Search Results (248)

Despite the increasing adoption of a syndemic approach in HIV research, few health communication campaigns have used a syndemic approach in messaging to improve health outcomes for persons living with HIV (PWH). This paper introduces a framework for practitioners and researchers developing health communication messages in support of a syndemic approach to HIV care for PWH in the United States. Grounded in insights from a review of counseling and psychosocial interventions that demonstrated significant positive effects on HIV clinical outcomes, the C4H Framework emphasizes four components: compassion, comprehensive messaging, capacity-building, and coordination. Compassion ensures that messages resonate with individuals experiencing the intertwined challenges of HIV, substance abuse, and mental health issues. Comprehensive messaging integrates a holistic view of the barriers faced by PWH. Capacity-building empowers individuals to effectively engage with and act upon health information. Coordination promotes alignment between stakeholders and resources to ensure consistent and supportive messaging. The C4H Framework bridges the gap between research and practice, offering a foundation for crafting effective communication messages that resonate with individuals facing the complex challenges inherent in HIV syndemics. Future research should explicitly test the effectiveness and acceptability of messages developed using the C4H Framework with people living with HIV. Full article

Emotion regulation is essential for mental health. However, many people ignore their own emotional regulation or are deterred by the high cost of psychological counseling, which poses significant challenges to making effective support widely available. This review systematically examines the convergence of multimodal sensing technologies and large language models (LLMs) for the development of Automated Emotional Regulation (AER) systems. The review draws upon a comprehensive analysis of the existing literature, encompassing research papers, technical reports, and relevant theoretical frameworks. Key findings indicate that multimodal sensing offers the potential for rich, contextualized data pertaining to emotional states, while LLMs provide improved capabilities for interpreting these inputs and generating nuanced, empathetic, and actionable regulatory responses. The integration of these technologies, including physiological sensors, behavioral tracking, and advanced LLM architectures, presents the improvement of application, moving AER beyond simpler, rule-based systems towards more adaptive, context-aware, and human-like interventions. Opportunities for personalized interventions, real-time support, and novel applications in mental healthcare and other domains are considerable. However, these prospects are counterbalanced by significant challenges and limitations. In summary, this review synthesizes current technological advancements, identifies substantial opportunities for innovation and application, and critically analyzes the multifaceted technical, ethical, and practical challenges inherent in this domain. It also concludes that while the integration of multimodal sensing and LLMs holds significant potential for AER, the field is nascent and requires concerted research efforts to realize its full capacity to enhance human well-being. Full article

Background: Mental health issues among medical students have gained increasing attention globally, with studies indicating a high prevalence of psychological disorders within this population. The use of antidepressants and anti-anxiety medications has become a common response to these mental health challenges. However, it is crucial to understand the extent of their usage and associated effects on students’ mental health and academic performance. This cross-sectional study explored the use of antidepressants and anti-anxiety drugs and their impact on the mental health of medical students in Saudi Arabia. Methods: A cross-sectional survey of 561 medical students from 34 universities was conducted between March and July 2024. An anonymous online questionnaire was used to collect sociodemographic, mental health, and medication usage-related information. Results: Most of the participants were female (71.5%) and aged 21–25 years (62.7%). Approximately 23.8% of them used antidepressants, 5.6% reported using anti-anxiety medications, and 14.0% used both types of medication. Among the medication users, 71.7% were using selective serotonin reuptake inhibitors (SSRIs), and 28.3% were using other medications. Adverse drug reactions were reported by 58.8% of the participants, and 39.6% changed drugs with inadequate efficacy. Notably, 49.0% of the respondents who have ever used medications discontinued their medication without consulting a healthcare professional. Despite these challenges, 62.0% of the participants felt that their medications had a positive impact on their academic performance, 73.4% believed that the benefits outweighed the drawbacks, and 76.2% expressed a willingness to continue taking their medication. In particular, 77.6% agreed that treatment with these drugs could prevent mental breakdowns. Sleep duration, physical activity, and family history of psychiatric disorders were significantly associated with medication use, with p values of 0.002, 0.014, and 0.042, respectively. Conclusions: These results shed light on the need to understand the prescribing practices of antidepressant and anti-anxiety drugs among medical students while promoting the appropriate use of these medications among the students. There is a need to incorporate mental health interventions into counseling services and awareness programs to support students. Future longitudinal studies are needed to explore long-term trends. Full article

