Search Results (3,832)

Facility dogs are increasingly incorporated throughout higher-education institutions as integrative conduits for supporting students by reducing stress, anxiety, and emotional exhaustion. While these programs are designed to enhance student well-being, little is known about the experiences of the handlers who train, care for, and work with these dogs—specifically within military-affiliated programs. The handlers’ role necessitates a unique dynamic of caregiving, emotional labor, and professional responsibility and management that can create role conflict and additional stress among those graduate students who dedicate their time to the working dogs. Despite the growing presence of animal-assisted interventions in university settings, handler experiences in military graduate contexts are largely unexplored. In an effort to establish ethical and sustainable animal-assisted interventions and facility dog programs that contribute to population-level mental-health resilience and institutional public health, there must be greater understanding of the demands and implications of the handler’s workload to develop sustainability. Therefore, this paper highlights the need for qualitative inquiry to explore the intersection of handler experience and educational responsibilities, as integrated into the military environment. Full article

Mental health counselors routinely work in emotionally demanding environments that require sustained psychological and occupational functioning. Identifying psychological resources and occupational factors that support adaptive functioning may inform strategies to enhance counselor well-being and reduce burnout. This study examined the relationships among counselors’ clinical service context, emotion regulation, growth mindset, self-compassion, job satisfaction, and burnout. Participants were 152 individuals with graduate degrees who provided counseling services and completed an anonymous online survey. Measures assessed burnout, job satisfaction, self-compassion, growth mindset, cognitive reappraisal, expressive suppression, and workplace and professional characteristics. Group comparisons and hierarchical regression analyses were conducted. Burnout was significantly associated with lower job satisfaction, self-compassion, cognitive reappraisal, and growth mindset. Counselors providing services to children reported greater burnout and lower self-compassion, whereas those providing services to adults reported greater cognitive reappraisal, higher job satisfaction, and lower burnout. Job satisfaction varied across service settings, with the highest levels observed in outpatient community mental health and private practice and the lowest in detention centers and K–12 schools. In hierarchical regression analyses, only job satisfaction and self-compassion independently predicted burnout after controlling for counseling experience, degree characteristics, growth mindset, and emotion regulation. Counselors’ adaptive functioning appears to reflect the combined influence of workplace context and psychological resources. Self-compassion and job satisfaction emerged as key protective factors against burnout. These findings have implications for counselor education, clinical supervision, workforce development, and interventions designed to promote occupational well-being and strengthen the behavioral health workforce. Full article

First-year students in STEM programs face significant academic and personal challenges that can undermine retention and success, particularly for those navigating new institutional environments without prior college experience. While self- regulated learning (SRL) theory offers a well-established framework for understanding how students plan and reflect, less attention has been paid to the performance phase, the stage where students must translate plans into action amid real academic and social demands. This qualitative study examines the experiences of 15 first-year life science students across three institution types, a Hispanic-Serving Institution, a predominantly white institution, and a liberal arts college, to investigate what plans students formed at the end of their first semester and what factors facilitated or hindered implementation during their second semester. Using thematic analysis of semi-structured interviews, three major plan themes emerged: help-seeking, internal academic adjustments, and managing social and emotional well-being. Facilitating factors for these plans included small class sizes, anonymized participation tools, approachable instructors, peer and family support, counseling services, and structured planning tools, while hindering factors included fear of judgment, high instructor-student ratios, scheduling conflicts, academic burnout, and unsupportive living environments. The findings reveal that plan implementation depended on the interplay of intersecting psychological, social, and structural factors, which created unique conditions that influenced whether students were able to enact their plans. Importantly, the findings reveal that plan implementation unfolded not as a linear process but through nested micro-cycles of forethought, performance, and reflection within the performance phase, triggered by specific events throughout the semester. These findings have implications for how institutions design learner-centered support for STEM students not only at key transition points, but also throughout the semester, to address the conditions that influence whether students are able to successfully implement, adapt, or abandon their regulatory efforts. Full article

