Search Results (10,304)

Mental health professionals’ perspectives on transdiagnostic mobile interventions for Emotional Disorders (EDs) remain underexplored, despite their potential role in integrating ecological interventions into psychological care. This study examined the usability, acceptability, perceived clinical utility, and implementation potential of EmoGuia, a smartphone-based Ecological Momentary Intervention grounded in the Unified Protocol. Using the Consensual Qualitative Research framework, focus groups involving nine therapists and researchers were conducted following a one-week app trial. Thematic findings identified 13 categories across three domains: (1) target population, (2) satisfaction and app experience, and (3) perceived utility. Usability was additionally assessed via the System Usability Scale (SUS). Participants perceived EmoGuia as intuitive, simple, and suitable for young adults with mild-to-moderate anxiety or depressive symptoms. It was perceived as useful for fostering emotional awareness, reinforcing therapeutic content, and preventing dropout. Recommended improvements included personalized feedback, simplified language, and better notification management. SUS scores indicated high perceived usability (M = 79.4; SD = 12.1). These findings support EmoGuia as a promising low-intensity, adjunctive tool for early intervention in EDs and provide implementation-relevant guidance for its iterative refinement. Patient-inclusive longitudinal studies are needed to establish acceptability, engagement, feasibility, and clinical effectiveness. Full article

A fundamental concern for coaches and sport practitioners is developing athlete performance while preserving health and well-being. An emerging topic is that performing in nature-based environments may have more benefits than performing in typical built/indoor environments. However, to understand athlete performance and well-being, it is essential to recognize how performers accommodate (adapt) skills and resources under environmental constraints in pursuit of sport and exercise task goals. This article presents a narrative review to support a hypothesis on the sustained benefits of performing in nature-based environments, with health and well-being as necessary aspects for performance, grounded in the ecological dynamics theoretical framework. We start by discussing: (i) performance in nature-based and indoor environments underpinned by affordance perception; (ii) evidence for the role of nature-based environmental constraints on movement and psychological aspects; (iii) the hypothesis that prolonged engagement with nature-based environments during sport and exercise may promote adaptive skill development, health, and well-being, and may facilitate the transfer of these adaptations to performance in built indoor competitive settings; (iv) the distinct lived experiences (e.g., emotion, well-being) that emerge from exercising in nature-based and built indoor environments; and (v) suggestions on how to include nature-based constraints on sport and exercise training, and future research considerations. Overall, the reviewed theoretical and empirical evidence provides a rationale for the hypothesis that prolonged engagement with nature-based environments during sport and exercise may promote adaptive skill development, health, and well-being, with potential transfer of these adaptations to performance in built indoor settings. Future longitudinal and experimental studies are required to test this hypothesis and determine whether, and under what conditions, these proposed adaptations transfer to performance in built indoor sport settings. Full article

Mental health significantly impacts state performance, productivity, public services, health care costs, and tax revenue. The 5.0 Revolution has redefined productive work as continuous, raising expectations for constant activity and responsiveness and heightening work-related stress. Excessive work stress, known as burnout, is not classified as a medical condition but is recognized as “unmanaged work burnout syndrome.” This research examines the need to strengthen legal frameworks to provide preventive protection against burnout for employees. The researcher conducted doctrinal research using primary legal sources, including the Law of the Republic of Indonesia Number 13 of 2003 concerning Manpower (as amended), the Law of the Republic of Indonesia Number 2 of 2022 concerning Job Creation, Law No. 17 of 2023 concerning Health, the Regulation of the Minister of Health Number 3 of 2023 concerning Health Service Tariff Standards, and the Regulation of the Minister of Health Number 19 of 2024 concerning Community Health Centers. We also reviewed secondary sources, such as scientific journal articles and books. We analyzed these sources using legal interpretation and synthesis, applying grammatical and systematic methods. To strengthen the legal framework, we recommend providing psychological consultation services in companies, implementing mental health screenings for employees, and enhancing psychological well-being services at health centers. Full article

Introduction: As seasonal influenza vaccination coverage among healthcare workers (HCWs) in Serbia remains suboptimal, we aimed to identify HCW beliefs associated with their intention to receive seasonal influenza vaccine (“vaccination intention”) in the season 2024/2025. Methods: In a cross-sectional survey conducted in 2024, healthcare institutions were selected from a national registry, using multi-stage sampling stratified by geographical region and healthcare level. All consenting HCWs present on the survey day self-completed questionnaires. Five dichotomised Health Belief Model constructs were assessed: perceived susceptibility to influenza, perceived disease severity, perceived vaccination benefits, perceived physical and psychological barriers, and perceived cues for action (recommendation by another HCW, someone close, or a supervisor). The association of vaccination intention (yes/no/undecided) with Health Belief Model constructs, demographic and occupational factors were assessed using multinomial logistic regression. Results: Of 1919 respondents, 30% declared positive vaccination intention, 52.5% no intention, and 17.5% were undecided. Compared with no intention, positive vaccination intention was associated with perceived self-benefit (aOR = 6.22, CI = 3.49–11.08), perceived patient benefit (aOR = 2.26, CI = 1.48–3.45), perceived susceptibility (aOR = 3.26, CI = 2.19–4.86), and perceived vaccine safety (aOR = 2.95, CI = 1.93–4.50). Participants were more likely to be undecided than reject vaccination if they experienced higher perceived susceptibility (aOR = 2.93, CI = 1.89–4.54), perceived influenza as severe (aOR = 2.04, CI = 1.30–3.21), perceived patient benefits (aOR = 1.77, CI = 1.14–2.74), or recalled receiving a recommendation from another HCW (aOR = 2.63, CI = 1.17–5.85). Conclusions: HCWs’ positive vaccination intention was associated with beliefs relevant for personal health and patient benefits. The undecided group showed a distinct pattern of beliefs warranting their separate analysis and specific approaches. Full article

Background/Objectives: Musculoskeletal disorders (MSDs) represent a significant occupational health concern among medical laboratory workers (MLWs) worldwide. However, in cross-sectional epidemiological assessments, these are more accurately characterized as self-reported musculoskeletal symptoms (MSSs). Despite growing awareness of physical ergonomic risk factors, the multifactorial etiology of these symptoms, such as psychosocial factors, remains incompletely understood in research laboratory settings. Consequently, this study aimed to determine the prevalence of MSSs among MLWs in a Malaysian research institute, assess physical ergonomic risk in their daily tasks, and evaluate the empirical association between MSSs and psychosocial work engagement. Methods: A cross-sectional study was conducted among MLWs at a Malaysian medical research institute. The 12-month prevalence of self-reported MSSs was assessed using the Nordic Musculoskeletal Questionnaire. Physical ergonomic risk was evaluated utilizing the Rapid Entire Body Assessment (REBA). Psychosocial work engagement was measured using the 17-item Utrecht Work Engagement Scale. Results: A total of 115 MLWs participated, with 73 (63.5%) reporting MSSs. The neck had the highest complaints (n = 43, 37.4%), followed by the lower back (n = 35, 30.4%) and shoulders (n = 33, 28.7%). Multivariable modified Poisson Generalized Estimating Equations revealed that physical ergonomic risk (REBA) was significantly associated with symptoms in the shoulder, upper back, and lower back. Female sex was independently correlated with the overall prevalence of MSSs (aPR = 1.39; 95% CI = 1.14–1.68), with marked associations observed for the neck and knees. Psychosocially, high “absorption” in work was significantly associated with upper back symptom prevalence (aPR = 1.57; 95% CI = 1.15–2.14). Conclusions: Ergonomic strain demonstrates a strong association with axial and shoulder symptoms among MLWs, while demographic characteristics and cumulative tenure correlate with specific extremity symptoms. Paradoxically, high psychological absorption emerges as a distinct correlate of upper back symptoms, likely due to prolonged postural neglect during deep concentration. Occupational health programs may benefit from combining targeted ergonomic accommodations with strategies designed to mitigate the potential physical vulnerabilities of highly absorbed personnel. Full article

