Cultura

Health Security, Complexity, and Mental Health in Healthcare Practice: A Cultural–Analytical Study Across Nursing, Pharmacy, Laboratory, and Dental Disciplines

VOLUME 22, 2025

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Nadin Gilan Albarakati, Reem Saad Alharbi, Mohammed Ali Al-Zamanan, Nouf Faisal Al Harthi, Abdulkaream Al Ahmed
Amal Ahmed Alzaydani, Sharifa Abdulwahab Amer, Hamad Mastour Alalhareth, Fatima Saad Ahmed Al-Shamrani, Saeed Mohammed Ahmad Senan

Abstract

Background: Health security has increasingly been recognized as a multidimensional construct that extends beyond technical safety measures to encompass institutional culture, professional values, and workforce well-being. In complex healthcare systems, the mental health of healthcare professionals plays a critical role in shaping safety practices, interprofessional collaboration, and system resilience. Despite growing attention to workforce well-being, mental health is often treated as a secondary outcome rather than a foundational element of health security culture.

Objective: This study aims to conceptually examine health security as a cultural framework supporting mental health within complex healthcare systems, with a specific focus on interprofessional practice across nursing, pharmacy, laboratory, and dental disciplines.

Methods: A qualitative conceptual cultural–analytical approach was adopted. The analysis draws on secondary sources, including peer-reviewed literature, international health security and mental health frameworks, and established theoretical models related to human security, organizational culture, system complexity, and interprofessional practice. An axiological lens was employed to explore how values, norms, and institutional culture shape the relationship between health security and mental well-being among healthcare professionals.

Results: The analysis indicates that mental health functions as a foundational condition for effective health security rather than a peripheral concern. Health security cultures that prioritize psychological safety, professional support, and interprofessional trust are more likely to sustain safety practices, ethical decision-making, and workforce engagement. Conversely, cultures characterized by excessive control, fragmented responsibility, and neglect of mental well-being may undermine both security objectives and professional performance, particularly in highly complex healthcare environments.

Conclusion: Conceptualizing health security as a cultural framework that supports mental health offers a more holistic and sustainable understanding of safety in healthcare systems. By positioning mental well-being as a core pillar of health security culture, this study contributes a value-based perspective that is relevant across healthcare disciplines and supports the development of human-centered, resilient, and ethically grounded healthcare systems.

Keywords : .
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty