Search Results (4,012)

The rapid digital transformation of the sports industry in Saudi Arabia under Vision 2030 has reshaped how football fans engage with sporting events through modern infrastructure, international competitions, and expanding digital media ecosystems. While sport participation and spectatorship have been associated with positive well-being outcomes, limited empirical evidence exists regarding how digitally enabled sports investments relate to football fans’ mental health. This study examines the associations between three dimensions of perceived sports industry investment, hosting international football events (HIFE), football infrastructure investment (FII), and digital platforms and broadcasting investment (DP&BI), and self-reported symptoms of depression, anxiety, and stress among 550 Saudi football fans. Data was analysed using partial least squares structural equation modelling (PLS-SEM). The findings indicate that HIFE was significantly associated with lower levels of depression, anxiety, and stress. FII was significantly associated with lower depression and anxiety, but not with stress. DP&BI was significantly associated with lower depression and anxiety, while its association with stress was non-significant. The results highlight the role of emerging digital sports ecosystems in supporting psychological well-being and demonstrate that different forms of sports investment contribute unequally to mental health outcomes. This study contributes to the literature on digital transformation in sport by illustrating how investments in digital platforms, broadcasting technologies, and digitally enhanced fan experiences are associated with mental health outcomes among football supporters. Practical implications are provided for policymakers and sport organisations seeking to leverage digital and physical sports investments to promote societal well-being within the framework of Saudi Vision 2030. Full article

Background/Objectives: Loneliness is a clinically relevant psychosocial factor in later life and has been associated with adverse mental, cognitive, and physical health outcomes. Views on ageing may shape social engagement, coping, and perceived belonging, but evidence from geriatric patient populations remains limited. This study examined whether views on ageing are associated with loneliness in geriatric patients. Secondary analyses explored subjective age, including felt age and the perceived onset of old age. Methods: This cross-sectional analysis used baseline data from two prospective observational studies in geriatric patients (N = 459). Loneliness was assessed with the three-item UCLA Loneliness Scale. Views on ageing were measured using five items from the German Ageing Survey. Associations were examined using Spearman correlations, non-parametric group comparisons, and multiple linear regression. Results: Participants had a mean age of 83.1 years and 65.6% were female. The mean UCLA loneliness score was 1.54 ± 2.07, and the mean views on ageing sum score was 13.21 ± 2.72. More negative views on ageing were associated with higher loneliness (ρ = 0.122, p = 0.009). In the fully adjusted regression model, views on ageing remained independently associated with loneliness after adjustment for chronological age, sex, and depressive symptoms (β = 0.117, p = 0.014; adjusted R² = 0.051). Depressive symptoms were also independently associated with loneliness (β = 0.182, p < 0.001), whereas chronological age and sex were not. At the item level, associations with loneliness were mainly driven by reduced positive ageing-related beliefs. Higher felt age was associated with higher loneliness (ρ = 0.151, p = 0.003), while a later perceived onset of old age was associated with lower loneliness (ρ = −0.136, p = 0.017). Conclusions: In geriatric patients, more negative views on ageing were weakly associated with higher loneliness independent of depressive symptoms. The small effect size suggests that views on ageing should be interpreted as one modest component within a broader biopsychosocial understanding of loneliness in geriatric care. Full article

Background: Public health emergencies disrupt daily life and impose a heavy burden on mental health. Middle-aged and older adults are particularly vulnerable to the shocks caused by such emergencies, which may substantially increase their risk of depressive symptoms. Although social ties are closely related to mental health, little is known about how different types of social ties are associated with mental health in emergency contexts. Moreover, these associations have rarely been examined alongside broader contextual shocks. This study explores how different social ties are associated with lower depressive symptoms and examines the role of indirect disaster exposure. Methods: Data were drawn from the 2020 wave of the China Health and Retirement Longitudinal Study (CHARLS) and matched with urban cumulative confirmed cases. Using data from 15,897 respondents, we employed linear regression and bootstrap resampling to test whether life satisfaction statistically accounts for some of the associations between social ties, household financial stability, and depressive symptoms. The model also examined whether the association between life satisfaction and depressive symptoms varied with indirect disaster exposure. Results: Broader social participation (b = −0.242, p < 0.01), more positive perceived changes in intergenerational relationships (b = −0.536, p < 0.05), and better household financial stability (b = −1.637, p < 0.01) were associated with fewer depressive symptoms. Life satisfaction statistically contributed to the link between weak ties, financial instability, and depressive symptoms (b = −2.136, p < 0.01). Indirect disaster exposure strengthened the negative association between life satisfaction and depressive symptoms (b = −0.134, p < 0.01). Conclusions: During public health emergencies, depressive symptoms among middle-aged and older adults are associated not only with social ties and household financial stability, but also with the broader context of city-level disaster exposure. Depression prevention strategies need to consider both individual psychological resources and contextual disaster exposure to identify vulnerable populations and reduce mental health risk. Full article

