Search Results (196)

Background: Population ageing, increasing care demands, and rapid advances in artificial intelligence and robotics have intensified interest in care robots as potential tools to support independent living and complement human caregiving. However, the successful implementation of robotic technologies depends largely on public acceptance, which is influenced by functional, psychological, ethical, cultural, and generational factors. Objective: This study examined generational differences in the acceptance of care robots among Portuguese adults by integrating the Almere Model of technology acceptance with the Katz Index of Activities of Daily Living (ADL) and the Lawton–Brody Instrumental Activities of Daily Living (IADL) Scale. The research sought to determine whether acceptance varies according to generation and the type of caregiving activity performed by the robot. Methods: A cross-sectional quantitative study was conducted using an online questionnaire administered to a purposive sample of 235 adults residing primarily in the Lisbon Metropolitan Area, Portugal. The questionnaire combined constructs from the Almere Model with perceptions of robotic assistance for ADLs and IADLs. Principal Component Analysis, reliability analysis, descriptive statistics, and inferential analyses were performed to examine differences across generational groups. Results: Acceptance of care robots was strongly task-dependent. Participants expressed significantly greater acceptance of robots assisting with instrumental activities, including housekeeping, shopping, transportation, meal preparation, and medication management, than with intimate personal care activities such as bathing, dressing, toileting, feeding, and continence care. Contrary to common assumptions regarding digital natives, Generation Z reported higher levels of fear, discomfort, and perceived intimidation than Generation X and Baby Boomers. Older generations generally demonstrated more pragmatic acceptance of robotic assistance, particularly regarding future support needs associated with ageing. Across generations, respondents preferred robots with more human-like appearances; however, emotional trust remained substantially lower than perceived functional usefulness. Conclusions: The findings suggest that acceptance of care robots is conditional rather than universal and is shaped by the nature of the caregiving task, generational differences, and broader emotional and cultural perceptions of care. Integrating the Almere Model with established ADL and IADL frameworks provides a novel perspective by linking technology acceptance to specific functional domains of caregiving. The results support the view that care robots are more likely to be accepted as complementary tools that enhance human-centred care rather than as substitutes for professional or family caregivers. Given the purposive and geographically limited sample, the findings should be interpreted cautiously and not generalised to the wider Portuguese population. They nevertheless provide valuable implications for the design of socially assistive robots, healthcare practice, and public policy in ageing societies. Full article

Background: Male nurses form a minority group in many healthcare institutions and can face gender-based stereotypes, patient refusal, gender role assignment, marginalization in the workplace, and questioning of their suitability for working in caring professions. This scoping review examines the literature on gender discrimination, psychological well-being, and adaptation in professional contexts among male nurses and male nursing students. Methods: This scoping review was performed according to the PRISMA-ScR guidelines. Searches were performed in Scopus and Web of Science databases and complemented with the use of pre-designed Google Scholar keyword searches. Included studies had a focus on male nurses, men in nursing, or male nursing students and were concerned with gender discrimination, stereotypes, discrimination, psychological well-being, emotional labor, professional identity, burnout, job satisfaction, adaptation, education, organizational support, or retention. Data were extracted and analyzed using narrative and thematic approaches. Results: Forty included studies were identified. Four major themes were revealed: (1) gender discrimination and stereotyping; (2) psychological and professional effects; (3) coping strategies and professional adaptation; and (4) organizational responses and support mechanisms. The included studies reported patient refusal, discomfort in intimate care, gendered role assignment, workplace marginalization, and masculinity-related stereotypes. These experiences were discussed in relation to emotional labor, identity conflict, reduced sense of belonging, burnout, job dissatisfaction, work engagement, and turnover intention. Conclusions: Gender discrimination against male nurses should be understood as both an interpersonal and organizational issue. Full article