Objective: Modern high-intensity warfare, such as the Russo-Ukrainian conflict, generates a high incidence of multisystem polytrauma, blast-induced traumatic brain injury, and limb amputations often complicated by post-traumatic stress disorder and chronic pain. Traditional specialised rehabilitation protocols are structurally inadequate for these co-occurring symptoms and rely heavily on medical treatments, increasing the risk of opioid dependency. The primary aim of this review is to conceptualise a multidimensional integrative framework for war-related polytrauma; a secondary aim is to evaluate and summarise the evidence underpinning its key rehabilitation strategies for limited-resource, post-conflict environments. Methods: This narrative review synthesises evidence identified through targeted database searches and purposive selection guided by clinical relevance, methodological quality, and applicability to war-related polytrauma across physical, technological, and non-pharmacological rehabilitation domains. Evidence was evaluated using a four-tier (A–D) hierarchy, comprising Tier A (systematic reviews and RCTs), Tier B (prospective cohort studies and non-randomised controlled trials), Tier C (descriptive, case-series, and retrospective studies), and Tier D (exploratory, mechanism-based, or expert opinion evidence). No systematic inclusion/exclusion protocol was applied, and no claims of comprehensive search coverage are made. Results: Concurrent physical and trauma-focused psychological rehabilitation, evidenced by reduced pain and psychological symptom burden alongside improved functional independence, is supported by high-quality evidence (Tier A) for managing comorbid polytrauma. Robotic exoskeletons and AI-supported tele-rehabilitation demonstrate dose-dependent motor benefits in selected rehabilitation populations (Tier A–B), but their scalability in wartime settings is contingent on electricity supply, connectivity, equipment maintenance, and trained personnel. Acupuncture shows Tier A evidence for neuropathic pain and Tier B cost-effectiveness; evidence for phantom limb pain and PTSD is preliminary (Tier C–D) and requires dedicated RCTs in veteran populations. Ayurvedic herbal interventions are exploratory (Tier C–D) with no war-specific clinical trials; mechanistic plausibility is discussed as hypothesis-generating only. Conclusions: Addressing the war-related rehabilitation gap requires integration of biomedical care, technology-assisted rehabilitation, and evidence-graded non-pharmacological adjuncts within a structured biopsychosocial framework. Future priorities include pragmatic, adapted trial designs (e.g., stepped-wedge or cohort-embedded designs, which are more feasible than classical RCTs under wartime conditions) for acupuncture in phantom limb pain, feasibility trials for robotic rehabilitation in frontline-adjacent facilities, and health-economic modelling adapted to the Ukrainian context. Full article

In recent years, concerns about youth mental health, school disengagement and territorial inequalities have renewed interest in arts-based, participatory educational practices, including participatory video (PV) and youth-led filmmaking. This scoping review, conducted and reported in accordance with the PRISMA-ScR guidelines, maps empirical studies employing PV or youth-led filmmaking with adolescents and young people (approximately 9–24 years) in school, after-school and community-based programmes, focusing on engagement, belonging, psychological well-being, agency, empowerment and socio-emotional skills. A structured search was conducted in four electronic databases (Scopus, Web of Science, PubMed, PsycInfo) and complemented by manual screening of reference lists, yielding nineteen peer-reviewed articles in English using qualitative, quantitative or mixed-methods designs in which PV was a central component. Narrative thematic synthesis suggests that PV can create “third spaces” for expression and co-authorship, support participation and voice, strengthen trust, self-efficacy and relational competences, and foster school connectedness. At the same time, the literature points to limitations linked to structural constraints, power hierarchies and partial institutional recognition of youth-produced narratives. Overall, the review indicates that participatory video is a promising but context-dependent approach for supporting protective factors associated with school disengagement and early school leaving and outlines implications for integrated school–community interventions and future research on longer-term impacts. Full article

