Search Results (2,223)

Background: Autism spectrum disorder (ASD) or psychiatric conditions, special education needs and addictions exert substantial demands on families, yet parental psychological functioning remains insufficiently integrated into prevention and family-based support. An in-depth understanding of parental experiences constitutes a cornerstone of family-centered care, given that parental well-being and resourceful functioning exert a direct and enduring influence on both intervention effectiveness and the broader trajectory of child development. This study aimed at identifying latent parental profiles across clinical and typical developmental contexts. Methods: A total of 281 parents of children with psychiatric diagnoses (primarily ASD), special educational needs, addiction, and typical development were assessed for positive and negative functioning. Latent Profile Analysis (LPA) identified psychological subgroups, followed by Welch’s ANOVA to determine discriminating variables and multinomial logistic regression to examine sociodemographic and contextual predictors. Results: A three-profile solution emerged: Low well-being, high co-dependency and low resource functioning (50%); High well-being, low co-dependency and high resource functioning (26%); and Moderate well-being, moderate co-dependency and moderately resourceful functioning (24%). Parents of children with psychiatric diagnoses were significantly less likely to belong to the High well-being, low co-dependency and high resource functioning profile, underscoring the heightened psychological vulnerability characteristic of this group. Parents of typically developing children tend to belong to Moderate well-being, moderate co-dependency and moderately resourceful functioning. Conclusions: Parental psychological functioning exhibits heterogeneity across developmental contexts. Although parents of children with psychiatric diagnoses revealed the highest vulnerability, the profiles also revealed substantial psychological strain among parents of typically developing children. These findings highlight the need to shift from child-focused to family-centered prevention and support. Full article

Background: Hypertension is one of the most common noncommunicable diseases. Objectives: This research assessed the magnitude of hypertension among young adults, identified its key determinants, and explored potential strategies adopted for prevention. Methods: A cross-sectional design was employed, including 1606 participants aged 18 years and older, recruited through convenience sampling from universities and community settings. Data were collected using a content-validated questionnaire covering sociodemographic information, personal and family medical history, and lifestyle habits. Results: Of the participants, 993 (61.8%) reported hypertension, nearly double previous national estimates. Male gender, age ≥ 30 years, and family history were significant risk factors, along with smoking, alcohol use, sedentary lifestyle, and unhealthy diet, while physical activity and dietary modification were protective. Despite high prevalence, only 22.1% had controlled blood pressure and 17.8% adhered to medication, with 51.5% relying on herbal remedies. Conclusions: These findings highlight the urgent need for early screening, youth-focused awareness, and culturally tailored interventions to reduce hypertension and prevent long-term cardiovascular complications. Hypertension among young adults in the UAE is a major public health concern, requiring integrated strategies combining education, lifestyle modification, and medical management to improve outcomes. Full article

Background: Work disability in fibromyalgia is only partially explained by symptom severity, suggesting a relevant contribution of cognitive–behavioral mechanisms. Objective: This study aimed to determine whether kinesiophobia is associated with fibromyalgia impact and work-related disability and to assess whether pain catastrophizing mediates these relationships within a hierarchical biopsychosocial framework. Methods: This cross-sectional study included 2096 women with fibromyalgia recruited through a nationwide online survey. Participants completed validated instruments assessing fibromyalgia impact (FIQ), pain catastrophizing (PCS), depressive symptoms (PHQ-9), central sensitization (CSI), and kinesiophobia (Tampa Scale). Pain-related work disability was defined using the Graded Chronic Pain Scale–Revised (GCPS-R). Hierarchical logistic regression models identified factors independently associated with work disability. Mediation was tested using bootstrapped analyses (5000 resamples). Results: Kinesiophobia demonstrated a robust independent association with work disability (OR 1.03; 95% CI 1.02–1.05) after adjustment for sociodemographic factors, clinical pain phenotype, systemic burden, pain severity, psychocognitive load, and medication burden. Other relevant contributors included pain severity (OR 1.96; 95% CI 1.70–2.27), psychocognitive burden (OR 1.35; 95% CI 1.15–1.58), use of benzodiazepines (OR 1.74; 95% CI 1.33–2.28), and opioid use (OR 1.29; 95% CI 1.06–1.56). Mediation analysis indicated a significant indirect effect of kinesiophobia on work disability through pain catastrophizing (β = 0.131; 95% CI 0.078–0.188). Conclusions: Kinesiophobia is a proximal determinant of work disability in fibromyalgia, exerting direct and cognitively mediated effects through pain catastrophizing, reinforcing the fear-avoidance framework and the need for psychologically informed rehabilitation. Full article