University-wide suicide risk screening is essential but difficult to implement at scale because professional counselling resources are limited and conventional tools often show low predictive value in low-prevalence populations. To support transparent and clinically interpretable campus mental health workflows, this study introduces and validates the Composite Key Conditions (CKC) method, an interpretable, computationally efficient screening approach for identifying students who match counsellor-defined suicide risk categories. A multi-phase, multi-site study involving 8819 students from two universities in the development and cross-site validation phases was conducted, followed by independent external validation at a third university. In the initial wave, students completed self-report questionnaires in November 2023, after which approximately 20% were selected and invited for centralized counsellor evaluation; the assessments were conducted in December 2023. From January to June 2024, 320 students who subsequently attended psychological services (103 at University A and 217 at University B) were assessed through the cohort pathway. CKC was further evaluated in October 2025 using an independent sample of 22,205 students from a third university. The CKC method, developed from the initial phase, correctly classified all students assigned to the suicide risk category during centralized assessment (sensitivity = 1.000, specificity = 0.901). When applied across both centralized and cohort assessments (yielding 89 counsellor-defined suicide risk cases), the method maintained high performance (sensitivity = 0.888, specificity = 0.904, PPV = 0.086). In the independent validation sample, the method correctly classified 17 of the 22 students identified by the internal reporting system as meeting its high-risk criteria, with a specificity of 0.923. CKC provides an interpretable and efficient approach to suicide risk screening that is suitable for large-scale implementation in university settings. By producing transparent, auditable risk rules rather than opaque predictions, CKC is positioned to complement (not replace) counsellor judgement and to support timely triage and referral within campus mental health service systems. Full article

Background/Objectives: Cognitive behavioural therapy (CBT) is an effective intervention for promoting personal recovery among individuals diagnosed with schizophrenia; however, Saudi Arabia has a shortage of healthcare professionals trained to deliver it. Mental health nurses are well positioned to help address this gap. This study explored mental health nurses’ perspectives on a proposed culturally adapted CBT intervention for individuals diagnosed with schizophrenia and identified perceived barriers and facilitators to its implementation. Methods: Situated within the development phase of the Medical Research Council framework for complex interventions, the study examined perceived acceptability and anticipated feasibility rather than efficacy. Three face-to-face focus groups involving 19 mental health nurses were conducted between December 2020 and February 2021 at a tertiary mental health hospital in Riyadh, Saudi Arabia, during the COVID-19 pandemic. The focus group questions were informed by a systematic review of culturally adapted CBT components, and data were analysed using framework analysis. Results: Three themes emerged: acceptability, with nurses recognising the value of CBT in promoting recovery; barriers, including lack of role clarity within mental health nursing policy, dominance of the medical model, and engagement difficulties among individuals diagnosed with schizophrenia; and facilitators, including supportive nursing management, training opportunities, and family involvement. Conclusions: Mental health nurses expressed support for delivering CBT but identified organisational and training-related barriers. Successful implementation will require clear policy frameworks, structured culturally adapted CBT training, ongoing clinical supervision, supportive nursing management, and collaborative approaches that appropriately involve families. Full article

