Search Results (73)

This study explored the relationship between technology acceptance and programming self-efficacy in the context of AI-supported programming learning, with learning engagement, reflective use, learning interest, and learning satisfaction acting as potential mediators. A total of 131 high school students participated in three weeks of AI agent-assisted programming learning and completed a questionnaire after the intervention. A cross-sectional, nonexperimental design was adopted, and PROCESS v5.0 Model 82 was used to examine multiple serial mediation effects. The results showed that technology acceptance did not have a significant direct effect on programming self-efficacy, whereas significant indirect effects were identified. Mediation analysis revealed that learning interest may play a critical mediating role in relation to programming self-efficacy. In addition, a significant serial mediating pathway was found through learning engagement and reflective use, indicating that technology acceptance was indirectly associated with programming self-efficacy through increased learning engagement and reflective use. These findings contribute to a deeper understanding of the mechanisms underlying the development of students’ programming self-efficacy in AI-supported programming learning and provide practical implications for the design and implementation of AI-assisted programming instruction. Full article

Background: The nursing profession is recognized as a high-risk occupation, with the emotional toll on healthcare workers reaching a critical point. A complex interplay of anger and cynicism, often stemming from systemic pressures and chronic moral injury, seems to increasingly affect nurses’ professional and personal lives. This psychological strain does not end when the shift ends; rather, it often manifests as insomnia and nightmare distress, creating a vicious cycle of exhaustion and emotional instability. This article explores how anger, cynical distrust, nightmare distress and insomnia are interrelated and jeopardize the well-being of nursing staff and what these “invisible” symptoms reveal about the current state of healthcare by confirming their prevalence rates. Methods: This cross-sectional study was conducted online in October 2025 and included 441 hospital nurses who completed the Dimensions of Anger Reactions-5 (DAR-5), the 8-item Cynical Distrust scale (CDS-8), the Nightmare Distress Questionnaire (NDQ) and the Athens Insomnia Scale (AIS). Results: The prevalence rates of anger, nightmare distress and insomnia were 41.5%, 6.6%, and 62.1%, respectively. Based on the CDS-8 scores, a notable proportion (20.9%) of nurses fell within the highest quartile of CDS-8 scores (CDS-8 > 29), indicating relatively elevated cynical distrust within this sample; this threshold is sample-derived and does not correspond to a validated clinical cut-off. Hierarchical multiple regression analysis indicated that the DAR-5 explained 22.1% of the variance in AIS, while an additional 10.2% was explained by NDQ and another 1.5% by the CDS-8. Both cynical distrust and nightmare distress displayed a chain mediation pattern in the association between anger and insomnia; however, given the cross-sectional design, the temporal order of these variables cannot be confirmed. Conclusions: Anger exhibited significant direct and indirect associations with insomnia, with cynical distrust and nightmare distress acting as serial mediators in this cross-sectional model. Findings from this cross-sectional study tentatively suggest that future intervention efforts targeting insomnia in nurses might benefit from addressing anger alongside nightmare distress and cynical attitudes; however, experimental studies are needed to confirm whether such interventions would be effective. Full article

