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

Healthcare Facilities and Medical Tourism Across the World: A Bibliometric Analysis

This study aimed to review the literature on healthcare facilities and medical tourism from a range of nations that have established medical tourism sectors and assess the effect of healthcare facilities on medical tourism. A bibliometric study of the Scopus database was carried out by using the search terms '(Facility AND of AND healthcare) AND TITLE-ABS-KEY (health AND tourism) AND medical tourism' for the years 2012-2022. A qualitative evaluation of the literature was then performed to find and locate 92 articles. VOSviewer and NVivo 12 Plus were employed for data analysis. The findings indicated that the following trending subject keywords were used during the period in question: health (rate 1.97), medicine (rate 1.91), tourism (rate 1.70), care (rate 0.83), facilities (rate 0.64) and healthcare (rate 0.61). Furthermore, this research identified four distinct clusters: i) medical tourism, ii) healthcare quality, iii) healthcare system and iv) health services. The study found that healthcare facilities, as actors that have a role in the development of medical tourism, have not been sufficiently explored, even though there is evidence that they play a role in the growth of the sector. This result is in line with Heung's argument, which makes the same point.

Knowledge and attitude of students of medical sciences universities regarding health tourism: A cross-sectional study

Background and Aims

Health tourism is already one of the most important sources of revenue for many countries all over the world, but it appears that it has not progressed as much in Iran. The aim of this study was to determine the knowledge and attitudes of students of Iranian medical sciences universities about this subject, which could have a great impact on the future of this industry in Iran.

Methods

In this cross-sectional study, the students of medical sciences universities in Iran were selected through convenience sampling; they filled out an online 36-item self-administrated questionnaire. The data were analyzed using SPSS software (version 25). Descriptive statistics of knowledge and attitude were provided. Also, independent samples t-test and analysis of variance were used as statistical tests and p value <0.05 was considered as the significant level.

Results

Overall, 390 students with a mean age of 24 ± 1.5 years and a female-to-male ratio of 1.9 participated in this study. The respondents answered 38% of the questions correctly in the knowledge section. Age, ethnicity, education level, job experience, experience of a health tourism-related job, participation in health tourism courses, and geographical region of the province of residence showed a significant association with the participants' knowledge. Also, most participants had an almost positive attitude regarding the potential for development of the industry.

Conclusion

According to the results obtained, the students' knowledge about health tourism was not desirable; however, their attitudes were almost positive. Therefore, educational interventions are highly recommended to be conducted in this regard.

Health and Wellness Tourists' Motivation and Behavior Intention: The Role of Perceived Value

In recent years, with the rapid change of people's health concept, health and wellness tourism has shown a vigorous development trend. However, existing literature has been lacking on travelers' behavioral intentions, influenced by their motivation in health and wellness tourism. To fill in this gap, we designed scales of tourists' behavioral intention and motivation in health and wellness tourism and investigated the aforementioned effects, with a sample of 493 visitors who have traveled in health and wellness tourism. Factor analysis and structural equation models were applied to explore the relations among motivation, perceived value, and behavioral intention in health and wellness tourism. The results indicate that health and wellness tourists' motivation significantly positively predicts their behavior intentions. Travelers' perceived value of health and wellness tourism significantly partially mediates the associations between their behavioral intention and escape motivation, attractive motivation, environmental motivation, as well as interpersonal motivation. No empirical evidence supports the mediating role of perceived value in the correlation between consumption motivation and behavioral intention. Health and wellness tourism industries are encouraged to meet the intrinsic motivation of travelers and make them perceive the value of this kind of tourism, which in turn promotes tourists' choice, evaluation, and satisfaction of health and wellness tourism.

A Study on Market Segmentation According to Wellness Tourism Motivation and Differences in Behavior between the Groups-Focusing on Satisfaction, Behavioral Intention, and Flow

The purpose of this study was to derive the visit motivations of wellness tourists and to derive strategies for the wellness tourism market through market segmentation based on visit motivations. First, this study derived seven motivators through a literature review with a discussion of experts: relaxation/healing/escape from everyday life, health improvement, novelty, luxury and prestige, self-examination/education, nature-friendly motivation, and social relations improvement. Then, in order to derive differentiated characteristics by motivation according to market segmentation, a difference analysis was conducted with the satisfaction, behavioral intention, and flow of wellness tourism participants. Data collection was carried out with the users of Chungcheongbuk-do wellness tourism products, and was supported by the Ministry of Culture, Sports, and Tourism (South Korea) from 2 September to 4 December 2021. Through the analysis in this study, it was first found that the wellness tourism motivations of wellness tourists were divided into a total of six factors (relaxation/healing/health improvement, novelty, luxury and prestige, self-examination/education, nature-friendly motivations, and social relation improvement). Then, as for market segmentation according to the visit motivations of wellness tourists, it was found that the markets were divided into "novelty-seeking type, comprehensive motivation-seeking type, neutral wellness-seeking type, and exploratory wellness-seeking type." Finally, it was determined that there were significant differences in satisfaction, behavioral intention, and flow among those types of wellness tourist groups, and the average levels of satisfaction, behavioral intention, and flow were commonly lower in the neutral wellness-seeking type than in the comprehensive motivation-seeking type and the exploratory wellness-seeking type. This study derived the necessity to conceive differentiated strategies for the wellness tourism motivation group with the development of a wellness tourism motivation scale and a market segmentation study, and provided practical implications according to the characteristics of individual groups.