Indigenous youth in Canada experience disproportionate mental health challenges, highlighting the need to better understand behavioural and contextual factors that influence wellbeing. This study examined associations between lifetime alcohol use and self-reported mental health among Indigenous adolescents, with attention to gender and age differences. Cross-sectional data from 64 participants in the Smart Indigenous Youth (SIY) study were analyzed using Fisher’s exact tests, stratified analyses, and logistic regression. In bivariate analyses, lifetime alcohol use was associated with lower odds of positive self-reported mental health (OR = 0.31, 95% CI [0.09–0.96], p = 0.042); however, this association attenuated after adjustment for gender (OR = 0.64, p = 0.631). Male youth had higher odds of positive mental health than female youth (OR = 4.99, 95% CI [1.65–15.10], p = 0.004). Although male participants reported greater land-based activity participation, land-based activity was not independently associated with mental health. Findings highlight the importance of considering gender alongside behavioural and contextual factors and support larger longitudinal studies using culturally relevant measures. Full article

Background and Objectives: Yoga has been proposed as a supportive intervention to enhance mindfulness and reduce stress among nursing students, but evidence from mixed-method studies remains limited. This study aimed to examine the effects of a 12-week course-based yoga intervention on mindfulness and perceived stress and to explore students’ experiences of practicing yoga. Materials and Methods: A total of 42 second-year nursing students at a university in Istanbul, Türkiye, participated in a mixed-methods study, with 22 students enrolled in the elective Health and Yoga course constituting the intervention group and 20 students enrolled in another elective course constituting the control group. Group allocation was non-randomized and determined by students’ elective-course enrollment. The intervention group attended weekly 90 min yoga sessions for 12 weeks, delivered by a certified instructor (E-RYT 200). Quantitative outcomes were measured using the Mindful Attention Awareness Scale (MAAS) and Perceived Stress Scale (PSS), with baseline-adjusted ANCOVA and change score analyses performed to control for pre-test differences and gender. Effect sizes (partial η²) were reported, and 95% CIs were calculated for the mean differences in change scores. Qualitative data were collected via semi-structured interviews and analyzed thematically, integrating findings with quantitative results. Results: Baseline-adjusted ANCOVA revealed greater improvements in mindfulness (F(1, 39) = 29.686, p < 0.001, partial η² = 0.432) and perceived stress (F(1, 39) = 158.293, p < 0.001, partial η² = 0.802) in the intervention group, controlling for baseline scores. Change score analyses confirmed these findings: mindfulness increased (MD = 10.68, 95% CI [6.62, 14.75], p < 0.001) and perceived stress decreased (MD = −11.40, 95% CI [−13.32, −9.48], p < 0.001) significantly more in the intervention group than controls. Qualitative findings complemented the quantitative results, indicating perceived physical (flexibility, posture, pain reduction), mental (positive emotions, awareness, emotion regulation), and social (motivation, interaction) benefits of yoga. Some participants reported hesitation in applying yoga in nursing practice due to cultural barriers. Conclusions: The findings suggest that participating in a course-based yoga program may help improve mindfulness and support stress reduction among nursing students. Qualitative findings complemented the quantitative results by providing insight into students’ perceived physical, mental, and social experiences of yoga. Given the small, single-center, and self-selected sample, these findings should be interpreted cautiously. Larger, multicenter randomized studies with longer follow-up are needed to confirm these findings and assess their generalizability. Full article

Background: Mental health has become a fundamental component of the sports world. Although previous studies have addressed psychological aspects of women’s soccer, no comprehensive review has mapped both mental health symptoms and adaptive psychological resources and psychophysiological markers in professional, semi-professional, and competitive adolescent women’s soccer. Objective: This scoping review aimed to map recent evidence from 2020 to 2025 on mental health in professional and semi-professional women’s soccer including competitive settings for adolescents, identifying key psychological constructs, assessment instruments, and risk and protective factors within the competitive sport context. Methods: Following the methodological guidelines of the Joanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR), a systematic search was conducted in PubMed/MEDLINE, Scopus, and Web of Science. Thirteen empirical studies that explicitly assessed mental health dimensions in professional and semi-professional women’s soccer players were included. Results: The most frequently studied constructs were psychological stress, competitive anxiety, resilience, motivation, and well-being. The main risk factors included intense competitive demands, accumulated fatigue, and performance pressure. Predominant protective factors were individual resilience, social support, team cohesion, and self-confidence. The most used instruments were validated scales including the Brunel Mood Scale (BRUMS), Sport Anxiety Scale-2 (SAS-2), Competitive State Anxiety Inventory-2 Revised (CSAI-2R), Generalized Anxiety Disorder-7 (GAD-7), Sport Mental Health Assessment Tool-1 (SMHAT-1) and qualitative interviews. Resilience emerged as a central concept; although it was measured directly in only two studies, it emerged conceptually as a central theme in the evidence, and recent qualitative studies have highlighted the influence of the institutional environment and technical support. Conclusions: The available evidence which is heterogeneous and limited to 13 studies points to a growing body of research on mental health in women’s soccer, focused primarily on stress and resilience. However, significant gaps remain, including a lack of multi-season longitudinal studies tracking players across full competitive cycles, limited representation of Latin American and Asian contexts (one study each), the absence of position-specific analyses such as studies focused on goalkeepers and insufficient attention to positive well-being. Prospective and intervention-based studies are needed to develop a comprehensive understanding of mental health in elite sports and in competitive adolescent settings. Full article

