Search Results (5,994)

Environmental degradation represents a critical global challenge. Given its profound impact on ecosystems and societies, understanding the psychological factors that motivate individuals to engage in natural resource conservation behaviors has become increasingly important. Because efficacy beliefs (i.e., self-efficacy, response efficacy, and collective efficacy) are key psychological drivers of both plans and actions, a meta-analytic approach was used to estimate the associations between efficacy beliefs and conservation-related intentions and behaviors. The moderating roles of data collection method, population type, culture, and participants’ gender were also examined. Five meta-analyses synthesized the findings from 50 studies on conservation intentions and behaviors, revealing medium-sized positive associations with self-efficacy (intention, r = 0.47; behaviors, r = 0.41) and response efficacy (intention, r = 0.36; behaviors, r = 0.34), whereas the association with collective efficacy was small (single index, r = 0.28). Although substantial heterogeneity was observed, none of the tested moderators reached statistical significance, highlighting the need for future studies. Overall, these findings underscore the importance of strengthening individuals’ beliefs in their ability to engage in conservation behaviors. Full article

Media primarily frames climate change as a threat or disaster, which may dampen public interest and engagement. Does shifting communication strategies to emphasize people’s ability to enact change increase political engagement with climate change? This study examines whether exposure to a news story containing efficacy information is associated with changes in self-efficacy, collective efficacy, and intentions to engage in political activism. Using a quasi-experimental classroom-based design, a single exposure to a news story embedded with efficacy information was not associated with higher levels of any of the three dimensions of political self-efficacy—internal, external, and response—as well as perceived collective efficacy among undergraduate students (N = 731) in a large city in India. Exposure to efficacy information was not associated with intentions to engage in individual or political activism indirectly either. However, internal efficacy, response efficacy, and collective efficacy were positively associated with intentions to engage in individual and collective political action. In addition, perceived collective efficacy mediated the association between internal and response efficacies with collective political action intentions, highlighting the critical role of collective efficacy in collective political action. The findings suggest that while perceived self- and collective efficacies are important for increasing public engagement, they may not be readily amenable to change through single or infrequent exposure to efficacy-oriented messages. Full article

The development of entrepreneurial competences has become established as a strategic learning outcome in higher education. However, shortcomings persist in students’ competency profiles, which have led institutions to design training programs aimed at strengthening entrepreneurial mindsets and improving the employability of their graduates. This study examines entrepreneurial competences among university students from a gender perspective within digitally mediated learning contexts. To this end, a quantitative methodology was employed, using a non-experimental, cross-sectional design with a sample of 705 students (77% women and 23% men), with a mean of 4.56 years of professional experience. Entrepreneurial competences were assessed using a validated questionnaire measuring five dimensions: self-awareness and self-confidence, vision of the future, achievement motivation, planning, and persuasion. The results show moderately high levels of entrepreneurial competences, with achievement motivation emerging as the strongest dimension. Gender differences were limited, except in self-awareness and self-confidence, where men obtained higher scores, while women showed a stronger positive tendency in achievement motivation, suggesting differentiated patterns of competence development. Sociodemographic variables such as gender, age, and early work experience showed a modest but statistically significant predictive effect on entrepreneurial competences, highlighting the relevance of integrating psychological, cultural, and contextual factors in future research. The study highlights the potential of inclusive and personalized pedagogical strategies to strengthen self-efficacy, motivation, and equity in the development of entrepreneurial competences in higher education, and the results are discussed in relation to their relevance for current digitally mediated educational contexts, labour market competence demands, and their alignment with international frameworks such as the 2030 Agenda for Sustainable Development. Full article

