Search Results (5,627)

Burnout constitutes a critical psychological and operational challenge in military environments, with potential implications for well-being and occupational functioning. Mindfulness-Based Cognitive Therapy has shown beneficial effects on stress and burnout across different populations; however, little is known about how brief online adaptations are perceived by active-duty military personnel prior to implementation. This qualitative study explored the prospective acceptability of a proposed brief online Mindfulness-Based Cognitive Therapy program and identified perceived implementation considerations within the Portuguese Army. Fifteen participants (11 men and 4 women) took part in semi-structured interviews, which were analyzed using reflexive thematic analysis within a constructivist framework. Five themes were identified: previous experiences with psychological services, prospective acceptability of the proposed program, practical and cultural barriers, conditions for implementation, and preferences regarding format and facilitation. Participants generally viewed the proposed program favorably and identified brevity, confidentiality, scheduling flexibility, digital access, leadership support, and facilitator credibility as potentially important for future implementation, while stigma and workload were perceived as relevant barriers. These findings reflect prospective perceptions rather than actual intervention feasibility or effectiveness. Public Significance Statement: This study identifies key factors influencing how active-duty military personnel perceive a proposed brief online mindfulness-based intervention before implementation. Full article

Social–emotional competence (SEC) is an important factor contributing to students’ academic success and psychological well-being. While research on SEC is widespread, studies within the unique demographic and ethnic context of the Arab minority in Israel remain scarce. This study examined SEC levels across three distinct educational subsystems (General Arab, Druze, and Bedouin), alongside gender and socioeconomic status (SES). A sample of 852 fifth- and sixth-grade students was recruited from 15 elementary schools in northern Israel. SEC was evaluated using an adapted 40-item self-report online questionnaire split into emotional and social subscales. A 3 × 2 factorial ANOVA revealed a significant main effect of the educational subsystem, with post hoc pairwise comparisons showing that Druze students scored significantly higher than both General Arab and Bedouin students. Intriguingly, independent t-tests revealed no significant differences in SEC based on gender, grade level or SES. These results suggest that cultural–ethnic background and distinct institutional contexts serve as the primary sources of variance in SEC in this cohort. However, given the regional scope and cross-sectional design of the study, these findings should be interpreted with caution. Key explanatory mechanisms, such as intergroup contact and communal belonging, were not directly measured and remain theoretical interpretations. Overall, the results highlight the need to move away from “one-size-fits-all” approaches in favor of culturally sensitive, localized interventions Full article

Background/Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as a promising therapeutic option for women with polycystic ovary syndrome (PCOS). Clinical trials and data demonstrate significant improvements in body weight, insulin resistance, hyperandrogenism, and, in some studies, menstrual regularity and reproductive outcomes. However, the current evidence base remains disproportionately focused on short-term metabolic and anthropometric endpoints, while outcomes most relevant to patients—including treatment satisfaction, gastrointestinal tolerability, psychological well-being, body image, fertility planning, financial burden, and long-term adherence—remain inadequately characterized. Methods: We searched PubMed and Google Scholar for English-language literature published between 2021 and 2026, using structured keyword searches. This narrative review evaluates the literature on GLP-1RA use in PCOS beyond weight-focused outcomes, examining mechanisms of action, comparative tolerability across agents, and patient-centered domains including quality of life, eating behavior, and reproductive planning. Results: The published literature reveals a substantial gap between trial-reported completion rates and treatment success, and actual persistence and patient satisfaction. This discrepancy is particularly consequential in PCOS, where treatment decisions intersect with high baseline rates of depression, anxiety, and body image disturbance, and where ovulatory benefits must be weighed against mandatory discontinuation before conception. Conclusions: We identify a systematic absence of validated patient-reported outcome measures, standardized core outcome sets, and long-term follow-up data after treatment withdrawal. This review proposes a research agenda prioritizing patient-centered endpoints as co-primary outcomes, structured assessment of acceptability and persistence, qualitative and mixed-methods approaches, and a dedicated study of fertility planning and treatment interruption. Full article

