Search Results (170)

Objective: This study aimed to improve the understanding of the lives of patients with chronic neuropathic pain planned for invasive motor cortex stimulation (iMCS) and assess their expectations towards this intervention and its impact. Methods: Semi-structured face-to-face interviews were conducted until saturation of data was reached. Patients were recruited from one university medical center in the Netherlands. All interviews were audio-recorded, transcribed verbatim, and subjected to thematic analysis using iterative and inductive coding by two researchers independently. Results: Fifteen patients were included (11 females; mean age 63 ± 9.4 yrs). Analysis of the coded interviews revealed seven themes: (1) the consequences of living with chronic neuropathic pain; (2) loss of autonomy and performing usual activities; (3) balancing energy and mood; (4) intimacy; (5) feeling understood and accepted; (6) meaning of life; and (7) the expectations of iMCS treatment. Conclusions: This is the first qualitative study that describes the suffering of patients with chronic neuropathic pain, and their expectations prior to invasive brain stimulation. Significant themes in the lives of patients with chronic pain have been brought to light. The findings strengthen communication between physicians, caregivers, and patients. Practice Implications: The insights gathered from the interviews create a structured framework for comprehending the values and expectations of patients living with central pain and reveal the impact of symptoms due to the central pain. This knowledge improves the communication between physicians and caregivers on one side and the patient on the other side. Furthermore, the framework enhances the capacity for shared decision-making, particularly in managing expectations related to iMCS. Full article

Objectives: This study explored perceptions, experiences, and outcomes associated with the choice of insulin therapies among pediatric patients with type 1 diabetes mellitus (T1D). Methods: This study included 20 adolescents (8 male and 12 female) with T1D, with a mean age of 15.05 ± 0.91 years, a mean diabetes duration of 5.19 ± 1.2 years, and a mean most recent HbA1c of 7.03 ± 0.16%. Ten of the participants were using an insulin pump (n = 10) and another 10 had either refused (n = 7) or discontinued (n = 3) insulin pump therapy. A qualitative inductive method was employed, using in-depth individual interviews. The interview material was transcribed verbatim and grounded theory was used to analyze the verbal material. Results: Four main thematic categories were identified from the narrations that captured both common and divergent perceptions of insulin pump users versus non-users: (1) adjusting to the lifelong diagnosis, (2) exposing diabetes versus hiding it, (3) becoming autonomous and integrating insulin pump therapy into daily life, and (4) worrying over the pump. The third theme, capturing autonomy and integration, surfaced as the core thematic category of this study. Conclusions: This grounded theory study revealed that, by using insulin pump therapy, adolescent T1D patients can enhance their autonomy and facilitate the integration of insulin treatment into their life. This study identified processes that inform diabetes education and contribute to ameliorating gaps in the uptake and maintenance of pump therapy in pediatric care. Full article

Women’s decision-making autonomy is widely recognized as a critical determinant of maternal, newborn, and child health (MNCH). However, prevailing measures often conflate genuine autonomy with decisions made within traditional gender roles, risking an overstatement of women’s empowerment. This study examines the extent to which reported female decision-making autonomy reflects authentic agency versus role-based compliance in a patriarchal context. A cross-sectional study was conducted among 280 male household heads in Kakamega County, Kenya, whose partners were pregnant or recently postpartum. Using multi-stage cluster sampling and structured interviews, men reported on household and MNCH decision-making and their rationales, categorized as gender-role conformity, belief in gender equality, or other reasons. Although 40.4% reported that their partners made decisions independently, only 11.4% attributed it to a belief in women’s equality; 28% framed it within traditional gender roles. Men were over four times more likely to perceive women’s decisions as role-based than autonomous (AOR = 4.40; 95% CI: 2.48–5.78). Younger men (18–34) were more likely to report female decision-making (AOR = 5.54; 95% CI: 5.08–7.27), without necessarily endorsing egalitarian norms. Findings highlight the urgent need for gender-transformative MNCH interventions that move beyond surface-level autonomy to address deeper structural inequities. Full article