This study investigates the effectiveness of peer assessment as a formative learning strategy in multilingual English-Medium Instruction (EMI) higher education. Although peer assessment is widely associated with enhanced learner engagement, self-regulation, and feedback literacy, its implementation in linguistically diverse EMI settings remains insufficiently explored. Addressing this gap, the study examines students’ perceptions of peer assessment, the degree of alignment between peer and instructor evaluations, and students’ reflective experiences in a multilingual university context. A mixed-methods design was employed with 60 undergraduate students enrolled in EMI courses at South East European University in North Macedonia. Quantitative data were collected through a structured questionnaire and peer-assessment rubric, while qualitative data were obtained from reflective interviews with 37 students. Quantitative data were analyzed using descriptive statistics, Pearson correlation analysis, and paired-samples t-tests, whereas qualitative responses were examined through thematic analysis. The findings reveal generally positive student perceptions of peer assessment, particularly regarding self-reflection, critical thinking, collaboration, and confidence in evaluating academic work. Significant positive correlations among key dimensions of feedback literacy suggest that peer assessment supports interconnected cognitive and metacognitive learning processes. Although a statistically significant difference emerged between peer and instructor scores, overall agreement was moderate, with students tending to assign slightly lower marks than instructors. Qualitative findings further indicate that peer assessment enhanced students’ understanding of assessment criteria and learning processes while also exposing challenges related to language proficiency, emotional discomfort, and concerns about feedback accuracy. The study demonstrates that peer assessment can be an effective pedagogical approach in multilingual EMI classrooms when supported by clear assessment criteria, structured guidance, and feedback training. These findings contribute to research on feedback literacy, formative assessment, and multilingual learning in higher education. Full article

Background: Pain during orthodontic debonding is a common clinical concern. Although previous studies have mainly focused on mechanical approaches to reduce discomfort, the influence of emotional characteristics of patients on pain perception remains insufficiently explored. In this study, we aimed to evaluate the association between pain perception, emotional affect, and anxiety during orthodontic bracket removal using different clinical protocols. Methods: A prospective observational comparative study was conducted at Rey Juan Carlos University (Madrid, Spain). A total of 140 orthodontic patients underwent bracket removal according to four routine clinical protocols determined by clinical scheduling: ligated with interocclusal cotton rolls (used for tooth stabilization), non-ligated with cotton rolls, ligated without cotton rolls, and non-ligated without cotton rolls. Pain intensity was assessed using a Visual Analog Scale (VAS) immediately before (T0) and after (T1) bracket removal. Baseline pain (T0) was recorded to control for pre-existing discomfort. Anxiety and emotional affect were measured using the State–Trait Anxiety Inventory (STAI) and the Positive and Negative Affect Schedule (PANAS), respectively. Statistical analyses included ANOVA, factorial ANCOVA adjusted for baseline pain, and multivariable regression models. Results: No significant baseline differences were observed among groups. The highest post-debonding pain scores were found in the group without cotton rolls and without ligatures. ANCOVA revealed a significant main effect of cotton roll use, with lower adjusted pain scores in patients treated with cotton rolls, whereas ligation showed no statistically significant independent effect. In multivariable regression analyses, baseline pain, age, and negative affect were independently associated with higher post-debonding pain. Conclusions: Within the limitations of a non-randomized design, cotton roll use was associated with lower post-debonding pain, whereas ligation appeared to have a limited influence. Patient-related factors—particularly negative affect, age, and baseline pain—were also associated with pain perception, supporting a biopsychosocial perspective. These findings should be interpreted as exploratory evidence rather than causal effects. Full article