Background: Sexual health is a fundamental pillar of well-being during the perinatal period. However, many studies suffer from scoring bias associated with zero values by failing to distinguish between women who are sexually inactive and those with physiological dysfunction. This study aimed to identify the distinct sociodemographic and psychological determinants of sexual inactivity versus sexual dysfunction quality in a Romanian perinatal cohort. Methods: An observational, cross-sectional study was conducted with 100 women (52% sexually active, 48% inactive). Participants were evaluated using the Female Sexual Function Index (FSFI), Patient Health Questionnaire-9 (PHQ-9), RSES (Rosenberg Self-Esteem Scale), and Generalized Anxiety Disorder-7 (GAD-7). Data were analyzed using binary logistic regression for activity status and multiple linear regression for functional quality. Results: Among sexually active women, 84.6% met the clinical criteria for sexual dysfunction (median FSFI = 21.6). Binary logistic regression revealed that self-esteem (RSES) was the sole independent predictor of sexual activity status (aOR = 1.144; 95% CI: 1.028–1.217, p = 0.016). Conversely, multiple linear regression showed that depression (PHQ-9) was the only significant independent predictor of functional quality (B = −0.73, p = 0.006). Maternal age, residence, and obstetric history did not significantly predict either outcome. Conclusions: Based on the findings of our preliminary, exploratory study, we propose a conceptual interpretation, framing perinatal sexuality as a potential two-stage process, where self-esteem appears to serve as a primary behavioral barrier for the resumption of intimacy, while depression serves as the primary disruptor of functional quality. Clinical interventions may benefit from moving beyond physical recovery to include psychological screening for body image and mood disorders to restore sexual quality of life. Full article

Background: Menopausal symptoms may adversely affect women’s overall health and well-being. Aim: This study investigated the effects of menopausal symptoms on subjective well-being in women in the 40–65 age group. Methods: The study sample consisted of 510 women, with 318 postmenopausal and 192 perimenopausal participants. Data were gathered using a Sociodemographic Information Form, the Menopause Rating Scale (MRS), and the Subjective Well-being Scale (SWBS), all administered as self-report instruments. Menopausal status was determined using the Stages of Reproductive Aging Workshop +10 criteria. Descriptive statistics, Chi-square test, Pearson correlation, and regression analyses were used. Results: Three regression models were specified to investigate the relationship between menopausal symptoms and subjective well-being. Model 1 demonstrated that overall menopausal symptoms were significant negative predictors of subjective well-being (B = −0.749, SE = 0.156, β = −0.260, t = −4.788, p < 0.001, 95% CI [−1.06, −0.44], R² = 0.068). Model 2 showed that both urogenital symptoms (B = −1.208, SE = 0.517, β = −0.139, t = −2.336, p = 0.020, 95% CI [−2.22, −0.20]) and somatic symptoms (B = −2.068, SE = 0.731, β = −0.168, t = −2.830, p = 0.005, 95% CI [−3.50, −0.64]) were significant negative predictors. Model 3 indicated that psychological symptoms significantly and negatively predicted subjective well-being (B = −1.114, SE = 0.262, β = −0.233, t = −4.253, p < 0.001, 95% CI [−1.63, −0.60], R² = 0.054). Conclusions: The findings highlight the importance of comprehensive health strategies and demonstrate that psychological symptoms significantly impact overall well-being. Full article