Background and objectives: Despite the substantial global burden of mental illnesses, there remains limited evidence evaluating the effectiveness of inpatient Models of Care (MOCs) for adolescents. This paper compares the effectiveness of an innovative MOC, the Brief Intervention MOC (BIMOC), with the Traditional MOC in an acute adolescent inpatient unit. Comparisons were based on clinical outcome measures and several Key Performance Indicators (KPIs) (length of stay, 28-day readmission rate, 7-day follow-up rate, seclusion rate, and self-harm incidents), which were tracked over the subsequent years to evaluate BIMOC’s effectiveness and sustainability. Materials and Methods: A retrospective, single-center, quasi-experimental non-randomized before-and-after study using historical controls was conducted. Clinical outcomes were assessed using the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) and the Children’s Global Assessment Scale (CGAS). Service-level KPIs were compared across models. Descriptive statistics, paired-samples t-tests, Cohen’s d, and z-tests were used to evaluate changes within models and compare outcomes between models. Results: Within the BIMOC, both acute and crisis subgroups showed substantial improvements, with mean CGAS scores increasing from 27.67 to 49.76 and mean HoNOSCA scores decreasing from 19.30 to 9.96 (p < 0.001). Overall, both models demonstrated significant improvements from admission to discharge. Effect size analysis indicated greater functional gains under the BIMOC compared with the TMOC (d = 1.89 vs. 1.22; z = −3.694, p = 0.0002), while no statistically significant difference in symptom improvement was detected between the two MOCs (z = −0.769, p = 0.4418). KPI data analysis identified favorable patterns in several service-level indicators during the BIMOC period compared to the TMOC period, including reduced length of stay (21.0 vs. 13.6 days), reduced 28-day readmission rates (11.9–17.0% vs. 8.1%), and increased 7-day follow-up completion (approximately 60% vs. 76.8%). Conclusions: The study suggests that a structured and integrated inpatient MOC (BIMOC) incorporating multidisciplinary collaboration, family involvement, and coordinated discharge and follow-up processes may support positive clinical and service-level outcomes in adolescent mental health inpatient settings. However, given the observational before-and-after design, the findings should be interpreted cautiously and do not establish causality. Full article

Background: Fathers may experience psychological difficulties during the transition to parenthood, and depressive symptoms during the antenatal period may be associated with fathers’ well-being and adjustment to the paternal role. Marital satisfaction and paternal attachment may be important psychosocial factors associated with fathers’ mental health during this period. This study aimed to examine the relationships among marital satisfaction, paternal attachment, and depressive symptoms among expectant fathers. Methods: A descriptive cross-sectional study design was employed. The study was approved by the Van Yüzüncü Yıl University Non-Interventional Clinical Research Ethics Committee (20 December 2024; Approval No. 2024/13-07). Institutional permission was obtained from the hospital where the study was conducted. Written and verbal informed consent was obtained from all participants, and the study was conducted in accordance with the principles of the Declaration of Helsinki. Data were collected between January 2025 and September 2025 at a hospital located in the Eastern Anatolia Region of Türkiye. The study was completed with 336 fathers. Data collection instruments included the Personal Information Form, Marital Life Scale (MLS), Paternal–Antenatal Attachment Questionnaire (PAAQ), and Edinburgh Postpartum Depression Scale (EPDS). Multiple regression analysis and forest plot analysis were performed. Results: A statistically significant difference was observed between EPDS scores and MLS, PAAQ, educational status, spouse’s educational status, place of residence, family type, income status, spousal attendance at antenatal visits, and history of depression (p < 0.05). The regression model was statistically significant (F(9326) = 14.4, p < 0.001) and explained 26.4% of the variance in EPDS scores (R² = 0.284). In the adjusted regression model, MLS, educational level, PAAQ, and family type were significantly negatively associated with EPDS scores, whereas a history of depression was significantly positively associated with EPDS scores (p < 0.05). Conclusions: Higher marital satisfaction and paternal attachment were associated with lower depressive symptoms among expectant fathers, whereas a history of depression was associated with higher depressive symptoms. These findings highlight the importance of considering marital and attachment-related factors when assessing fathers’ psychological well-being during the antenatal period. Full article