Against the backdrop of the growing emphasis on cultural confidence and the continuous expansion of cultural consumption, how local museums effectively transform local cultural resources into cultural and creative consumption behavior has become an important research issue. Taking the Luoyang Museum as the empirical context, this study integrates Place Attachment Theory (PALT) with the Stimulus-Organism-Response (S-O-R) framework to construct a research model of “place attachment–cultural participation–perceived authenticity/experience satisfaction–behavioral intention.” Based on 182 valid samples, Partial Least Squares Structural Equation Modeling (PLS-SEM) was employed for empirical analysis. The results indicate that place attachment significantly and positively influences cultural participation; cultural participation significantly and positively affects experience satisfaction, perceived authenticity, and behavioral intention; experience satisfaction significantly enhances perceived authenticity; and perceived authenticity significantly promotes behavioral intention. Further analysis reveals that cultural participation plays a significant mediating role between place attachment and experience satisfaction, perceived authenticity, and behavioral intention. Perceived authenticity serves as a key mediator between cultural participation, experience satisfaction, and behavioral intention. In addition, multiple serial mediation paths, such as “cultural participation–experience satisfaction–perceived authenticity–behavioral intention,” are found to be significant. The findings demonstrate that place attachment does not directly translate into cultural consumption behavior, but instead operates through cultural participation to activate authenticity perception and experiential evaluation, which in turn influence behavioral intention. This study enriches the application of Place Attachment Theory and the S-O-R framework in the context of museum cultural consumption and provides both theoretical support and practical implications for enhancing the transformation capacity of cultural and creative products in local museums. This study enriches the application of Place Attachment Theory and the S-O-R framework in museum cultural consumption research and provides theoretical support and practical implications for enhancing the transformation capacity of cultural and creative products in local museums, particularly in promoting sustainable cultural consumption. Full article

Background/Objectives: Mindfulness has been identified as a protective factor in promoting adaptive psychological outcomes among cancer patients, yet the mechanisms linking mindfulness to fundamental existential beliefs, such as basic hope, remain underexplored. In addition, mediational processes underlying these relationships remain understudied. Building on the theoretical framework of Acceptance and Commitment Therapy, we tested a serial multiple mediation model in which illness acceptance and fear of recurrence sequentially mediated the association between mindfulness and basic hope. Methods: Adult patients diagnosed with pelvic cancer (N = 273) who were undergoing oncological treatment completed questionnaires measuring mindfulness, illness acceptance, fear of recurrence, and basic hope. Mediation analysis was used to examine multiple mediation effects. Results: Illness acceptance also functioned as a single mediator between mindfulness and basic hope. In contrast, fear of recurrence was not a mediator between mindfulness and basic hope. The main finding was the serial mediation pathway through illness acceptance and fear of recurrence. The indirect effects showed that mindfulness was positively associated with illness acceptance dimensions—life satisfaction during illness, reconciliation with the disease, and self-distancing from the disease—which, in turn, were negatively associated with fear of recurrence, ultimately relating to higher levels of basic hope. Conclusions: The findings highlight the critical role of acceptance- and fear-related processes in sustaining basic hope among cancer patients and suggest that mindfulness-based interventions may foster adaptive adjustment to illness. Implications for clinical practice include integrating mindfulness and acceptance-focused strategies to enhance hope and support emotional well-being in patients coping with cancer. Full article

The current study aimed to investigate sleep problems in children with Attention Deficit Hyperactivity Disorder (ADHD) within a framework highlighting emotion regulation (ER), emotional intensity (EI), oppositional defiant symptoms, and internalizing symptoms. A total of 100 children with ADHD and 50 controls aged 6–14 were recruited from University Hospital, and were assessed with semi-structured interviews. Parents completed the Children’s Sleep Habits Questionnaire, Conners’ Parent Rating Scale–Revised-Short, Emotion Regulation Scale for Children–Adult Form, and the Revised Children Anxiety and Depression Scale-Parent. Group comparisons, correlations, multiple regressions, and serial mediation models were conducted, adjusting for age, gender, and other covariates. After correction for multiple comparisons, sleep parameters and internalizing symptoms did not differ between groups. In the ADHD group, total sleep problems were correlated with ADHD and oppositional symptoms, EI, ER, and internalizing symptoms. Regression models indicated that internalizing symptoms predicted total sleep problems, while EI predicted night wakings. Across mediation models, internalizing symptoms consistently mediated associations between ADHD/oppositional symptoms and total sleep problems, with EI/ER contributing indirectly via internalization. Findings suggest that sleep problems related to ADHD are related to pathways of emotional distress, emphasizing the importance of assessing internalizing symptoms concurrently with behavioral/emotional processes during the evaluation of sleep problems. Full article