Background/Objectives: Clinical empathy is a core competency in nursing education and is conceptually relevant to person-centered nursing care. However, limited evidence is available on how clinical empathy in advanced nursing students is associated with dispositional characteristics such as personality traits and resilience. This study aimed to examine cross-sectional associations between clinical empathy, Big Five personality traits, and resilience in third- and fourth-year nursing students. Methods: A descriptive, cross-sectional secondary analysis was conducted using an existing survey database. The final analytic sample comprised 66 third- and fourth-year nursing students from a nursing school in Spain. Clinical empathy was assessed with the Jefferson Scale of Empathy, resilience with the 6-item Brief Resilience Scale, and personality traits with the Big Five Inventory-44. Life satisfaction, academic engagement, and general self-efficacy were included as secondary psychosocial variables. Descriptive analyses, correlation analyses, group comparisons, and exploratory multiple linear regression were performed. Results: Higher agreeableness was associated with higher total clinical empathy (ρ = 0.390, p = 0.001) and perspective-taking (ρ = 0.440, p < 0.001). Higher conscientiousness was also associated with higher total clinical empathy (ρ = 0.480, p < 0.001), perspective-taking (ρ = 0.432, p < 0.001), and compassionate care (ρ = 0.324, p = 0.008). In the exploratory multivariable cross-sectional model, agreeableness and conscientiousness were independently associated with total clinical empathy, whereas resilience was not. Findings involving the Standing in the Patient’s Shoes subscale should be interpreted cautiously because of its low internal consistency. Conclusions: In this exploratory sample of advanced nursing students, self-reported clinical empathy was associated mainly with agreeableness and conscientiousness. These findings should be interpreted as cross-sectional associations based on self-report data and should not be taken as evidence of causal effects, ethical behavior, or person-centered care practices. Further longitudinal and multicenter studies are needed to examine whether these associations are stable and whether they relate to observable educational or clinical outcomes. Full article

Diabetes disproportionately affects rural populations in the United States where prevalence and associated complications remain among the highest in the nation. Access to diabetes education and support services is often limited by geography, socioeconomic barriers, and workforce shortages. This study qualitatively explored participant experiences in a telehealth-based Diabetes Self-Management Education and Support (DSMES) program. This study uses interview techniques and takes a phenomenological approach to exploring the lived experiences of 27 program participants. Transcripts were analyzed through three cycles of coding to identify shared themes. Four themes emerged: (1) structural benefits of the program, (2) knowledge gained, (3) lifestyle changes implemented, and (4) improved quality of life. Participants consistently emphasized the value of personalized coaching, emotional encouragement, and practical nutrition education. Findings suggest that individualized telehealth coaching plays an important role in diabetes self-management, particularly in rural and underserved populations. By combining personalization with education and encouragement, programs can improve patient engagement, enhance self-efficacy, and support meaningful behavior change. Full article

Background and Objectives: The aging process impacts physical function and quality of life, often exacerbated by chronic conditions such as low back pain. This pilot study explored the feasibility and preliminary outcomes of a 12-week machine-based Classical Pilates program on quality of life and low back pain in older adults. Materials and Methods: An exploratory mixed-methods approach was used. The quantitative phase included 13 participants (Mage = 64.76 ± 4.71) to evaluate quality of life. All 13 participants were assessed for low back pain and quality of life, and 4 females participated in a focus group for a qualitative analysis of perceived benefits. The intervention consisted of two individual sessions per week. Results: Preliminary quantitative analysis revealed an increase in the physical domain of quality of life (p < 0.05). There was a reduction in pain intensity and global pain values (p < 0.05). Qualitative data provided context for these preliminary findings, with participants reporting perceived improvements in mobility, body awareness, pain management, and sleep quality, alongside notable psychosocial benefits. Conclusions: Preliminary findings suggest that a 12-week individual machine-based Pilates program is feasible and may be associated with improvements in the physical domain of quality of life and perceived low back pain in active older adults. Due to the complete absence of a control group and the very small sample size, it is impossible to isolate the intervention’s efficacy from natural progression or placebo effects. Consequently, these results are strictly exploratory and hypothesis-generating. The mixed-methods approach highlights that individualized machine-based Pilates may provide self-reported psychosocial and daily living benefits, supporting the need for future well-powered randomized controlled trials. Full article