Background: Promoting sustainable eating is gaining increasing attention, yet the transition from intentions to actual behaviors remains unclear. This study compares the theory of planned behavior (TPB) and the theory of behavioral choice (TBC) in predicting such intentions and examines the moderating role of distress, psychological well-being, and dysfunctional eating styles in the intention–behavior relationship. Methods: A total of 223 participants from the general population (29.49 ± 9.30 years; 68.6% females) completed an online survey assessing TPB and TBC predictors, the Sustainable and Healthy Dietary Behaviors (SHDB) questionnaire, the Depression and Anxiety Stress Scale (DASS-21), the Psychological Well-Being Scale (PWBS), and the Dutch Eating Behavior Questionnaire (DEBQ). Results: The TBC model explained a significantly greater variance in intention (R² = 0.45, ΔR² = 0.28, F(215,4) = 27.27, p < 0.001) compared to the TPB, with TBC-affect (β = 0.48, p < 0.001) and felt obligation (β = 0.23, p < 0.001) being the strongest predictors. Moderation analyses revealed that the intention–behavior link was stronger in participants with lower external eating and autonomy. Conclusions: Both internal and external factors play a crucial role in predicting intentions. In addition, the intention–behavior link is stronger in individuals who are less reactive to external food stimuli and more influenced by social pressure. Promoting more balanced psychological well-being and functional eating habits may foster more sustainable diets. Full article

The ultimate goal of developed societies is to age with quality of life, but this concept is broad, and few studies have addressed which variables specifically affect its dimensions. This study aims to test a model for predicting the impact of frailty, pain, and loneliness on the four dimensions of quality of life (control, autonomy, pleasure, and self-realization). Data were drawn from a sample of 61,355 Europeans from the Wave 7 of the SHARE project, aged 60 or older (M = 71.87, SD = 8.22), from which 55.9% were females. Statistical analyses included a fully Bayesian structural equation model that evidences the significant effect of loneliness, frailty, and pain on the four dimensions of quality of life. The variables have an unequal impact on the different dimensions’ loneliness was the main predictor for the dimensions control, autonomy, and pleasure, while frailty was the main predictor to self-realization. This study supports the need to address these variables to intervene on the different aspects of quality of life in old age. Full article

The transition towards adulthood represents a complex period in which the development of personal identity culminates in young adults, whilst, at the same time, many undertake university studies in order to access the job market. The aim of the present study was to analyse the associations between self-concept, motivation, and learning strategies in the Spanish university context using structural equations to examine sex as a modifying factor. A descriptive, cross-sectional, and ex post facto study was conducted with a representative sample of 2736 students. The results revealed a positive association between academic self-concept and the three basic psychological needs, with the needs of autonomy and competence being of particular importance amongst the males. It was determined that the satisfaction of all of the needs favoured the development of learning strategies in both genders, with the exception of the need for relatedness, which was not relevant. Finally, it was demonstrated that the females employed better elaboration strategies, whilst the males were better able to regulate effort. It can, therefore, be concluded that the promotion of self-determined motivation favours the development of a positive self-image and learning strategies, with it being crucial for students to be intrinsically motivated. This may help university students avoid dropping out from degree courses. Full article

This study examines the determinant factors of women’s empowerment in Chepén, Peru, during 2024, analyzing how socioeconomic status potentially moderates this relationship. Using a quantitative approach with a non-experimental, cross-sectional design, the research surveyed 367 women aged 22–52 years through digital questionnaires employing validated scales. The results revealed that both internal factors (individual and collective psychological competencies) and external factors (economic and cultural conditions) significantly influence female empowerment (β = 0.57, p = 0.049 and β = 0.87, p = 0.039, respectively). Contrary to our hypothesis, socioeconomic status did not significantly moderate these relationships (internal factors × socioeconomic level: β = 0.02, p = 0.323; external factors × socioeconomic level: β = −0.02, p = 0.584). The models demonstrated strong explanatory power, with internal factors explaining 84.3% and external factors explaining 58.5% of the variance in women’s empowerment. The study found moderate levels of autonomy and decision-making (44.8%) and cultural dimensions (43.3%). While 76.1% of participants had higher education, 41.8% earned below PEN 1500, highlighting a significant education–income gap. These findings suggest that psychological competencies and sociocultural environment enhancement are more critical than initial economic conditions for promoting women’s empowerment across all socioeconomic strata. The study recommends implementing targeted public policies to improve cultural and economic conditions, establish flexible educational programs, and promote dignified employment opportunities that recognize women’s capabilities regardless of socioeconomic background. Full article