Background/Objectives: Although illness perception has been examined in oncology populations, there is a lack of empirical studies focusing specifically on post-treatment thoracic cancer patients and on the mechanisms through which illness perception relates to fear of cancer recurrence and generalized anxiety. In particular, prior research has rarely tested meaning-making and changes in beliefs and goals as mediating factors. This study aimed to examine the mediating roles of meaning-making and changes in beliefs and goals within a serial multiple mediation model between illness perception, fear of recurrence, and generalized anxiety. Method: A cross-sectional study was conducted with 284 thoracic cancer patients (149 men and 135 women) who had completed treatment. Participants completed validated self-report measures assessing illness perception, meaning-making, changes in beliefs and goals, fear of cancer recurrence, and generalized anxiety. Hierarchical regression analyses and serial multiple-mediation models based on path analysis were employed to examine direct and indirect associations among variables. Results: Negative illness perception was positively associated with fear of recurrence and generalized anxiety, while positive illness perception predicted lower levels of both outcomes. Path analyses revealed that meaning-making and changes in beliefs and goals jointly mediated the relationships between illness perceptions and psychological distress. Specifically, adaptive meaning-making and belief–goal restructuring were associated with lower fear of recurrence and generalized anxiety, whereas maladaptive forms were associated with higher levels of both outcomes. Conclusions: Findings indicate that both negative and positive illness perceptions influence post-treatment emotional adjustment in thoracic cancer patients through mediation effects. Based on the meaning-making model, interventions targeting maladaptive illness perceptions, promoting meaning-making, and supporting adaptive changes in personal beliefs and goals may reduce fear of recurrence and anxiety. These results support the incorporation of meaning-centered strategies into psychosocial oncology care, emphasizing cognitive–motivational cognitive-motivational factors as critical targets for improving emotional well-being in cancer survivorship. Full article

Background and Objectives: This study aimed to examine the severity of misophonia symptoms in individuals diagnosed with obsessive–compulsive disorder (OCD) and to evaluate the pattern of the relationship between misophonia and OCD symptom severity in relation to anxiety sensitivity and mindfulness. Materials and Methods: This comparative and cross-sectional study included 108 patients diagnosed with OCD according to DSM-5 criteria and 81 healthy control subjects without any psychiatric diagnosis. Participants completed the Misophonia Symptom List (MSL), Anxiety Sensitivity Index-3 (ASI-3), Mindful Attention Awareness Scale (MAAS), Yale–Brown Obsessive Compulsive Scale (Y-BOCS), and Beck Anxiety Inventory (BAI). Statistical analyses included group comparisons, Pearson correlations, multiple linear regression, and mediation analyses using the PROCESS macro. Results: MSL scores were significantly higher in the OCD group compared to the control group (104.10 ± 33.00 vs. 87.56 ± 20.07, p < 0.001). ASI-3 (33.53 ± 18.72 vs. 18.12 ± 11.55, p < 0.001) and BAI scores (20.74 ± 13.14 vs. 11.04 ± 8.47, p < 0.001) were higher; MAAS scores were lower (53.23 ± 14.92 vs. 60.72 ± 12.70, p < 0.001). In the OCD group, MSL scores were positively correlated with anxiety sensitivity (r = 0.626, p < 0.001) and Beck anxiety (r = 0.515, p < 0.001) and negatively correlated with MAAS (r = −0.357, p < 0.001). In multiple regression analysis, anxiety sensitivity was identified as the only variable significantly predicting misophonia severity (β = 0.523, p < 0.001). Mediation analyses showed that anxiety sensitivity emerged as the dominant indirect pathway between OCD symptom severity and misophonia, whereas the contribution of mindfulness was not independent of anxiety sensitivity in the serial mediation model. Conclusions: The findings indicate that misophonia symptoms are significantly elevated in individuals diagnosed with OCD and that these symptoms are particularly associated with cognitive-emotional variables such as anxiety sensitivity and mindfulness. Given the cross-sectional design, the mediation findings should be interpreted as indirect associations rather than evidence of causal pathways. Considering these variables may be useful in assessing misophonia symptoms accompanying OCD and planning clinical approaches. Full article

