Search Results (14)

Background/Objectives: Feeding and Eating Disorders (FEDs) are among the most challenging mental disorders due to their pervasive symptomatology and high relapse rates. While considerable research has focused on the role of personality in the onset and maintenance of FEDs, it remains unclear whether specific personality dimensions and emotion dysregulation mechanisms predict clinical severity and purging behaviors. This study aimed to explore the role of personality dimensions, emotion dysregulation, and purging behaviors in predicting psychological distress in patients with FEDs, adopting a dimensional and integrated perspective. Methods: A sample of cisgender women in a semi-residential treatment for FEDs or obesity (n = 124) was recruited in southern Italy and assessed using a psychodiagnostics survey, including the Eating Disorder Inventory-3 (EDI-3), the Symptom Checklist-90-R (SCL-90-R), and the Personality Inventory for DSM-5 (PID-5). Results: Patients with bulimia nervosa exhibited higher psychological distress compared to patients with other FEDs and Obesity, which was not significantly determined by the co-occurrence of personality disorders. Negative affectivity, detachment, and purging symptoms were significantly related to psychological distress in patients with FEDs and Obesity (p ranging from 0.028 to <0.001). Moreover, the results showed an indirect effect of emotion regulation on the relationship between self-esteem and purging symptoms in patients with FEDs and Obesity (β = 0.107; p = 0.046). Conclusions: These findings suggest that specific personality dimensions, emotion dysregulation, and purging symptoms are associated with psychological distress in individuals with FEDs and Obesity. Therefore, it is necessary to reflect on the impact of these psychological components in planning tailored treatment for FED patients. Full article

Background: Empathy is a critical component of patient-centered care, influencing clinical outcomes, patient satisfaction, and adherence. Despite its recognized importance, empathy often declines during medical training, particularly in clinical years. Traditional teaching methods, such as reflective writing or self-assessment scales, often fail to promote sustained behavioral change. This study evaluated a structured, skills-focused empathy training program integrated into the third-year medical curriculum, designed to improve observable communication behaviors through actor-led simulation and multi-rater feedback. Methods: This single-group pre-post study evaluated a four-week mandatory intervention embedded within the clinical communication curriculum. Students were assessed before and after the intervention using a 19-item checklist covering five domains of empathy-related communication. Pre-post changes were analyzed using paired-sample t-tests and Cohen’s dz. Results: Thirty-two third-year medical students (mean age 21.25 years, 53% female) participated in the study. Post-intervention scores were significantly higher than baseline scores for the overall empathy-related communication score and across all five domains (all p ≤ 0.001). The overall mean score increased from 7.5 (SD 1.43) to 9.2 (SD 1.14), with a mean difference of 1.7 points (95% CI 1.12 to 2.28; p < 0.001), corresponding to a large paired-sample effect size (Cohen’s dz = 1.03). The largest domain-level gains were observed in verbal and non-verbal communication. Conclusions: This curriculum-embedded, actor-led empathy training intervention was associated with short-term improvement in observed empathy-related communication behaviors among third-year medical students. These findings support the feasibility of behaviorally grounded empathy training within undergraduate medical education, while highlighting the need for controlled and longitudinal studies to assess durability and transferability. Full article

Background: Existing XR simulators for enteral feeding rely mainly on self-reported learning outcomes and procedural checklists. As a result, they offer limited opportunities to capture objective behavioral data or to present dynamic patient reactions. This two-stage pilot study evaluated an XR-based gastrostomy tube-feeding simulator (ESTE-TF) that integrates sensor-derived performance metrics and two biological-reaction presentation modalities (projection mapping and tablet display). Methods: In Experiment 1, nursing students completed pre- and post-experience questionnaires assessing perceived learning across seven domains, alongside sensor-based measurements of feeding-start timing, dosing-rate characteristics, and total procedure time. Experiment 2 employed a tablet-based version with four learning items assessed for students and post-experience evaluations collected from registered nurses. Participants also compared the two XR presentation methods. Results: Students demonstrated perceived learning gains of small-to-large magnitude across both experiments (Experiment 1: d = 0.455–0.974; Experiment 2: d = 0.014–0.886), with wide 95% confidence intervals reflecting the exploratory nature of this pilot work. Sensor-derived data showed greater dosing-rate variability and longer procedure times among students than nurses. Participants reported that projection mapping offered a more embodied experience, whereas tablet displays provided clearer visibility. Conclusions: These findings indicate the feasibility and preliminary educational potential of integrating sensing technologies with XR-based biological-reaction presentation for gastrostomy-feeding training. Given the small samples and non-validated measures, results should be interpreted as exploratory. Future research will refine sensor accuracy, establish standardized performance metrics, and evaluate learning outcomes using validated instruments and controlled study designs. Full article