Background: Medication non-adherence remains a major challenge in psychiatric care, yet its prediction often relies on clinical and sociodemographic characteristics, while giving comparatively limited attention to modifiable psychological–cognitive factors. Integrating mental health literacy and medication-related beliefs with explainable machine learning approaches may provide a more informative framework for understanding and predicting adherence. Objective: This study examined the association of mental health literacy and medication-related beliefs with psychotropic medication adherence and evaluated their explanatory and predictive values using conventional statistical modeling, machine learning, explainable artificial intelligence, and structural path analysis. Methods: A cross-sectional study was conducted with 225 psychiatric patients. Medication adherence; mental health literacy; and beliefs about medication necessity, concerns, harm, and overuse were assessed using self-report measures, including a MARS-derived eight-item adherence measure. Associations were examined using Spearman correlations, hierarchical regression with robust inference, and a secondary observed-variable path representation of multivariable associations with 5000 bootstrap resamples. The Elastic Net, Random Forest, and Gradient Boosting models were evaluated using repeated five-fold cross-validation. Shapley Additive exPlanations (SHAP) were used to interpret the best-performing model. Results: Greater adherence was associated with higher mental health literacy (ρ = 0.361) and stronger necessity beliefs (ρ = 0.353), whereas concern (ρ = −0.474), perceived harm (ρ = −0.528), and overuse beliefs (ρ = −0.284) were negatively associated with adherence (all p < 0.001). The psychological–cognitive model explained 40.0% of the variance in the primary eight-item adherence composite. The integrated Random Forest achieved the best out-of-sample performance (R² = 0.402, MAE = 0.958, RMSE = 1.299; n = 208), although the improvement over the psychological–cognitive Random Forest (R² = 0.375) was modest. SHAP identified perceived harm and medication concerns as leading predictors. Conclusions: Medication adherence in psychiatric patients was more strongly characterized by psycho-cognitive factors than by sociodemographic and clinical characteristics alone. Mental health literacy, necessity beliefs, medication concerns, and perceived harm may represent particularly informative targets for individualized adherence assessments and future intervention development. Prospective external validation is required before clinical implementation. Full article

Background/Objectives: Self-management for adults living with intestinal stomas secondary to colorectal cancer encompasses technical ostomy care, physical symptom control, psychological adjustment, and social participation, creating demand for standardised assessment instruments to identify unmet rehabilitation needs. Definitions of generic self-care and stoma-specific self-management remain inconsistent across published literature, and psychometric indicators are incompletely reported across available measurement instruments. This review includes both stoma-specific instruments and generic self-care scales that have been validated or widely applied specifically in colorectal cancer ostomy cohorts. Following JBI scoping review methodology, this work systematically maps all published self-management assessment instruments developed for adults with intestinal stomas secondary to colorectal cancer, summarises their core measurement domains and documented psychometric properties, and identifies prevailing gaps in scale development and validation research. Methods: This scoping review was conducted in accordance with Joanna Briggs Institute methodological guidance and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) reporting checklist. Ten electronic databases were searched from inception to 31 December 2025, with supplementary manual screening of reference lists. Eligible sources were peer-reviewed English or Chinese articles focusing exclusively on adults with colorectal cancer–related intestinal stomas. Two independent researchers completed title/abstract and full-text screening, followed by data extraction using a piloted standardised form. Consistent with descriptive scoping review design, no formal methodological quality evaluation or risk-of-bias assessment was performed. Results: Thirty-two studies involving 12 self-management assessment instruments were finally included. All tools documented Cronbach’s α coefficients ranging from 0.805 to 0.977. Content validity indicators were documented for eight instruments, whereas construct validity verified via factor analysis or structural equation modelling was only available for three tools. Criterion-related validity, cross-cultural validity and responsiveness were scarcely reported across most instruments. Only three instruments were fully developed based on complete and clearly articulated theoretical frameworks. Four consistent core measurement domains were identified across scales: stoma technical care, symptom and complication management, psychological adaptation, and family-social interaction. Conclusions: Although internal consistency metrics are universally reported, comprehensive multi-faceted validity testing and responsiveness evaluation are largely absent from existing published evidence. Cross-cultural measurement invariance between original and locally adapted versions (such as the ESCA and its Chinese revised forms) has rarely been examined. Future research priorities include rigorous cross-cultural adaptation following International Society for Pharmacoeconomics and Outcomes Research (ISPOR) and Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) protocols, full psychometric verification of currently available instruments, and development of brief validated short forms for clinical screening. New instrument development should only be initiated if existing tools fail to capture core rehabilitation priorities identified by patients, caregivers, and clinical staff. No responsiveness metrics were identified across the 32 included colorectal cancer-specific clinical studies. The absence of relevant evidence in this literature pool does not prove that these instruments cannot detect longitudinal changes; formal responsiveness testing is required before applying these tools for long-term outcome monitoring. Full article