Background/Objective: A growing body of international research continues to show evidence of worsening youth mental health since the beginning of the COVID-19 global pandemic, yet very little research in this area has included young children under 6 years. Given the potential impact of early life stress during this critical period of development, it is crucial to better understand the effects on this age group. The objective of this study was to better understand the impact of the COVID-19 pandemic on the emotional health of very young children. Methods: This study utilized retrospective chart review of primary care records to compare the prevalence of markers of stress in two cohorts of children under the age of 6 years, comparing children presenting for care prior to the pandemic (1 April 2019–31 March 2020; control period) with those presenting for care during the first year of the pandemic (1 April 2020–31 March 2021; study period) in a large pediatric primary care clinic in Washington, DC, USA. Based on power calculations, charts of 200 patients from each cohort were reviewed and prevalence of stress markers were summarized using counts and percentages and compared between groups using chi-squared tests. Multivariable logistic regression models were also conducted for each domain adjusting for age, gender, and insurance type. Results: Overall, sleep difficulties were significantly more prevalent during the pandemic period compared to the control period (14% vs. 6.5%, p = 0.013). In addition, signs of stress presented differently across age groups. For example, during the pandemic period toddlers (13–35 months) were 13 times more likely (OR = 13, 95% CI [2.82, 60.4], p < 0.001) and preschool-aged children (36–71 months) were 18.5 times more likely (OR = 18.5, 95% CI [4.0, 86], p < 0.001) than infants to present with behavior problems, indicating substantially higher risk of externalizing symptoms in older children compared to infants. Toddlers were less likely than infants to present with mood changes (e.g., fussiness or crying) (OR = 0.15, 95% CI [0.03, 0.65], p = 0.011). In addition, toddlers (OR = 0.55, 95% CI [0.31, 0.97], p = 0.038) and preschool-aged children (OR = 0.15, 95% CI [0.06, 0.4], p < 0.001) were also less likely to present with feeding difficulties compared to infants. Conclusions: One of the very few studies of young children under 6 years (including infants) during the COVID-19 pandemic, this study found that even very young children experienced stress during the pandemic. Signs of emotional stress were identified in a primary care office during routine care, highlighting an important opportunity for early intervention and/or prevention, such as counseling and resources for caregivers, in settings where young children are already presenting for routine care. Full article

Background/Objectives: Despite the psychological benefits of breast reconstruction (BR) after mastectomy, uptake remains limited among women with breast cancer. This study explores psychosocial and personality predictors of BR intentions in the pre-mastectomy phase, aiming to inform strategies for mental health promotion in oncology care. Methods: This cross-sectional analysis used preoperative data from a longitudinal study at a university hospital in Greece. Women with primary breast cancer scheduled for mastectomy completed a battery of validated self-report measures, including the International Personality Item Big-Five Factor Markers (IPIP-BFFM), the Hospital Anxiety and Depression Scale (HADS), and the Short Form-36 Health Survey (SF-36). Demographic, clinical, and psychosocial data were also collected. Binary logistic regression was used to examine predictors of (a) BR information-seeking and (b) BR intention. Results: Seventy-four women participated (mean age = 61.1 years). Older age predicted lower BR intention (Exp(b) = 0.897, 95% CI: 0.829–0.970) and information-seeking (Exp(b) = 0.925, 95% CI: 0.859–0.997). Single/divorced status was associated with reduced BR information-seeking (Exp(b) = 0.053, 95% CI: 0.005–0.549). Openness to experience significantly predicted both outcomes (BR information-seeking: Exp(b) = 1.115, 95% CI: 1.028–1.209); BR intention: Exp(b) = 1.095, 95% CI: 1.016–1.181). Higher physical health-related QoL scores were associated with increased BR intention (Exp(b) = 1.039, 95% CI: 1.007–1.072), whereas higher mental health-related QoL (Exp(b) = 0.952, 95% CI: 0.912–0.994) and higher depression scores (Exp(b) = 0.797, 95% CI: 0.638–0.996) were linked to decreased BR intent. No psychological factor significantly predicted information-seeking. Conclusions: These findings underscore the value of psychosocial screening and personality-informed counseling prior to surgery. By identifying individuals less likely to seek information or consider BR, pre-mastectomy assessments can contribute to tailored, mental health-promoting interventions and support informed, patient-centered surgical decision-making. Full article

