Search Results (33)

Background/Objectives: Family caregivers of people with schizophrenia experience substantial psychological and practical demands associated with long-term caregiving. This study examined whether participation in a web-based digital psychoeducation program was associated with longitudinal changes in coping mechanisms among family caregivers of people with schizophrenia. Methods: A non-randomized quasi-experimental pretest–posttest control-group study was conducted at a mental health hospital in Indonesia. The final analytic sample comprised 202 family caregivers of people with schizophrenia, with 101 participants in the intervention group and 101 in the control group. The intervention comprised 10 structured web-based psychoeducation modules delivered over 10 weeks. Coping was assessed using the Brief COPE Inventory and summarized into problem-focused, emotion-focused, and avoidance coping domains. Linear mixed-effects models were used as the primary adjusted longitudinal analysis, with study group, time, group-by-time interaction, age group, and marital status included as fixed effects. Wilcoxon signed-rank and Mann–Whitney U tests were retained as complementary unadjusted analyses, while baseline-adjusted linear regression models were used as sensitivity analyses. Results: Significant group-by-time interactions were observed for problem-focused coping and emotion-focused coping. The adjusted between-group difference in change was 0.450 points (95% CI: 0.357–0.544; partial ηp² = 0.312; p < 0.001) for problem-focused coping and 0.263 points (95% CI: 0.137–0.390; partial ηp² = 0.078; p < 0.001) for emotion-focused coping. In contrast, no statistically significant differential change was observed for avoidance coping (adjusted difference in change = 0.074 points, 95% CI: −0.055 to 0.204; partial ηp² = 0.006; p = 0.259). Baseline-adjusted sensitivity analyses produced a consistent overall pattern. Conclusions: Participation in the 10-week web-based digital psychoeducation program was associated with greater longitudinal improvements in problem-focused and emotion-focused coping, but not avoidance coping. Given the non-randomized design and baseline differences between groups, these findings should be interpreted as adjusted longitudinal associations rather than definitive evidence of causal efficacy. The program may therefore represent an accessible complementary approach to supporting caregiver adaptation in long-term schizophrenia care. Full article

Primary prevention is essential to reduce disease burden before clinical onset, yet it remains less systematically integrated into care than diagnosis and treatment. Although artificial intelligence (AI) is increasingly used in medicine, most applications have focused on secondary and tertiary prevention, including diagnosis, prognostic stratification, and disease management, while its role in primary prevention remains less defined. This narrative review examines current AI applications across four modifiable lifestyle domains relevant to prevention and healthspan promotion: nutrition, physical activity, sleep, and mental health. We synthesize evidence on machine-learning models, wearable-derived algorithms, computer-vision tools, just-in-time adaptive interventions, and conversational agents used in consumer, community, and hybrid clinical–digital settings. AI applications support postprandial glycemic prediction, automated dietary assessment, meal-planning adherence, sedentary-pattern detection, personalized exercise recommendations, adaptive behavioral nudges, sleep monitoring, circadian-aware recommendations, psychoeducation, stress-management support, and early identification of psychological vulnerability. Collectively, these tools may extend prevention beyond episodic clinical encounters toward continuous, personalized, and context-aware support. However, evidence remains limited by short follow-up, reliance on surrogate or engagement outcomes, digitally literate populations, and insufficient validation in real-world preventive-care pathways. AI is therefore a promising enabling technology for proactive, healthspan-oriented medicine, provided future studies demonstrate long-term effectiveness, equity, safety, and responsible implementation. Full article