Questioning motherhood as a social mandate has been one of the main objectives of feminism. Motherhood has traditionally been linked to the idea of femininity and the reproductive function, which has led to women being thought of as “compulsory mothers”. However, this idea is currently changing, despite the fact that judgment is exercised on non-mothers. This research is part of a cross-sectional descriptive study, whose objective is to analyze the barriers and incentives to childbearing in the female population. A questionnaire was designed and administered to a representative sample of 318 women who were selected for our analysis, with a confidence level of 95% and a margin of error of 5%. Results: Economic motives correlate positively with other variables, as well as work motives, the couple’s decision to not want to have children, and not having a stable partner, which suggests that these women have different motives for choosing not to have children. The main conclusions are that social and family pressures appear to have a limited impact on the decision not to have children, suggesting a change in social norms and expectations about the role of women in society, as women continue to gain autonomy and control over their reproductive decisions. Full article

This study aimed to clarify the menstrual experiences and perceptions of women with visual impairments in Japan. An anonymous web-based questionnaire consisting of both multiple-choice (quantitative) and open-ended (qualitative) questions was administered to female Riryouka Kyouin (visually impaired teachers who provide instruction in traditional Japanese therapeutic practices—such as acupuncture, moxibustion, and massage—to students with visual impairments) employed at prefectural schools for the blind. The multiple-choice responses suggested several difficulties in menstrual management, including challenges in detecting menstrual blood, limited access to information, and concerns related to embarrassment. The open-ended responses revealed that participants, as individuals with visual impairments who also serve as educators and healthcare professionals, expressed efforts to manage menstruation appropriately in social contexts. These findings highlight the practical experiences of visually impaired women who are actively engaged in society and suggest the importance of support approaches that respect individual autonomy in managing menstruation—a bodily practice imbued with social meaning. Full article

Background/Objectives: The evaluation of metabolic and physiological health indicators in people with Down syndrome (DS) is crucial, since these people are more prone to metabolic problems. However, there is limited scientific evidence regarding the health status and health literacy (HL) of adults with DS and their legal guardians. This study aimed to assess the health status of adults with DS and determine the HL levels of their legal guardians. Methods: Eighteen adults (11 females, 7 males) with DS aged 28.64 ± 9.01 years were tested for health status, and their legal guardians completed the HL survey. Gender differences in all study variables were checked by t-tests for independent samples and Cohen’s D effect sizes (ESs). Differences in all study variables between parents with low and adequate HL were calculated via receiver operating characteristic curves. Results: Males were overweight, whereas females were obese (mean BMI = 26.51 and 30.10 for males and females, respectively). Females had higher high-density lipoprotein concentrations (large ES), whereas males had higher hematocrit and hemoglobin concentrations (large ES). Hematological parameters were the most significant variables that differed between parents with limited and adequate HL status (AUC = 0.79–0.87). Conclusions: These findings suggest that in the absence of severe comorbidities, adults with DS may achieve stable health profiles, particularly when supported by structured physical activity and informed caregiving. The influence of parental HL on health parameters points to the potential for parent-targeted health education to improve health outcomes and promote autonomy in individuals with DS through supported decision-making. Thus, our findings highlight the need for greater investment in caregiver and parental health education and systemic support to optimize health outcomes in adults with DS. Future research should explore interventions aimed at improving parental HL and examine the extent to which these efforts translate into improved health outcomes for people with DS. Full article