Background: In the context of population aging and the growing burden of chronic conditions, promoting exercise participation has become an important strategy for supporting healthy aging. However, older adults with chronic conditions often face multiple constraints related to symptom burden, risk perception, and everyday life. A theory-informed understanding of the determinants of exercise participation in this population is therefore needed. Methods: This study adopted a theory-informed qualitative descriptive design and conducted face-to-face semi-structured interviews with 30 community-dwelling older adults with chronic conditions. Purposive sampling was used to ensure variation in age, sex, chronic condition type, and exercise participation. Data were analyzed using the framework method guided by the Theoretical Domains Framework (TDF), and the resulting themes were subsequently mapped onto the Capability, Opportunity, Motivation–Behavior (COM-B) model. Results: Participants were aged 60–86 years, and most were women, had low educational attainment, came from rural backgrounds, and lived with multimorbidity. Participants described exercise participation as a day-to-day process of negotiating symptoms, risk, functional boundaries, and everyday responsibilities rather than as a simple matter of willingness. Although most participants recognized the value of exercise, many lacked disease-specific knowledge about suitable exercise types, safe intensity, progression, and warning signs. Symptom burden and functional limitations constrained exercise, but many participants used symptom-based self-regulation strategies, such as resting, slowing down, or modifying activity when discomfort occurred. Family members, peers, health professionals, and community resources could either facilitate exercise or restrict it, depending on their accessibility, continuity, specificity, and practical relevance. Continued participation was closely linked to perceived benefits, controllable risk, self-efficacy, positive emotional experience, and immediate bodily feedback. Conclusions: Exercise promotion for older adults with chronic conditions should move beyond general advice and provide disease-adapted exercise education, symptom-based self-regulation strategies, family and peer support, professional guidance, age-friendly community resources, and feedback mechanisms that support long-term maintenance. Full article

Background: Procrastination is a voluntary and irrational delay in taking action despite negative consequences. We aimed to conceive/suggest a definition of procrastination, assess the behavior, and determine its psychopathological features (within the contexts of attention-deficit/hyperactivity disorder and obsessive–compulsive disorder. Method: In this scoping study, we systematically reviewed original research studies with conceptual and clinical data related to procrastination. Data were extracted regarding definitions, populations, instruments used, and psychopathology. Results: A total of 387 studies were included. Only 13% utilized clinical/subclinical populations. Definitions of procrastination showed no single consensus. The most cited elements involved irrational delay, awareness of consequences, task aversiveness, and self-regulation failure. The most frequently used assessment tool was Lay’s General Procrastination Scale. A considerable number of studies identified associations between procrastination and clinical constructs such as impulsivity, perfectionism, executive dysfunction, low self-esteem, and mood instability. Few studies directly assessed procrastination in formal diagnostic categories, suggesting that procrastination shares neurocognitive and emotional regulation deficits with these disorders, especially in domains involving task initiation, inhibitory control, and intolerance of discomfort. Conclusions: Procrastination is a transdiagnostic construct rather than a unitary behavioral trait. Its multifactorial nature calls for further clinical investigation, particularly in structured diagnostic settings. A unified definition is needed to distinguish between normative delay and clinically relevant procrastination. Full article

Background: Loneliness is prevalent amongst university students and may be influenced by social eating behaviours. This study explored associations between loneliness and social eating habits and practices and examined whether loneliness varies by demographic characteristics and mealtime behaviours. Methods: A cross-sectional online survey was conducted amongst 255 undergraduate and postgraduate students at a UK campus-based university. Loneliness was measured using the UCLA Loneliness Scale (ULS-8). Self-reported social eating habits, emotional experiences during mealtimes, and technology use while eating were assessed. Results: The mean loneliness score was 18.27 (SD = 4.90), with 16.1% of participants experiencing severe loneliness. Loneliness did not differ across most demographic groups, except by year of study, with first-year undergraduates reporting higher loneliness than PhD students. Higher loneliness was reported by students who felt embarrassed or lonely when eating alone, were apprehensive about eating with others, or lacked someone to eat with. Greater use of electronic devices or television during meals was also associated with higher loneliness. Conclusions: Loneliness is common amongst university students and is associated with social eating habits/practices and emotional experiences during mealtimes. Interventions promoting social eating could address discomfort and anxiety related to eating alone or with others. Full article