Building on multiple theoretical views, this paper aimed to investigate how traits and their specific mechanisms transfer into realized entrepreneurial behaviors. Thus, this paper seeks to address various apparent gaps through an integrative theoretical framework that examines the serial mediation between Individual Entrepreneurial Orientation, Entrepreneurial Alertness, and Entrepreneurial Intentions, and their influence on Entrepreneurial Behavior. Based on a quantitative method with a survey strategy, this paper applied partial least squares-based structural equation modeling on a sample of 405 aspiring entrepreneurs in Saudi Arabia. The paper’s findings confirmed the positive and significant relationships between Individual Entrepreneurial Orientation and Entrepreneurial Alertness, Entrepreneurial Alertness and Entrepreneurial Intentions, and Entrepreneurial Intentions and Entrepreneurial Behavior. In addition, the results supported three indirect hypotheses, corroborating that Individual Entrepreneurial Orientation could affect Entrepreneurial Behavior indirectly through Entrepreneurial Alertness and Entrepreneurial Intentions. Likewise, the results supported the serial mediation hypothesis, in which Individual Entrepreneurial Orientation influenced Entrepreneurial Behavior through a sequential process, with both Entrepreneurial Alertness and Entrepreneurial Intentions as mediators. This paper offers theoretical and practical implications for the literature and practice of entrepreneurship. The study contributes to our understanding of the traits and cognitions that can motivate individuals to start a business. In addition, this study responded to many previous calls to examine not only the direct effects of EI antecedents but also the mediating roles of key factors. Full article

Although previous studies have extensively explored the relationship between urban green spaces and residents’ well-being, research on how nature-based sports venues enhance urban well-being through multiple emotional mechanisms remains relatively limited. Drawing on environmental psychology, place attachment theory, and the principles of biophilic design, this study constructs a dual-mediation model incorporating Connectedness to Nature (CN) and Place Attachment (PA) to examine the pathways through which natural design features—including Natural Visibility (NV), Spatial Integration (SI), and Human–Nature Interactivity (HNI)—influence individuals’ urban well-being. Using ten representative nature-integrated sports venues in China as research sites, a total of 856 valid questionnaires were collected, and structural equation modeling (SEM) was applied for empirical analysis. The results show that (1) NV, SI, and HNI all exert significant positive effects on CN and PA; (2) CN significantly promotes both PA and Urban Well-being (UWB); (3) PA has a significant positive effect on UWB; and (4) both CN and PA serve as significant mediators between natural design features and UWB, with an evident serial mediation effect from CN to PA. These findings reveal the multilayered psychological mechanisms through which nature-based sports venues enhance residents’ well-being, enrich the theoretical framework of nature-oriented design and urban sustainability, and provide empirical evidence for the health-oriented and emotion-responsive design of urban sports facilities. Full article

This study examines the mechanisms through which ecological public art influences pro-environmental behavior, addressing the urgent challenges of the global ecological crisis and sustainable urban development. Using the 5th Shanghai Urban Space Art Season (SUSAS) as a case study, a serial multiple mediation model was established, with ecological public art perception as the independent variable, environmental psychological ownership and ecological awareness as mediators, and pro-environmental behavior as the dependent variable. Based on 326 valid responses, structural equation modeling (SEM), which integrates confirmatory factor analysis (CFA) and path analysis, demonstrates that ecological public art perception significantly enhances pro-environmental behavior. Environmental psychological ownership and ecological awareness function not only as independent mediators but also jointly constitute a serial mediation pathway. The findings reveal a multidimensional process whereby ecological public art enhances pro-environmental behavior through “perceptual activation–emotional identification–cognitive enhancement–behavioral transformation”. Building on these insights, the study proposes intervention strategies focusing on multi-sensory integration, emotional narrative, digital technology application, and community-based practices to reinforce the role of ecological public art in urban environmental governance and sustainable development. Overall, this research advances the theoretical understanding of the social functions of public art and offers a valuable perspective for fostering ecological awareness and action. Full article