Background and objectives: Type 2 diabetes mellitus (T2DM) care depends on sustained self-management behaviour and psychological wellbeing. This study examined diabetes self-management behaviour, depressive symptom burden, and associated demographic factors among adults with T2DM. Methods: The present cross-sectional study was conducted among T2DM patients attending 10 primary healthcare centres in the Al-Jouf region, northern Saudi Arabia. Diabetes self-management behaviour was assessed using the Summary of Diabetes Self-Care Activities, and depressive symptoms were assessed using Patient Health Questionnaire-9. Binomial logistic regression identified factors associated with low self-management behaviour and no-to-mild depressive symptom status. Results: Of the 350 T2DM patients studied, the mean self-care activity score was 28.38 ± 12.10, and the mean PHQ-9 score was 6.39 ± 3.91. Moderate-to-severe depressive symptoms were present in 87 participants (24.9%). Low self-management behaviour was significantly associated with obesity (Ref: normal body mass index; AOR: 1.47, 95% CI: 1.10–2.06, p = 0.041), T2DM duration of 6–10 years (Ref: 0–5 years; AOR: 2.12, 95% CI: 1.18–3.83, p = 0.013), other chronic illnesses (Ref: no; AOR: 1.93, 95% CI: 1.18–3.16, p = 0.004), and moderate-to-severe depressive symptoms (Ref: none-to-mild; AOR: 1.76, 95% CI: 1.21–3.06, p = 0.034). Conclusions: Suboptimal diabetes self-management behaviour and depressive symptom burden were observed. Integrating structured self-management education, repeated behavioural counselling, and depressive symptom screening may improve patient-centred diabetes care. Full article