Teacher coaching is a widely used approach to support teacher professional development, yet the relational and psychological factors that influence coaching outcomes remain underexplored. Guided by the Expectancy-Value Theory and prior literature, this study examined the role of coaching relationships, teacher self-efficacy, and teachers’ motivation for coaching in the coaching process, with two key outcomes: teachers’ acceptability of coaching and perceived stress. A sample of 308 K-12 teachers from the United States completed relevant measures. Structural equation modeling revealed that high-quality coaching relationships were significantly associated with greater acceptability, self-efficacy, and motivation, particularly increased perceived benefits and reduced reservations. Coaching relationships and coaching acceptability were indirectly associated via self-efficacy and perceived benefits. The indirect association between coaching relationships and stress was fully explained through self-efficacy. These findings underscore the importance of fostering strong relationships with teachers and addressing motivational components to enhance the effectiveness of coaching interventions. Full article

Children’s food choices are shaped early in life through cognitive, social, and environmental influences, yet relatively little is known about how school-based nutrition education supports these processes in routine settings. This study examined mechanisms potentially relevant to children’s food choices using a multi-source process evaluation of the municipal “I Know What I Eat” program implemented in Warsaw primary schools. A prospective observational implementation study was conducted in 81 public schools, covering 198 workshop cycles for students aged 8–9 years. Data were obtained from teacher-observers (n = 198), trained program implementers (n = 6), and implementation records. The evaluation focused on implementation quality, fidelity, acceptability, and mechanisms relevant to food-related decision-making. Quantitative data were analyzed using descriptive statistics, Kruskal–Wallis tests, and Spearman correlations; qualitative comments were examined using content analysis. The program was implemented with high quality and consistency, with mean ratings ranging from 4.88 to 4.96 on a five-point scale and no significant differences by implementer or class size. Qualitative findings indicated that experiential learning, practical food preparation, peer interaction, and active participation supported children’s engagement. These findings suggest that school-based nutrition education can create conditions relevant to food-related decision-making, although direct behavioral measures are needed. Full article

Background: A bidirectional association between diabetes and oral health is well established, yet oral self-care is overlooked in diabetes management. Health Belief Model (HBM)-guided oral care interventions have exhibited promising outcomes in the literature but have not been used to guide oral self-care interventions designed for people with diabetes (PWD). Positioned at the early conceptualization and design stage of such a program, this developmental study was to identify self-perceived needs in oral self-care practices and to obtain preliminary feedback among PWD about the blueprint of a new program—DiaOral^©. Methods: We conducted semi-structured interviews with 15 PWD recruited from a large healthcare system, with a goal to recruit patients from racially/ethnically diverse urban/suburban zip codes. Interviews explored participants’ oral self-care practices in relation to diabetes. Sample DiaOral^© content and images on a blueprint were presented and feedback was solicited. Braun and Clarke’s reflexive thematic analysis was used to code and interpret transcripts, aligning emerging themes with HBM constructs through team-based consensus. Results: Three major themes and 27 sub-themes emerged: (1) lack of knowledge on optimal oral care, (2) low perceived importance of preventive care and oral health in diabetes, and (3) low self-efficacy for performing effective oral self-care. Participants expressed satisfaction with the content and their perceived confidence and interest potentially in using the DiaOral^© program based on their preliminary review of the blueprint. Conclusions: Findings support the relevance of HBM constructs in shaping oral self-care among PWD. This developmental study suggests that the DiaOral^© blueprint is ready to move forward to website prototype development. Future work will finalize the program and evaluate its efficacy among PWD. Full article

Cancer vaccines represent a promising strategy in cancer immunotherapy by inducing tumour-specific immune responses. However, their clinical efficacy remains limited due to challenges in antigen selection, including the distinction between self and non-self-antigens, as well as issues related to antigen delivery, immune activation, and tumour immune evasion. Advances in nanotechnology have introduced innovative approaches to improve vaccine stability, targeted delivery, and immunogenicity. Nanoparticle-based platforms, including lipid, polymeric, inorganic nanoparticles, and virus-like particles, enable efficient delivery of tumour antigens and immunostimulatory adjuvants to antigen-presenting cells, thereby enhancing adaptive immune responses. Despite these advances, several translational challenges persist, including immunosuppressive tumour microenvironments, inefficient lymph node targeting, safety concerns, and manufacturing limitations. This review summarizes key nanoparticle platforms used in cancer vaccine development and discusses major barriers to their clinical translation. We also emphasize platform-selection criteria, cargo-dependent carrier design, nanoparticle size constraints, engineering strategies used to improve cytosolic delivery and endosomal escape, and the current clinical pipeline of cancer nanovaccines. Additionally, emerging strategies such as personalized nanovaccines, mRNA vaccine platforms, and combination immunotherapies are highlighted as promising approaches to improve therapeutic efficacy. These advances are expected to accelerate the clinical translation of nanotechnology-enabled cancer vaccines and support the development of next-generation cancer immunotherapies. Full article

