Search Results (277)

Introduction: Nurses are the largest group of healthcare workers, and healthcare managers should pay attention to the quality of work life and the health and working capacity of nurses in order to ensure a sufficient number of nurses and a stable workforce. Aim: The present study aimed to determine nurses’ quality of work life, work ability index and intention to leave the nursing profession and to examine the associations between nurses’ quality of work life, work ability index and intention to leave the nursing profession. Methods: An online cross-sectional study was conducted. A total of 498 nurses completed the instrument, consisting of demographic data, Brooks’ Quality of Nursing Work Life Survey (BQNWL), Work Ability Index Questionnaire (WAIQ) and questions on their intention to leave their current job or the nursing profession. Results: Most nurses had a moderate quality of work life (QWL) (73.7%) and a good work ability index (WAI) (43.78%). Men (p = 0.047), nurses who study (p = 0.021), nurses who do not have children (p = 0.000) and nurses who do not take care of their parents (p = 0.000) have a statistically significantly higher total WAIQ score. Most nurses (61.1%) had considered changing jobs in the last 12 months, and 36.9% had considered leaving the nursing profession. A statistically significant positive correlation was found between the total BQNWL and the total WAI. The study found no correlation between QWL, WAI and intention to change jobs or leave the profession, which was unexpected. Conclusions: To ensure the provision of necessary nursing care and a healthy working environment for nurses, it is necessary to regularly monitor QWL and WAI and take measures to ensure the highest quality of working life. Further longitudinal and mixed-methods research is needed to understand the relationship between QWL, WAI and intention to leave. Full article

Purposes: This study aims to construct a research framework integrating the theory of human values and Self-Determination Theory (SDT) to examine whether parents’ sport values influence their support for children’s continued participation in balance bike activities in terms of the mediation of participation motivation. Methods: Data were collected from 439 parents whose children participated in balance bike activities using a snowball sampling method. Descriptive statistics and structural equation modeling (SEM) were employed to analyze the relationships among parents’ sport values, participation motivation, and continued participation intention. Results: The findings revealed that parents’ sport values significantly predicted participation motivation, which, in turn, remarkably influenced continued participation intention. Participation motivation fully mediated the relationship between sport values and continued participation intention, supporting SDT’s assumption of motivational internalization and highlighting the crucial role of intrinsic motivation. Full article

Internet addiction among adolescents has emerged as a significant global health issue, contributing to social isolation, academic difficulties, and emotional disorders, with excessive use of social networks further intensifying these challenges. This study evaluated the effectiveness of an educational intervention grounded in the Theory of Planned Behavior (TPB) in reducing Internet addiction and enhancing academic performance among adolescent girls in southern Iran. A randomized controlled trial was conducted with 370 female students aged 15–16 years, selected through two-stage cluster random sampling and divided equally into intervention and control groups. The intervention group participated in a five-week TPB-based program, incorporating lectures, group discussions, and parent–teacher meetings, while the control group received unrelated health education. Data were collected using the Yang Internet Addiction Test (IAT), a TPB-based questionnaire, and academic performance scores (grade point average, GPA) before and after the intervention. A repeated measures ANOVA revealed significant improvements in attitudes, subjective norms, perceived behavioral control, and intentions to reduce Internet use (p < 0.001). Internet addiction scores significantly declined, and GPA improved in the intervention group compared to the control group (p < 0.001, Cohen’s d = 0.950). The findings support TPB-based interventions as effective tools for reducing Internet addiction and improving academic outcomes among adolescents. This study was registered with the Iranian Registry of Clinical Trials (IRCT20131014015015N18). Full article

Background/Objectives: Asthma is a prevalent chronic condition affecting approximately 300 million people globally. Despite advancements in treatment protocols, poor adherence to asthma medication remains a significant issue, often leading to severe complications, especially in children. This study aimed to identify factors influencing medication adherence among parents of children with asthma, using constructs from the theory of planned behaviour to better understand and improve adherence. Methods: This cross-sectional study employed a survey incorporating constructs from the theory of planned behaviour, demographic variables, and other adherence-related factors. Descriptive statistics and logistic regression analyses were applied to explore the relationship between these factors and adherence to asthma medications. Results: Out of 152 parents who visited the survey link, 150 were eligible. The average age was 35.58 ± 9.913 years; most participants were married (82%) and female (62.6%). Multivariate linear regression analysis of the parents’ factor showed parental attitude (β = 0.38, p < 0.001) and subjective norms (β = 0.34, p < 0.002) were significantly associated with parents’ intention to adhere to asthma medications. Conclusion: The study found that parental attitudes and subjective norms significantly impact the intention to adhere to asthma medication. Improving adherence is crucial for effective disease management, reducing healthcare costs, and enhancing the quality of life for children and their families. Interventions should focus on educating parents about the importance of adherence and engaging more family members to positively influence adherence through strengthened subjective norms. Full article

