European Journal of Investigation in Health, Psychology and Education

This study aimed to translate, culturally adapt, and validate the Arabic version of the 6-Item Lubben Social Network Scale (LSNS-6). The LSNS-6 was translated, culturally adapted, and administered, alongside the Medical Outcomes Study Social Support Survey (MOS-SSS), to 327 Arabic-speaking adults aged 60 years and older. Internal consistency was examined using Cronbach’s alpha and McDonald’s omega. Confirmatory factor analysis (CFA) tested the hypothesized two-factor structure (Family and Friends), and measurement invariance was evaluated across key sociodemographic and lifestyle variables. Convergent validity was assessed through correlations with MOS-SSS domains. Item response theory (IRT) analyses examined item discrimination and threshold parameters. Latent class analysis (LCA) explored whether the LSNS-6 could identify subgroups with distinct patterns of social connectedness and perceived support. The Arabic LSNS-6 demonstrated good internal consistency (α = 0.83; ω = 0.84) and supported the expected two-factor structure with satisfactory model fit (CFI = 0.963; TLI = 0.931; SRMR = 0.03). Convergent validity was evidenced by moderate correlations with overall perceived social support (r = 0.51). IRT analyses indicated strong discrimination for most items, and LCA identified four distinct latent classes. Overall, the Arabic LSNS-6 is a reliable and valid tool for assessing social isolation among older Arabic-speaking adults.

Burnout represents a critical occupational health issue within the maritime sector, where demanding work schedules, prolonged periods at sea, and safety-critical responsibilities expose seafarers to significant psychological strain. This study investigates how burnout influences safety behaviors among maritime workers, adopting a multilevel framework that incorporates work engagement, quality of life, and work–family conflict as key factors shaping this relationship. Data was collected through a structured questionnaire administered to 216 seafarers distributed across 36 commercial vessels, representing a diverse range of onboard roles and operational contexts. The multilevel design allows for simultaneous examination of individual-level experiences and ship-level dynamics, offering a more nuanced understanding of how psychosocial risks translate into safety-relevant outcomes in maritime environments. Data were analyzed using multilevel structural equation modeling (MSEM), including multilevel confirmatory factor analysis (ML-CFA) and multilevel path analysis, implemented in Mplus version 8.10. The findings reveal that burnout undermines seafarers’ safe behaviors through diminished work engagement and a worsened quality of life. Furthermore, high levels of interference between work and family life amplify the negative effect of burnout on safe behaviors. This study contributes to the limited empirical literature on maritime behavioral health and provides implications for strengthening safety culture and crew well-being in the global shipping industry.

(1) Background: Proactive health behaviors are key to reducing their burden and supporting healthy aging. (2) Methods: We analyzed five waves (2011–2020) of CHARLS data from 1343 middle-aged and older adults (≥45 years) with multimorbidity. An entropy weight method was used to create a composite score for proactive health behaviors, and group-based trajectory modeling identified behavioral trajectories. Multivariate logistic regression and Shapley value decomposition assessed determinants and their relative contributions. Generalized structural equation modeling and latent class analysis were applied to estimate direct and indirect effects across the full sample and key multimorbidity subgroups. (3) Results: Two trajectories emerged: a “declining group” (91.44%) and an “improving group” (8.56%). The improving group was more likely to include younger, urban individuals with higher education, retired status, smaller family size, and lower depression levels. Education (40.67%) and depressive symptoms (31.22%) were the strongest determinants of trajectory. Path analysis showed that higher education and retirement indirectly supported sustained proactive health behaviors by reducing depression. The direct and indirect effects varied across subgroups. (4) Conclusion: The proactive health behaviors of middle-aged and elderly patients with multimorbidity exhibit a declining trend. Future health policies and interventions should prioritize mental health.