Objective: Given the critical workforce challenges in home care settings and the limited understanding of empowerment mechanisms in isolated work environments, this study aimed to examine how structural empowerment influences psychological empowerment among home care workers in South Korea through the mediating pathways of thriving at work and caregiver reciprocity. Based on Kanter’s empowerment theory, we specifically investigated the serial mediation effects to understand the complex processes through which organizational support structures translate into enhanced worker empowerment. Methods: A cross-sectional survey was conducted with 192 home care workers. Data were analyzed using descriptive statistics, correlation analysis, and serial multiple mediation analysis using SPSS Process Macro Model 6. Results: Structural empowerment demonstrated significant positive correlations with thriving at work (r = 0.445, p < 0.001), caregiver reciprocity (r = 0.490, p < 0.001), and psychological empowerment (r = 0.337, p < 0.001). Thriving at work significantly influenced both caregiver reciprocity (β = 0.3968, p < 0.001) and psychological empowerment (β = 0.1685, p < 0.001). The serial mediation analysis revealed that the indirect effect of structural empowerment on psychological empowerment through thriving at work and caregiver reciprocity was statistically significant (indirect effect = 0.1327, 95% CI [0.0713, 0.1929]), with the model explaining 58% of the variance in psychological empowerment. Conclusions: Structural empowerment significantly enhances psychological empowerment among home care workers through the sequential mediation of thriving at work and caregiver reciprocity. Healthcare organizations should prioritize strengthening structural empowerment through comprehensive support systems and conducive work environments to optimize care quality and worker well-being. Full article

Background: The mechanisms through which information and communication technology (ICT) use influences chronic disease self-management remain unclear. Method: This cross-sectional investigation examined the mediating effects of health literacy, social support, and self-efficacy on the association between ICT use and self-management behaviors among older adults (≥60 years) with comorbidities in China (n = 520). The participants were recruited from a tertiary hospital in Shanghai (July 2023–June 2024), and data on sociodemographics, self-management, health literacy, social support, self-efficacy, and ICT use were collected via structured questionnaires. Results: Pearson’s correlation analysis revealed a significant association between ICT use, health literacy, social support, self-efficacy, and chronic disease self-management (p < 0.001). Multiple mediation modeling revealed a direct positive effect of ICT use on self-management (b = 1.3314, 95% CI = 0.6629, 2.0002). Furthermore, significant indirect effects were observed, mediated independently by both health literacy and social support. Additional serial mediation pathways included health literacy → social support, health literacy → self-efficacy, social support → self-efficacy, and a comprehensive pathway from health literacy through social support to self-efficacy. Conclusions: These findings collectively indicate that ICT use directly enhances chronic disease self-management among older adults with comorbidities. Moreover, ICT use indirectly improves self-management by enhancing health literacy, augmenting social support, and bolstering self-efficacy. Full article

Background/Objectives: Self-compassion, characterized by treating oneself with kindness during challenges, has been shown to alleviate anxiety and fear of recurrence in cancer patients by mitigating negative emotions such as depression and fatigue. Psychological flexibility and coping strategies have emerged as potential mediators in the relationship between self-compassion and emotional well-being, suggesting that these factors play a critical role in managing distress in cancer patients. However, further research is needed to clarify the mechanisms through which self-compassion, psychological flexibility, and coping interact to influence fear of recurrence and anxiety in cancer populations. Methods: Two hundred and ninety-six women who had completed cancer treatment completed self-report assessments of self-compassion, psychological flexibility, coping, fear of recurrence, and generalized anxiety. Structural equation modeling (SEM) was applied to test a multiple-mediation model, including serial and parallel pathways among the study variables. Results: Self-compassion was positively associated with psychological flexibility and coping strategies, and negatively associated with fear of recurrence and generalized anxiety. Path analysis identified significant serial and parallel mediation effects, where both positive and negative self-compassion were associated with lower fear of recurrence and generalized anxiety through pathways involving psychological flexibility and emotion- and meaning-focused coping. The findings highlight the protective role of self-compassion in reducing psychological distress, suggesting that enhancing self-compassion may improve emotional adjustment in cancer patients. Conclusions: Attitudes based on self-kindness and a nonjudgmental approach have significant potential in reducing fear of cancer recurrence and generalized anxiety in female cancer patients, emphasizing the mediating role of psychological flexibility and coping strategies. According to the acceptance and commitment therapy (ACT) model, these relationships highlight the important roles of personal resources and coping mechanisms in alleviating negative emotional states in women with cancer. Interventions focused on self-compassion and psychological flexibility could provide valuable support in coping with the emotional suffering associated with cancer. Full article