This study presents the development of a Korean-specific safety checklist for fishing vessels under 10 tons, aiming to strengthen self-safety management in small-scale fisheries. The research first reviewed representative European self-inspection systems and checklists from Norway, Denmark, the United Kingdom, and Ireland, which have established integrated safety management schemes combining self-managed risk assessment with periodic inspection. Following on these systems, three human and system analysis methods were employed: SRK/SLMV for identifying human error types and operational error mechanisms, CREAM for evaluating cognitive performance conditions and failure probabilities, and STPA for analyzing control-loop deficiencies and unsafe interactions within the system. Based on these analyses, a Korean-specific safety checklist was developed and structured into three components: Pre-operation, Post-operation, and Periodic Inspection. Each part was designed to reflect the actual operational characteristics of coastal fishing vessels while maintaining consistency with domestic regulatory requirements. The resulting checklist integrates human, technical, and organizational dimensions, providing a structured tool for evaluating risks and supporting self-assessment-based safety management in daily fishing operations. Full article

Increasing healthcare demands and physician shortages have prompted many countries to expand clinical responsibilities of pharmacists. Although Canada, the UK, and the US have implemented pharmacist prescribing, other nations lag behind. This review compares international roles, identifies inferred competencies, and explores implications for role expansion. A systematic search of MEDLINE, CINAHL, and the Cochrane Library was conducted using the PICO framework; studies were appraised with Critical Appraisal Skills Programme (CASP) checklists, and interrater reliability assessed via Cohen’s Kappa. Data from 23 studies were thematically synthesized following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Four themes emerged: (1) expanding clinical and public health roles and pharmacists’ self-perceived readiness; (2) regulatory frameworks defining legal authority, qualifications, and temporary pandemic exemptions; (3) inferred competencies, including micro-skills (patient assessment, guideline application) and macro-capabilities (clinical judgment, accountability, reflective practice); and (4) contextual barriers such as training gaps, limited funding, unclear legal provisions, and workflow challenges. Implementation implications were synthesized and included training, funding, acceptance, and integration. Evidence indicates pharmacist prescribing is safe and patient-centered when supported by regulation, structured training, and systemic integration. Insights from established models can guide incremental implementation, optimizing medication management, enhancing healthcare access, and promoting equitable care. Full article