Entrepreneurship development strategies are crucial for translating academic potential into economic and societal value. To achieve this, educational institutions must understand the factors influencing students’ entrepreneurial intentions. While research on academic entrepreneurship exists, comparative studies that explore these factors across different national contexts are scarce. This study addresses this gap through a comparative analysis of student entrepreneurship in Bulgaria, Malta, and Turkey, investigating key factors, such as attitudes toward entrepreneurship (ATE), the role of entrepreneurship education (EEdu), and entrepreneurial inspirations. Based on 415 survey responses collected between April and June 2024, hypothesized relationships were tested using appropriate bivariate statistical analyses. The results indicate that a positive evaluation of running one’s own business significantly increases entrepreneurial intentions, particularly when the business is perceived as safe, realistic, pleasant, and strong. The university’s role is pivotal: students largely relied on institutional support for their business initiatives; showed a strong preference for practical, hands-on educational methods; and identified a lack of entrepreneurship education as a key obstacle. A family background with entrepreneurial parents also positively influenced students’ preference for running their own businesses. Interestingly, the findings challenge a simple dichotomy between employment and entrepreneurship. A preference for full-time employment did not diminish entrepreneurial intentions, suggesting students may view these career paths as complementary or sequential. Conversely, preferences for part-time or self-employment did not have a significant positive impact on entrepreneurial initiatives. These findings underscore the need for universities to provide tailored, practical support and to recognize the complex and non-linear career trajectories envisioned by modern students. Full article

Background: Human papillomavirus (HPV) vaccination is crucial for preventing HPV-related cancers, yet vaccination rates remain suboptimal, particularly in Florida. Social influence, including family and peer support, may shape parental decisions to vaccinate their children. In this study, we examined the role of social networks (online and offline) in parental intention to vaccinate their 11- to 12-year-old children against HPV. Methods: We conducted a cross-sectional survey among 746 parents in Florida as part of the Text & Talk trial (2022–2023). Among other questions, parents reported on their intention to vaccinate, perceived social norms, and support received from up to three reported confidants. We performed logistic regression and multivariable analyses to assess the relationship between network support, social norms, and vaccination intent. Results: Seventy percent of parents intended to vaccinate their children. Greater support from the first reported confidant was significantly associated with higher vaccination intention (OR = 1.30, p < 0.0001). Perceived norms among friends (p = 0.01) and higher overall network support (p < 0.0001) were also predictive of intent. The higher the percentage of reported family members, the higher the support received for the vaccine (p = 0.04). Conclusions: Social support, particularly from close confidants and peers, plays a critical role in shaping parental HPV vaccination decisions while accounting for perceived social norms. Public health interventions can leverage peer networks alongside family support to enhance HPV vaccine uptake. Full article

Objectives: The Human papillomavirus (HPV) vaccine is a cornerstone of cancer prevention, yet uptake remains suboptimal in many countries. This study analyzed the factors influencing HPV vaccine acceptance among adults, including a focused analysis of parental behaviors. Methods: Data were collected through a web-based survey using a questionnaire. We performed univariable analysis and three logistic regression analyses to investigate the determinants in the overall sample and among parents. Results: A total of 1821 participants were surveyed. HPV vaccination uptake was low, with only 6.9% of the total sample and 7.6% of young adults (18–35 yo) vaccinated. Among parents, 47.9% had vaccinated children aged 12–17, and 21.1% those aged 18 and over. Higher health literacy was associated with positive attitudes (OR 2.03, 95% CI 1.48–2.79), while receiving information from pediatricians or gynecologists was linked to children’s vaccination status (OR 7.30, 95% CI 2.29–23.31) and parents’ intentions for future HPV vaccination (OR 5.86, 95% CI 1.85–18.50). Adequate knowledge emerged as a strong predictor of positive attitudes (OR 6.50, 95% CI 4.91–8.61) and parents’ intentions (OR 4.89, 95% CI 2.21–10.84). Vaccination status was a key factor influencing parental decisions and overall vaccine acceptance. Conclusions: These findings highlight the critical role of health professionals and the need for targeted communication to address persistent knowledge gaps and promote HPV vaccine confidence within general population. Full article