The increasing prevalence of anxiety, depression, and stress has intensified the demand for scalable, evidence-based psychological interventions that can be delivered across traditional and digital modalities. University students represent a high-risk group due to academic demands and developmental transitions, making them a relevant population for evaluating flexible, technology-mediated interventions. Cognitive-behavioral therapy (CBT)-based psychoeducation offers a structured approach that may accommodate variability in accessibility, preferences, and delivery contexts. This quasi-experimental pre–post study evaluated a CBT-based psychoeducation protocol delivered in group settings in both online and in-person formats. A total of 104 undergraduate and graduate students participated and completed the intervention. Symptom severity was assessed using the Depression, Anxiety and Stress Scale (DASS-21), the Hamilton Anxiety Rating Scale (HAM-A), and the Beck Depression Inventory–II (BDI-II). Significant reductions in anxiety, depression, and stress symptoms were observed over the intervention period, with moderate to large effect sizes. DASS-21 scores decreased from moderate to mild severity levels, and reductions were also observed in BDI-II and HAM-A scores. No significant differences were found between delivery modalities. These findings support the potential of CBT-based group psychoeducation as a scalable intervention. Similar patterns of symptom change were observed across delivery formats, contributing to the expansion of accessible and digitally informed mental health care. Full article

Background: The global prevalence of anxiety and internalizing disorders in adolescence has increased epidemiologically over the past decade, compounded by the impact of the COVID-19 pandemic and the expansion of digital social networks. Despite the availability of empirically based interventions, their systematic implementation in Spanish educational settings—especially in socioeconomically vulnerable environments—remains insufficient. This study aimed to assess the emotional symptomatology profile in a sample of adolescents enrolled in the 2nd year of Compulsory Secondary Education (CSE) and to describe the changes in symptomatology observed after implementation of a multicomponent intervention program in an ordinary school setting. Methods: a quasi-experimental single-group repeated-measures design was used, with pretest–posttest measurements (T1–T2). The sample included 79 participants (age in completed years: M = 13.28 years, SD = 0.64; range: 12–15; 49.4% female, 44.3% male, 6.3% undisclosed), selected by convenience at IES Estuaria (Huelva). The assessment instrument was the Revised Child Anxiety and Depression Scale (RCADS-47), which measures total anxiety, total internalization, and six clinical subdimensions aligned with DSM-5: generalized anxiety disorder (GAD), major depressive disorder (MDD), panic disorder (PD), separation anxiety (SA), social phobia (SP), and obsessive–compulsive disorder (OCD). The intervention consisted of five multicomponent group workshops (45 min/session; three class groups) integrating emotional psychoeducation, receptive music therapy, cognitive–behavioral emotional regulation, assertive communication, and body expression/mindfulness. Results: At pretest, Social Phobia (SP) showed the highest clinical impairment, significantly affecting more females (66.67%) than males (20.00%). Generalized Anxiety Disorder (GAD) also presented high impairment in females. Significant correlations between pairs of subdimensions revealed a high comorbidity pattern. Following the intervention, reductions in clinically significant levels were observed across all dimensions. Matched-pairs Wilcoxon signed-rank tests confirmed statistically significant score reductions from T1 to T2 in Total Anxiety, Total Internalization, Social Phobia, and Generalized Anxiety Disorder (all p < 0.05), with the largest effect for Social Phobia (r = 0.46); no significant change was detected for Panic Disorder, Separation Anxiety, Major Depressive Disorder, or Obsessive–Compulsive Disorder, although the direction of change favored improvement in all cases. Conclusions: The multicomponent intervention program produced improvements in emotional symptomatology over the short-term follow-up period, although without achieving complete clinical remission in any subdimension. The persistent sex differences—with greater residual impairment in the female group after intervention—underscore the need to incorporate a gender perspective in the design of school emotional health programs. High comorbidity rates between subdimensions support the utility of transdiagnostic approaches. Implications for school nursing practice and future research are discussed. Full article