Objective: The present investigation sought to examine the interrelationships between early-life adverse experiences, dissociative symptoms, suicidal ideation, and depressive manifestations among metropolitan firefighters screened with post-traumatic stress disorder (PTSD), and to elucidate the potential mediating effects of these psychological variables on both the presence and severity of PTSD symptomatology in this high-risk occupational cohort. Methods: A cross-sectional investigation was performed to assess psychological conditions among 760 metropolitan male firefighters, employing conditional process analysis with multiple mediation modeling (PROCESS macro Model 6). The investigative protocol employed validated psychometric instruments including the PTSD Checklist (PCL-5); the Childhood Trauma Questionnaire (CTQ-33); the Dissociative Experiences Scale (DES); the Suicidal Behaviors Questionnaire (SBQ-4); and the Patient Health Questionnaire (PHQ-9). Bootstrap resampling (n = 5000) generated bias-corrected 95% confidence intervals, enabling interrogation of complex trauma response mechanisms. Results: Conditional process analysis demonstrated that childhood trauma functions as a significant mediator (indirect effect = 0.142, 95% CI [0.086, 0.198]), with emotional abuse pathways revealing significant mediational effects (β = 0.285, p < 0.001). Stratifying participants using a PCL-5 ≥ 33 threshold (non-PTSD: n = 543, 71.5%, median PCL-5: 22; PTSD: n = 217, 28.5%, median PCL-5: 39), the investigation elucidated serial mediation mechanisms, particularly through childhood trauma to dissociative experiences (serial indirect effect = 0.168, 95% CI [0.092, 0.244]), collectively explaining nearly half of PTSD variance through complex psychological interaction pathways. Conclusions: Conditional process analysis revealed childhood trauma as a pivotal mediator, with emotional abuse pathways demonstrating significant mediational effects, while dissociative experiences emerged as a significant secondary mechanism, collectively explaining a substantial portion of PTSD variance through interactions between occupational trauma exposure and intrinsic psychological vulnerabilities. Full article

Background/Objectives: Research on eating disorders (EDs) in individuals with multiple sclerosis (MS) is limited. In ED populations, neuroticism has been linked to ED symptoms through lower self-esteem and greater body dissatisfaction, but these relationships remain unexplored in MS. This study aimed to examine whether self-esteem and body dissatisfaction mediate the link between neuroticism and ED symptoms in individuals with MS. Methods: The current sample consisted of 275 participants who reported a neurologist-confirmed diagnosis of MS (Mage = 43.0, SD = 12.9) with the majority being female (218/275; 79.3%). Participants completed an online questionnaire measuring neuroticism (Big Five Inventory), self-esteem (Rosenberg Self-esteem Scale), body dissatisfaction (Body Shape Questionnaire), and ED symptoms (Eating Attitudes Test-26). Results: A serial mediation analysis controlling for age, sex, and level of ambulation revealed that the association between neuroticism and ED symptoms is respectively and serially explained by self-esteem and body dissatisfaction in individuals with MS. The total model accounted for 43% of the variance in ED symptoms. Conclusions: Findings suggest that self-esteem and body dissatisfaction are important in understanding the relationship between neuroticism and ED symptoms. Neuroticism, self-esteem, and body dissatisfaction may be important targets for assessing and treating EDs in individuals with MS. Future longitudinal research is needed to examine causal relationships. Full article