Background: Fear of cancer recurrence (FCR) is a common, distressing concern among cancer survivors, with implications for psychological well-being and quality of life. Despite the proliferation of patient-reported outcome measures (PROMs) to assess FCR, consensus on the most valid and reliable instruments remains limited. Objective: To conduct a comprehensive psychometric evaluation of FCR PROMs developed or validated between 2011 and 2023, using the full COSMIN methodology. This review builds on earlier work by systematically appraising both newly developed and adapted instruments to inform evidence-based PROM selection for clinical and research use. Methods: This review followed the COSMIN 10-step procedure and PRISMA 2020 guidelines. Six databases were searched from January 2011 to December 2023. A search cut-off of 31 December 2023 was applied to align with COSMIN feasibility recommendations and ensure sufficient time and resources for full psychometric evaluation across all included PROMs. Eligible studies included adults diagnosed with cancer and reported on the psychometric evaluation of a self-reported, Likert-scale-based FCR PROM. PROMs were appraised across eight psychometric properties using COSMIN’s Risk of Bias checklist, criteria for good measurement properties, and modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE) for evidence quality. Instruments were categorized as A, B, or C according to COSMIN’s recommendations. Results: Of the 34 PROMs evaluated across 32 studies, 28 achieved COSMIN Category A status, indicating sufficient psychometric quality for clinical or research use. Among the 19 FCRI and FoP-Q instruments validated in new cultural or population contexts, 15 received a Category A rating, reflecting strong cross-cultural performance. Short forms such as the FCRI-SF and FoP-Q-SF demonstrated consistent psychometric strength across French, English, Portuguese, and Asian-language versions. Of the 14 newly developed PROMs—including the CWS-6, FCR4/7, CARQ-4, and FCR-1—12 achieved Category A. The FCR-1 was the only single-item PROM to demonstrate responsiveness, supporting its use in both screening and longitudinal monitoring. For practical guidance, five PROMs (FCR-1, FCRI-SF, FoP-Q-SF, FCR-7, and CWS) emerged as the most strongly supported for clinical use. Conclusions: This review provides a comprehensive evaluation of contemporary FCR PROMs and highlights substantial progress in the development of valid, reliable, and culturally adaptable tools. The FCRI, FoP-Q-SF, and several newly developed short forms, such as FCR7, CWS, and particularly, the FCR-1, emerge as strong candidates for use in clinical screening and longitudinal assessment. These findings offer clear evidence-based guidance for instrument selection in research and survivorship care. PROSPERO registration: CRD42023453783. Full article

In Italy, the livestock sector is facing a crucial transformation phase towards a production system able to guarantee a high standard of health and animal welfare. With this aim, the ClassyFarm platform (CFp) has been activated by the Italian Ministry of Health, with a prominent role for farm veterinarians, who are responsible for the livestock farms’ evaluation and the entering of data for self-monitoring purposes into the information system. This work aimed to analyse the application of CFp in the biosecurity and animal welfare areas in twenty-five beef cattle farms of the Marche Region, Central Italy, using the checklists provided by the platform itself. The results, expressed in percentages, were compared with the national averages. The percentages of the animal welfare assessment, which were higher than the national average, are likely the result of improved management and a broad understanding of these indicators based on animal observations. At the same time, the biosecurity area, in line with the national average, resulted in much lower percentages, leading to the assessment that some farming areas should definitely be improved. This result reflects the non-intensive and family-run breeding type of breeding typical of this region, characterised by particular attention to animal welfare. Full article

The aim of this study was to assess the mental health situation of children and adolescents during a period of less strict COVID-19-pandemic-related measures after the first pandemic wave. This cross-sectional study was conducted in July 2021 by carrying out an online survey among children and adolescents (aged 10–18 years) from Halle (Saale), Germany (n = 233). The questionnaire measured important aspects of mental health among young people, namely health-related quality of life (HRQoL, using the self-report version of the KIDSCREEN-10), mental health problems in general (using the SDQ), depressive symptoms (using the CES-DC), and psychosomatic complaints (using the HBSC symptom checklist). In addition, other important health issues such as sleep behavior and related difficulties, disordered eating, and any positive consequences of the pandemic were addressed. The results were analyzed using descriptive statistics. A total of 223 children participated in the survey. About 69.7% of the participating children and adolescents had a high HRQoL, while 10.5% displayed abnormal results on the SDQ. There were indications of emotional problems in 16.5% of the participants based on the SDQ subscales. Almost 44% of the participants were screened as positive for depressive symptoms on the CES-DC, with girls and older adolescents being more likely to be affected. This also applied for psychosomatic complaints. Here, irritability was experienced at least once a week or more frequently by 58.9% of the children and adolescents. Although we had a small sample size, this study showed a high prevalence of mental health problems regarding the SDQ and HRQoL. However, our study population showed a better mental health than comparable studies conducted earlier in the pandemic. Depressive symptoms were still substantially higher than those in pre-pandemic data. We hypothesize that this might reflect the fact that there were a few COVID-19-related restrictions at the time when our survey took place. Based on these findings, we assume that the mental health of children and adolescents differed between different phases in the pandemic. Full article