Background/Objectives: Therapeutic education for children and adolescents with Type 1 Diabetes Mellitus (T1DM) is a continuous and essential process in the effective management of the disease. These programs consider the unique characteristics and developmental needs of each child or adolescent, aiming to empower them to take responsibility for their disease self-management, improve quality of life, and prevent complications. The purpose of this systematic review was to evaluate the impact of therapeutic education in children and adolescents with T1DM on self-management of their disease. Methods: International bibliography was reviewed using electronic databases such as PubMed, Cochrane Library, and Scopus. Key words such as “Therapeutic Education”, “Type 1 diabetes”, “children”, “self-management”, “glycemic control”, and “educational programs” in combination with Boolean operators (AND, OR) were used in English language to search for studies conducted during 2014–2024. Results: A total of 23 studies met the inclusion criteria. Most reported improvements in glycemic control, though not all showed statistically significant reductions in glycated hemoglobin (HbA1c). Enhanced treatment adherence and increased diabetes-related knowledge were common outcomes. Combined educational approaches incorporating psychoeducational interventions demonstrated greater effectiveness in promoting self-management. Digital tools, such as Continuous Glucose Monitoring (CGM), further supported adherence. Quality-of-life improvements were noted but were not always sustained long-term. Parental involvement appeared to improve children’s confidence in disease management. The critical role of interdisciplinary diabetes care teams, particularly nurses’ role, was also highlighted. Conclusions: Therapeutic education appears to support self-management among children and adolescents with T1DM, particularly when programs are individualized, family-centered, multidisciplinary, and supported by psychosocial or technological components. However, effects on glycemic control were not consistent across studies, and further research is needed to confirm long-term outcomes. Full article

Assisted reproductive technologies (ART), particularly in vitro fertilization (IVF), are characterized by substantial emotional burden, uncertainty, and repeated decision-making under probabilistic conditions. Although psychological distress is common among individuals and couples undergoing ART, psychosocial care remains inconsistently integrated into fertility pathways and is rarely tailored to individual needs. This narrative review synthesizes evidence concerning infertility-related distress, anxiety and depressive symptoms, couple functioning, treatment discontinuation, psychosocial screening, and psychological interventions across the IVF trajectory. Key phases of treatment, including pretreatment assessment, ovarian stimulation, embryo transfer, the waiting period, cycle outcome, and decisions regarding repetition or discontinuation, are described, and phase-specific psychological vulnerabilities are identified. On the basis of the available literature, we propose a conceptual stepped-care framework ranging from universal psychoeducation and routine monitoring to structured psychological interventions, couple-based care, and specialist psychiatric management. Practical screening thresholds, referral criteria, reassessment intervals, and a safety pathway for suicidal ideation are outlined. Particular attention is given to male-factor infertility, strategies for engaging male partners, and the ethical and data-governance requirements of digital mental health tools. Current evidence supports psychosocial interventions for improving emotional well-being and quality of life and suggests a potential role in treatment continuation, but their effects on pregnancy and live-birth outcomes remain uncertain. The proposed framework should therefore be regarded as a clinically informed conceptual model rather than a validated prediction algorithm. Prospective studies are required to assess its feasibility, predictive performance, cost-effectiveness, and impact on patient-centered outcomes. Full article

Background/Objectives: The family constitutes a primary ecological system shaping infant emotional and mental health. Parent responsiveness in particular shapes early regulatory capacities in the developing child. Added contextual stress such as that associated with natural disasters may strain caregiving relationships. Brief, universally accessible parenting interventions offer scalable support for strengthening early relational health and may be useful in contexts of natural disaster-related stress as well as in the general population. This qualitative study examined the perceived impact and contextual relevance of MERTIL (My Early Relational Trust-Informed Learning) for Parents, a brief digital psychoeducational parenting program targeting early relational health, among families raising young children in disaster-affected communities. Methods: Fourteen parents residing in the Hunter New England and Central Coast region of New South Wales, Australia, with young children aged 0–5 years, participated in semi-structured interviews conducted approximately 6 months after completing MERTIL for Parents. Interviews explored lived experiences of parenting in the context of natural disaster (analysed via applied phenomenological methods) and parents’ perceptions of program components that supported everyday caregiving (analysed via reflexive thematic analysis and content analysis). Results: Parents described interconnected personal, relational, and environmental stressors that influenced aspects of the parent–infant relationship. Key retained knowledge from the program included a normalisation of parenting challenges, a strengthened understanding of attachment, trust, safety and repair, and attuned, emotion-focused parenting practices. Conclusions: This pilot study illuminates the lived experience of parenting in disaster prone regions and highlights the potential for this brief, universal digital parenting program to provide support for early relational health in such contexts. Full article

