Search Results (542)

Background: Intermediate care units face growing complexity due to aging populations and chronic illnesses. Non-technical skills such as empathy and communication are crucial for quality care. We aimed to examine the relationship between communication skills, self-efficacy, and sense of coherence among intermediate care nurses. Methods: We conducted an observational, cross-sectional study with 60 intermediate care nurses from three units in a Catalan hospital, Spain. Participants engaged in high-fidelity simulation using geriatric end-of-life scenarios with an ultra-realistic manikin representing a geriatric patient at the end of life. NTSs were measured using validated tools: the Health Professionals Communication Skills Scale (HP-CSS), the General Self-Efficacy Scale, and the Sense of Coherence Questionnaire (OLQ-13). Sessions followed INACSL standards, including prebriefing, simulation, and debriefing phases. Results: Post-simulation outcomes revealed significant gains in interpersonal competencies, with men reporting higher assertiveness (p = 0.015) and greater satisfaction with both the simulation experience (p = 0.003) and the instructor (p = 0.008), underscoring gender-related perceptions in immersive training. Conclusions: Ultra-realistic clinical simulation is effective in enhancing NTS among intermediate care nurses, contributing to improved care quality and clearer professional profiles in geriatric nursing. Full article

Asthma is the leading chronic condition in children and adolescents, requiring continuous monitoring to effectively prevent and manage symptoms. Symptom monitoring can guide timely and effective self-management actions by children and their parents and inform treatment decisions by healthcare providers. This paper examines two conventional monitoring methods, including symptom-based and peak expiratory flow (PEF) monitoring, reviews early efforts to quantify respiratory symptoms, and introduces an emerging sensor-based mHealth approach. Although symptom-based monitoring is commonly used in clinical practice, its adequacy is a concern due to its subjective nature, as it primarily relies on individual perception. PEF monitoring, while objective, has shown weak correlations with actual asthma activity or lung function and suffers from suboptimal adherence among youth. To enhance objectivity in symptom monitoring, earlier efforts focused on quantifying respiratory symptoms by harnessing mechanical equipment. However, the practicality of these methods for daily use is limited due to the equipment’s bulkiness and the time- and labor-intensive nature of data processing and interpretation. As an innovative alternative, sensor-based mHealth devices have emerged to provide automatic, objective, and continuous monitoring of respiratory symptoms. These wearable technologies offer promising potential to overcome the issues of perceptual inaccuracy and poor adherence associated with conventional methods. However, many of these devices are still in developmental or testing phases, with limited data on their clinical efficacy, usability, and long-term impact on self-management behaviors. Future research and robust clinical trials are warranted to establish their role in asthma monitoring and management and improving asthma outcomes in children and adolescents. Full article

In recent decades, there have been significant changes in employment relationships, leading to more precarious forms of employment and heightened perceptions of job insecurity. The purpose of this study was to test the effects of job insecurity on perceived psychological well-being and work engagement, with self-efficacy at work acting as a mediator and perceived supervisor support acting as a moderator. This study analyzed a sample of 938 individuals from Portugal who participated in the 2015 European Working Conditions Survey (EWCS). The results show that job insecurity has a negative impact on both psychological well-being and work engagement. Furthermore, the study found that self-efficacy at work acts as a mediator in the relationship between job insecurity, psychological well-being, and work engagement, with a buffering effect. Our results also show evidence of a moderation effect of perceived supervisor support, which works in two ways: perceived supervisor support amplifies the positive effect of self-efficacy at work on psychological well-being, as well as the indirect negative effect of job insecurity. However, this moderation effect was not observed in the relationship with work engagement. These results emphasize the significance of job insecurity regarding individual mental health and job-related attitudes, taking into consideration individual and organizational resources. Full article