Background/Objectives: Concussions occur across all sports globally; however, inconsistent symptom recognition continues to challenge diagnosis, management, and recovery. Although concussion effects extend beyond neurological dysfunction, gastrointestinal (GI) symptoms remain insufficiently captured within current assessment frameworks and may influence athletes’ fuelling choices and food tolerance during recovery. This study aimed to describe the prevalence and patterns of GI symptoms reported among athletes with a history of concussion and to explore whether symptom prevalence and burden differed by sex and country. Methods: A total of 401 adult athletes (225 males; mean age 32.4 ± 11.3 years) with a history of concussion were recruited from a multinational cohort (n = 123) and a US community rugby cohort (n = 278). Participants completed online surveys assessing concussion history, post-concussion symptoms (RPQ or SCAT-6), and GI-specific symptoms. Data were stratified by sex and country and analysed descriptively and comparatively. Results: Overall, 62.1% of athletes reported ≥1 GI symptom, with most reporting 1–5 symptoms (79.9%). The most frequent symptoms were nausea/vomiting (74.3%) and loss of/poor appetite (56.6%), followed by diarrhoea, abdominal pain/discomfort, and flatulence. Although GI symptom prevalence was higher in females (65.9% vs. 59.1%), no significant sex differences were observed (all p > 0.05). GI symptom burden varied by country (p < 0.001), with higher prevalence among Irish than US athletes (85.9% vs. 51.2%); however, these analyses were exploratory and unadjusted. RPQ and SCAT captured symptoms across somatic, cognitive, emotional, and sleep domains, however GI symptoms were underrepresented, with nausea/vomiting more frequently reported on RPQ/SCAT items (51.4%) than on GI-specific items (46.1%). Conclusions: GI symptoms were common following concussion, with variation by country and no statistically significant differences by sex. Findings indicate that concussion assessment tools (RPQ/SCAT) underrepresent the breadth of GI symptoms. Greater attention to GI assessment in concussion care is warranted. Incorporating simple GI screening alongside timely nutrition support may represent feasible additions to multidisciplinary, athlete-centred care pathways. Prospective studies are needed to clarify the clinical relevance of these findings and evaluate nutrition-related strategies. Full article

This study investigates how immersive journalism delivered through virtual reality may shape audience responses toward refugees by activating affective and cognitive mechanisms associated with behavioral response. Drawing on four focus group sessions with a total of thirty two participants in Northern Cyprus, the research compares the empathic engagement and evaluative reflections associated with a 360 degree VR documentary with those produced through a traditional 2D viewing format. Participants who experienced the content in VR reported a heightened sense of presence, emotional proximity, and perspective taking, which corresponded with a positive change in their views toward refugees. In contrast, those who watched the same content in 2D expressed emotional discomfort yet generally did not describe a notable attitudinal shift, suggesting that non-immersive viewing maintains psychological distancing and reinforces pre-existing beliefs. The findings indicate that immersive journalism can operate as a technological catalyst for short-term attitudinal reorientation in politically sensitive contexts, particularly by eliciting embodied emotional responses that traditional formats struggle to generate. Although the study is limited by its small sample size and reliance on self-reported reflections, it contributes to the growing body of evidence that immersive media hold behavioral and perceptual relevance for journalism practice, audience engagement, and the broader public understanding of marginalized populations. Full article