Background: The expansion of telenursing in primary care requires undergraduate nursing programmes to prepare students for clinical decision making in virtual care. However, evidence on educational interventions integrating clinical reasoning with managing uncertainty, anxiety, and self-confidence in telenursing remains limited. Objective: This study aims to assess changes in nursing students’ self-confidence and anxiety related to clinical decision making following a simulation-based video consultation intervention, and to explore their satisfaction and perceived learning regarding this educational experience. Methods: A quasi-experimental pretest–post-test study with a comparison group was conducted at two public universities during the 2024–2025 academic year. Undergraduate nursing students (N = 115) were included. The intervention consisted of theoretical training on video consultations, complemented by structured simulated consultations based on primary care scenarios. The control group received no intervention. Outcomes were assessed before and after, with self-confidence and anxiety measured using the Nursing Anxiety and Self-Confidence with Clinical Decision Making (NASC-CDM^©) scale. Satisfaction and perceived learning were evaluated in the intervention group using the Student Satisfaction and Self-Confidence in Learning Scale. Results: At baseline, students had high digital competence but limited preparedness for telenursing, with heterogeneous self-confidence and moderate anxiety in virtual decision making. After the intervention, the intervention group showed significant increases in self-confidence and reductions in anxiety, particularly in global clinical judgement and autonomous decision making. Students reported high satisfaction and perceived learning. Conclusions: Simulation-based video consultations may improve nursing students’ self-confidence and reduce anxiety in virtual care decision making, suggesting a potentially valuable strategy for integrating psychoeducational dimensions into nursing curricula on digital health. Full article

Background/Objectives: Dieting is a widespread behavior that is associated with psychological distress, body dissatisfaction, and eating disorders. Recent research suggests that a body-positive attitude and mindful approach to eating may influence individuals’ experiences with dieting; however, their combined role has been insufficiently explored. Methods: A two-phase study was conducted among voluntary adults using online data collection. In Phase 1, a cross-sectional survey was completed by 180 participants (71.7% women), assessing dieting behavior, body appreciation, nutritional awareness, psychological distress, well-being, and eating disorders. Correlation analyses, group comparisons, and regression models were performed. In Phase 2, 90 participants entered the pilot and received a brief psychoeducational digital material promoting mindful eating and positive body image. The follow-up assessment was completed by 59, after one month of engagement. Results: Body appreciation and nutritional awareness were positively associated with mental well-being and inversely related to psychological distress (p < 0.001 for all) and to eating disorder screening scores (p < 0.001 and p = 0.046, respectively). More frequent dieting was associated with lower body appreciation (p < 0.001). According to the observed pattern of correlations, body appreciation may play a role in the relationship between dieting and psychological distress. In the intervention phase, greater engagement with the psychoeducational material was associated with higher reported levels of nutritional awareness (p = 0.003) and greater perceived body awareness (p = 0.026) at follow-up; however, due to the exploratory design, findings are preliminary. Conclusions: The results suggest that dieting, as a behavior, may be embedded in broader psychological processes that include body-related attitudes and nutritional awareness. Taking these factors into account may have potential implications for preventive measures aimed at promoting healthier dietary habits, a more positive relationship with one’s body, and mental well-being. Full article