Background: The number of people with heart failure (HF) is rapidly increasing globally. Self-care plays a key role in improving HF outcomes. The readiness to engage in heart failure self-care (HFSC) behaviors encompasses a commitment to change and the capacity to make the change. Commitment is a personal investment and value toward enacting self-care and health-related behaviors. Capacity includes an individual’s skills, knowledge, beliefs, previous experience, and resources. Aim: The aim of this study was to describe patient-identified commitment and capacity factors influencing their readiness to carry out HFSC behaviors. Methods: A qualitative study using thematic analysis was conducted using data from 21 interviews to develop readiness for HFSC themes. Results: The commitment themes identified were cultural values and beliefs, social roles, will to live, attitude, self-efficacy, HF perceptions, and general emotional state. Capacity themes included HF literacy, functional capacity, environmental resources, comorbidities, time, cognitive functioning, and social support. Conclusions: Novel themes related to an individual’s commitment to HFSC activities included their will to live and social roles, while time emerged as a consideration in the capacity to engage in self-care. To optimize HF outcomes, people with HF must be ready to engage in HFSC. Evaluating an individual’s readiness for HFSC can focus healthcare team efforts on targeting specific self-care activities that require intervention. Enhancing readiness by intervening with specific commitment and capacity factors is a step toward optimizing HFSC and improving patient outcomes. Full article

Based on ecological systems theory, adolescents’ school climates can influence family interactions. In this study, it was tested whether associations between adolescents’ and parents’ perceptions of school climate in 7th grade (Wave 1) and adolescents’ later psychological functioning in 11th grade (Wave 4) were partially mediated by parental self-efficacy and parenting practices when the adolescents were in 8th grade (Wave 3). Path analyses were conducted in MPlus v. 7.4. Among 660 Black American families from the Maryland Adolescent Development in Context Study, adolescents’ positive perceptions of school climate were directly related to fewer internalizing and externalizing symptoms, higher resourcefulness, and higher self-esteem. Adolescents’ perceptions of school climate were also indirectly related to their externalizing symptoms through parent–adolescent communication and conflict. Adolescents who reported more positive school climates reported higher parent–adolescent communication and lower parent–adolescent conflict. Adolescents’ reports of school climate were also indirectly associated with self-esteem. Parents’ perceptions of school climate were not directly related to adolescents’ psychological functioning but were directly related to parental self-efficacy and parent–adolescent communication. They were also indirectly related to adolescents’ externalizing symptoms through parental self-efficacy. Parental self-efficacy was positively related to parent–adolescent communication and parents’ home-based school involvement. Overall, the findings highlight the role of school context in adolescents’ psychological functioning and family processes. Full article

This study used an equity ethic framework and a STEM identity model to contextualize and understand Latine students’ perceptions of STEM identity development. The purpose of this study was to investigate how Latine undergraduate students who engaged in STEM coursework perceived their learning experiences and stories of resilience through an equity ethic framework. Data were collected through interviews with 19 Latine college students attending a Hispanic-Serving Institution. Findings revealed the following themes related to Latine students’ STEM identity development and lived experiences in STEM coursework: implicit biases, imposter syndrome, self-efficacy, and support system and resources. Findings highlight the need for institutions of higher education to promote Latine students’ self-efficacy to positively influence STEM identity development while addressing systemic issues, such as implicit biases and imposter syndrome to create safe, growth-enhancing educational climates for students with minoritized identities. We provided implications to cultivate Latine students’ STEM identity development through inclusive teaching and learning practices that foster equitable learning environments as well as institutional resources that support students’ mental health and resilience. Implications of this study can be modeled at HSIs to positively influence STEM identity development and increase Latine students’ persistence in STEM fields. Full article

Cultural landscapes in World Heritage cities are attracting a growing global tourist population. Given the limitations of self-report methods in capturing tourists’ immediate and deep perceptions, and the lack of comprehensive investigation into the cultural types and naturalness of landscapes, this study aims to investigate how cultural landscape types influence tourists’ recommendation intention through the mediating roles of place attachment and perceived restorativeness while examining the moderating effect of landscape naturalness. Integrating Place Attachment Theory (PAT), Attention Restoration Theory (ART), and the Associative–Propositional Evaluation Model (APE), three studies were conducted using behavioral and neurophysiological approaches. Study 1, a scenario-based experiment, revealed that high-culture landscapes enhance recommendation intention via place attachment, with the effect of perceived restorativeness being stronger under low naturalness conditions. Study 2, an event-related potential (ERP) experiment, showed that landscapes with low culture and low naturalness elicit stronger emotional responses, as indicated by heightened P2 and LPP amplitudes. Study 3 demonstrated the efficacy of a Decision Tree model in classifying landscape naturalness based on EEG features. This study deepens the understanding of the complexity of tourist experiences in cultural heritage sites, provides new evidence for the application of Place Attachment Theory in tourism contexts, and offers scientific foundations and practical implications for optimizing landscape design in heritage sites, enhancing tourist experiences, and exploring brain–computer interface applications in the tourism field. Full article