Background/Objectives: Health outcome determinants affecting Human Papillomavirus (HPV) vaccination among the adult female population are scarce in Spain. This study aimed to describe the health outcomes and determinants of HPV vaccination in women 18–65 years attending lower genital tract outpatient clinics across regions of Spain. Methods: This was a cross-sectional, multicenter, non-interventional, descriptive, and comparative nationwide study. Sociodemographic characteristics and health outcomes included obstetric, gynecological and HPV vaccination antecedents, together with patient-reported outcomes related to HPV infection. Statistical analysis included multivariate logistic regression models. Results: Among 2004 adult women recruited, 1907 (95.2%) were eligible for analysis. Vaccine uptake was 48.8%; 81.6% among women who were ever HPV positive (adjusted OR = 2.16 [95% CI: 1.59–2.93], p < 0.001), but 65.9% among women with an active infection, which acted as a negative factor for vaccination (OR = 0.63 [0.45–0.87], p = 0.005), as did increasing age (OR = 0.92 [0.90–0.93], p < 0.001); the higher the age, the lower the adjusted likelihood of being vaccinated. HPV knowledge and adequate physician-provided information were weakly associated with vaccination likelihood. A history of conization (OR = 7.48 [5.34–10.47], p < 0.001), use of contraception (OR = 1.49 [1.13–1.96], p = 0.004), infection with high-risk or unknown-risk HPV genotypes (OR = 1.86 [1.23–2.82], p = 0.003 and OR = 1.68 [1.17–2.42], p = 0.006, respectively), and Spanish nationality (OR = 2.46 [1.68–3.61], p < 0.001) were identified as factors associated with a higher vaccination likelihood. Conclusions: This study found that HPV vaccination uptake is improvable. Previous HPV infection favored vaccination; however, active infection and increasing age acted against vaccination. HPV knowledge and adequate healthcare professional information appeared to favor vaccination, along with, most notably, a history of cervical surgery (conization), contraceptive use, or infection with high-risk or unknown-risk HPV genotypes. Spanish women had a higher likelihood of receiving HPV vaccination than foreign residents. Full article

Background/Objective: Kinesiophobia is a major fear-avoidance concept in chronic low back pain (CLBP); however, its independent contribution to pain, disability, and health-related quality of life (HRQoL) beyond sociodemographic and clinical variables remains unclear. This study aimed to evaluate the associations between kinesiophobia and patient-reported outcomes in adults with chronic low back pain regarding (i) pain intensity, (ii) functional disability, and (iii) HRQoL. Methods: This cross-sectional study included 298 participants with CLBP (average age 38.7 ± 13.2 years; 58.0% female). Kinesiophobia was evaluated using the Tampa Scale of Kinesiophobia (range, 17–68). Outcomes were pain intensity (Numerical Pain Rating Scale; 0–10), functional disability (Roland–Morris Disability Questionnaire; 0–24), and HRQoL (RAND-36; 0–100). Two multivariable linear regression models were used per outcome. Model 1 was adjusted for sex and age, and Model 2 was additionally adjusted for BMI, marital status, education, employment, smoking status, and chronic disease. Hierarchical regression analysis evaluated the incremental variance explained by kinesiophobia (ΔR²) when entered after all covariates. Effects were reported per 10-point increase in Tampa score, with 95% confidence intervals (CI). Results: In the fully adjusted models, higher kinesiophobia was associated with greater pain intensity (B = +1.17 points per 10 Tampa; 95% CI 0.55–1.79, p < 0.001), greater disability (B = +3.24 points; 95% CI 2.05–4.43; p < 0.001), and lower HRQoL (B = −7.98 points; 95% CI −11.1–−4.81; p < 0.001). Hierarchical regression analyses showed that kinesiophobia explained additional variance in pain (ΔR² = 0.11), disability (0.12), and HRQoL (0.11), all p < 0.001. Conclusions: In adults with CLBP, kinesiophobia was associated with greater pain intensity, functional disability, and lower HRQoL, accounting for 11–12% of variance in each outcome beyond demographic and clinical covariates. These findings support routine assessment of kinesiophobia and justify longitudinal and interventional studies to determine temporal relationships and treatment effects. Full article