Background: Psychoeducational interventions are increasingly implemented to promote psychological and physical health, yet evidence guiding personalized intervention selection remains limited. This systematic review and meta-analysis quantifies the effectiveness of psychoeducational interventions across five settings and identifies empirically derived moderator patterns to inform the selection of tailored interventions. Methods: Systematic searches of PubMed/MEDLINE, PsycINFO, Scopus, Web of Science, ERIC, the Cochrane Library, and Google Scholar were conducted to identify eligible studies published between January 2015 and December 2024. A two-tier analytical approach was employed: a random-effects meta-analysis of k = 53 studies reporting extractable effect-size data, and a direction-of-effect narrative synthesis of all 186 included studies (N = 50,328 verified from 124 studies reporting sample sizes), following SWiM guidelines. Results: The quantitative meta-analysis yielded a significant medium-to-large pooled effect (g = 0.66, 95% CI [0.50, 0.82], p < 0.001) with substantial heterogeneity (I² = 96.1%). Effects varied across settings: clinical/vulnerable populations showed the largest effect (g = 0.91), followed by university programs (g = 0.62), school-based (g = 0.60), mindfulness/positive psychology (g = 0.55), and community-based (g = 0.49). The broader narrative synthesis confirmed near-universal effectiveness: 131 studies (70.4%) reported significant positive effects, 51 (27.4%) reported mixed results, and none reported null effects—yielding 97.8% favorable outcomes across the full evidence base. Direction-of-effect moderator patterns indicated a stepped severity gradient (indicated 100% favorable, selective 98.6%, universal 95.6%), and that programs exceeding 8 weeks (99.0% vs. 96.6%), theory-based interventions (98.2% vs. 95.2%), and guided digital delivery were consistently associated with the most favorable outcomes. Publication bias assessment confirmed robustness (fail-safe N = 22,942; leave-one-out range: 0.61–0.67). GRADE evidence quality was rated Moderate for four of five research questions. Conclusions: This systematic review and meta-analysis provide converging quantitative and direction-of-effect evidence supporting the effectiveness of psychoeducational interventions. The near-universal favorable direction across 186 studies, combined with a medium-to-large pooled effect in the quantitative subset, provides a preliminary empirical foundation for personalized intervention matching. A preliminary four-phase implementation framework is proposed as a hypothesis-generating heuristic; prospective validation through a meta-analysis of individual participant data is needed before prescriptive application. Full article

During pregnancy, women are more inclined to modify their habits and lifestyle to find a new balance and promote well-being for themselves and the child-to-be. However, the availability of nutritional and psychological support is often limited by stigma, geographic barriers, and a lack of services. Digital health tools are emerging as possible solutions to cover these needs. This study explores the acceptability, feasibility, and user experience of Demetra, a virtual coach based on Acceptance and Commitment Therapy (ACT), designed to promote healthy lifestyles and mental well-being. Fifty pregnant women will be enrolled in the feasibility study of the intervention. It starts with an educational part on the foundations of healthy eating and suggestions about lifestyle habits, followed by a six-week psychoeducational module. Content is delivered through text, audio, and video formats. User experience and engagement will be measured through validated questionnaires and semi-structured interviews. Psychological well-being will be evaluated both before and after the program. The intervention is expected to be well-received, with high levels of satisfaction and engagement, leading to a greater awareness of healthy behaviors, improved psychological flexibility, and enhanced overall well-being. Demetra offers an accessible solution to support women through the transformative experience of motherhood with a multidisciplinary and innovative approach. Full article

Background: Home-based digital healthcare interventions are increasingly used to support people living with dementia (PLWD) and their family caregivers. However, evidence regarding their effectiveness across patient and caregiver outcomes remains heterogeneous. Methods: This systematic review followed PRISMA 2020 guidelines and was prospectively registered in PROSPERO (CRD420261302166). Six databases (PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Scopus) were searched from January 2000 to October 2025. Randomized and quasi-experimental quantitative studies evaluating home-based or remotely delivered digital interventions for PLWD and/or informal caregivers were included. Risk of bias was assessed using RoB 2 and ROBINS-I. Due to heterogeneity, findings were synthesized narratively. Results: Fourteen studies met the inclusion criteria. Interventions included web-based psychoeducation, telecoaching, digital cognitive training, assistive technologies, and multicomponent programs. Caregiver outcomes demonstrated the most consistent benefits, including reduced burden and stress, improved self-efficacy, and improved sleep efficiency in technology-supported trials. For PLWD, small-to-moderate improvements were observed in global cognition and selected neuropsychiatric symptoms, particularly in interactive and personalized programs. Multicomponent interventions combining caregiver education with patient activation and professional feedback showed more durable effects. Conclusions: Home-based digital interventions appear feasible and beneficial, particularly for caregiver outcomes. Future large-scale trials with longer follow-up and standardized outcome measures are needed to confirm durability, equity, and cost-effectiveness. Full article