Background/Objectives: Hispanic immigrants (HIs) in the U.S.A. are disproportionately affected by cervical cancer compared to other groups, at least partly due to low HPV vaccination rates. The aim of this study was to investigate strategies to improve HPV vaccine attitudes and intent of HIs in the U.S.A. by developing and testing the effectiveness of video-based interventions. Methods: This study employed a two-phase mixed-methods approach. In the first phase, focus groups with new and established HIs explored perspectives, concerns about HPV vaccination, types of information to include in a video intervention, and how an effective intervention should be designed. Findings from the focus groups guided the creation of seven short educational videos, including a summary video and a testimonial-based video, addressing key questions about HPV and its vaccine. The second phase, which involved a nationwide survey of 1500 Spanish-speaking HIs, revealed a significant change in overall HPV vaccine attitude generally, and a significant increase in both HPV vaccine intent and attitudes among parents of unvaccinated children. Results: Regression analysis revealed general vaccine attitudes (β = 0.620, p < 0.001), English proficiency (β = 0.066, p = 0.01), and gender (β = −0.072, p = 0.002), as significant predictors of attitudinal changes. Notably, females exhibited less favorable post-intervention attitudes compared to males. Additionally, perceived care from video creators was a strong predictor of normalized gains in vaccine attitudes (β = 0.270, p < 0.001). Video content effectiveness varied; the video addressing vaccine side effects demonstrated the highest impact on attitude improvement. Testimonials and the summary video were also effective in fostering positive changes in attitudes. Despite differences in trust levels between new and established immigrants, both groups valued culturally tailored, Spanish-language information from credible sources. Conclusion: Addressing language and cultural barriers can improve trust in healthcare interventions among Hispanic immigrants in the U.S.A. Public health initiatives should consider these factors to more effectively reduce HPV vaccine hesitancy in this population. Full article

Background: Sepsis remains a significant cause of morbidity and mortality in preterm and low birth weight (LBW) neonates, especially in low- and middle-income countries (LMICs). Lactoferrin, a glycoprotein present in breast milk with antimicrobial activity, is a low-cost, readily available, and promising intervention currently under investigation. The available literature presents conflicting results on the impact of lactoferrin on the risk of late-onset sepsis (LOS). This study evaluated the effectiveness of two doses of bovine lactoferrin (bLF) supplementation in preventing LOS and necrotizing enterocolitis (NEC) in preterm and LBW neonates in Pakistan. Methods: A three-arm, double-blind, placebo-controlled, randomized clinical trial in the neonatal intensive care unit of Aga Khan University was conducted from July 2019 to August 2020. Preterm (28 to 36 + 5 weeks gestational age) and low birth weight (≥1000 g to <2500 g) neonates who established enteral feeding by 72 h were eligible. The exclusion criteria included sepsis before randomization, maternal history of chorioamnionitis or group B streptococcus colonization, and congenital anomalies. Enrolled neonates were randomly assigned in a 1:1:1 ratio using a computer-generated random allocation sequence to receive placebo (D-glucose), 150 mg bLF, or 300 mg bLF mixed with breast milk once daily for 28 days. The study staff, parents, and outcome assessors were blinded to the allocation. The primary outcome was late-onset sepsis from the trial entry to 28 days. The secondary outcome was NEC from the trial entry to 28 days. Neonates were followed weekly for 28 ± 2 days, and episodes of LOS and NEC were recorded. Results: Of 305 neonates enrolled, 102, 102, and 101, respectively, were randomized to receive a placebo (arm A), 150 mg bLF (arm B), and 300 mg bLF (arm C), respectively. Outcome data of 291 participants (99 in arm A, 95 in arm B, and 97 in arm C) were available for inclusion in the intention-to-treat analysis. The frequency of culture-proven sepsis was 8/102 (7.8%) in arm A compared to 1/102 (0.98%) (p = 0.020) in arm B and 5/101 (4.9%) in arm C (p = 0.390). We did not find any difference in episodes of NEC between arms A (n = 3, 3%) and B (n = 0, 0%) (p = 0.087) or between arms A and C (n = 2, 2%) (p = 0.650). We reported compliance rates of 79 (79.79%) in arm A, 78 (82.1%) in arm B, and 82 (84.53%) in arm C for investigational products. Arm C recorded two deaths, but neither was attributed to the intervention. Conclusions: Bovine lactoferrin supplementation did not prevent late-onset sepsis in neonates of preterm and low birth weight in our trial. However, given the small sample size, further trials with larger sample sizes are required to investigate its efficacy in these at-risk groups. Full article