Introduction: Humanized care is a core indicator of nursing quality, yet its prevalence and determinants among Spanish undergraduates remain unclear. Methods: A cross-sectional survey was administered to fourth-year nursing students from public and private universities. Instruments included the Health Professional’s Humanization Scale (HUMAS), the Communication Styles Inventory-Revised (CSI-R) and a sociodemographic questionnaire that captured prior training: completion of ≥6 h role-playing seminars in patient–family communication. Results: Mean scores were 3.62 ± 0.48 for HUMAS and 2.50 ± 0.52 for CSI-R. Women exceeded men on HUMAS total (p = 0.025) and on Sociability, Emotional Understanding, Dispositional Optimism and Self-Efficacy (all p ≤ 0.013), but not on Affect-Regulation or CSI-R. Age correlated weakly with Optimism (r = 0.24) and Self-Efficacy (r = 0.21). Students who had completed the role-playing seminars recorded higher HUMAS totals (d = 0.50; p = 0.001) and sub-scores, with only a modest gain in Affect-Regulation, and showed a trend towards better CSI-R performance (p = 0.06). No differences emerged by university type. HUMAS and CSI-R correlated moderately (r = 0.32; p = 0.001). In multivariate analysis, training (β = 0.36; p = 0.001) and CSI-R (β = 0.26; p = 0.001) jointly explained 27.9% of humanization variance; male sex exerted a small negative effect (β = −0.19; p = 0.001), whereas age was nonsignificant. Conclusions: Structured communication seminars are a key factor associated with higher levels of humanization in senior nursing students, whereas sociodemographic influences are modest. Embedding longitudinal, simulation-rich modules in communication and emotional intelligence is therefore recommended to cultivate truly person-centered nurses and to narrow observed sex disparities. Full article

Background: Internet Gaming Disorder (IGD) has been linked to sleep disturbances, yet evidence from Saudi students is limited. Objective: We examined IGD symptom burden and its associations with daily gaming time and sleep quality among high school and university students in Riyadh, Saudi Arabia. Methods: In a cross-sectional online survey, participants completed the applicable consent process and were screened for gaming. Gamers completed a DSM-5–based IGD checklist and the Pittsburgh Sleep Quality Index (PSQI). IGD symptom count was analyzed using negative binomial regression (IRR), adjusting for sociodemographic and academic covariates and then adding PSQI total score. Results: Of invited students (N = 534), (n = 408) were gamers. Among those with complete PSQI totals (n = 352), the mean PSQI was (7.49) (SD = 3.46), and poor sleep (PSQI > 5) affected about two-thirds. Longer daily gaming time was significantly associated with higher expected IGD symptom counts. After adjustment, higher PSQI total score remained significantly associated with greater symptom burden (Adjusted IRR = 1.049 per 1-point increase), while demographic variables and academic-performance score were not significant. Conclusions: IGD symptom burden and poor sleep were common among student gamers in Riyadh. Longer daily gaming time and poorer sleep quality were associated with higher IGD symptom counts. These findings may inform prevention efforts related to gaming habits and sleep hygiene; however, longitudinal studies are needed to clarify temporal directionality and determine whether these associations reflect causal pathways. Full article

Background/Objectives: Early mobilization following open-heart surgery is a key component of postoperative recovery, yet psychological barriers such as kinesiophobia (fear of movement) may limit patient participation. This study examined the association between kinesiophobia and mobilization level in patients after open-heart surgery and explored sociodemographic and clinical correlates of both variables. Methods: A cross-sectional descriptive design was used. The sample comprised 96 adult cardiac surgery patients recruited consecutively from cardiovascular surgery ICUs at two centers in Istanbul—a public training and research hospital and a foundation-affiliated university hospital—between December 2024 and April 2025. Data were collected via a Personal Information Form, the Tampa Scale of Kinesiophobia (TSK), and the Intensive Care Units Mobility Scale (IMS). Analyses (SPSS 25.0) included Mann–Whitney U and Kruskal–Wallis H tests, Pearson correlation with 95% confidence intervals (CIs) calculated via Fisher’s z-transformation, Bonferroni correction for k = 12 subgroup comparisons within each outcome, and a multivariable linear regression adjusted for sex, age, smoking, and history of surgery. Results: Of the 96 patients enrolled, 76.0% were male, with a mean age of 58.30 ± 6.50 years (SD) and a mean body mass index of 27.53 ± 5.84 kg/m². The mean TSK total score was 46.81 ± 6.51 and the mean IMS score was 5.48 ± 0.73. Kinesiophobia and mobilization showed a small inverse association that reached statistical significance (r = −0.104; 95% CI: −0.298 to 0.099; r² = 0.011; p = 0.041), accounting for approximately 1% of the variance in mobilization. After multivariable adjustment, kinesiophobia was no longer a significant predictor (β = −0.092; p = 0.360), whereas smoking (β = −0.279; p = 0.008) and female sex (β = 0.215; p = 0.039) emerged as the strongest independent correlates. Mobilization level differed by gender and smoking, and kinesiophobia level differed by marital status, history of surgery, and family history of heart disease at the uncorrected level; however, none of these subgroup differences remained significant after Bonferroni correction. Conclusions: Higher kinesiophobia scores were associated with lower mobilization levels following open-heart surgery, but the effect size was small and the association did not persist after adjustment for clinical confounders. The cross-sectional design precludes causal inference. Kinesiophobia may be considered as one of several psychosocial factors potentially relevant to postoperative mobilization rather than as a primary determinant. Full article