Background/Objectives: This study assessed teacher self-efficacy in school-based asthma management in two southern states in the United States. Current literature focuses primarily on supporting school-based asthma management, but few studies have focused on teacher self-efficacy in the asthma management process. Methods: With data collected from a two-state survey of a randomly selected group of teachers in grades kindergarten to grade eight (n = 379), teachers’ demographic variables, general opinions about asthma management practices, and their self-perceptions on the Teacher Asthma Management and Information Seeking Scale, which assesses self-efficacy, were examined. Results: Teachers’ self-efficacy in managing asthma and seeking information was significantly higher among teachers who had completed in-service professional learning sessions and those who had access to community resources or links to community agencies. Additionally, teachers with personal experience of chronic illness, asthma, or allergies and those who had students with chronic illnesses in their classrooms reported higher self-efficacy scores. Conclusions: Findings suggest that providing professional learning about asthma for teachers, offering access to asthma action plans and community resources, and increasing awareness of chronic conditions and training for handling medical emergencies can enhance teachers’ self-efficacy and improve outcomes for students with chronic illnesses. Full article

Background: Fear of childbirth (FOC) or tokophobia has a detrimental impact on women during and after pregnancy. Childbirth fear is multidimensional and may differ across nations and cultures. We aimed to determine the psychosocial determinants of tokophobia among Asians. Methods: We conducted a systematic literature search using the PubMed, Scopus, and Web of Science databases in September 2023. Included were original English-language articles that focused on Asian cohorts. We identified independent variables associated with maternal childbirth fear based on multivariable logistic and linear regression analysis. Results: Twenty-three studies are discussed in this review. We categorized the factors into (1) psychiatry, (2) psychology, (3) perception and experience, (4) relationships and support, (5) spirituality, and (6) COVID-19. The studies involved 10,538 women with overall FOC prevalence ranging between 56.6% to 82.1%. Maternal history of psychiatric disorder, depression, and anxiety were positive predictors of childbirth fear. Childbirth self-efficacy protects Asian mothers against tokophobia. A reduced level of fear was associated with higher maternal psychological and spiritual well-being, as well as stronger maternal resilience. Spousal and social support alongside good family function were shown to exert a protective effect against childbirth fear. Intimate partner abuse was associated with an increased risk of tokophobia in women. Studies during the pandemic indicated that maternal fear, obsession, and anxiety about COVID-19 were positively correlated to fear of childbirth. Conclusions: Childbirth fear among Asian women is greatly influenced by various psycho-social factors. More culturally driven research is needed to help develop relevant interventions that will enhance maternal psychological and spiritual well-being and reduce the fear of childbirth. Full article

Managers often need to stay motivated and effectively motivate others. Therefore, they should rely on evidence-based interventions to effectively motivate and self-motivate. This research investigated how self-determination theory-based interventions affect employees’ motivation dynamics and motivational consequences within short time frames (i.e., within an hour, within a few weeks or months) in two empirical studies. Study one focused on assessing the effectiveness of a one-day training workshop in helping to improve managers’ work motivation, basic psychological needs satisfaction/frustration, subordinates’ motivation, and perceptions of managers’ needs-supportive/thwarting behaviors within a few weeks. Results support the effectiveness of the training, as managers were rated by their direct subordinates as having fewer needs-thwarting behaviors and reported self-improvement in needs satisfaction and frustration six weeks after completing the training program. Study two used the mean and covariance structure analysis and tested the impact of three types of basic psychological needs-supportive/thwarting and control conditions (3 × 2 × 1 factorial design) on participants’ situational motivation, vitality, and general self-efficacy for playing online word games within 30 min. Multi-group confirmatory factor analysis (CFA) confirmed the scalar measurement invariance, then latent group mean comparison results show consistently lower controlled motivation across the experimental conditions. During a quick online working scenario, the theory-based momentary intervention effectively changed situational extrinsic self-regulation in participants. Supplementary structural equation modeling (SEM; cross-sectional) analyses using experience samples supported the indirect dual-path model from basic needs satisfaction to vitality and general efficacy via situational motivation. We discussed the theoretical implications of the temporal properties of work motivation, the practical implications for employee training, and the limitations. Full article