Background and Objectives: Oral health is an important component of overall health, including in children, since dental caries is the most frequent oral health condition in this demographic. It affects children’s daily performance and can lead to complications ranging from moderate discomfort to highly disabling problems, which are reflected in their quality of life. Validating instruments that provide reliable information to measure how oral health impacts children’s quality of life will help prioritize the management of these problems through personalized treatments. The aim of this study was to perform transcultural adaptation and Spanish validation of a POQL instrument in children aged 6 to 12 years who attended the Pediatric Dentistry Clinic at the Universidad Autónoma de Ciudad Juárez (UACJ), and to establish an association between the presence of carious lesions and the quality of life of children. Materials and Methods: We conducted a validation study involving a sample of 379 children aged 6 to 12 years who were attending the Pediatric Dentistry Clinic at the Universidad Autónoma de Ciudad Juárez. The instrument, adapted into Spanish, was applied to measure oral health-related quality of life, and the clinical diagnosis of caries was established using the ICDAS II system. Results: The mean age of the children was 8.51 years ± 1.64; 50.4% were boys and 49.6% girls. A total of 45.9% of the children presented caries with ICDAS II codes 5 and 6, corresponding to a severe stage with advanced tooth destruction, and 52% of the children reported their perception of their oral health-related quality of life as good. In the bivariate statistical analysis, the chi-square test showed no relationship between moderate and severe ICDAS II stages and the children’s perception of their quality of life, resulting in a very low Spearman correlation. Conclusions: The findings suggest that this instrument may represent a reliable and valid tool for use in children aged 6 to 12 years. The observed association between different degrees of carious lesions and children’s quality of life may reflect the close relationship between oral health and important psychosocial domains, including physical, emotional, and social development, which constitute the core dimensions evaluated by the POQL instrument. Full article

Urban destinations increasingly incorporate green–blue infrastructure, sensory-balanced public spaces, and microclimate-responsive design to mitigate visitor fatigue and support sustainable tourism experiences. To understand how insights from broader tourism environments, particularly nature-based contexts, can inform emerging urban well-being strategies, this study conducts a global bibliometric review (2005–2025) on psychological restoration, stress relief, and visitor well-being. Using Scopus and a Boolean search combining mental health constructs, tourism setting, and analytical approaches, 825 records were identified, and 149 articles were retained after applying eligibility criteria. Science mapping and performance analyses reveal accelerated post-2018 growth and three dominant knowledge clusters centered on restoration pathways, environmental determinants, and behavioral/hospitality components. Based on these patterns, this study introduces the RESTOR-URBAN model, integrating environmental moderators, psychological mechanisms, and behavioral interactions that jointly shape stress reduction and emotional well-being across urban tourism systems. The results show increasing relevance of micro-restorative experiences, thermal comfort management, and stress-aware service design, while highlighting persistent methodological heterogeneity and limited integration of environmental co-data (Universal Thermal Climate Index (UTCI), Physiological Equivalent Temperature (PET), and Discomfort Index (DI)). The findings suggest that restoration-based evidence from nature-based tourism can inform sustainable urban tourism planning, hospitality practice, and visitor experience design, and propose a research agenda emphasizing standardized well-being indicators, longitudinal and structural equation modeling (SEM)-based approaches, and environmental quality variables for resilient, health-oriented urban destinations. Full article

The therapeutic alliance is widely recognized as a central mechanism of change in psychotherapy; however, much existing research risks reifying it as a measurable and static construct, obscuring its fluid, co-constructed nature and the ways it is shaped by power, identity, and social context. This study aimed to explore how psychotherapists understand, construct, and enact the therapeutic alliance in their everyday practice, with particular attention to diversity, anxiety, rupture, and the reciprocal impact of the therapeutic relationship on the therapist. Using a qualitative design, semi-structured interviews were conducted with 14 psychotherapists primarily working in private practice, and the data were analyzed using reflexive thematic analysis. Six interrelated themes were identified: moving from technique to relational presence; diversity as relational negotiation; anxiety as a co-created relational process; rupture as inevitable and generative; therapist transformation through the therapeutic relationship; and navigating professional role and human authenticity. The findings suggest that effective therapeutic work relies less on rigid adherence to technique and more on reflexivity, emotional attunement, and a willingness to engage with discomfort, difference, and relational rupture. The study highlights the need for psychotherapy training to prioritize relational, ethical, and reflexive capacities alongside technical skills, and contributes a more process-oriented understanding of the therapeutic alliance from therapists’ lived perspectives. Full article