Background/objectives: Influenza vaccines are recommended and free in Australia for children aged <5 years, but uptake remains low at 25.8% compared to the targets of 40% and 50%. National data on barriers hindering paediatric influenza vaccination can inform strategies to improve uptake. The aim of this study was to measure barriers to influenza vaccination in Australian children aged <5 years. Methods: A national, cross-sectional survey of parents of children aged <5 years was conducted in March/April 2024. Parents were recruited using an online panel and asked about their intention to get an influenza vaccine for their youngest child in the upcoming influenza season. An adapted version of the validated Vaccine Barriers Assessment Tool measured 14 influenza vaccination barriers. Analysis assessed the prevalence of barriers and differences between parents intending to and those unsure or not intending to vaccinate by calculating the prevalence difference and 95% confidence interval. Results: A total of 2000 parents were recruited nationally. The most common barrier was parents feeling distressed when thinking about vaccinating their child against influenza (66.1% of intending parents, 65.6% of unsure/not intending parents). The barrier with the largest difference between intending and not intending/unsure parents was not prioritising their child’s influenza vaccination (47.2% vs. 6.1%, PD = 41.1 ppts, 95% CI: 35.9%, 46.3%). Other barriers with large differences were parents not feeling guilty if their unvaccinated child got influenza (41.5% vs. 7.5%, PD = 34.0 ppts, 95% CI: 28.8%, 39.1%) and parents not believing that influenza vaccines are effective (31.3% vs. 3.0%, PD = 28.2 ppts, 95% CI: 23.6%, 32.9%). Conclusions: Parents should be encouraged and supported to prioritise influenza vaccination alongside routine childhood vaccines in campaigns that emphasise disease risk and the importance, safety and effectiveness of influenza vaccination, and by optimising access to influenza vaccination. We recommend conducting similar surveys regularly to monitor trends in parental barriers to childhood influenza vaccination. Full article

Research on vaccination hesitancy has been extensive, but the role of information processing in decision making still needs to be explored. The study examines the alignment between parents’ COVID-19 vaccination intentions and actual behavior, focusing on the impact of different kinds of information processing on the consistency or inconsistency of these behaviors. It analyzes parents’ reliance on health information sources, and education levels, with institutional trust, ability to critically evaluate conspiracy theories and scientific knowledge as moderators. A total of 1118 Israeli parents participated in digital surveys and were classified into the following 4 groups based on their initial vaccination intentions and actual behaviors: (1) consistent—pro-vaccine and vaccinated; (2) inconsistent—pro-vaccine but unvaccinated; (3) inconsistent—anti-vaccine but vaccinated; and (4) consistent—anti-vaccine and unvaccinated). The results show that consistent parents process information using system 1, i.e., heuristic information processing, reliance on health information sources, moderated by institutional trust and education. However, inconsistent parents used systems 1 and 2, namely heuristic–systematic information processing, influenced by knowledge of COVID-19 and the ability to assess conspiracy theories critically. Full article

In postmodern society, many protagonists promote a “distorted and unnatural” image of marriage and family, while others consider marriage and the family unit relics of the past. The contemporary world is characterized by different kinds of “turbulence” that affect individuals on both psychological and spiritual levels, as well as by extreme oscillations between a normal and a distorted image of the family and the image of God. In this context, all Catholics, especially Catholic families, are called to be “protagonists of the New Evangelization”. However, due to Catholic “mediocrity”, the family, which is the heart of the New Evangelization, can become less effective and limited in its evangelical mission. The individualism of our postmodern era, along with the prevalence of unstable and fluid relationships, impacts family bonds. Catholic families are not immune to the negative trends that affect families today. Many Catholic families face challenges and difficulties that can damage the relationship between parent and child. This article aims to explore how contemporary family dynamics within Catholic families influence the attachment between parent and child. Furthermore, it examines how children’s perceptions of parents relate to their perceptions of God. The intention is also to recognize the consequences of certain images of God on religious development. Does God become a “substitute attachment figure” when a parent is absent from the family? If so, how can religious education help individuals develop a more mature faith and relationship with God, moving beyond an infantile attachment? Full article