Urban parks provide recreation, cultural ecosystem services, microclimate regulation, and benefits for well-being, but their realized value may vary with air pollution and heat. This exploratory study linked 2947 Google Maps reviews posted in 2024–2025 to daily PM2.5, temperature, humidity, and precipitation and assessed a BERT-based workflow for classifying star-linked sentiment and dominant emotion text labels. Star-linked sentiment classifications were highly favorable (mean score of 4.86/5; 88.39% very positive). Independent weighting of the rounded air-quality and heat-stress subgroup summaries yielded consistent approximate overall shares for provisional joy (28.9%) and anger (32.5%), but the full seven-class distribution could not be reconstructed from the archive. All emotion-label analyses remain provisional. All 25 tested environmental correlations were negligible (absolute Spearman ρ ≤ 0.049), and none met the Bonferroni-corrected significance threshold (α = 0.002). Posting dates classified as heat-stress days showed descriptive differences in provisional anger and joy labels, but posting date is an uncertain proxy for the visit date. The findings do not establish individual-level exposure associations. They instead illustrate the methodological safeguards needed before user-generated park feedback and environmental monitoring can support climate-responsive management. Full article

Island destinations combine natural settings, local culture, and participatory activities that may support recovery, social connection, and personal meaning. Evidence remains limited on the relative contribution of different island experience dimensions to tourist satisfaction and well-being, especially in inhabited island destinations. This study examined four experience dimensions in West Island, Sanya, China, and used the findings to develop a destination improvement model. Tourist satisfaction was conceptualised as a visit-specific evaluation, while tourist well-being referred to the broader psychological benefits associated with travel. An explanatory sequential mixed-methods design was adopted. The quantitative phase used 411 valid questionnaires from Chinese domestic tourists. A full six-construct confirmatory factor analysis assessed the measurement model, after which multiple and simple linear regressions tested the prespecified direct relationships. The six-factor model showed good fit (χ²(390) = 389.98, p = 0.491, CFI = 1.000, TLI = 1.000, RMSEA = 0.000, SRMR = 0.035). The four experience dimensions explained 58.0% of the variance in tourist satisfaction. Co-creation experience made the largest unique contribution (β = 0.345), followed by emotional experience (β = 0.329) and environmental experience (β = 0.312; all p < 0.001). Educational experience was not significant (β = 0.029, p = 0.422). Tourist satisfaction had a significant positive influence on tourist well-being (β = 0.764, p < 0.001; R² = 0.583). Semi-structured interviews with 12 experienced tourists explained the coefficient pattern through ten themes, and seven academic and industry experts refined five strategic components through two Delphi rounds. The resulting model prioritises cultural co-creation, emotional resonance, environmental quality, and service support, while treating transformative learning as an area for targeted development and evaluation. The integration of survey results, tourist accounts, and expert assessment provides an evidence base for selecting and monitoring destination improvements in inhabited island settings. Full article

Background: Sports injuries in children and adolescents may affect physical health, emotional well-being, sleep, quality of life, confidence, sport participation, and readiness to return to sport. Objective: This systematic review synthesized evidence on the relationship between sports-related injuries and mental health in athletes aged 19 years or younger, considering both psychological factors associated with injury vulnerability and psychosocial outcomes following injury. Methods: The review was conducted in accordance with the PRISMA 2020 guidelines. PubMed, Web of Science, Scopus, and Google Scholar were searched from inception to 8 July 2026, with eligibility restricted to studies published between 2021 and 2026. Risk of bias was assessed using Joanna Briggs Institute critical appraisal tools, and findings were synthesized narratively. Results: Twenty-one studies were included. Lower well-being, anxiety, stress, fatigue, sleep disturbance, kinesiophobia, and reduced psychological readiness were associated with injury occurrence, symptom burden, recovery, or reinjury. Conversely, injuries were associated with anxiety, depressive symptoms, sleep problems, reduced health-related quality of life, lower confidence, disrupted athletic identity, and return-to-sport difficulties. Conclusions: The findings suggest a potentially bidirectional association between sports injury and mental health within a broader biopsychosocial context. However, heterogeneity and predominantly observational designs limit causal inference. Full article