Ethical leadership has become increasingly relevant to employee well-being and creative performance in Saudi Arabia’s tourism sector, where Vision 2030 emphasizes human capital development, decent work, and sustainable tourism. This study examines how ethical leadership is associated with employees’ creative performance through three resource-related mechanisms: workaholism, employee voice, and self-efficacy, among full-time employees in travel agencies. A cross-sectional survey design was employed; 1094 questionnaires were distributed and 689 usable responses were analyzed using partial least squares structural equation modeling. Ethical leadership was directly associated with higher creative performance and indirectly associated with it through lower workaholism and higher employee voice and self-efficacy. All three indirect associations were significant and reflected complementary partial mediation, indicating that the ethical leadership–creative performance relationship is associated with distinct strain-related, behavioral, and psychological pathways. The cross-sectional, single-source design and the focus on travel agencies in two major cities limit causal inference and generalizability. Practically, the findings highlight the relevance of ethical leadership for limiting workaholic tendencies while supporting employee voice, self-efficacy, and creative performance within workplace conditions aligned with Vision 2030 and sustainable employee well-being. The study contributes by integrating three theoretically distinct mediating pathways within a single resource-based framework in the underexamined context of Saudi Arabian travel agencies. Full article

The performance of healthcare facilities during the COVID-19 pandemic demonstrated that healthcare environments can support or hinder critical aspects of pandemic response, such as infection control, surge capacity, workforce safety, and continuity of care. This study maps the scholarly landscape at the intersection of pandemics, healthcare, and the built environment to clarify how built environment-related concepts are positioned within pandemic-related healthcare research. A total of 5061 records were retrieved from the Web of Science Core Collection and analyzed using VOSviewer (1.6.20). Author keyword co-occurrence analysis was used to examine thematic patterns. The keyword network identified eight major thematic clusters, with subclusters addressing infection control, pandemics and public health, telemedicine and remote care, data technologies and digital infrastructure, healthcare leadership, care quality and safety, healthcare education, occupational stress and resilience, psychological distress, older adult care, pediatric care, health disparities, workplace safety, and waste management. Overall, the findings show that built environment considerations were present across multiple thematic areas but often appeared indirectly within broader clinical, operational, public health, and environmental discussions. Based on these findings, this study discusses future directions for environmental design research, including systems-based approaches, pandemic-readiness assessment, healthcare worker wellbeing and safety, continuity of care, and more explicit integration of design knowledge into pandemic preparedness, response, and recovery. Full article

Academic engagement is associated with the resources available to students, yet it remains unclear through which psychological processes resources of different origins are related to academic engagement. Bringing together Basic Psychological Needs Theory and the Study Demands–Resources framework, this study examined whether autonomy, relatedness, and competence satisfaction mediate the associations of an institutional resource, a fair learning environment, and a resource rooted outside the academic environment, subjective financial well-being, with academic engagement. The measures were first evaluated using data from 278 university students. The structural model, specifying the three needs as parallel mediators, was then tested in a subsequent, non-overlapping sample of 741 students in Türkiye. Both resources positively predicted all three need satisfaction dimensions, whereas academic engagement was predicted only by autonomy (β = 0.43) and competence satisfaction (β = 0.36); relatedness satisfaction made no significant unique contribution. Neither resource was directly associated with academic engagement. The total indirect effects were β = 0.31 for a fair learning environment and β = 0.13 for subjective financial well-being. The model explained 47.4% of the variance in academic engagement. Resources of different origin were indirectly associated with academic engagement through the same two needs, autonomy and competence satisfaction. Full article

This study examined the effects of artificial intelligence (AI) chatbot counseling and face-to-face counseling on perceived stress, athlete burnout, and resilience among athletes. In this three-arm quasi-experimental pretest–posttest study, 73 athletes participated in AI chatbot counseling, face-to-face counseling, or a control condition over a 12-week intervention period. Nonparametric longitudinal analyses revealed significant group-by-time interactions. After adjustment for multiplicity, significant group-by-time interactions were observed for perceived stress and reduced sense of accomplishment, a sub-variable of athlete burnout. Perceived stress significantly decreased in the face-to-face counseling group, whereas reduced sense of accomplishment significantly decreased in the AI chatbot counseling group. For supportiveness, a sub-variable of resilience, the group-by-time interaction was significant before multiplicity adjustment but did not remain significant after adjustment. These findings indicate different patterns of change across the counseling conditions and psychological outcomes. Given the quasi-experimental design and baseline differences among the groups, these findings should be interpreted cautiously and further investigation is needed to clarify the potential roles of AI chatbot counseling and face-to-face counseling in supporting athletes’ psychological well-being. Full article