Background: Postpartum depression (PPD) affects about 15–20% of women worldwide. While observational studies have increasingly linked nature exposure to improved perinatal mental health, the extent to which nature-based approaches constitute a viable non-pharmacological intervention for PPD remains unclear. This scoping review and evidence mapping aimed to systematically characterize the current evidence base for nature-based approaches in PPD and perinatal populations. Methods: We searched PubMed, Web of Science, PsycINFO, Embase, Cochrane Library, Medline, CNKI, and WanFang Data from inception to December 2025. Two independent reviewers screened titles/abstracts and full texts against predefined inclusion criteria, with disagreements resolved through discussion. Empirical studies investigating any nature-based approach (NBA) (e.g., nature exposure, green space, forest therapy) in pregnant or postpartum women were incorporated. The review followed the PRISMA extension for Scoping Reviews (PRISMA-ScR) guidelines. No formal risk-of-bias assessment was conducted, consistent with scoping review methodology. The narrative synthesis and evidence mapping methodology were used to classify findings by population type and research design. Results: Of 1245 screened records, 11 studies fulfilled the inclusion criteria. To address the specific question of nature-based approaches for PPD, we classified evidence by its directness: studies on women with clinically significant PPD symptoms were treated as direct evidence; studies on general perinatal populations were treated as indirect evidence. Evidence mapping uncovered a significant deficiency: there are no randomized controlled trials (RCTs) that have specifically assessed NBA for women with PPD. Direct evidence was confined to two qualitative studies elucidating favorable experiences of nature engagement among postpartum women facing mental health challenges. Indirect evidence from observational studies (n = 10) generally supported associations between exposure to residential green space—especially tree canopy cover—and reduced risk of PPD and psychological distress, although some studies reported null findings. Physical activity was identified as a partial mediator in several studies. Only one pilot RCT focused on general postpartum women, indicating feasibility but not achieving significant depression reduction. Conclusions: Although encouraging observational data suggest a correlation between nature exposure and improved perinatal mental health, robust RCT evidence for structured Nature-Based Interventions in postpartum depression populations is lacking. Subsequent research must formulate and evaluate standardized, theoretically informed NBA protocols specifically tailored for women experiencing PPD. Full article

Background: Type 2 diabetes mellitus (T2DM) represents a significant global health challenge, with physical activity recognized as a cornerstone of effective disease management. Nurse-guided physical activity programs offer a promising approach to enhancing glycemic control and quality of life; however, patients’ lived experiences of such interventions remain underexplored, particularly in Middle Eastern contexts. Aim: To explore the perceived experiences of patients with T2DM participating in a nurse-guided physical activity program and understand its role in improving their health outcomes and quality of life. Methods: A qualitative descriptive design was employed. Sixteen adults with T2DM who completed a 12-week nurse-guided physical activity program were purposively recruited from multiple healthcare institutions in Saudi Arabia, including both public and private facilities. Semi-structured interviews were conducted using a 20-item interview guide. Data were analyzed using Braun and Clarke’s six-phase reflexive thematic analysis. Trustworthiness was ensured through member checking, peer debriefing, and maintaining an audit trail. The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results: Four overarching themes emerged: (1) Transformative Health Journey, encompassing perceived physiological improvements and enhanced energy levels; (2) Psychological Awakening, reflecting improved mood, self-efficacy, and reduced diabetes-related distress; (3) The Pivotal Role of Nursing Support, highlighting the significance of professional guidance, monitoring, and therapeutic relationships; and (4) Navigating Challenges and Charting Future Directions, addressing barriers, facilitators, and recommendations for program enhancement. Conclusions: Nurse-guided physical activity programs offer multidimensional benefits for patients with T2DM, extending beyond physiological improvements to encompass psychological well-being and lifestyle transformation. Nursing professionals play a critical role in motivating, educating, and supporting patients throughout their health journey. These findings support the integration of nurse-led physical activity interventions into routine diabetes care. Full article

Background: Psychological distress is common among patients with cardiovascular disease and adversely affects secondary prevention. We investigated whether depressive and anxiety symptoms, identified by guideline-recommended ultra-brief screening instruments, were associated with blood pressure (BP) control after hospital discharge, with particular attention to sex. Data in very high-risk populations remain limited. Methods: In this prospective observational single-center study, 305 consecutive hospitalized cardiovascular patients (mean age 63.9 years, 62.6% men, 79.3% at very high cardiovascular risk) underwent screening for depressive and anxiety symptoms using the Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder-2 (GAD-2). BP control was assessed at discharge and at routine follow-up after a median of 36.0 (32.5–39.5) days using ambulatory or home BP monitoring. Clinical, echocardiographic and psychosocial characteristics were analyzed. Results: Depressive and anxiety symptoms were identified in 31.1% and 29.2% of patients, respectively. Depressive symptoms were more prevalent in women. BP target achievement declined from 78.4% at discharge to 49.5% during follow-up. PHQ-2 ≥ 3 was independently associated with lower odds of achieving BP targets (OR 0.12, 95% CI 0.06–0.23; p < 0.001), together with overweight/obesity (OR 0.20, 95% CI 0.09–0.42; p < 0.001), while male sex was independently associated with better BP control (OR 2.06, 95% CI 1.12–3.77; p = 0.02). Female sex, overweight/obesity, chronic kidney disease, loneliness, and poor sleep quality were associated with PHQ-2 ≥ 3. Conclusions: Female sex and depressive symptoms were independently associated with a lower likelihood of achieving guideline-recommended BP targets during early post-discharge follow-up. These findings highlight the potential utility of brief psychological screening to identify patients at increased risk after discharge. Full article

