Health tourism destinations as therapeutic landscapes: Understanding the health perceptions of senior seasonal migrants

A study on the influence of rural tourism's perceived destination restorative qualities on loyalty based on SOR model

Introduction

Tourists' restorative perception of the environment in rural tourism is a key factor to enhance tourism experience and promote physical and mental recovery, as well as a new perspective of tourist psychological research. However, the current research on the impact of tourists' perceived destination restorative qualities on loyalty in rural tourism has not been deeply discussed.

Methods

Based on the Stimulus-Organism-Response (SOR) framework, this study explores the relationship between tourists' perceived destination restorative qualities, well-being (hedonic experience and eudaimonic experience), destination image and loyalty. Through a questionnaire survey, 489 valid questionnaires were obtained and analyzed by structural equation model.

Results

The results show that: (1) Perceived destination restorative qualities have a direct positive impact on hedonic experience, eudaimonic experience and destination image; (2) Both hedonic experience and eudaimonic experience have a direct positive impact on destination image and loyalty, in which the impact of hedonic experience is greater; (3) The relationship between destination image and loyalty is not significant.

Discussion

The research results provide important guiding significance and enlightenment for the development of rural tourism.

Why are individuals tracing travel trends? A case study of City Walk in Malaysia

Studying the emerging travel trends of City Walk is a beneficial activity for young groups. However, there is a lack of research and understanding regarding the motivation and mechanism behind these trends, both in theory and practice. The aim of this study was to investigate the motivation of persons who follow the travel trend of City Walk and evaluate how behavioral intentions are formed by exploring the link between motivation and behavioral intention using the self-determination theory, and social influence theory. Social influence, variety seeking, and self-identification were extrinsic and intrinsic motivations of behavioral intention. A quantitative purposive survey approach was employed, wherein 315 young individuals aged 18 to 40 were recruited to respond. The findings derived from the partial least squares structural equation modeling demonstrate that extrinsic incentives related to social influence, variety seeking, and health care have a considerable impact on behavioral intention, and to some extent influence self-identification. Self-identification has a mediating role in the relationship between health care and behavioral intention. By examining both theoretical and practical aspects, it seeks to provide useful theoretical insights and practical contributions to advance research and industry in the field of rural tourism.

Health-related quality of life and its associated factors among Chinese seasonal retired migrants in Hainan

Background

Seasonal retired migrants are mainly retired or semiretired people who migrate to warmer areas during the winter and then return to their original homes in the following year. Despite its increasing popularity, the evidence concerning the health status of Chinese seasonal retired migrants is controversial. Although some studies have shown that seasonal retired migrants have better health status, other studies note that migrants are driven involuntarily by health concerns and that their mental health suffers during migration. The objective of this study was to provide quantified evidence on the health-related quality of life (HRQoL) of seasonal retired migrants in China and to identify potential factors associated with HRQoL.

Methods

This was a community-based cross-sectional study of seasonal retired migrants who lived in Wuzhishan, Hainan during the winter. The Chinese version of the EuroQol 5-Dimension 5-Level (EQ-5D-5L) was used to assess participants' HRQoL. Data on demographic and behavioral characteristics, body mass index, and the presence of chronic diseases were collected using a self-administered survey. Logistic regressions were used to explore the factors associated with responses in each dimension of the EQ-5D-5L descriptive system, and a multiple linear regression model was used to explore the factors associated with EuroQol visual analogue scale (EQ-VAS) scores.

Results

A total of 992 participants (female: 56.5%) were enrolled in the current study, with a mean age of 67.87 ± 6.98 years. Most participants reported problems in the pain/discomfort dimension (16.7%), followed by the anxiety/depression dimension (8.3%). Few participants reported problems in the first three dimensions of the EQ-5D-5L: mobility (5.4%), usual activities (2.0%), and self-care (1.2%). The median EQ-VAS score was 84 (interquartile range: 80-89). The regression results indicated that poor sleep quality, the presence of chronic diseases, and low-level physical activity were important factors that were negatively associated with multiple dimensions of the EQ-5D-5L. In addition, the EQ-VAS score was negatively associated with age, the presence of chronic diseases, poor sleep quality, and low-level physical activity.

Conclusion

This study revealed that Chinese seasonal retired migrants have high HRQoL. In addition, this study revealed that sleep quality and physical activity are correlated with multiple dimensions of the EQ-5D-5L descriptive system and EQ-VAS. Therefore, lifestyle interventions related to sleep quality and physical activity are essential for improving HRQoL among Chinese seasonal retired migrants.

