Search Results (264)

It is important to study if and how athletes’ mental resilience and mindfulness are connected, because both could promote mental health, as well as facilitate coping with stress and successful athletic performance. It was hypothesized that mental resilience and mindfulness would correlate, and also that mental resilience and mindfulness would differ in both means and correlation strength according to the type of sport. The possible nexus of mental resilience and mindfulness with the longevity of sports practice was also examined. The sample consisted of 177 athletes whose mean age was 21 years old and whose average sports practice lasted 8.7 years. Most of them were professional athletes (N = 121, 68.4%). They practiced individual sports (N = 85, 48.0%), combat sports (N = 47, 26.6%), and team sports (N = 45, 25.4%). The Bulgarian adaptations of the Mindful Attention Awareness Scale and the Brief Resilience Scale were used. The athletes’ mental resilience and mindfulness correlated significantly and positively. The athletes’ mental resilience correlated positively with the years of sports practice among the amateur athletes and among the athletes practicing team sports. The athletes’ mindfulness increased with age for the athletes practicing combat sports and team sports. Mindfulness diminished with more years of sports practice for the amateur athletes and for those practicing individual sports. The athletes practicing combat sports had higher mental resilience than those practicing individual sports and those practicing team sports. The male athletes had higher mental resilience than the female athletes. The established positive nexus between the athletes’ mental resilience and mindfulness means that training mindfulness could be a mechanism for strengthening mental resilience, as well as higher mental resilience could facilitate mindful awareness of the present moment and focus attention on what is happening now. The athletes practicing individual sports are those who need more training for enhancing mindfulness and mental resilience. Physical activity and sports participation may contribute to mental health improvement by strengthening mindfulness and mental resilience. Full article

Background: Informal caregivers of individuals with mild cognitive impairment (MCI) experience high levels of psychological and physical stress, with limited access to supportive interventions and time constraints. Virtual Reality (VR) technologies may provide brief and accessible opportunities to support caregiver well-being, particularly during waiting periods in clinical settings. This pilot study aimed to explore the potential of a semi-immersive VR intervention to enhance psychological well-being in informal caregivers. Methods: This non-randomized pilot study investigated the effects of a semi-immersive VR-based physical training program (K-HERO^®) on psychological well-being and coping strategies in informal caregivers. Participants were recruited from January to May 2025 at the IRCCS Centro Neurolesi “Bonino-Pulejo” (Messina, Italy), and the intervention was delivered individually in a dedicated room within the rehabilitation facility, while caregivers accompanied their relatives to treatment sessions. Ten caregivers completed six sessions (30–40 min each). The study was conducted in accordance with TREND reporting guidelines. Pre- and post-intervention assessments included the State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS), COPE Inventory, Caregiver Burden Inventory (CBI), and International Physical Activity Questionnaire (IPAQ). Visual Analog Scales and instrumental data from the VR system were used to monitor physical performance and user experience. Non-parametric statistics were applied. Results: Significant reductions were observed in avoidance (p = 0.033) and social support-based (p = 0.023) coping strategies. Differences emerged based on caregiver-patient relationships: parental caregivers showed increased anxiety, while offspring caregivers showed improvements. The intervention was well tolerated, with high usability and no adverse events reported. Conclusions: A short, structured, VR-based intervention delivered during clinical waiting periods may effectively reduce maladaptive coping strategies and support emotional well-being in informal caregivers. These findings highlight the potential of brief digital interventions in real-world care contexts. Larger randomized studies are needed to validate these preliminary findings and personalize interventions to different caregiver profiles. Full article