Background: Research on family support has primarily focused on emotional aspects, paying less attention to instrumental support and its concurrent association with food-related well-being. Aim: To explore direct and indirect actor and partner effects among parents’ instrumental family support, diet quality, and satisfaction with food-related life (SWFoL) in dual-earner families with adolescents. Methods: Online surveys were conducted with 860 dual-earner parent dyads and one adolescent child (mean age 12.7 ± 1.8 years; 49.8% female) in Chile. Family members completed the Adapted Healthy Eating Index and the SWFoL Scale; parents also answered an Instrumental Support subscale. Analyses were conducted using a mediation Actor–Partner Interdependence Model via structural equation modeling. Results: Mothers’ and fathers’ instrumental support was positively associated with their own SWFoL, both directly and indirectly via their diet quality. Parents’ support was also positively related to adolescents’ SWFoL directly and indirectly via adolescents’ diet quality. Symmetrical crossover effects between instrumental support and SWFoL emerged for both parents. Mothers’ support was additionally associated with fathers’ SWFoL indirectly through fathers’ diet quality. Conclusions: Instrumental support operates as a vital systemic resource within dual-earner households. By enhancing diet quality, tangible support protects family food-related well-being and embeds adolescents’ nutritional health within the parental resource ecosystem. Full article

The paradigm shift toward precision oncology in advanced breast cancer has increased therapeutic complexity, prolonging survival for many patients while simultaneously expanding the temporal burden associated with cancer care. Time toxicity, defined as the cumulative time spent receiving, accessing, coordinating, and recovering from medical interventions, is increasingly recognized as a clinically meaningful but still under-assessed dimension of patient-centered value. Beyond its organizational and economic implications, time toxicity may exert profound psychological and psychiatric effects, particularly in patients with advanced disease, for whom time represents not only a practical resource but also an existential, relational, and emotional domain. This narrative review examines how objective and subjective dimensions of time toxicity may inform patient-centered decision-making in advanced breast cancer. We summarize current evidence on the temporal demands of cancer care in advanced breast cancer and their psychological and relational consequences, focusing on how these factors can be discussed in patient-centered treatment decisions. From a value-based oncology perspective, the review examines how treatment optimization, subcutaneous formulations, oral therapies, telemedicine-based surveillance, decentralized care models, and early psycho-oncological assessment may reduce non-value-added time in clinical settings while preserving quality of care. Methodological challenges in measuring time toxicity and correlating it with overall survival, health-related quality of life, anxiety, depression, demoralization, and illness-related distress are also discussed. Incorporating time toxicity into shared decision-making may help clinicians move beyond traditional efficacy endpoints. It may support a more comprehensive approach in which survival benefit, psychological well-being, personal priorities, and the subjective value of time are considered together. Full article

Happiness at work is an important factor associated with nurses’ wellbeing, performance, retention, and quality of care. However, evidence on workplace happiness among nurses working in prehospital emergency care remains scarce, despite the emotional demands and complexity of this setting. This study aimed to analyse overall happiness at work and its dimensions—engagement, job satisfaction, and affective organisational commitment—among nurses working in prehospital emergency care in Portugal and to identify associated sociodemographic and professional factors. A cross-sectional observational, correlational study was conducted between June and July 2025 with 103 nurses working in Portuguese prehospital emergency services. Data were collected using a sociodemographic and professional questionnaire and the Short Happiness at Work Scale. Descriptive statistics, Student’s t-test, one-way analysis of variance, and stepwise multiple linear regression were performed. Participants reported moderate levels of happiness at work (M = 4.91; SD = 0.96). Engagement had the highest mean score (M = 5.42; SD = 1.20), whereas job satisfaction had the lowest (M = 4.04; SD = 1.16). Leisure activities outside work were statistically associated with higher happiness at work. These findings should be interpreted in light of the cross-sectional design and convenience sampling, and suggest that strategies promoting wellbeing, work–life balance, and psychological recovery may contribute to occupational health among prehospital emergency nurses. Full article