In the Hexaflex model of Acceptance and Commitment Therapy (ACT), psychological flexibility refers to the ability to openly embrace difficult thoughts and emotions while acting in alignment with personal values. In contrast, psychological inflexibility involves rigid avoidance and control strategies that hinder adaptive functioning. Although previously studied, more culturally relevant evidence is needed to inform interventions that promote well-being and mental health among Latin American students. This study explored manifestations of psychological flexibility and inflexibility in 15 undergraduate students from the University of Magdalena in Colombia (mean age = 20.13 years; 53.33% female) through semi-structured, face-to-face interviews (~45 min each). Data were analyzed using Interpretative Phenomenological Analysis (IPA), focusing on how participants described and made sense of their experiences. A total of 25 emergent themes were identified and grouped into 12 subordinate themes, mapped onto the 6 core ACT processes. The participants reported efforts to control or avoid distressing internal experiences, often resulting in difficulty acting in accordance with their values. The findings highlight a recurring ambivalence between avoidance and acceptance, and barriers to committed action, underscoring the dynamic interplay between flexibility and inflexibility. These results support the relevance of ACT-based interventions, such as structured group sessions that foster acceptance, mindfulness, and values-based behavior. Integrating this training into counseling and academic support services could enhance students’ well-being and performance. Future research should examine these dynamics longitudinally and across diverse contexts. Full article

In addition to recruiting new staff, retaining qualified teachers and supporting their mental well-being are becoming key priorities in German schools. One crucial factor associated with well-being is the use of emotion management. Given the emotional demands of the teaching profession, this study examines teachers’ strategies to manage their work-related emotions and the role of school-based support in maintaining mental health. The analysis is based on interviews with 51 primary and secondary school teachers in Germany, using thematic analysis following Braun and Clarke. The results indicated that teachers employed various strategies to manage their emotions. In classroom settings, suppression—a response-focused strategy—was frequently used. Outside the classroom, teachers tended to seek emotional relief through attentional shifts and conversations with colleagues or family, which offer reassurance, cognitive reframing, and emotional release. The findings underscore the importance of a supportive school culture characterized by collegial exchange, supervision, counseling, and committed leadership. Such environments can reduce emotional strain and contribute significantly to teachers’ well-being. Implementing opportunities for consultation and collegial case discussion during working hours may represent a valuable investment in teacher retention, particularly in times of teacher shortages. Full article

Introduction: Access of transgender and gender diverse (TGD) youth to gender-affirming medical care (GAMC) has become a contentious topic in the West, with many members of the general population, politicians, and even some experts and academic researchers voicing concerns about possible adverse effects of GAMC on the mental and physical health of TGD youth. Due to these concerns, recent years have seen a significant rise in legislation restricting TGD youth from accessing GAMC in countries such as the United States, the United Kingdom, and Canada. However, in this critical review of the literature on the psychological (e.g., anxiety, depression, suicide, and body satisfaction) and physical (e.g., bone health, cognitive function, and fertility) health outcomes associated with GAMC among TGD youth, we argue that, given the state of current research, youth should not be restricted from accessing GAMC. Conclusions: Our findings reinforce the importance of close monitoring by doctors, counselling for TGD youth with respect to potential risks, and increased studies on the topic, especially those focusing on reproductive health. Full article