Background: Contemplative pedagogy, specifically yoga, introduced into the higher education curriculum has the potential to develop and entrain intellectual, emotional, and social development in relation to mental health among university students studying for medical and nursing degrees. The objective of the study is to determine the extent of the current literature on the prevalence of yoga as a contemplative practice that contributes to student well-being and self-knowledge in the first-year transition from high school to university. Methods: As part of the scoping review, CINAHL, EBSCO, Medline, Emerald, Eric, and PsycINFO were searched to identify the prevalence and connection of mind–body courses to student well-being between 2011 and 2022. Screening and selection of studies were based on eligibility criteria and methodological quality assessment. Colaizzi’s method of data analysis enabled the phenomena of interest to be examined and follows the PRISMA for Scoping Reviews (PRISMA-ScR) checklist. Results: Seventeen studies were included with two themes emerging, which include physical practices and training and barriers to success. Conclusion: Yoga is a practice that supports undergraduate students in managing their stressful lives. Due to the experiential nature of yoga the participatory reflective processes established within the physicality of the students provided a framework to cope with the stress and challenges of higher education. Full article

Hospitals’ operational performance during disasters varies from failing, to being responsive and resilient, to dealing with disruption and surprise. Transformational leaders enable continuously learning hospitals that are resilient in the face of disasters by adapting regeneratively and evolving beyond undertaking conventional lesson-learning after each disaster. However, learning from successful transformational leaders in healthcare is still ad hoc with a lack of guidance on how to develop such leaders. Hence, this study sought to identify key competencies of transformational leaders by exploring hospital leaders’ actions in dealing with disasters, considering the disaster cycle of prevention, preparedness, response, and recovery (PPRR). A qualitative case-study design was adopted comprising in-depth semi-structured interviews with twelve senior hospital staff with operational leadership experience with disasters. Three significant categories (themes) and seven key component competencies (sub-themes, in brackets) of transformational leaders were revealed through the analysis of transcripts: (1) ‘Governance and leadership’ (‘transformative agency’ and ‘decisive accountability’); (2) ‘Planning and risk assessment’ (‘risk navigation’, ‘disaster attunement’, and ‘planning agility’); and (3) ‘Communication and network engagement’ (‘communication accelerator’ and ‘collaboration innovator’). The authors propose a transformational leadership model for hospital disaster resilience and an assessment checklist for leaders’ self-reflection to support hospitals in their transition to resilient operations. Full article

This qualitative study aimed to explore the psychological resilience of undergraduate nursing students partaking in a virtual practicum during the coronavirus pandemic (COVID-19) in Taiwan. The virtual practicum, a form of online learning, creates challenges compared to the traditional teaching–learning experience of an actual clinical placement. Exploring how students overcome learning difficulties and build resilience is necessary for a new learning environment or for future online learning. Constructivist grounded theory and the Standards for Reporting Qualitative Research checklist were followed. Purposive and theoretical sampling were used to recruit 18 student nurses for data saturation. Semi-structured, face-to-face interviews were conducted individually to collect data. Initial, focused, and theoretical coding and constant comparative data analysis were performed. Credibility, originality, resonance, and usefulness guided the assessment of the study’s quality. The core category of psychological resilience in the virtual practicum was constructed to reflect Taiwanese nursing students’ progress and experiences of learning during the virtual practicum. This core category consisted of three subcategories: (i) learning difficulties within one’s inner self; (ii) staying positive and confident; and (iii) knowing what is possible. The findings identified psychological resilience as an important factor for students to adjust to the adverse experiences of a rapidly changing learning environment, such as the virtual practicum. The substantive theory of psychological resilience provided a frame of reference for coping with possible future difficulties. Correspondingly, psychological resilience reflected individuals’ potential characteristics and may help students to enter and remain in the nursing profession. Full article