Background: Adolescence is a pivotal developmental stage marked by physiological and behavioral changes that significantly influence dietary habits and long-term health outcomes. Objectives: This study aimed to examine the associations between socio-demographic characteristics, psychological factors, and dietary behaviors among school-aged children and adolescents in Romania. Methods: A cross-sectional study was conducted using a structured, self-administered questionnaire completed by 662 children and adolescents aged 6 to 18 years, enrolled in primary, middle, and high schools across urban and rural areas. The questionnaire evaluated nutritional intake, meal patterns, hydration habits, physical activity, screen time, and psychological factors such as fatigue, stress, and mood fluctuations. Body mass index (BMI) was calculated based on self-reported height and weight. Results: The analysis reveals significant gender differences in body mass index (BMI), weight-loss behaviors, and family structure. Female adolescents were more likely to be underweight (18.27%) compared to male adolescents (10.82%), while overweight prevalence was higher among male adolescents (18.66%) than female adolescents (11.68%) (χ² = 11.457, p = 0.009). Dietary patterns varied significantly across age groups, with high-school-aged children demonstrating lower vegetable consumption and increased autonomy over food choices. Primary school children exhibited higher intake of carbonated beverages (OR = 0.185, p = 0.002 for high school; OR = 0.116, p < 0.001 for middle school), whereas teenagers showed a preference for structured meals and lower fast-food intake. Meat consumption frequency correlated with greater diversity in protein sources (χ² = 48.77, p < 0.001), while chaotic eating behaviors were more prevalent among middle and high-school-aged children (OR = 2.291, p = 0.032 for middle school; OR = 2.225, p = 0.030 for high school). Hydration habits played an essential role in dietary quality, with school-age children consuming ≥ 3 L of water daily exhibiting healthier eating patterns (OR = 7.146, p = 0.001). Additionally, psychological factors such as fatigue and stress were significantly associated with unhealthy dietary choice. Conclusions: These findings highlight the need for targeted nutritional education, school-based interventions, and family-focused strategies to improve adolescent health behaviors. Full article

Background: Cardiovascular disease (CVD) is the leading cause of death worldwide and is exacerbated by poor dietary habits, particularly in settings such as women’s prisons. Incarcerated women are often exposed to ultra-processed foods, limited nutritional education, and restricted living conditions that increase their risk of CVD. Objectives: This study aimed to explore the challenges perceived by professionals in a Portuguese women’s prison regarding the prevention of CVD, particularly through dietary interventions. Methods: A qualitative, exploratory and descriptive study was conducted using a focus group with six professionals. Data were collected in July 2024 and analysed using thematic content analysis. Results: Three thematic categories emerged: (1) contextual challenges of the prison system (e.g., sedentary lifestyle, limited food options); (2) socio-cultural resistance to behavioural change (e.g., low adherence to health programmes, use of food as a coping mechanism); and (3) the need for sustainable and interdisciplinary intervention strategies. Conclusions: The findings highlight the complexity of promoting cardiovascular health in female prisoners. Interventions need to take into account mental health support, prisoner autonomy and institutional constraints. Future research should develop and test targeted, context-specific nutrition programmes in similar settings. Full article