Background: Absence epilepsy is a common pediatric neurological disorder characterized by brief seizures and lapses in awareness. The relationship between anxiety and absence epilepsy is multifaceted. This study aims to investigate neurobehavioral signs directly and indirectly related to anxiety and potential sex differences in aged WAG/Rij rats, a well-established animal model of absence epilepsy. Methods: A battery of behavioral tests was conducted to assess various aspects of neurobehavior, including anxiety (elevated plus maze), anhedonia (sucrose preference), social function, and associative learning (fear conditioning). Multidimensional metrics assessed cognition, motor function, and exploration strategies, prioritizing anxiety as a key influencing factor. Results: Electroencephalogram (EEG) phenotyping was used to identify epileptic and non-epileptic rats. Traditional anxiety measures in the elevated plus maze did not reveal significant differences between groups. However, the Anxiety Composite Index revealed higher autonomic reactivity in non-epileptic females. Cognitive assessments showed no epilepsy- or sex-related differences in overall learning performance. Females exhibited superior avoidance learning compared males. Among epileptic males, those with poor learning performance also displayed higher anxiety-avoidance scores. Rats with high anxiety levels showed enhanced socio-affective reactivity and passive coping, with no effect on exploratory learning. Conclusions: Our findings highlight the importance of sex-specific analyses and physiological measures in epilepsy research. Neurobehavioral comorbidities in WAG/Rij rat model are significantly influenced by anxiety-like behavioral phenotype. Enhanced phenotyping of rat models of absence epilepsy can improve its translational value in understanding epilepsy-associated psychiatric disorders. Full article

Background: Undergraduate nursing students (UNSs) often enter clinical training just as they are still mastering the emotional labor of the profession. In Nepal, where teaching hierarchies discourage upward dialogue and hospitals routinely struggle with overcrowding, supply shortages, and outward nurse migration, these learners confront a distinct, under-documented burden of psychological distress. Objective: This study examines how UNSs interpret, negotiate, and cope with the mental health challenges that arise at the intersection of cultural deference, resource scarcity, and migration-fueled uncertainty. Methods: A qualitative design employing reflexive thematic analysis (RTA), guided by the Reflexive Thematic Analysis Reporting Guidelines (RTARG), was used. Fifteen second-, third-, and fourth-year Bachelor of Science in Nursing students at a major urban tertiary institution in Nepal were purposively recruited via on-campus digital flyers and brief in-class announcements that directed students (by QR code) to a secure sign-up form. Participants then completed semi-structured interviews; audio files were transcribed verbatim and iteratively analyzed through an inductive, reflexive coding process to ensure methodological rigor. Results: Four themes portray a continuum from silenced struggle to systemic constraint. First, Shrouded Voices, Quiet Connections captures how students confide only in trusted peers, fearing that formal disclosure could be perceived as weakness or incompetence. Second, Performing Resilience: Masking Authentic Struggles describes the institutional narratives of “strong nurses” that drive students to suppress anxiety, adopting scripted positivity to satisfy assessment expectations. Third, Power, Hierarchy, and the Weight of Tradition reveals that strict authority gradients inhibit questions in classrooms and clinical placements, leaving stress unvoiced and unaddressed. Finally, Overshadowed by Systemic Realities shows how chronic understaffing, equipment shortages, and patient poverty compel students to prioritize patients’ hardships, normalizing self-neglect. Conclusions: Psychological distress among Nepalese UNSs is not an individual failing but a product of structural silence and resource poverty. Educators and policymakers must move beyond resilience-only rhetoric toward concrete reforms that dismantle punitive hierarchies, create confidential support avenues, and embed collaborative pedagogy. Institutional accountability—through regulated workloads, faculty-endorsed wellbeing forums, and systematic mentoring—can shift mental health care from a private struggle to a shared professional responsibility. Multi-site studies across low- and middle-income countries are now essential for testing such system-level interventions and building a globally resilient, compassionate nursing workforce. Full article