Background: The rapid integration of artificial intelligence (AI) tools into medical education has opened up new possibilities for academic support. However, it has also raised concerns about over-dependence on AI. Students’ use of AI may have implications for students’ academic self-concept and psychological well-being, but the interrelationships among these constructs are not yet sufficiently understood. This study aimed to examine the association between AI dependency and academic self-efficacy and depressive symptoms among medical students in Saudi Arabia. Methods: We conducted a cross-sectional study among 207 medical students recruited from three public universities in Riyadh, Saudi Arabia. Data were collected anonymously using an online questionnaire distributed through QR-coded recruitment announcements. AI dependency was assessed using a 9-item subset of the AI Dependence Scale, academic self-efficacy using the 5-item General Academic Self-Efficacy Scale, and depressive symptoms using the two depression items of the PHQ-4. AI dependency and academic self-efficacy were modeled as latent constructs in a structural equation model. The model examined the direct association between AI dependency and depressive symptoms and the indirect associational pathway through academic self-efficacy. Results: The mean AI dependency score was 2.83 (SD = 0.78), while the mean academic self-efficacy score was 3.87 (SD = 1.07) and the mean depressive symptom score was 2.05 (SD = 1.42). AI dependency was positively associated with academic self-efficacy (β = 0.298, 95% CI 0.157–0.439, p < 0.001). Academic self-efficacy was inversely associated with depressive symptoms (β = −0.212, 95% CI −0.382–0.041, p = 0.016). AI dependency showed a strong positive direct association with depressive symptoms (β = 0.608, 95% CI 0.491–0.725, p < 0.001). The indirect association through academic self-efficacy was negative (β = −0.063, 95% CI −0.124–0.002, p = 0.052), while the total association remained positive and significant (β = 0.545, 95% CI 0.409–0.671, p < 0.001). The model explained 49% of the variance in academic self-efficacy and 37% of the variance in depressive symptoms. Conclusions: Greater AI dependency was associated with higher academic self-efficacy but also with substantially higher depressive symptom levels among medical students. Academic self-efficacy was inversely associated with depressive symptoms, although evidence for an indirect pathway between AI dependency and depressive symptoms was limited. Our findings highlight the importance of distinguishing productive AI use from excessive dependence. This supports the need for responsible AI integration alongside attention to medical students’ psychological well-being. Full article

Background: Sustainable gymnastics training requires a balance between performance development, injury prevention, workload management, athlete health, psychological well-being, and long-term participation. This focused narrative review aimed to synthesize selected evidence on training optimization, technological applications, athlete health and injury prevention in gymnastics. Methods: A structured narrative review was conducted using the Web of Science Core Collection. The literature search covered publications issued between 1 January 2005 and 30 September 2025, with the final search performed on 30 September 2025. English-language publications retrieved through three predefined Topic searches in the Web of Science Core Collection were considered. The searches covered the period from 1 January 2005 to 30 September 2025 and were restricted to the Sport Sciences category. No additional publications were identified through reference-list screening. Three complementary thematic searches addressing gymnastics training models, technological applications, and injury prevention identified 485 records. After applying the eligibility criteria, removing duplicates, assessing full texts, and excluding ineligible or retracted publications, 140 publications were included in the narrative synthesis. No formal risk-of-bias assessment was performed. Results: The reviewed evidence emphasized progressive and individualized training, workload monitoring, recovery, physical preparation, age-appropriate development, and early identification of pain, fatigue, and other health-related concerns. Injury occurrence was associated with biomechanical loading, rapid growth, training exposure, previous injuries, insufficient recovery, menstrual dysfunction, psychological factors, and discipline-specific technical demands. Wearable sensors, video analysis, biomechanical modelling, artificial intelligence, virtual reality, and digital learning platforms supported movement assessment, technical feedback, training monitoring, and education. Evidence for several emerging technological applications, particularly artificial intelligence and automated assessment, remains preliminary and requires further validation in gymnastics-specific and real-world settings. However, substantial differences in study designs, populations, technologies, outcome measures, and methodological characteristics limited direct comparison across studies. Coaching communication, athlete motivation, psychological well-being, and access to validated technologies also influenced the sustainability of gymnastics training. Conclusions: Sustainable gymnastics training may benefit from an interdisciplinary and athlete-centered approach integrating individualized load management, injury prevention, health monitoring, recovery, educational coaching practices, and appropriately validated technologies. The evidence identified in this review highlights converging themes suggesting the potential value of combining these components to support safe performance development and long-term participation. However, more longitudinal, discipline-specific, and methodologically consistent research is needed. Full article