Across their lifespans, and in many clinical settings, patients have spiritual care needs. Many nurses lack competence related to providing spiritual care. Popular educational strategies, such as simulated educational programs and objective structured clinical examinations (OSCE), have not been widely adopted in nursing spiritual care education. The purpose of this study was to explore the effects of a scenario-based spiritual care course on spiritual care competence in nurses. This quasi-experimental study employed a repeated-measures pre-test/post-test design with assessments immediately before, immediately after, and 3 months post-intervention. Nurses providing direct patient care in diverse clinical settings were recruited from a large medical foundation in northern Taiwan. The intervention was a one day scenario-based spiritual care course and OSCE. The experimental group (n = 53) and controls (n = 85) were matched for their similar units, ages, working experience, and clinical ladder status. The Spiritual Care Competence Scale (SCCS), Spiritual Perspective Scale (SPS), Spiritual Care Perspective Scale-Revised (SCPS-R), and reflection logs were completed by both experimental and control groups. The Course Satisfaction Scale, OSCE Checklist, and Standardized Patient Feedback Scale (SPFS) were completed by the experimental group only. The experimental group had significantly higher SPS scores and self-evaluated SCCS scores, and lower SCPS-R scores (more positive spiritual perspectives), than controls at 3 months post-intervention. The experimental group showed significant within-subject effects at three time points on SPS scores, SCPS-R scores, and self-evaluated SCCS scores. Mean global performance of OSCE was 3.40 ± 0.91, and SP feedback indicated strengths and areas for improvement. In conclusion, the scenario-based spiritual care course effectively enhanced nurses’ spiritual care competence, competence, and skills. Blended education techniques can therefore enhance nurses’ ability to support patients with spiritual care needs. Full article

This study investigated the relationship between eye frailty and physical, social, and psychological/cognitive weaknesses among older adults in Japan. The participants were 192 community-dwelling older adult women. We measured handgrip strength, walking speed, and skeletal muscle mass; additionally, their physical, social, and psychological/cognitive frailties were surveyed using questionnaires. Eye frailty self-checks were used to assess eye frailty. Exploratory and confirmatory factor analyses were employed to verify the validity of the eye frailty self-checks. Eye frailty prevalence and related factors were investigated by conducting a binomial logistic regression analysis, with eye frailty as the dependent variable. The factor analysis results showed that a model could be constructed with the two factors of visual acuity or contrast and visual field. The model’s goodness of fit was acceptable, supporting the validity of the self-checking construct. The Kihon checklist was the only variable with a significant relationship to eye frailty. Regarding the relationship between eye frailty and subordinate items of the Kihon checklist, social withdrawal [odds ratio (OR) 2.437, 95% confidence interval 1.145–5.188], cognitive function (OR 2.047, 95%CI 1.051–3.984), and depressed mood (OR 1.820, 95%CI 1.163–2.848) were significant. Eye frailty can be considered a factor reflecting the existence of social and psychological/cognitive frailties. Full article

Orthopedic and sport-related injuries are a major public health concern and a common reason for referral to physical therapy. The use of psychological techniques by physical therapists has been assessed in research studies primarily with retrospective self-report questionnaires that have not been validated against concurrent assessments of the same behaviors. The primary purpose of this study was to examine the extent to which the results obtained from physical therapists’ retrospective self-reports of their use of psychological techniques reflect their use of the techniques assessed concurrently. Physical therapists (N = 14) completed the Physiotherapists and Sport Psychology Questionnaire (PSPQ) at the beginning of this study and a checklist based on the PSPQ at the end of the sessions with patients (N = 306). Patients also completed the checklist at the end of the sessions. Across 12 psychological techniques, the physical therapists’ retrospective (PSPQ) responses showed relatively weak correspondence (mean r = 0.31) and poor concordance with their concurrent (checklist) responses. Compared to the physical therapists’ checklist responses, the patients’ checklist responses showed weaker correspondence (mean r = 0.03) and better concordance with the physical therapists’ PSPQ responses. The findings suggest that retrospective self-reports may not accurately reflect the use of psychological techniques by physical therapists and, consequently, that physical therapists should consider documenting their use of psychological techniques as close to their implementation as possible. Suggestions for improved assessment are provided. Full article