Background: Emotional aspects of early dental experiences have long-lasting effects. This study aimed to assess parents’ childhood dental experiences and their impact on current attitudes toward dental treatment and to evaluate the subjectively perceived usefulness of an educational material focused on psychological management of children’s dental visits. Methods: A cross-sectional descriptive pilot study was conducted using an educational booklet developed and distributed to parents, who read it and completed a short questionnaire. Responses received between 27 February–31 March 2025 were analyzed using IBM SPSS Statistics 25. Results: A total of 142 parents (88% mothers) participated. Most participants (83.1%) had a university degree. Negative childhood dental experiences were reported by 44.4% (more frequent among mothers, p < 0.001), and 18.3% had shared these experiences with their children. Emotional discomfort during dental visits was reported by 61.3% of respondents. Dental anxiety was significantly associated with negative childhood experiences (p < 0.001). Parents with higher education were more likely to choose a certified paedodontist for their child than a nearby general dentist (p = 0.002). Most parents (97.9%) found the material provided helpful for managing future dental visits, and 91.6% were willing to share it with others. Conclusions: Childhood dental fear and anxiety may persist into adulthood. Despite the limited generalizability of our results, parents appreciated targeted resources which may support them in promoting positive dental experiences for their children. Full article

Children’s everyday routes to school are increasingly recognised as important environments shaping physical and mental well-being. Yet, their emotional dimension remains insufficiently integrated into health-oriented urban design research, particularly in cities without formalised School Street policies. This study examines how children in Belgrade perceive and emotionally experience their everyday school routes and how such evidence can inform context-sensitive urban design. A mixed-method, child-centred participatory approach was applied with primary school pupils, combining participatory evaluation boards, cognitive route mapping, photo documentation, and facilitated classroom discussion. The material was analysed through qualitative coding, triangulation, and a health-oriented reinterpretation of the SCORELINE framework (h_SCORELINE). The findings reveal recurring stress nodes associated with traffic-dominated streets, complex crossings, obstructed sidewalks, and poorly legible route segments, which children linked to fear, discomfort, and insecurity. By contrast, greenery, recognisable landmarks, visually calm environments, and wider pedestrian spaces emerged as joy nodes associated with comfort, enjoyment, and emotional ease. These patterns suggest that children’s emotional-spatial evidence can enrich the assessment of school-route environments beyond conventional traffic indicators alone. By linking children’s lived experiences with health-oriented urban design, the study provides evidence-based support for the gradual introduction of School Streets in Belgrade. It offers a transferable framework for integrating child-centred experiential knowledge into healthier street design. Full article

Impulsivity is a core transdiagnostic construct in adolescent psychiatry, associated with emotional dysregulation, behavioral disorders, and increased vulnerability to mental health problems. Adolescents engaged in performing arts education may experience heightened psychosocial stressors that challenge self-regulatory capacities during a critical neurodevelopmental period. Methods: This mixed-methods study examined psychosocial and family-related factors associated with impulsivity in adolescent students enrolled in drama programs. Two focus groups with 28 upper-grade students (grades 11–12) explored subjective experiences of stress, emotional overload, and family communication. Based on these findings, a 77-item questionnaire was developed and administered to 90 ninth-grade students. Impulsivity was assessed using the Barratt Impulsiveness Scale (BIS). Results: An exploratory stepwise multiple linear regression analysis identified perceived school-related stress (β = 0.370, p < 0.001), conflictual parental communication (β = 0.273, p = 0.013), and discomfort during school discussions at home (β = 0.331, p < 0.001) as significant predictors of higher impulsivity scores. Conclusions: The findings highlight the interaction between neurodevelopmental vulnerability and environmental stressors in shaping impulsivity during adolescence. These results are clinically relevant for child and adolescent psychiatry, emphasizing the importance of early psychosocial interventions targeting stress regulation and family communication to prevent the escalation of impulsivity-related psychopathology. Full article