Background: Doctoral training involves prolonged performance demands, uncertainty, supervisory dependence, and career pressure, yet objective biochemical correlates of academic stress remain incompletely characterized. This study examined academic stress in relation to glycemic, neuroendocrine, inflammatory, and thyroid-related markers, alongside psychological symptoms and sleep quality, in doctoral research scholars. Methods: This cross-sectional study included 203 doctoral research scholars (123 female, 80 male; mean age 27.2 years). Academic stress was assessed using a 34-item doctoral-adapted Academic Stress Scale (AST). Glycated hemoglobin (HbA1c), evening cortisol, C-reactive protein (CRP), and thyroid-stimulating hormone (TSH) were measured as biochemical outcomes. Depression, anxiety, and stress symptoms were assessed using the 21-item Depression Anxiety Stress Scales (DASS-21), and sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Primary associations were examined using linear regression with heteroscedasticity-consistent type 3 (HC3) robust standard errors, adjusted for age, gender, body mass index, and lifestyle activity, with false-discovery-rate (FDR) correction. Results: Mean AST was 109.5 (standard deviation 21.0). Above-normal DASS-21 scores were observed for depression in 64.5%, anxiety in 86.7%, and stress in 49.3%, while 79.3% had poor sleep quality. Higher AST was associated with all four biochemical markers. Per 10-point increase in AST, HbA1c was 0.225 percentage points higher (95% confidence interval 0.158–0.291), evening cortisol 0.502 µg/dL higher (0.299–0.706), CRP 13.9% higher (8.4–19.7%), and TSH 0.125 µIU/mL higher (0.049–0.200); all FDR q ≤ 0.0013. Depression and anxiety severity distributions differed by gender, whereas stress did not. Exploratory analyses showed positive correlations between DASS-21 symptoms and all four biomarkers (Spearman ρ = 0.22–0.58; all FDR q < 0.01). Conclusions: Higher academic stress was associated with variation across glycemic, neuroendocrine, inflammatory, and thyroid-related markers in doctoral scholars, alongside substantial psychological symptom and sleep burden. The cross-sectional design precludes conclusions regarding temporal direction or causality and supports the need for longitudinal research on doctoral health and well-being. Full article

Climate change is increasingly recognized as a significant stressor affecting well-being, yet responses to climate-related distress are heterogeneous and may reflect the interplay of eco-anxiety and trauma-related symptoms. This study used latent profile analysis to identify patterns of climate-related distress and examined their associations with environmental identity, developmental adversity, attachment, prior psychopathology, demographic characteristics, and direct exposure to climate-related events. A sample of 917 Portuguese adults completed measures of eco-anxiety, post-traumatic stress disorder (PTSD) symptom clusters, Disturbances in Self-Organization (DSO) symptoms, environmental identity, childhood adversity, and attachment. Correlates were examined using multinomial logistic regression and MANOVA. A five-profile solution was identified, ranging from minimal symptom endorsement to severe, co-occurring elevations in eco-anxiety, PTSD, and DSO symptoms. Profiles differed in Protection of Nature, but not Connectedness with Nature. Higher-distress profiles were associated with greater direct exposure to climate-related events, childhood adversity, insecure attachment, prior psychopathology, younger age, and female sex, whereas lower-distress profiles were more strongly associated with secure attachment and the absence of previous mental health difficulties. These findings support a person-centered conceptualization of climate-related distress and highlight heterogeneity in the co-occurrence of eco-anxiety and trauma-related symptoms. Climate-related distress may be embedded within developmental, psychological, demographic, and socioecological contexts. Full article

Views of cognitive aging refer to how people think and believe about age-related cognitive changes with aging, including whether they perceive these age-related cognitive changes as fixed (essentialism of cognitive aging) or as potentially malleable (nonessentialism). This cross-sectional study examined the role of cognitive functioning—in particular working memory and cognitive inhibition/interference performance—and psychological well-being in explaining views of cognitive aging among older adults. A total of 237 community-dwelling older adults aged 64–85 years completed the Views of Cognitive Aging questionnaire, along with verbal working memory, cognitive inhibition/interference tasks, and a Psychological Well-Being questionnaire. Regression analyses showed that cognitive performance and psychological well-being explained a significant, though modest, part of the variance mainly in nonessentialist (malleable) views of cognitive aging. Better working memory performance was associated only with stronger generalized and personal nonessentialist views. In addition, greater cognitive resistance to proactive interference, but not inhibition, and psychological well-being were positively associated with generalized nonessentialist views of cognitive aging. These associations were more evident among adults aged 75–85 years than among those aged 64–74 years. Overall, these findings suggest that cognitive performance and psychological well-being contribute differently to the views of age-related cognitive changes and are more closely related to flexible, rather than fixed, views of cognitive aging, particularly in adults 75 and older. The examination of views of cognitive aging could be included in assessment protocols aimed at promoting healthy aging. Full article