Background/Objectives: Acute collective emotional events may coincide with variation across multiple dimensions of mental health and health-related behaviors. This study compared mental health outcomes and recent alcohol consumption between assessments conducted before and after a major international sporting event and explored factors associated with psychological and behavioral outcomes among young adults. Methods: An observational study was conducted among 146 adult students in western Mexico who participated in assessments surrounding the 2026 FIFA World Cup match between Mexico and England. Assessments were conducted approximately 10 h before kick-off and 11 h after completion of the match. Because individual responses could not be linked across assessment periods, comparisons were analyzed as repeated cross-sectional marginal comparisons rather than paired longitudinal analyses. Psychological outcomes were assessed using standardized instruments, and recent alcohol consumption was defined as alcohol use during the eight hours preceding each assessment. Results: Anxiety-related symptom scores were lower at the post-event assessment, whereas depressive-related symptoms remained relatively stable. Emotional well-being was also lower at the post-event assessment, while recent alcohol consumption during the eight hours preceding the assessment was substantially more frequent post-event than pre-event (41.1% vs. 0.7%). The small difference observed in sexual-attitude scores was considered exploratory. Post-event multivariable analyses identified several factors associated with psychological outcomes and recent alcohol consumption; these associations were interpreted as cross-sectional. Conclusions: Psychological and behavioral outcomes exhibited distinct patterns between assessment periods surrounding the sporting event. Given the observational design, inability to link individual responses, and presence of unmeasured co-occurring exposures, these differences should not be interpreted as within-participant changes or as effects attributable specifically to the match. Full article

Background/Objectives: Children and adolescents living with HIV (ALHIV) are among the most vulnerable groups affected by HIV and AIDS. Their vulnerability exposes them to several challenges, such as HIV-related stigma and/or interrupted academic activities due to health-related complications. Since they are still minors who cannot independently make decisions regarding their own lives, most of the challenges extend to their caregivers, who sometimes provide care and support under difficult psychological, social, and economic conditions. This study aimed to explore the lived experiences and challenges of primary caregivers caring for ALHIV in Gauteng Province of South Africa. Methods: A qualitative exploratory design with phenomenological orientation was adopted. Eight primary caregivers of ALHIV were purposively sampled and interviewed using individual face-to-face semi-structured interviews. Data was analysed thematically according to the eight steps of Tesch’s qualitative analysis framework. Since it involved human participants, this study was subjected to ethical clearance by the Research Ethics Committee of the University of South Africa, which imposed conditions for upholding ethical principles such as informed consent and confidentiality. Results: Primary caregivers encounter challenges such as regular monitoring of ALHIV who are always sick, treatment adherence monitoring, behavioural management, financial strain, stigma and discrimination, lack of proper nutrition and managing adolescents’ academic difficulties. These challenges require support from multidisciplinary team members which include nurses because they play a crucial role in supporting treatment adherence among ALHIV and in strengthening the capacity of primary caregivers to provide effective treatment support. Conclusions: It is essential to adopt an integrated approach to psychosocial, as well as financial support interventions targeting primary caregivers. Full article