Objectives: Severe hypoglycemia is more common among young children with type 1 diabetes mellitus (T1DM) than older youth, and parents report significant hypoglycemia fear (HF). Parents experiencing HF describe constant and extreme worry about the occurrence of hypoglycemia and may engage in potentially risky behaviors to avoid hypoglycemia. Our team developed and tested a behavioral intervention, Reducing Emotional Distress for Childhood Hypoglycemia in Parents (REDCHiP), to decrease HF in parents of young children with T1DM. Here, we qualitatively analyzed parent feedback to refine and optimize future intervention iterations. Methods: The randomized pilot study included parents (n = 73) of young children with T1DM who participated in the 10-session video-based intervention. We qualitatively analyzed 21 recordings of the final intervention session, where parents provided feedback about intervention content. Trained coders independently reviewed each session. The frequency of parent quotes regarding active REDCHiP treatment components were calculated. Results: The coded themes reflected active treatment components [viz., Use of Cognitive Behavioral Therapy (CBT) Skills, Coping, Behavioral Parenting Strategies]. Also, two secondary process codes were identified: Appreciate REDCHiP Content and Challenges in Applying REDCHiP Strategies. Parents provided examples of skills or concepts they applied from REDCHiP, the challenges they encountered, and if they planned to apply these skills in the future. Conclusions: A qualitative analysis provided insight into parent perceptions of the active treatment components within the REDCHiP intervention, their acceptability, and parents’ intention to apply REDCHiP skills/concepts within daily T1DM cares. Future iterations of the intervention that trial alternative formats (i.e., individual vs. group and asynchronous vs. telehealth) may increase accessibility and scalability. Full article

Background: Interactive conversational agents (chatbots) simulate human conversation using natural language processing and artificial intelligence. They enable dynamic interactions and are used in various fields, including education and healthcare. Objective: This systematic review aims to identify and synthesize studies on chatbots for women and expectant parents in the preconception, pregnancy, and postnatal period through 12 months postpartum. Methods: We searched in six electronic bibliographic databases (MEDLINE (Ovid), CINAHL (EBSCO), Embase, Web of Science, Inspec, and IEEE Xplore) using a pre-defined search strategy. We included sources if they focused on women in the preconception period, pregnant women and their partners, mothers, and fathers/coparents of babies up to 12 months old. Two reviewers independently screened studies and all disagreements were resolved by a third reviewer. Two reviewers independently extracted and validated data from the included studies into a standardized form and conducted quality appraisal. Results: Twelve studies met the inclusion criteria. Seven were from the USA, with others from Brazil, South Korea, Singapore, and Japan. The studies reported high user satisfaction, improved health intentions and behaviors, increased knowledge, and better prevention of preconception risks. Chatbots also facilitated access to health information and interactions with health professionals. Conclusion: We provide an overview of interactive conversational agents used in the perinatal period and their applications. Digital interventions using interactive conversational agents have a positive impact on knowledge, behaviors, attitudes, and the use of health services. Interventions using interactive conversational agents may be more effective than those using methods such as individual or group face-to-face delivery. Full article

Background/Objectives: The HPV vaccine is key to preventing HPV-related cancers, yet vaccination rates are low, particularly among immigrant and ethnic minority groups. This study explored factors influencing HPV vaccine initiation and intention among Central American immigrant parents in the U.S. Methods: A cross-sectional study with parents of children aged 11 to 17 years. Results: Among the 168 parents (53.8% mothers, 46.2% fathers) in this study, 20% reported that their children had initiated the HPV vaccine and 23% of parents of unvaccinated children intended to vaccinate within the next 12 months. Sociodemographic factors, including the parent’s gender and length of U.S. residence, were significant predictors of HPV vaccine initiation and intention. Higher vaccine literacy was also a key factor, with parents with higher vaccine literacy scores being more likely to initiate vaccination and express intent to vaccinate their children. HCP communication strongly predicted both vaccine initiation and intention, yet fewer than 30% of parents received HPV vaccine information from a HCP, and less than 28% received a vaccine recommendation. In the multiple logistic regression analysis, receiving HPV vaccine information from a HCP was the strongest predictor of vaccine initiation (AOR = 93.23, 95% CI = 14.50–599.63, p < 0.001), adjusting for other variables. For vaccination intention, significant predictors included the length of U.S. residence (AOR = 0.84, 95% CI = 0.75–0.95, p < 0.01), having a U.S.-born child (AOR = 10.47, 95% CI = 1.51–72.68, p < 0.05), and receiving vaccine recommendation from a HCP (AOR = 14.73, 95% CI = 1.77–122.32, p < 0.05). Conclusions: To improve vaccination rates, interventions should enhance HCP training, strengthen provider–patient communication, and address vaccine literacy through culturally tailored strategies and community engagement. Full article