Background and Objectives: Inflammatory bowel diseases (IBDs) are chronic conditions of the digestive tract, often requiring life-long treatments in order to achieve and maintain remission. However, treatment adherence among patients with IBD can frequently be suboptimal, which can compromise disease control and long-term outcomes. The aim of this study was to analyze the adherence rate and to identify factors that significantly influence treatment adherence in patients with IBD. Materials and Methods: The study employed a cross-sectional design and was conducted at the Fundeni Clinical Institute, a tertiary medical center in Bucharest, Romania. The treatment adherence was assessed using the Medication Adherence Report Scale-5 (MARS-5), with patients scoring greater than 23 considered adherent. Anxiety, depression and perceived stress were assessed using the Depression, Anxiety and Stress Scale-21 (DASS-21). Perceived social support was measured with the Multidimensional Scale of Perceived Social Support (MSPSS), and coping strategies were assessed using the Brief Coping Orientation to Problems Experienced Inventory (Brief COPE Inventory). Results: A total of 188 patients were included in the final analysis. Of these, 99 patients (52.7%) were male and 109 (58.0%) had a diagnosis of Crohn’s disease. The majority of patients (81.9%) were receiving treatment with advanced therapies, including biologics or small molecules. Forty patients were receiving their therapy through more than one route of administration. Optimal adherence was noted in 160 patients (85.1%). Patients treated with advanced therapies (biologics and small molecules) had significantly higher odds of optimal adherence (OR 10.52, 95% CI: 4.3–25.74, p < 0.001), with a rate of adherence of 92.2%. Significantly lower odds of adherence were found for the oral (OR 0.35, 95% CI: 0.14–0.83, p = 0.01) and rectal (OR 0.09, 95% CI: 0.03–0.29, p < 0.001) routes of administration, while the intravenous administration had higher odds of adherence (OR 4.85, 95% CI: 1.02–22.9, p = 0.04) compared to the subcutaneous route. Other factors associated with an improved adherence were being retired (OR 3.5, 95% CI: 1.13–10.8, p = 0.029) and using positive reframing (p = 0.04), planning (p = 0.01) and venting (p = 0.02) as coping strategies; active smoking (OR 0.26, 95% CI: 0.11–0.6, p = 0.002), active disease (OR 0.36, 95% CI: 0.16–0.81, p = 0.014) and behavioral disengagement (p = 0.04) were associated with impaired treatment adherence. No significant differences in adherence were observed between disease phenotypes. Conclusions: The route of administration, smoking status and psychosocial factors, such as perceived stress of social support and coping strategies, may play an important role in influencing treatment adherence in patients with IBD. While the disease phenotype was not associated with differences in adherence, patients with active disease had significantly lower odds of optimal adherence. Full article

The COVID-19 pandemic and related public health and hospital restrictions directly influenced Canadian perinatal healthcare. This study aimed to evaluate predictors of pandemic-related pregnancy and postpartum stress in Canada. A sample of 398 women with Canadian pandemic pregnancy experiences completed an online cross-sectional survey between September 2021 and February 2022. Demographic factors, perinatal healthcare characteristics, and psychometric measures including Oslo Social Support Scale (OSSS-3) and Brief COPE were analyzed by independent hierarchical generalized linear models (GLM) to identify predictive variables associated with prenatal and postpartum pandemic-related pregnancy stress scales (PREPS). Respondents reported low social support, low–moderate Problem-Focused and Emotion-Focused Coping scores, with low Avoidant Coping. Middle income and canceled prenatal care appointments were associated with prenatal PREPS-Preparedness Stress, with provider satisfaction negatively associated. Avoidant Coping was positively associated with both prenatal and postpartum Preparedness Stress and Infection Stress scores, whereas Problem-Focused Coping was associated with both prenatal and postpartum Positive Appraisal. High COVID-19 rates and region of healthcare were associated with prenatal and postpartum Infection Stress. Our findings that perinatal healthcare characteristics and psychometric measures, rather than demographic characteristics, were greater predictors of pandemic-related stress reflect the broad societal disruptions that shaped Canadian pregnancy experiences in our sample of mostly high income, well-educated, non-racialized women. Full article

Background: Emotional intelligence refers to individuals’ ability to recognize and manage their own emotions as well as those of others, playing a crucial role in stress management. This study aimed to investigate the relationship between different dimensions of emotional intelligence and stress management strategies in patients undergoing hemodialysis. Methods: In this cross-sectional study, 468 patients on hemodialysis completed the (i) Wong and Law Emotional Scale (WLEIS) and (ii) Trait Emotional Intelligence Questionnaire Short Form (TEIQue-SF) for the assessment of emotional intelligence as an emotional ability or as a personality trait, respectively; (iii) the Brief COPEQuestionnaire (Brief- COPE) for the assessment of stress management strategies; and (iv) a questionnaire about demographic characteristics. Spearman’s correlations coefficients were used to explore associations between two continuous variables. Multiple linear regression analysis was used with Brief-COPE dimensions as the dependent variable. Results: High levels of emotionality were associated with an active approach to coping with stress (p = 0.018), while increased well-being and high regulation of emotions were associated with decreased behavioral disengagement (p < 0.001). Moreover, high emotional appraisal of others was linked to an increased use of humor (p = 0.042), while self-control and use and regulation of emotions were associated with decreased expression of negative feelings (p < 0.001). Conclusions: The current findings suggest potential links between emotional intelligence and stress management strategies in patients undergoing hemodialysis. Full article