Background: No systematic review has yet been conducted simultaneously on the effectiveness of psychological interventions across multiple outcome measures during rehabilitation following anterior cruciate ligament reconstruction (ACLR). This study aims to assess the effects of such interventions on pain, psychological outcomes, patient-reported knee function, objective knee measures, and quality of life following ACLR. Methods: We searched PubMed, Medline, Embase, PsycINFO, and the Cochrane Library from inception to 20 April 2026 (PROSPERO CRD42023483889). Eligible randomized controlled trials compared psychological interventions with usual care in ACLR patients. Two reviewers assessed eligibility, risk of bias, and extracted data. Random-effects models were used; effect sizes were interpreted using Cohen’s guidelines. Results: Of 401 records screened, 11 RCTs (440 participants) were included. Psychological interventions significantly improved pain (six trials, SMD = −0.96, 95% CI −1.40 to −0.52, p < 0.001, I² = 47%; large effect), kinesiophobia (TSK-11: five trials, SMD = −0.48, −0.74 to −0.22, I² = 0%; small effect), knee self-efficacy (K-SES: three trials, SMD = 0.53, 0.19–0.86, I² = 0%, moderate effect), patient-reported knee function (IKDC: two trials, SMD = 0.58, 0.26–0.90, I² = 0%, moderate effect), and physical role function (SF-36: two trials, SMD = 0.41, 0.04–0.78, I² = 0%, small effect). No significant effects were found for KT1000, knee strength, SF-36 mental well-being, or ACL-RSI (all p > 0.05, with substantial heterogeneity for ACL-RSI). Particularly, imagery therapy reduced pain (three trials, SMD = −1.54, I² = 15%). Conclusions: This meta-analysis provides preliminary evidence that psychological interventions, especially imagery therapy, may improve pain, psychological outcomes, patient-reported knee function, and quality of life after ACLR. Adequately powered trials with standardized protocols are needed to confirm these findings. Full article

Background: Virtual reality (VR) simulations provide immersive, interactive learning environments that can support clinical skill development in medical education. However, evidence for its application in Korean medical education remains limited. This pilot study aimed to develop and evaluate HaniE-VR1, a 360° VR simulation program designed to teach ultrasound-guided pharmacopuncture. Methods: A one-group pre–post experimental design was used with 60 undergraduate students from the College of Korean Medicine (pre-intervention n = 60; post-intervention n = 59, due to one missing post-survey response). The primary outcomes were changes in self-efficacy (MASS) and ultrasound skill-related performance (OSAUS). Secondary outcomes included VR awareness, usability, satisfaction, presence, and cognitive load. Participants completed a VR-based training session using a Meta Quest 3 headset. Effect sizes (Cohen’s d) were calculated for pre–post comparisons. Statistical significance was set at p < 0.05. Results: Post-intervention findings showed significant improvements in self-efficacy (MASS: 3.21 ± 0.51 to 3.54 ± 0.61, p < 0.001, d = 0.66) and ultrasound skill performance (OSAUS: 2.66 ± 0.73 to 3.54 ± 0.71, p < 0.001, d = 1.16). VR awareness also improved significantly (4.33 ± 0.66 to 4.76 ± 0.56, p < 0.001, d = 0.65). Participants reported acceptable usability (SUS = 69.49) and high satisfaction (4.51 ± 0.56), confidence (4.32 ± 0.53), and presence (4.40 ± 0.65). Cognitive load and simulator sickness were minimal. Conclusions: The HaniE-VR1 program was associated with improvements in perceived clinical competence, self-efficacy, and learning satisfaction, demonstrating acceptable usability and preliminary educational potential. VR simulations represent a feasible, safe, and engaging approach for integrating experiential learning into Korean medical curricula. Given the exploratory nature of this pilot study, findings should be interpreted with caution, and future controlled research is warranted. Full article