Background/Objectives: During the first COVID-19 lockdown, the sudden disruption of formal care services substantially increased reliance on informal caregiving. Emerging evidence suggests that increased caregiving demands may have contributed to a higher burden of mental-health-related temporary work disability; however, population-based data from occupational health systems remain limited. This study aimed to quantify and characterise, descriptively, the sociodemographic, clinical, and territorial characteristics of mental-health-related temporary work disability among workers with informal caregiving responsibilities in Spain during the first COVID-19 lockdown, and to descriptively examine differences between episodes occurring among workers with and without caregiving responsibilities. Methods: A retrospective descriptive study was conducted using anonymised nationwide occupational health records from Mutua Asepeyo. All episodes of temporary work disability certified for mental and behavioural disorders (ICD-10 F00–F99) between 14 March and 21 June 2020 were analysed. Caregiver status was determined based on documented informal caregiving responsibilities recorded within the occupational disability records. Sociodemographic, occupational, clinical, and territorial variables were examined using descriptive statistics and non-parametric tests. Results: A total of 2857 caregiver-associated episodes were identified, representing 55.6% (95% CI: 54.2–57.0) of all mental-health-related temporary work disability episodes during the study period. The majority involved women (68.1%) and caregivers of older dependent adults (59.3%). Generalised anxiety disorder was the most frequent diagnosis, followed by adjustment disorders and acute stress reactions, with significant differences by sex and employment regime. Marked territorial variability was observed, as well as longer durations of temporary work disability in specific regions and among women. Conclusions: A substantial proportion of mental-health-related temporary work disability episodes during the lockdown occurred among workers with informal caregiving responsibilities, particularly women and those caring for older dependents. These findings suggest that informal caregiving may be a determinant of occupational mental health during crises. However, given the descriptive and unadjusted nature of the study, no causal inferences can be drawn. Further research is needed to understand these associations better and inform future occupational health strategies. Full article

Background: Nurses’ job satisfaction is an important factor associated with motivation, retention, and performance, potentially influencing the quality and safety of healthcare delivery. Identifying organizational and professional determinants of job satisfaction is essential for the sustainability of healthcare systems. Objective: This study aims to describe nurses’ job satisfaction across its multiple dimensions and examine differences in job satisfaction dimensions across sociodemographic and professional groups. Methods: A quantitative, cross-sectional, descriptive–correlational study was conducted with 153 nurses. Data were collected between October and December 2024 using an online questionnaire, with a response rate of 28.9%, which included the Escala de Satisfação dos Enfermeiros com o Trabalho (ESET). Descriptive and inferential statistical analyses were performed, with the significance level set at 0.05. Results: Moderate levels of job satisfaction predominated among participants (75.8%), with 5.2% of participants reporting low satisfaction. The highest mean scores were observed in satisfaction with co-workers and professional recognition, while the lowest scores were found in the recognition and remuneration dimension. Statistically significant differences in mean job satisfaction scores were observed across groups defined by variables such as work setting, work schedule, weekly workload, and employment across multiple workplaces. Conclusions: Nurses’ job satisfaction is multidimensional and varies across different professional and organizational groups. These findings highlight areas of lower job satisfaction that may represent priorities for future organizational assessment and management attention. Full article