Background/Objectives: Nursing research on children with disabilities spans diverse disability groups, care settings, and areas of practice; however, its development and structure have not been comprehensively examined. This study aimed to examine publication trends, major research themes, temporal development, and collaboration patterns. Methods: The Web of Science Core Collection was searched on 29 June 2026 without publication-year restrictions. English-language articles and reviews indexed in Science Citation Index Expanded (SCI-EXPANDED) and Social Sciences Citation Index (SSCI) were included, yielding 1915 publications from 1977 to 2026. VOSviewer and Biblioshiny were used to analyze publication trends, keyword co-occurrence, thematic structure and evolution, trend topics, and country and institutional collaboration. Results: Research output increased substantially, particularly during the last decade. Across the study period, the United States had the highest publication output and co-authorship connectivity, followed by England, Canada, and Australia. Nursing, children, autism spectrum disorder, intellectual disability, and cerebral palsy were among the largest nodes in the keyword network. The thematic map positioned the autism–pediatrics–developmental disability cluster slightly within the motor themes quadrant, while the disability–children with disabilities–qualitative research, adolescents–communication–transition, and children–nursing–intellectual disability clusters were positioned among the basic themes. Thematic evolution showed both continuity and diversification, with autism, nursing, children, and intellectual disability represented across multiple periods, while quality of life, education, and mental health were represented in the most recent period. Trend topic analysis further showed that well-being, implementation, pediatric nursing, anxiety, and mental health were among the topics with more recent median publication years. Conclusions: Nursing research on children with disabilities has expanded and diversified, with recurring disability-specific topics alongside more recent topics related to psychosocial issues, pediatric nursing, and implementation. Future research could build on the thematic patterns identified in this study through systematic reviews and primary nursing research, while bibliometric studies incorporating additional databases could provide a more comprehensive view of the field. Full article

Background: Mothers of children with autism spectrum disorder (ASD) face numerous challenges in meeting their children’s needs. This study aimed to assess parent-reported child behavioural and emotional outcomes and the levels of anxiety, depression, and stress among mothers of children with ASD. It also explored the correlations between parent-reported child behavioural and emotional outcomes and maternal mental health, as well as potential factors associated with these outcomes. Methods: A cross-sectional study was conducted between 30 December 2022 and 23 March 2023. An online questionnaire was distributed through autism associations across Saudi Arabia. The survey included (1) demographic data; (2) the Autism Family Experience Questionnaire (AFEQ) for children’s behavioural and emotional outcomes; and (3) the Depression, Anxiety, and Stress Scale-21 (DASS-21). Statistical analyses were performed using Jamovi software. Results: The study included 218 mothers of children with ASD. Extremely severe anxiety was reported by 41.3% of mothers, while 30.7% had normal stress and 30.7% had normal depression scores. The mean AFEQ symptom score was 37.4 ± 5.02. Univariate analysis revealed significant associations between parent-reported child behavioural and emotional outcomes and maternal mental health. In the multivariate analysis, higher family income (5000–10,000 SAR, p < 0.001; >10,000 SAR, p = 0.009) was associated with more favourable outcomes, while having more than one child with ASD was associated with less favourable outcomes (p = 0.015). Anxiety was positively associated with having two (p = 0.003) or three children (p = 0.029), while depression was negatively associated with having more than three children (p = 0.001). Conclusions: Higher family income was associated with more favourable parent-reported child behavioural and emotional outcomes, whereas having more than one child with ASD was associated with less favourable outcomes and higher maternal anxiety. Full article