Background/Objectives: Employment instability is increasingly recognized as an organizational stressor, yet its combined effect on nurse burnout, humanized care, and work engagement is poorly quantified. This study investigates those relationships and tests a serial mediation model linking contract instability, burnout, humanization, and engagement in Spanish hospital nurses. Methods: A nationwide cross-sectional survey was completed by 400 fixed-term nurses between March and May 2025. The data included demographics, number of contracts signed during 2024, and scores on the Maslach Burnout Inventory (MBI), Utrecht Work Engagement Scale (UWES), and Health Professionals’ Humanization Scale (HUMAS). Spearman coefficients described the bivariate relations. Results: Burnout correlated positively with both contract count (r = 0.42, p = 0.039) and years of experience (r = 0.74, p = 0.040). Work engagement was inversely associated with instability (r = –0.62, p = 0.018). Humanized care was strongly and negatively related to burnout (r = –0.61, p = 0.032), particularly in sociability and self-efficacy dimensions. Discussion: Contractual precarity elevates burnout, erodes perceptions of humanized care, and, through this erosion, suppresses nurse engagement. Stabilizing workforce arrangements and strengthening empathy-centered skills may mitigate these effects and foster a socially sustainable nursing workforce. Full article

Background/Objectives: Early care and education programs promote children’s social–emotional development, predicting later school success. The COVID-19 pandemic worsened an existing youth mental health crisis and increased teacher stress. Therefore, we applied an infant and early childhood mental health consultation model, Jump Start Plus COVID Support (JS+CS), aiming to decrease behavioral problems in children post-pandemic. Methods: A cluster randomized controlled trial compared JS+CS to an active control, Healthy Caregivers–Healthy Children (HC2), at 30 ECE centers in low-income areas in South Florida. Participants were not blinded to group assignment. Teachers reported on children’s social–emotional development at baseline and post-intervention using the Devereux Early Childhood Assessment and Strengths and Difficulties Questionnaire. We assessed whether teacher stress, classroom practices, and self-efficacy mediated the relationship between JS+CS and child outcomes. We also explored whether baseline behavior problems moderated JS+CS effects on child protective factors, relative to HC2. Results: Direct group-by-time differences between JS+CS and HC2 were limited. However, JS+CS demonstrated significant within-group improvements in teacher-reported child protective factors, behavior support practices, and classroom safety practices. Classroom safety practices consistently mediated positive changes in child behaviors, including the DECA total protective factor score and subdomains of initiative and self-regulation. Additionally, teacher perceptions of behavior support mediated gains in child attachment. Conclusions: JS+CS shows promise in building protective systems around children through intentional support for teachers, underscoring the value of whole-child, whole-environment approaches in early intervention. Full article

Despite the availability of pre-exposure prophylaxis (PrEP) in the United Kingdom (UK), uptake among men who have sex with men (MSM) remains inconsistent, signalling a persistent ‘PrEP Gap’. Empirical studies show the important role of psychosocial factors (e.g., stigma, identity, trust in science, and sexual behaviours) in PrEP acceptability and uptake. This study aimed to identify subgroups of MSM in the UK based on psychosocial predictors of PrEP acceptability. A cross-sectional survey of MSM (N = 500) was conducted between June and September 2023. Participants completed validated measures assessing identity resilience, internalised homonegativity, LGBTQ+ connectedness, trust in science, NHS perceptions, HIV stigma, PrEP self-efficacy, condom self-efficacy, sociosexual orientation, perceived HIV risk, and PrEP acceptability. Latent Profile Analysis (LPA) was used to identify distinct subgroups based on these psychosocial dimensions. Four psychosocial profiles were defined: (1) PrEP Ambivalent (15%); (2) PrEP Accepting (36.2%); (3) PrEP Hesitant (37%); and (4) PrEP Rejecting (11.8%). These profiles provide evidence for varied combinations of personal and structural factors influencing PrEP acceptability. PrEP acceptability among MSM in the UK is shaped by distinct psychosocial configurations, influenced by identity, stigma, trust, and perceived risk. These findings highlight the need for differentiated and targeted interventions for enhancing PrEP acceptability based on psychosocial profile. Audience segmentation strategies offer a promising pathway to bridge the awareness-to-engagement gap and address the nuanced barriers facing diverse subgroups within the MSM community. Full article