Therapeutic landscapes, networks, and health and wellbeing during the COVID-19 pandemic: A mixed-methods study among female domestic workers

The COVID-19 pandemic has had profound impacts on access to and use of therapeutic landscapes and networks, especially for people who are vulnerable due to economic, social, and work-related disadvantage. For one such vulnerable population, Indonesian female domestic workers (FDWs) in Hong Kong, this study employed a mixed methods approach to examine the associations between perceptions of therapeutic landscapes (TLs), therapeutic networks (TNs), subjective wellbeing, and self-rated health during the COVID-19 pandemic. Data from an online survey were analyzed via structural equation modeling (SEM) and confirmatory factor analysis (CFA) to investigate the direct and indirect associations between TLs, TNs, and health and wellbeing. The findings demonstrate little or no association among FDWs' perceptions of TLs and TNs and FDWs' self-rated health and subjective wellbeing, except for a negative total association between TL and subjective wellbeing. Using insights gleaned from thematic analysis of in-depth interviews with FDWs, we suggest that these unexpected findings are mainly due to restricted access to public places, reduced social gatherings, and the fact that employers rarely granted days off during the lockdown. Although processes at the employer and municipal scales limited FDWs' access to therapeutic places, increased use of digital communications and spaces provided an important source of social and emotional support during the pandemic.

[Review of methodological approaches for the assessment of social and medical rehabilitation in the cardio-respiratory system diseases at the post-COVID period]

There is currently no systematic relationship between the quantification of funding for the treatment and rehabilitation of cardio-respiratory diseases and the length of a citizen's working life. The development of a universal evaluation methodology that can be used for qualitative and quantitative evaluation of the effectiveness of social and medical rehabilitation is a relevant area of research. The survey contains an analysis of the scientific approaches used in research on social and medical rehabilitation, as well as the development of medical and social rehabilitation and health resort and spa treatment, and to assess the impact of medical rehabilitation on restoration of ability to work. On the basis of the data obtained, a set of indicators for the assessment of the socio-medical rehabilitation of diseases of the cardio-respiratory system at the post-COVID period is proposed, which in the future will serve as a methodological tool in the field of medical and social rehabilitation, health resort and spa activities and at all stages of rehabilitation and preventive medicine.

Tourism at the Crossroads between Well-Being, Public Health and the Environment: Panel Data Evidence from the European Union

The recent pandemic crisis led to a drop in tourism, and it highlighted the connection between tourism, healthcare, environmental concerns and well-being. In this context, the purpose of the research is to clarify the relationship between tourism, happiness, healthcare and environmental expenditure. Statistical data provided by the World Bank, Eurostat and the World Happiness Database from the EU27 countries, from 2000 to 2019, were used. In order to investigate the relationship between these indicators, the panel Autoregressive Distributed Lag (ARDL) method was used. In the long run, happiness and environmental and healthcare expenditure have a statistically significant and positive impact on tourism arrivals and receipts. It follows that a 1% increase in happiness supports between 4% and 9% of international tourism, while a 1% increase in environmental expenditure supports an increase of 2% in international tourism. Additionally, there is a significant interaction between happiness and either environmental or healthcare expenditure in the long run. This means that increasing happiness diminishes the effect of the later on tourism arrivals and receipts. No short-term relationship was identified between arrivals and any of the above-mentioned variables. In the same context, healthcare expenditure has a negative short-term effect on tourism receipts. The research contributes to the literature by suggesting that increasing national happiness, healthcare and environmental expenditure has a beneficial spillover effect on tourism arrivals and receipts in the long run.

How to evaluate surgical tourism service organizations in China: indicators system development and a pilot application

Background

Surgical tourism is an emerging economic sector, with the most growth potential demonstrated in China's health industry before the COVID-19 pandemic. Surgical tourism accounts for a large part of medical tourism services in China, with high requirements in terms of quality and safety. By contrast, China suffers from insufficient measurement tools and theoretical research. The aim of this study was to develop a set of reliable and feasible indicators by augmenting the Donabedian model to evaluate the quality of surgical tourism services.

Methods

A literature review and focus group interview were used to generate indicators for the quality of surgical tourism services. The basic framework of the evaluation system was based on the structure–process–outcome Donabedian model. The screening and weight setting were conducted through an analytical hierarchy process (AHP) and a two-round Delphi consultation with 13 panelists. The validity and reliability of experts were tested by the experts' positive coefficient, authority coefficient, and coordination coefficient. The reliability of the questionnaire was assessed by a pre-test distributed within an International Medical Department of a public hospital in China.