Mood disorder symptoms represent an important but understudied mental health concern among physicians in Romania, with potential implications for quality of life and suicide risk. This cross-sectional study included 104 medical doctors. Validated self-report instruments were used to assess depressive symptoms, manic and cyclothymic symptoms, bipolar risk, suicidal behaviour, and quality of life. Pearson correlation analyses and multiple linear regression models were conducted to examine associations and identify predictors of quality of life and suicide risk. Overall, 33% of participants screened positive for depressive symptoms, 21% for manic symptoms, 71% for cyclothymic symptoms, 12% for suicide risk, and 2% for bipolar risk. Depression, cyclothymia, and suicide risk were negatively correlated with quality of life, whereas manic symptoms showed a positive association. In multivariate analyses, cyclothymia predicted poorer quality of life (β = −0.43, p < 0.001) and manic symptoms seemed to predict better quality of life (β = 0.26, p = 0.008), while depressive symptoms uniquely predicted greater suicide risk (β = 0.24, p = 0.048). These findings indicate a high prevalence of mood disorders among Romanian physicians and suggest distinct patterns linking mood symptoms to quality of life and suicide risk. The results highlight the importance of early identification, stigma reduction, and targeted mental health interventions to support physician well-being and healthcare system sustainability. Full article

The COVID-19 pandemic lockdowns heavily impacted the stress levels of families worldwide. We examined parental stress levels regarding a variety of subtopics (including finances, schooling, and seeing extended family) in North Bay, Ontario, Canada. A mixed-method survey approach was used with a volunteer sample of 101 parents from the North Bay community. Included in the survey were 25 potential parental stressors, which parents were asked to rate in terms of their stressfulness, both during the COVID-19 lockdowns and post-pandemic. To accomplish this, participants were administered only one questionnaire, after the height of the pandemic was over, and asked to reflect on both the current time and on the time during the lockdown phase of the pandemic. General stress levels were higher after the lockdowns ended compared to during the lockdowns, indicated by 20 out of the 25 surveyed parental stressors. Four themes were identified in the qualitative data obtained from open-ended questions: ability to parent; requiring additional support; mental and physical well-being; and child-rearing. Specifically, in terms of the first theme, some parents felt that parenting had become more difficult, while others did not. With respect to theme two, many parents felt a need for support in a variety of areas, which relates to theme three, as supports were often desired to improve mental or physical well-being. The fourth theme highlighted the opportunity to spend more time at home with family and raise children according to parents’ own principles. Parents were also asked about changes in their behaviours, like gambling and alcohol use; gambling, in particular, increased during and after the pandemic compared to before. However, parents reported that the difficulty associated with continuing to parent as they did before the lockdowns was minimal, and that it did not change during or after the lockdowns. Finally, parents were asked about changes to their own mental and physical health; results were mixed, but approximately half of participants perceived positive changes in their well-being. Thus, compared to existing research, the current study provides a more comprehensive overview of stressors experienced by families in the wake of COVID-19 lockdowns. It also brings to light suggestions and recommendations from survey respondents to improve parents’ quality of life in post-COVID-19 North Bay, Ontario. Full article

Previous studies have shown that Bouldering Psychotherapy (BPT), an emerging integrative intervention combining bouldering with psychotherapeutic techniques, may promote improvements in mental health and well-being. This pilot study aimed to examine the effects of BPT on symptoms of depression and anxiety in a Brazilian population and explore participants’ perceptions of its psychological and social impacts. Eleven participants completed an eight-week BPT program and were compared with a matched control group. Symptoms of anxiety and depression were assessed before and after the intervention. Qualitative data were collected through semi-structured interviews and analyzed using word-frequency analysis and reflexive thematic analysis. The BPT group showed a significant reduction in depressive symptoms (p = 0.015, d = 0.66) and a marginally non-significant reduction in anxiety symptoms (p = 0.059, d = 0.44). The qualitative findings indicated perceived improvements in psychological well-being, emotional regulation, self-awareness, social connectedness, and psychological skills. Participants also reported transferring skills and insights acquired during the program to everyday life. Overall, the findings suggest that BPT may improve mental health, particularly depressive symptoms, while fostering supportive social relationships and positive psychological experiences. The results support the feasibility of adapting BPT to the Brazilian context and encourage further research on climbing-based psychotherapeutic interventions. Full article