Urban climate resilience is shaped by both direct exposure to environmental risks and cognitive, socioeconomic and institutional factors. This study investigates climate change risk perception (CCRP), psychological distance (PD) and adaptive capacity (AC) across five districts of Istanbul: Beşiktaş, Kadıköy, Kağıthane, Şişli and Üsküdar, using a structured survey (sample size = 500) and advanced multivariate statistical modeling to explore the factors influencing adaptive behavior. To evaluate perceptual and behavioral responses to climate threats, the study constructs both equal-weighted indices and indices derived through principal component analysis (PCA). ANOVA and chi-square tests reveal significant district-level differences in risk perception and adaptation engagement. PCA results validate the internal structure of the indices by identifying latent dimensions such as institutional confidence, emotional proximity and self-efficacy. Correlation and regression analyses confirm that CCRP and PD significantly predict AC in theoretically meaningful patterns. Structural equation modeling (SEM) demonstrates both direct and indirect pathways linking climate risk perception to adaptive capacity, highlighting the complex interplay of these variables. Mediation analysis shows that PD partially mediates the CCRP–AC relationship, accounting for 39.7% of the total effect. Cluster analysis identifies distinct cognitive profiles where proactive adaptation behaviors are more common in affluent districts while disengagement is more prevalent in low-income areas. These findings underscore the importance of localized communication efforts, institutional credibility and financial equity in shaping effective climate adaptation. By integrating perceptual and structural dimensions, the study advances a multidimensional understanding of urban climate readiness and offers empirical guidance for socially equitable resilience policy design. Full article

Background: Despite the significant global disease burden associated with HPV infection, the vaccination coverage among female college students in China remains suboptimal. This study aimed to examine HPV vaccination coverage, knowledge levels, and determinants influencing vaccination behavior among female college students in northern China, utilizing the Health Belief Model (HBM) as a theoretical framework. Methods: A cross-sectional online survey was conducted from December 2024 to January 2025, involving 4076 female students from six universities in Jinan, China. The participants were categorized into three groups: vaccinated (VG), willing-to-vaccinate (WTG), and unwilling-to-vaccinate (UTG). Data on sociodemographic characteristics, HPV knowledge, health beliefs, and vaccination behavior were analyzed using ANOVA, chi-square tests, correlation analysis, and multivariate logistic regression. Results: The vaccination rate was 18.11%, with 40.19% expressing willingness to vaccinate and 41.71% expressing unwillingness. Vaccinated students demonstrated higher levels of HPV knowledge (6.66 ± 2.67 compared to 4.76 ± 3.10 in the UTG, p < 0.001) and were predominantly from urban areas (OR = 0.64, p < 0.001). The key determinants of vaccination uptake included perceived benefits (OR = 1.54, p < 0.001), perceived barriers (OR = 3.34, p < 0.001), self-decision-making ability (OR = 1.80, p < 0.001), and social motivation (OR = 0.21, p < 0.001). Notably, increased knowledge was associated with vaccine hesitancy in the WTG group (OR = 0.45, p < 0.001), indicating that information overload may adversely affect decision-making processes. Structural barriers, such as cost (42.63%), safety concerns (46.59%), and misconceptions (e.g., 57.76% cited “no sexual activity” as a reason for refusal), significantly impeded vaccine uptake. Conclusions: The low coverage of HPV vaccination is indicative of deficiencies in knowledge, socioeconomic disparities, and cultural perceptions. Tailored interventions should focus on educational efforts to correct misconceptions, provide subsidized access to vaccines, and implement empowerment strategies that enhance self-efficacy and informed decision-making. Policymakers should incorporate these findings into national cervical cancer prevention programs to address the gap between vaccination intention and behavior among young women in China. Full article