Overnight programming is an effective intervention that builds social satisfaction, well-being and community; however, the mechanisms supporting these outcomes are not well understood. This qualitative study explores concepts that contribute to social benefits of overnight programs and outlines best practices. Using purposive convenience sampling of an agency that conducts overnight programming, eight adults with disabilities (ages 22–56) participated in semi-structured interviews. Researchers utilized thematic analysis to analyze the interviews. Five themes developed: (a) Experience (program activities, connection to friends, and fun), (b) Liminality (being away from everyday life, respite, and transitory spaces), (c) Opportunity (personal growth, and trying new things), (d) Social Facilitation (interactions between participants, like-mindedness and relationship building), and (e) Support (friends, and staff). Results illustrate overnight programming provides opportunities for participants to experience new things and build social connections. The findings of this study are consistent with the ideas of liminality and communitas, supported by sense of community theory. Practitioners should consider incorporating the four elements of sense of community (membership, influence, fulfillment of needs, and strong emotional connections) when designing overnight programming. Full article

Background/Objectives: Highly sensitive persons (HSPs) are characterized by increased emotional and sensory responsiveness, which may predispose them to anxiety, emotional dysregulation, and sensory overload. Music therapy based on gong sound sessions has emerged as a complementary intervention aimed at promoting emotional well-being. This study analyzed immediate pre- and post-intervention variations in an adult population with sensory processing sensitivity. Methods: A quantitative, quasi-experimental, single-group (non-controlled), pre–post intervention study was conducted using music therapy in a sample of N = 93 individuals, who were evaluated during an initial session (62 Highly Sensitive Persons [HSPs] and 31 Non-HSPs), from which a synchronized longitudinal sub-cohort of 39 participants (27 HSPs and 12 Non-HSPs) completed a second exposure. Indicators were assessed using the Questionnaire on the Impact of Music Therapy Sessions in Adult Patients (CISMA), whose technical designation corresponds to an acronym of Spanish-language origin. Results: Participants demonstrated significant score variations following gong sound therapy in each session. In the first session, the mean CISMA score changed by 7.0 points (p < 0.001), while the second session showed a mean variation of 7.0 points (p < 0.001). Participants reported favorable trends in emotional self-regulation, reduced anxiety, mitigated pain intensity, increased tolerance to sensory overload, and greater overall psychological well-being. Conclusions: Music therapy using gong sound appears to be a promising complementary framework, contributing to immediate positive shifts in emotional regulation, anxiety, pain, and sensory distress. Within the limitations of this non-controlled framework, these immediate shifts describe a specific statistical variation within the observed sample, which cannot be generalized as clinical efficacy. Controlled trials are needed to confirm these insights and show the potential integration of music therapy using gong sound into holistic nursing and mental health care models. Full article

Human–animal therapeutic relationships are commonly evaluated through their effects on human psychological, emotional and social well-being, whereas the experiences and welfare of non-human animals remain less consistently examined. This narrative interdisciplinary review analyses such relationships through interpretative asymmetry, integrating human–animal studies, ethology, animal welfare science and biological approaches to interspecies communication. Selected cultural examples are used only as illustrative boundary narratives. Interpretative asymmetry is defined not as a statistically measured variable, but as a conceptual and structural imbalance in interpretative authority, communicative access and agency. Humans define therapeutic goals, organize interaction and attribute meanings such as trust, reciprocity or support to non-human animal behaviour. Non-human animals respond through species-specific sensory, behavioural and physiological mechanisms that may indicate affiliation, habituation, stress regulation, inhibition or conflict avoidance. Animal-assisted interventions and animal-assisted therapy (AAI/AAT) should therefore be assessed through human benefit and animal welfare indicators, including workload, rest, agency, withdrawal opportunities and handler competence. Dogs and horses are discussed as applied contexts in which these asymmetries become visible, whereas wild-animal narratives are treated as boundary examples of projection and romanticization. Recognizing non-human animals as active, welfare-sensitive participants is essential for ethical therapeutic practice. Full article