Results

Based on the Donabedian quality theory, a novel evaluation system of surgical tourism service institutions was constructed with three dimensions, nine first-level items and 39 second-level items. The three dimensions consisted of the structure (0.315), process (0.287), and outcome (0.398), with several indicators for each dimension and each indicator was given a weight. Of the two rounds of Delphi consultation, the response rates were 86.67% and 100%. The coordination coefficient of expert opinions in the two rounds of consultation were 0.49 and 0.65 (p < 0.05). For the empirical study, the self-evaluation score of a public hospital was 86, which could rate as a two-star institution.

Conclusions

Our evaluation system identified three suitable quality dimensions of surgical tourism services to improve the safety and quality of practical healthcare. It reflects the access criterion of surgical tourism institutions, provides references for the best choice of surgical services for tourists, and can be applied by healthcare managers and policy makers to allocate resources more efficiently and promote more surgical tourism services with international standards.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41256-022-00262-2.

Understanding the Reality of China's Health Tourism and Consumer Demand From the Perspective of Consumers: A Cross-Sectional Study

Background

Travel for health reasons is booming around the world and in China. As a huge source and destination of health tourism, little is understood about the volume, characteristics, motivations, and preferences of health travelers in China. This study provides details of China's health tourism reality and consumer demand of Chinese residents who did or will travel for health.

Methods

We established a questionnaire through literature analysis and a focus group, then collected 695 responses based on an online random sampling design. Finally, 629 questionnaires (effective recovery rate was 90%) were analyzed with statistical description, binary logistic regression, and word frequency analysis to draw the reality of health tourism, explore the influential factors, and sort out suggestions.

Results

In this study, 387 respondents knew of health tourism (61.53%), 446 reported interest (70.9%), and 234 had traveled for health reasons before (37.2%), with 329 occurring within China (91.4%). The top three reasons for health tourism were decompression and relaxation (116, 20%), physical examination (82, 14.1%), and health care (73, 12.6%). High costs (372, 16.3%), little disposable time (309, 13.5%), and lack of reliable professional institutions (289, 12.6%) were the main potential barriers for consumers. Professional level and quality of the institution, personal privacy, and service personnel's attitude were the most important concerns for consumers when arranging health travel. Marital status (OR = 0.209, 95% CI = 0.085-0.514, P = 0.001) and attitude to health tourism (OR = 2.259, 95%CI = 1.553-3.287, P < 0.001) were factors for consumers' willingness to perform health tourism. "Propaganda" was proposed most frequently by participants, followed by "service" and "price".

Conclusion

The popularity of health tourists is low although there is a huge market in China. There are also differences between willingness of previous and prospective customers with varying socio-demographic characteristics in this investigation. Overall, more diverse propaganda measures should be taken, and government policies or legal documents ought to keep pace with it. Health tourism products' promotion, as well as supporting measures and brand, need to be emphasized.

Understanding the Value of Tourism to Seniors' Health and Positive Aging

The value of tourism has been included in studies of active aging, and the existing public health implications of the physical and mental health effects of tourism among seniors are recognized as important issues. This study uses a mixed methods research approach to explore the effects of tourism value on the health and mortality risk of older adults, referred to in this paper as seniors. Survival analysis and cohort analysis are combined with the narrative analysis of in-depth interviews with eight convenience-sampled seniors to construct a narrative framework of seniors' active aging tourism and its intrinsic drivers. The study found that the intrinsic framework of active aging tourism values for seniors has a three-stage continuum, an interaction, and orientation characteristics. There are six intrinsic key value drivers of tourism value and public health for seniors. In addition, this study identifies the personal characteristics and strengths of seniors as important influences on tourism value practices for active aging and public health. This study provides a positive psychological and behavioral research direction for existing research on the value of tourism in active aging. It provides an empirical basis for exploring the intrinsic mechanisms of tourism and public health.

Medical, Health and Wellness Tourism Research-A Review of the Literature (1970-2020) and Research Agenda

Medical, health and wellness tourism and travel represent a dynamic and rapidly growing multi-disciplinary economic activity and field of knowledge. This research responds to earlier calls to integrate research on travel medicine and tourism. It critically reviews the literature published on these topics over a 50-year period (1970 to 2020) using CiteSpace software. Some 802 articles were gathered and analyzed from major databases including the Web of Science and Scopus. Markets (demand and behavior), destinations (development and promotion), and development environments (policies and impacts) emerged as the main three research themes in medical-health-wellness tourism. Medical-health-wellness tourism will integrate with other care sectors and become more embedded in policy-making related to sustainable development, especially with regards to quality of life initiatives. A future research agenda for medical-health-tourism is discussed.