Tourism as a Tool in Nature-Based Mental Health: Progress and Prospects Post-Pandemic

The healthcare sector recognises the role of nature in mental health. The tourism sector is equipped to take people to national parks. The conservation sector gains support from visitors. Theoretical frameworks for mental health benefits from nature tourism include: tourism destinations and activities; tourist personalities and life histories; sensory and emotional components of tourist experiences; and intensity and duration of memories. Mental health deteriorated worldwide during the COVID-19 pandemic. Recovery of global economic productivity requires immediate, accessible, affordable mental health measures at national scales, and nature-based approaches provide the best option. Different countries have adopted a variety of public, private, or voluntary mechanisms. Some focus on design of activities, others on provision of facilities. Costs and implementation depend on key research questions: marginal benefits of nature tour guides or psychologists compared to self-guided nature experiences; comparisons between repeated brief visits and one-off nature holidays; effects of biodiversity, flagship species, and scenic or wilderness quality; and differences between individuals, depending on personalities, life histories, and mental health status and symptoms.

Empirical Research into the Development Mechanism of Industry Innovation of Health and Wellness Tourism in the Context of the Sharing Economy

Health and wellness tourism has become an emerging form of tourism economy. In the era of the sharing economy, it is of theoretical and practical significance to study the development mechanism of the industry innovation (II) of health and wellness tourism. Based on theoretical analysis, hypotheses were proposed for the relationships of industry sharing (IS) as well as its constitutional dimensions with the resource acquisition capability (RAC), policy support (PS), and II of health and wellness tourism. The constitutional dimensions of IS include public operational resources (PORs), infrastructures, and industry cooperation networks (ICNs). In addition, a model for the influencing mechanism of IS on the II of health and wellness tourism was established. Questionnaire surveys were conducted with 542 managers of health and wellness tourism enterprises in 21 provinces (or municipalities) in China, using the empirical research method, and the survey data are subjected to mathematical statistical analysis. Results show that the PORs, infrastructures, and ICNs of the IS of health and wellness tourism have significant positive influences on the II. RAC has a partial mediating effect between the IS and the II of health and wellness tourism. PS exerts a moderating effect between the IS and the II of health and wellness tourism. Finally, suggestions for promoting the II development of health and wellness tourism are proposed from the perspective of optimizing IS.

Research trends in college students' sleep from 2012 to 2021: A bibliometric analysis

BACKGROUND

A great proportion of college students experience various sleep problems, which damage their health and study performance. College students' sleep problems, which are caused by several factors, have been easily ignored before. In the past decade, more research has been published to expand our understanding of undergraduates' sleep. The purpose of the study is to explore the research hotspots and frontiers regarding college students' sleep using CiteSpace5.8.R3 and offer guidance for future study.

METHODS

We retrieved relevant literature from the Web of Science Core Collection Database and imputed the downloaded files into CiteSpace5.8.R3 for visualization analysis. We generated network maps of the collaborations between authors, countries, institutions, the cited journals, and co-occurrence keywords. The analysis of keywords clusters, timeline views, and keywords citation bursts help us identify the hotspots and research trends.

RESULTS

A total of 1,841 articles related to college students' sleep, published from 2012 to 2021, were selected. The number of publications gradually increased. Karl Peltzer was the most prolific authors with 15 publications. The United States and Harvard University separately contributed 680 and 40 articles and had the greatest impact in this field. SLEEP ranked first in the frequency of cited journals. The article published by Lund HG was the most influential publication. Based on the analysis of keywords, we summarized research hotspots as follows: current status, affecting factors, and adverse outcomes of college students' sleep. The frontiers were the further understanding of the relationships between sleep and mental and physical health, and various interventions for sleep disorders.

CONCLUSION

Our study illustrates the research hotspots and trends and calls for more research to expand the findings. In the future, the cooperation between institutions and authors needs to be strengthened. The complex relationships between sleep and mental and physical health and problematic substance use disorders are necessary to be explored. Longitudinal studies or randomized controlled trials should be constructed to verify the current findings or assumptions.

First Systematic Review on Health Communication Using the CiteSpace Software in China: Exploring Its Research Hotspots and Frontiers

Since the 1970s, health communication (HC) has attracted widespread attention from practitioners and researchers in various fields in China, leading to the production of a vast array of literature. In order to reveal the current state, popular themes, and research frontiers of HC research, this study employed the CiteSpace software to conduct a comprehensive review based on 1505 HC publications from 1992 to 2021 retrieved from the China National Knowledge Infrastructure (CNKI) database. The results demonstrated that (1) the number of HC publications has experienced an annual increase over the past 20 years, albeit with certain inverted S-shaped fluctuations and (2) the most prolific authors mainly included Wang L.Y., Zhang Z.L., and Wang Y.L., while well-known universities played a leading role in HC research in China. A significant finding was that a stable core group of authors or institutional has been not formed in the HC field. Furthermore, (3) research hotspots included health education, new media, health literacy, health information, animal husbandry and veterinary medicine (AHVM), the doctor-patient relationship, and public health emergencies. Additionally, the development of the field could be divided into four stages, indicating a significant shift in HC research from focusing on medicine and public health issues towards communication issues. Finally, (4) new research frontiers have mainly included the WeChat official account and Health China.