Treatment adherence can improve the prognosis of severe mental illnesses. Self-report questionnaires are the main tools to measure it. However, a new assessment method has emerged: the electronic prescription system. This enables us to verify whether patients have collected their medication from the pharmacy, providing an objective measure of adherence. The ADHERA study aims to: (1) Compare digital self-report questionnaires with the electronic prescription system. (2) Identify factors associated with non-adherence. (3) Evaluate the effectiveness of an adherence-promoting intervention. This intervention will consist of the identification of patients with poor adherence and a subsequent program of psychoeducation led by clinical psychologists. Adherence will be reassessed six months later to evaluate the intervention’s effectiveness. By identifying key sociodemographic and clinical factors associated with non-adherence, this project will inform targeted interventions to support patients with schizophrenia and bipolar disorder. Furthermore, the psychoeducational telehealth program may represent an effective, scalable, and patient-centered strategy to improve long-term treatment adherence and clinical outcomes. If successful, this model could be implemented in other regions and chronic conditions, contributing to a more efficient and patient-focused healthcare system. Full article

Background: A sedentary behavior and being overweight represent major public health issues associated with both physical and psychological risks. Based on self-determination theory (SDT), the psychoeducational intervention PsicoFIT—a component of the TIGREFIT program—aims to foster motivation toward physical activity, to promote healthy habits, and to reduce psychological ill-being in sedentary adults who are overweight and are fans of a football club. Methods: This protocol corresponds to a longitudinal comparative pragmatic clinical trial, designed in accordance with the recommendations of the SPIRIT Statement. The intervention, preceded by a training program for the coaches involved, will comprise 12 weekly modules delivered in two modalities: (1) face-to-face, through group sessions, and (2) semi face-to-face, through short video capsules hosted on a digital platform. Changes associated with the intervention will be evaluated using hierarchical multiple regression and pre-post comparisons, assessing baseline and post-intervention data within and between the intervention modalities. Primary outcomes will include changes in healthy lifestyle and burnout as indicators of well-being and ill-being, respectively. Secondary outcomes will assess basic psychological needs satisfaction and autonomous motivation as potential mediators of these effects, as well as the coach’s controlling interpersonal style as a possible contextual predictor. The modality of participation will be analyzed as a potential moderator of the observed changes. Finally, the acceptability and perceived contribution of the intervention will be explored through a focus group. Discussion: PsicoFIT will provide a methodological framework for designing interventions within multicomponent programs aimed at promoting healthy lifestyles and psychological well-being in sedentary adults who are overweight, considering the social context of football fandom and allowing for an exploration of the impact of the face-to-face and semi-face-to-face modalities. Future empirical application of the protocol will help verify its effectiveness, guide adaptations across contexts, and contribute to the development of evidence-based interventions. Conclusions: The implementation of PsicoFit will allow for the evaluation of its effectiveness, psychological mechanisms, and delivery modalities, thus guiding future evidence-based interventions in sport. Full article

Schizophrenia is a complex, chronic psychiatric disorder with significant global impact, characterized by persistent positive, negative, and cognitive symptoms that are not fully addressed by current treatments. This review aims to synthesize established theories and advancing mechanistic concepts and also critically compare the latest international treatment guidelines. Recent evidence expands beyond the traditional dopamine hypothesis to include glutamatergic, serotonergic, and cholinergic dysfunctions, as well as emerging mechanisms such as neuroinflammation, oxidative stress, iron dysregulation, and gut–brain interactions. A review of major international guidelines (APA, NICE, CINP, WFSBP, and others) confirms consensus on the use of second-generation antipsychotics as first-line therapy and the early introduction of clozapine for treatment-resistant cases. All guidelines emphasize the essential role of integrated psychosocial interventions, including cognitive behavioral therapy for psychosis, family psychoeducation, and supported employment. Differences remain regarding the prioritization of precision medicine, pharmacogenomics, and digital health innovations. Prognosis varies widely but improves with early intervention, sustained treatment adherence, and comprehensive physical health monitoring. Overall, schizophrenia care is evolving toward a precision-based, recovery-oriented model that integrates biological, psychological, and social strategies to improve long-term outcomes and quality of life. Full article