Background/Objectives: Hemodialysis requires sustained patient participation in demanding treatment and self-management routines. Spiritual well-being may be a patient-centered psychosocial resource relevant to adherence and self-management, but its independent associations with these patient-reported outcomes remain uncertain. This study examined the associations of spiritual well-being with treatment adherence and self-management among adults undergoing hemodialysis. Methods: This single-center cross-sectional study included 72 adults receiving maintenance hemodialysis at a public hospital in Türkiye between March and May 2025. Spiritual well-being, treatment adherence, and self-management were assessed using the Spiritual Well-Being Scale, End-Stage Renal Disease Adherence Questionnaire, and Chronic Disease Self-Management Scale, respectively. Pearson correlations and two multivariable linear regression models with HC3 robust standard errors were used. Models were adjusted for age, sex, dialysis duration, and number of comorbidities. Rank-based, influence-restricted, and nonlinear sensitivity analyses were performed. Results: Spiritual well-being was positively correlated with treatment adherence (r = 0.822, p < 0.001) and self-management (r = 0.891, p < 0.001). In adjusted linear models, higher spiritual well-being was associated with greater treatment adherence (B = 4.338, 95% CI 3.550–5.126; p < 0.001; adjusted R² = 0.655) and better self-management (B = 0.494, 95% CI 0.418–0.569; p < 0.001; adjusted R² = 0.787). Sensitivity analyses confirmed the direction and statistical significance of both associations, while nonlinear models suggested attenuation at higher spiritual well-being scores. Conclusions: Spiritual well-being was associated with two patient-reported outcomes relevant to long-term hemodialysis care after adjustment for the measured demographic and clinical covariates. Person-centered nephrology assessment may consider spiritual well-being alongside health literacy, psychological distress, social support, and practical treatment barriers. Longitudinal multicenter studies should determine the temporal direction and clinical implications of these relationships. Full article

Adolescent anxiety presents a growing challenge for schools, with emotional difficulties affecting educational engagement, attendance and wellbeing before some pupils meet thresholds for specialist mental health support. This creates a need to investigate accessible and non-stigmatising forms of early support within schools. Emerging TTRPG research has described experiences involving social connection, confidence, self-expression and emotional exploration, but direct evidence concerning secondary-aged pupils experiencing emerging or subthreshold anxiety remains limited. This opinion paper brings together findings from existing TTRPG research, mechanisms identified in broader psychological theory and related narrative approaches, and propositions concerning how these may operate through school-based TTRPG participation. Its contribution is a conceptual model linking components of TTRPG participation with five overlapping proposed mechanisms: narrative distance; psychological safety and social connectedness; intrinsic motivation and agency; identity exploration and self-efficacy; and cognitive flexibility and emotional regulation. The paper also outlines an illustrative school-based delivery model and a staged agenda for future research. These pathways are theoretically plausible rather than empirically established, and TTRPG participation should not be assumed to reduce anxiety or replace specialist assessment or treatment. Initial research should establish feasibility, acceptability and safety, including potential adverse experiences, before psychological or educational outcomes are evaluated. Full article

Background/Objectives: The Caregiver Wellness: U-Model Questionnaire offers a self-guided approach to assessing caregiver well-being and provides resources designed to empower caregivers to embrace self-care. The instrument consists of 27 items organized into nine wellness dimensions: occupational wellness, physical wellness, psychological wellness, intellectual wellness, social wellness, resilience, empowerment, spiritual wellness, and financial wellness. The purpose of this study was to evaluate the validity and reliability of the Caregiver Wellness: U-Model Questionnaire for measuring the perceived well-being of caregivers. Methods: This secondary analysis used a convenience sample of 225 participants who completed the questionnaire between 2022 and 2025; family caregivers and frontline direct care workers could not be distinguished within the dataset. Analyses of the CWQ included internal reliability consistency, exploratory factor analysis (EFA) and subscale correlations for model and subscale refinement. Results: McDonald’s omega (0.828) indicated high reliability of the CWQ. The EFA revealed six factors retained on Eigenvalues > 1 and visual inspection of a scree plot. Subscale correlations showed evidence of convergent validity. The original nine subscale questionnaire items were mapped to the corresponding six factors from the structure matrix. The resulting six subscales are Connected Well-Being, Personal Agency, Empowered Adaptive Capacity, Functional Capacity, Resilient Self-Regulation, and Occupational Wellness. Conclusions: The findings of this study and the revised six-factor Caregiver Wellness model demonstrate an improved understanding of caregiver wellness as an interplay of relational connectedness, personal empowerment, adaptive resilience, functional resources, self-regulatory processes, and occupational fulfillment. Full article