Background/Objectives: Endometriosis is a chronic gynecological condition affecting approximately 10% of women of reproductive age and is associated with chronic pain, fatigue, infertility, and reduced quality of life. Beyond its physical burden, delayed diagnosis, healthcare dismissal, and inadequate support may contribute substantially to psychological distress. In line with growing efforts to promote mental health and wellbeing within healthcare settings, this study explored women’s experiences of healthcare services and the psychological impact of living with endometriosis. Methods: A qualitative study was conducted using thematic analysis of 2500 publicly available Twitter/X posts shared by accounts self-presenting as women discussing experiences of endometriosis. Results: Three overarching themes were identified: (1) Institutional Invalidation of Women’s Endometriosis Experiences, (2) Living with the Multidimensional Burden of Endometriosis, and (3) Reimagining Endometriosis Care. Participants described chronic pain, reproductive uncertainty, and significant emotional distress that were frequently intensified by delayed diagnosis and experiences of not being believed or taken seriously within healthcare settings. Accounts suggested that suffering was shaped not only by disease symptoms but also by interactions with healthcare systems that undermined the legitimacy of women’s experiences. Conversely, validation, empathy, and collaborative communication were associated with improved wellbeing and engagement with care. Participants advocated for greater awareness of endometriosis, earlier diagnosis, and more integrated models of support. Conclusions: Endometriosis should be understood as a biopsychosocial condition whose impact extends beyond physical symptoms alone. The narratives analyzed highlight how psychological distress may be amplified by experiences of invalidation, delayed recognition, and fragmented care. Improving outcomes requires timely diagnosis, patient-centered healthcare interactions, and the integration of psychological support within multidisciplinary endometriosis services. Full article

Background/Objective: Family caregivers of individuals with serious mental illness and substance use disorders experience substantial psychological burden. However, emerging evidence suggests many develop resilience and post-traumatic growth despite adversity. This integrative review synthesizes evidence on resilience, coping strategies, post-traumatic growth, and protective factors among these caregivers. Methods: The Whittemore and Knafl integrative review framework guided this synthesis. A systematic literature search was conducted across PubMed, CINAHL, and PsycINFO databases for peer-reviewed articles examining resilience, coping mechanisms, and post-traumatic growth in family caregivers of individuals with serious mental illness and substance use disorders. Qualitative, quantitative, and mixed-methods studies were included. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Data were extracted and analyzed using thematic synthesis to identify common patterns. Results: Multiple protective factors facilitate resilience and post-traumatic growth, including cultural values, family connectedness, religious faith, and emotional intelligence. Individual characteristics such as personality traits and decision-making styles influence adaptation outcomes. Structured interventions including psychoeducation, mindfulness practices, and peer support show initial evidence of enhancing caregiver resilience and psychological well-being, based on a single randomized controlled trial and cross-sectional associations. The caregiving experience provides opportunities for meaningful personal transformation despite significant burden. Conclusions: Family caregivers of individuals with serious mental illness and substance use disorders possess substantial capacity for positive psychological change. Healthcare professionals should implement strength-based, family-centered interventions acknowledging caregiver resilience. Future research employing longitudinal designs and investigating intervention mechanisms is essential to advance caregiver-focused mental health services. Full article

Objective: Large Language Models (LLMs) are emerging as a key component for digital health systems based on Artificial Intelligence (AI). The objective of this paper is to systematically review the characteristics, effectiveness, and implementation challenges of LLM-based assistants targeting adolescent health and well-being. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. PubMed, Scopus, and Web of Science were searched in November 2025 for studies published from 2022 onwards. Eligible studies examined LLM-based assistants used directly by adolescents in health and well-being contexts and reported quantitative outcomes. Data was extracted independently by multiple reviewers and synthesised narratively. Risk of bias was assessed using the Mixed Methods Appraisal Tool (MMAT). Results: Nine studies met the inclusion criteria, involving between 3 and 40 participants and covering mental health support, physical activity promotion, treatment engagement, vaccination awareness, and academic self-efficacy. Most studies were proof-of-concept investigations or pilot studies. LLM-based assistants were associated with reductions in depression, anxiety, stress, and negative affect, improvements in emotional regulation, physical activity, treatment motivation, HPV knowledge, and academic self-efficacy. Risk of bias was generally moderate and the evidence base was limited by small samples, short follow-up periods, and heterogeneous methodologies. Conclusions: LLM-based assistants show promise as scalable and accessible tools for supporting adolescent health and well-being, particularly in mental health domains. However, the current evidence remains preliminary. Larger, long-term, and rigorously designed studies are required to establish effectiveness, safety, and implementation feasibility. Registration: This review was not pre-registered and no review protocol has been published prior to conducting the review. Full article