the existing quantitative evidence on palliative care interventions that offer coping skills that facilitate the quality of life and psychological well-being of women with Gynecological Cancers.

Method: PubMed, Google Scholar, Clinical Key, and Cochrane Reviews databases were searched from 2000 to 2024. Articles in English with quantitative evidence were screened to determine whether the population included women with gynecological cancers, whether interventions were related to offering coping skills, whether control groups were available, and whether outcomes were related to psychological well-being and quality of life. Data were extracted to report on intervention models, outcome measures, and intervention outcomes. The risk of bias on randomization, allocation concealment, blinding, incomplete outcome data, selection of outcomes for reporting, and other biases was assessed by using the RoB 2, ROBINS I, and ROBINS E. Two independent reviewers were involved in all the above steps, with a third contributing to solving discrepancies. Meta-analysis was not done following heterogeneity assessments.

Results: Searches returned 297 unique articles, with twelve being for review. There were eight randomized controlled trials (RCT), two quasi-experimental trials, one cohort study, and one comparative study. The interventions or exposures included: group therapy based on coping strategies, supportive and coordinated care, communication therapies, mindfulness sessions, educational sessions, psychological counseling, and use of engagement in active coping and seeking social support. Seven studies measured psychological outcomes, six using multidimensional instruments. Five studies measured quality of life, and three used multidimensional instruments. Across the evaluated outcomes, the results consistently and significantly indicated benefits linked to providing coping skills. The majority of RCTs show significant (<0.05) improvement in quality of life with the coping skills from the baseline to the endpoint as interval measures and Growth curve analyses based on the intent-to-treat approach showed that participants in both the coping and communication-enhancing intervention (CCI) and supportive counseling (SC) groups reported lower levels of depressive symptoms compared to those receiving usual care In the Quasi-experimental trials survival expectancy by group interaction (β = 5.102, P = 0.044) was significant as well the patients who survived throughout the study, changes in FACT-G score were greater over time for patients with high survival expectancy in the treatment group compared to with all other patients.

Conclusion: Palliative care interventions offering coping skills are effective in supporting women with gynecological cancers. These interventions significantly contribute to enhancing their mental and emotional well-being and overall quality of life.