Background/Objectives: Nonattendance at healthcare appointments remains a major challenge, particularly in chronic diseases like diabetes. Dietary therapy is essential in diabetes care, yet nonattendance at dietitian appointments persists. This study aimed to identify key drivers of nonattendance at dietitian appointments, explore prior experiences with dietary counseling, and determine factors motivating attendance. Methods: A mixed-methods approach was used in this quality improvement project, drawing on multiple data sources to explore nonattendance at dietitian appointments. This included combining a retrospective analysis of clinical and attendance data from patient records at a Danish outpatient diabetes clinic with semi-structured interviews with 25 individuals who had recently missed a dietitian appointment. Quantitative and qualitative data were analyzed separately and then integrated to characterize overall nonattendance patterns. Interview data were analyzed using systematic text condensation. Results: Individuals who missed dietitian appointments were also more likely to miss other healthcare appointments. Vulnerable individuals (i.e., those with complex health conditions or mental health issues) were more likely to miss appointments. Four principal barriers to attendance were identified: administrative, digital, and logistical challenges; competing health concerns; personal priorities; and unclear referral communication and patient involvement. Conclusions: Improving attendance at dietitian appointments requires a multifaceted approach. Key recommendations include optimizing scheduling practices, implementing digital reminders, offering continuity of care and virtual consultation options. Referring clinicians should improve patient communication by clearly explaining the purpose of the dietitian consultation and involving patients in shared decision-making prior to referral. Dietitians should collaborate with patients to establish realistic, personalized goals to foster engagement in their diabetes management. Full article

Stories are widely used by parents or educators to teach children the virtue of honesty. However, the existing empirical findings on the effect of story-telling on children’s honesty are limited and mixed. This study examined whether moral stories involving honesty can promote honesty in Chinese preschool children (N = 208). The Temptation Resistance Paradigm (TRP) was used to assess children’s honesty. Study 1 showed that children in the positive moral story condition were more likely to tell the truth than those in the control condition, while negative moral story-telling did not have this effect. Study 2 further examined whether combining external appeals with positive moral story-telling could further promote children’s honesty, and the results showed that the combination of the two techniques was equally as effective as moral story-telling alone. These findings have important implications for moral development and moral education. Full article

Total hip arthroplasty (THA) is the definitive treatment for end-stage hip osteoarthritis, reliably relieving pain and restoring joint function. However, patient-reported quality of life (QoL) after THA remains heterogeneous, with recovery trajectories influenced by a range of biological, psychological, and social factors. A comprehensive synthesis of these determinants is lacking, limiting our ability to optimize individualized perioperative care and long-term outcomes. This review examines the various factors impacting quality of life (QoL) before and after hip arthroplasty. An analysis of 67 studies reveals significant postoperative enhancements in physical function, pain alleviation, and overall patient satisfaction. Identified key factors encompass physical activity, mental health status (anxiety and depression), lifestyle choices (diet and weight management), and social support systems, particularly from spouses and family members. The review indicates that, although these elements positively influence recovery, it also recognizes limitations including dependence on subjective, self-reported QoL measures, possible selection biases, and inconsistencies in study design. The results indicate that a com-prehensive, patient-focused strategy—integrating organized rehabilitation, psychological assistance, and family engagement—can markedly improve recovery and long-term QoL for arthroplasty patients. Nonetheless, additional research employing standardized protocols and extended follow-up durations is essential to corroborate these findings and guide clinical practice. The early implementation of tailored, multidisciplinary perioperative pathways—including structured rehabilitation programs, routine psychological screening and intervention, nutritional counseling for weight management, and active family involvement—may optimize functional recovery, reduce complications, and maximize long-term QoL in patients undergoing THA. This review highlights the importance of a multidisciplinary approach to enhance post-surgical quality of life, thereby advancing the understanding of patient-centered recovery strategies in orthopedic care. Full article