While the use of artificial intelligence (AI) in higher education is widespread, students’ experiences with AI-supported learning in their regular courses remain underexplored. Objective: This research examines the relationships among perceived usefulness, perceived ease of use, and academic engagement among undergraduate students enrolled in AI-supported courses at a Taiwan university. It adopts the Technology Acceptance Model, where learning desire indicates perceived usefulness, and technology self-efficacy indicates perceived ease of use. Methods: The study takes a questionnaire with six dimensions of technology self-efficacy, learning desire, learning methods, learning planning, learning habits, and learning process to evaluate students’ attitudes toward AI-supported learning and their academic engagement. Results: Students’ attitudes toward AI-supported learning were moderate to positive. Multiple regression analysis showed that perceived usefulness was significantly and positively associated with academic engagement, whereas perceived ease of use showed a positive but non-significant association. Implications: Students’ academic engagement is influenced more by how useful AI tools are perceived for learning, rather than by their confidence in using AI tools. This paper enriches the literature on student-centered AI in higher education and gives insights for designing AI-supported courses that integrate AI tools with meaningful learning tasks. Future research can examine larger and more diverse samples and use longitudinal or experimental designs to test how students’ perceptions of AI tools develop over time. Full article

Background/Objectives: Occupational stress is a prevalent issue in healthcare settings, particularly among nurses, and is often associated with increased levels of burnout and reduced well-being. This study aims to examine the relationship between occupational stress and burnout among nurses, with a particular focus on the mediating role of job satisfaction and the moderating role of self-efficacy. Methods: A quantitative research design was employed using data collected from 245 nurses in Saudi Arabia through a bilingual survey instrument incorporating validated psychological measures. Statistical analyses were conducted to test the direct, mediating, and moderating relationships among the study variables. Results: The findings indicate that occupational stress is positively associated with burnout and negatively related to job satisfaction. Job satisfaction was found to partially mediate the relationship between stress and burnout, suggesting that reduced job satisfaction serves as a key mechanism through which stress contributes to burnout. In contrast, self-efficacy did not demonstrate a significant moderating effect in this relationship. Conclusions: This study contributes to the occupational health literature by highlighting the critical role of job satisfaction in mitigating the adverse effects of stress on burnout among nurses. The findings offer practical implications for healthcare leaders and policymakers seeking to design targeted interventions aimed at enhancing job satisfaction, reducing burnout, and improving nurses’ overall well-being. Full article

Background: Oncology nurses are highly vulnerable to impaired mental health and reduced quality of life due to the emotionally demanding nature of their work. Although mental health is a well-established determinant of quality of life, the mechanisms underlying this relationship remain insufficiently understood. Objective: This study examined the effect of the mental health continuum on quality of life among oncology nurses and tested the serial mediating roles of exercise self-efficacy and psychological resilience. Methods: A cross-sectional design was conducted with 604 oncology nurses in Türkiye. Data were collected using the Mental Health Continuum—Short Form, the Exercise Self-Efficacy Scale, the Psychological Resilience Scale, and the WHOQOL-BREF. Serial mediation analysis was performed using PROCESS Model 6 with 5000 bootstrap resamples. Results: The mental health continuum had a significant positive effect on exercise self-efficacy (a1 = 0.08, p < 0.001) and psychological resilience (a2 = 0.05, p < 0.001). Exercise self-efficacy significantly predicted psychological resilience (d1 = 0.51, p < 0.001). Both exercise self-efficacy (b1 = 0.88, p < 0.001) and psychological resilience (b2 = 1.60, p < 0.001) were significant predictors of quality of life. The direct effect of the mental health continuum on quality of life remained significant (c′ = 0.65, p < 0.001), indicating partial mediation. Bootstrap results further confirmed that all indirect effects were statistically significant, as their 95% confidence intervals did not include zero. Conclusions: Quality of life is influenced not only by mental health but also by sequential cognitive and adaptive processes. Interventions targeting exercise self-efficacy and psychological resilience may enhance well-being among oncology nurses. Full article