Background and Objectives: Community fluoridation is an effective public health measure for dental caries prevention; however, knowledge and risk perception vary. This study assessed knowledge, attitudes, and sociodemographic determinants related to community fluoridation. Materials and Methods: A cross-sectional study was conducted in May–June 2023 among 200 adults from Iași, Romania, using a self-administered questionnaire. Chi-square tests were applied. Results: Most respondents were familiar with fluoride (94%) and its protective role (91%), but fewer knew fluoridation methods (34%) or dental fluorosis (53%). Educational level was associated with awareness of water fluoridation (χ² = 32.219, p < 0.001), and gender with safety perceptions (χ² = 6.031, p = 0.049). Perceived toxicity was strongly associated with fluoridation safety attitudes (χ² = 29.116, p < 0.001). Conclusions: Although general awareness is high, understanding remains limited. Sociodemographic factors influence knowledge and risk perception, highlighting the need for targeted communication. Full article

Background: Loneliness and social isolation are major public health challenges linked to premature mortality and significant healthcare and productivity costs. However, their geographic distribution and socio-demographic determinants remain poorly understood, with few studies applying spatial methods to identify high-need areas and protective factors. Methods: This study aimed to investigate the geographic distribution and determinants of loneliness and social isolation across Australia using a spatial epidemiological approach. Utilising longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) survey, along with Australian Bureau of Statistics (ABS) census data, greenness vegetation index and walkability index, we employed Bayesian conditional autoregressive (CAR) models to assess spatial and temporal patterns at the Statistical Area Level 3 (SA3) over a 22-year period and present the relative risks (RR) and credible intervals (CrI). Results: Our analysis revealed spatial variation in the RR of both loneliness and social isolation, with notable hotspots in socioeconomically disadvantaged areas. In multivariable models, area-level socio-economic disadvantage (as measured by the Index of Relative Socio-economic Advantage and Disadvantage, IRSAD) (RR = 0.8, 95% CrI: 0.76–0.85) for the highest quintile (most advantaged) and a higher prevalence of depression and/or anxiety (RR = 4.3, 95% CrI: 3.0–6.1) were associated independently with relative risk of loneliness but not with age structure, remoteness, green space or walkability index. For social isolation, higher average hospital admission rates per region were the strongest factor. Conclusions: The spatial heterogeneity observed in our study underscores the need for place-based public health responses, including community-based interventions and targeted resource allocation, especially in disadvantaged communities. Full article

Background/Objectives: Disc herniation, also termed herniated nucleus pulposus (HNP), is a common spinal disorder affecting approximately 10% of the global population, associated with pain, neurological complications, and diminished quality of life. Despite its global burden, regional variations in public awareness and sociodemographic determinants remain inadequately characterized, particularly in Middle Eastern populations. This study aimed to assess the prevalence, public awareness, and sociodemographic determinants of HNP among adults in Saudi Arabia at a nationwide level. Methods: An analytical cross-sectional study was conducted from December 2024 to July 2025. Using a convenience sampling approach via social media platforms, an online questionnaire was distributed nationwide across Saudi Arabia. Data from 1112 participants were analyzed using descriptive statistics and multiple logistic regression. The questionnaire comprised two sections: sociodemographic characteristics and knowledge and awareness of HNP. Results: The prevalence of disc herniation was 8.9%, consistent with global estimates. Overall awareness was relatively high at 67.6%, though knowledge of specific risk factors varied considerably. Most participants recognized obesity (88.0%), poor sitting posture (85.8%), history of lower back trauma (86.2%), and work requiring physical effort (88.8%) as risk factors, while fewer acknowledged smoking (46.4%), diabetes (51.2%), sleeping on a soft bed (36.9%), and increased height (35.9%). Multiple logistic regression, adjusted for all sociodemographic, lifestyle, and health-related covariates, identified significant independent predictors of HNP including marital status (married OR = 2.90), current smoking (OR = 2.91), hyperlipidemia (OR = 1.86), family history (OR = 8.95), and prior knowledge of the condition (OR = 2.28). Knowledge of HNP was significantly associated with university education (OR = 1.70), higher income levels (OR = 2.23 for ≥15,000 SAR; OR = 2.07 for 5000–9999 SAR), and family history (OR = 4.70), while those in low and medium workload jobs demonstrated lower knowledge. Conclusions: Although overall public awareness of HNP is relatively high in Saudi Arabia, substantial gaps persist in knowledge of modifiable risk factors, particularly smoking and diabetes mellitus. Targeted smoking cessation campaigns, diabetes awareness programs, and ergonomic education initiatives delivered through primary healthcare centers, workplaces, and schools are recommended. Full article