The transition from correctional service to life in the community can be very challenging for young ex-offenders because they often lack the skills and knowledge they need to function successfully in society. This exploratory study aimed to explore whether the educational opportunities provided in correctional services really help young ex-offenders make a successful transition back into society. The study adopted a qualitative research approach, interviewing a group of 20 young ex-offenders aged 18 to 35 from the Cape Flats region. The data from the interviews were analysed through thematic analysis. The study found that correctional education, particularly programmes focused on mental health, counselling and life skills, significantly improved the mental well-being and self-efficacy of young ex-offenders, aiding their successful reintegration into society. These programmes also emphasised moral education, fostering harmonious coexistence with community members’ post-release. This study recommends a revolutionary pedagogical approach to correctional education aiming at comprehensive education of young offenders. This pedagogy should use modern digital technologies, allowing correctional educators to undertake pre-attendance assessments of each offender’s learning preferences, inclinations as well as individual aptitudes and limitations. This method facilitates the learning of basic education required for successful reintegration of young offenders into society. Full article

Background: The integration of artificial intelligence (AI) into mental health care is reshaping psychological support systems, particularly for digitally literate populations such as nursing students. Given the high prevalence of anxiety and depression in this group, understanding their perceptions of AI-driven mental health support is critical for effective implementation. Objectives: to evaluate nursing students’ perceptions toward AI-driven mental health support and examine its relationship with anxiety, depression, and their attitudes to seeking professional psychological help. Methods: A cross-sectional survey was conducted among 176 undergraduate nursing students in northern Jordan. Results: Students reported moderately positive perceptions toward AI-driven mental health support (mean score: 36.70 ± 4.80). Multiple linear regression revealed that prior use of AI tools (β = 0.44, p < 0.0001), positive help-seeking attitudes (β = 0.41, p < 0.0001), and higher levels of psychological distress encompassing both anxiety (β = 0.29, p = 0.005) and depression (β = 0.24, p = 0.007) significantly predicted more positive perceptions. Daily AI usage was not a significant predictor (β = 0.15, p = 0.174). Logistic regression analysis further indicated that psychological distress, reflected by elevated anxiety (OR = 1.42, p = 0.002) and depression scores (OR = 1.32, p = 0.003), along with stronger help-seeking attitudes (OR = 1.35, p = 0.011), significantly increased the likelihood of using AI-based mental health support. Conclusions: AI-driven mental health tools hold promises as adjuncts to traditional counseling, particularly for nursing students experiencing psychological distress. Despite growing acceptance, concerns regarding data privacy, bias, and lack of human empathy remain. Ethical integration and blended care models are essential for effective mental health support. Full article

The COVID-19 pandemic greatly impacted care aides in long-term care facilities (LTCFs), exacerbating existing challenges and introducing new stressors that profoundly affected their job satisfaction, mental health, and overall well-being. This study investigates these multifaceted effects by conducting a comprehensive literature review of 18 studies from 2020 to 2023 across multiple countries. The findings reveal that care aides, mostly older and female and often immigrants with limited formal education, faced increased workloads, emotional exhaustion, physical fatigue, anxiety, and heightened stress levels during the pandemic. These factors led to decreased job satisfaction, higher burnout rates, and further pressure on LTCFs. The review emphasizes the need for strong support systems and targeted interventions, including mental health resources, counseling, adequate personal protective equipment (PPE), effective workload management, professional development opportunities, fair compensation, and supportive work environments. Addressing these issues is crucial for maintaining a stable and effective LTC workforce, improving care outcomes for residents, and enhancing the healthcare system’s resilience against future challenges. Full article

Humans interact with virtual environments for a variety of purposes, and the use of telemedicine services and e-health platforms has become increasingly significant in recent years. Telepsychology is an emerging service and is understood as the provision of psychological aid and counseling through the use of telecommunication technologies. This study investigates the impact of visual backgrounds in a mental health simulation app and explores the decision-making of potential patients for telepsychology. In this experimental study, we developed an instrument to assess the preferences for manipulated features of photomontages and portraits. A total of 310 participants from diverse backgrounds were surveyed about their preferences regarding visual backgrounds and silhouettes for this hypothetical service, with key independent variables such as complexity, naturalness, and color hues being manipulated. Our findings represent the first example of data collected on background preferences in telepsychology. The results suggest a preference for backgrounds with medium complexity and naturalness for clinical settings. Additionally, we observed variations in preferences based on gender and age. These findings highlight the importance of customizing visual elements to enhance patient engagement in telepsychology. Full article