Background and Objectives: Contraceptive education may influence reproductive health outcomes, foster greater sexual autonomy, and improve mental well-being. The current study investigated the efficacy of a structured contraceptive counseling program on reproductive health knowledge, sexual autonomy, anxiety, and depressive symptoms among Romanian college women. Materials and Methods: A prospective study was conducted during the 2021–2024 academic years, enrolling 240 female students aged 18–26 from the “Victor Babes” University of Medicine and Pharmacy in Timisoara. The participants were divided into two arms: (1) Intervention Group (IG, n = 115), which was provided counseling materials, and (2) Control Group (CG, n = 116), which received no additional counseling. Baseline and post-intervention data were collected using a contraceptive knowledge quiz (CKQ), a sexual autonomy scale (SAS), the WHOQOL-BREF, GAD-7, and PHQ-9. Results: After the 12-week intervention, the IG demonstrated significant improvements in contraceptive knowledge (mean CKQ score: 25.5 ± 3.1 vs. 20.1 ± 4.3 in CG, p < 0.001), sexual autonomy (SAS: 82.6 ± 9.2 vs. 75.7 ± 10.1, p < 0.001), and psychological well-being indicators: lower anxiety (GAD-7: 3.1 ± 2.0 vs. 5.2 ± 2.3, p < 0.001) and depression scores (PHQ-9: 4.8 ± 2.0 vs. 7.1 ± 2.2, p < 0.001). Multiple regression analysis showed that membership in the IG was the most significant predictor of improved post-intervention contraceptive knowledge and reduced mental distress, even after adjusting for confounders such as age, socioeconomic status, and relationship status. Conclusions: A structured contraceptive counseling program can significantly enhance reproductive health knowledge, strengthen sexual autonomy, and reduce depressive and anxiety symptoms among Romanian college women. The findings emphasize the importance of developing systematic, multi-faceted interventions for improving students’ reproductive well-being and mental health outcomes within university settings. Full article

Background/Objectives: Instrumental Activities of Daily Living (IADL) are the key indicators of the autonomy and functional ability in older adults with neurocognitive disorders (NCDs). However, the specific predictors of IADL performance across the NCD spectrum remains insufficiently characterized. This study aimed to identify the cognitive, motor, and caregiver-related determinants of the IADL in individuals with minor and major NCDs. Methods: A cross-sectional study was conducted involving 117 participants referred from a university-based dementia clinic. Standardized tools were administered to evaluate their IADL performance (Lawton IADL Scale), cognition [Addenbrooke’s Cognitive Examination III (ACE-III)], Functional Cognitive Assessment Scale (FUCAS)], motor functions, balance, and mobility [Tinetti Test, Timed Up and Go (TUG)], emotional status [Geriatric Depression Scale (GDS)], neuropsychiatric symptoms [Neuropsychiatric Inventory (NPI)], and caregiver burden [Zarit Burden Interview (ZBI)]. Multiple regression analyses were performed to identify the significant predictors of IADL performance. Results: In the total sample (n = 117), the IADL performance was significantly predicted via ACE-III, FUCAS, and Tinetti-balance (adjusted R² = 0.729). In the minor NCD group (n = 41), the significant predictors included sex, FUCAS, GDS, Tinetti-balance, and TUG (adjusted R² = 0.725). In the major NCD group (n = 76), ACE-III, FUCAS, and Tinetti-balance remained the significant predictors (adjusted R² = 0.634). Female sex and a worse profile on the other variables were associated with lower IADL scores. Conclusions: Global cognitive decline, executive dysfunction in everyday problem-solving situations, and balance impairment are the key determinants of IADL performance across both minor and major NCDs. Female sex and depressive symptoms further predicted the IADL performance in the minor NCD group. These findings highlight the need for multidisciplinary assessment and intervention strategies to promote health and autonomy and preserve the functional independence in older adults with NCDs. Full article

It is not uncommon that women residing in Dutch shelters following domestic violence consider returning to their partners during the course of their stay. Social workers cannot prohibit return due to the importance of the client’s autonomy, as stated in the Code of Ethics. Simultaneously, social workers aim to ensure women’s safety and encourage a positive future, which can lead to tensions in their way of support-giving. Based on thirty-five interviews with social workers, this study explores how they navigate these tensions and the support they give in such cases. Building on Martha Nussbaum’s capabilities approach, we distinguish a hands-off and an interventionist approach to autonomy. While the hands-off approach leads to non-intervention and respecting the woman’s decision, the interventionist approach focuses on providing tools and encouraging safer alternatives. The findings show that the hands-off approach is the common type of support, leading to feelings of powerlessness for social workers and often prompting endeavors to intervene more actively. Simultaneously, we argue that, whilst the Code of Ethics demonstrates an ambivalence towards these different forms of autonomy, it is often interpreted by social workers as promoting only a hands-off approach. Consequently, we argue that social workers would benefit from a greater recognition of an interventionist approach to autonomy and more liberty in support-giving. Full article