Background: The COVID-19 pandemic caused lasting disruption to healthcare systems and the mental health of frontline workers. Though the acute crisis has passed, many healthcare workers (HCWs) continue to experience long-term psychological effects, including anxiety, grief, and burnout. This mixed-methods study investigates the enduring effects of the COVID-19 pandemic on the mental health of physicians in a low-resource country. Methods: Drawing on data from the ear, nose, and throat (ENT) or otolaryngology department at a tertiary care hospital in Pakistan, the study employed an explanatory mixed-methods design, combining structured surveys and semi-structured interviews. The Hospital Anxiety and Depression Scale, the Perceived Stress Scale, and the Brief COPE Inventory were administered to 42 ENT specialists, trainees, and house officers, alongside semi-structured interviews with eight ENT physicians. Results: Survey results revealed moderate to high levels of anxiety, depression, and stress that persisted beyond the acute crisis phase of the pandemic. Interviews provided nuanced insights into the emotional burden experienced by physicians, including persistent concerns about contagion risk, professional isolation, and increased workload. Physicians described maladaptive responses and employed active coping strategies, such as seeking peer support and utilizing adaptive problem solving. Conclusions: The COVID-19 pandemic has had enduring effects on the mental well-being of physicians. Targeted interventions and policy reforms that address the ongoing pressures frontline physicians face in resource-constrained environments may help mitigate these burdens, support healthcare professionals more effectively, and improve their mental health. Full article

This study examines the relationships between spirituality, resilience, and happiness among higher education students, exploring the moderating roles of religious belief and years of study based on developmental and religious coping theoretical frameworks. Developmental theory suggests that university students’ psychological resources evolve across academic years, while religious coping theory posits that individual differences in religious commitment may buffer spirituality’s protective effects on well-being outcomes. Using a quantitative cross-sectional approach, data were collected from 459 university students from environmental science programs across public and private universities in northern Peru. Participants were predominantly female (59.04%) and aged 18–24 years (73%). Three validated instruments were administered: the Personal Spirituality Scale, Connor–Davidson Brief Resilience Scale, and Subjective Happiness Scale. Religious beliefs were measured on a 5-point scale, while years of study was categorized by academic year. Results from partial least squares structural equation modeling revealed significant direct effects of spirituality on both happiness (β = 0.256, p < 0.001) and resilience (β = 0.274, p < 0.001), with resilience also significantly influencing happiness (β = 0.162, p < 0.05). The structural model demonstrated exceptional explanatory power, with spirituality explaining 97.1% of variance in resilience, while spirituality and resilience together accounted for 86.2% of variance in happiness. Contrary to theoretical expectations, neither religious beliefs (β = 0.032, p = 0.489) nor years of study (β = −0.047, p = 0.443) showed significant moderating effects. These results suggest that spirituality and resilience serve as universal contributors to student well-being, operating independently of specific religious orientations and academic progression. The findings support integrating spiritual development and resilience-building components into inclusive university student support programs. Full article

Background/Objectives: Occupational well-being and professional quality of life are essential for healthcare sustainability. While clinical staff are presumed to experience higher stress, few studies have compared their experience to that of non-clinical personnel within the same institution. Methods: This observational study involved 63 employees from an Italian research hospital: 36 healthcare workers in critical care and 27 administrative staff. Participants completed the Brief Coping Orientation to Problems Experienced Inventory (Brief COPE), an ad hoc organizational questionnaire, and the ProQoL Version 5 (administered to clinical staff only). Non-parametric tests (Mann–Whitney U and Chi-square) were used to explore group differences. Results: No significant differences emerged between groups in coping styles or strategies. Significant differences were observed only in reports of work-related injuries (42% of healthcare staff vs. 4% of administrative staff; p = 0.002) and perceived disruption caused by vacation requests (64% vs. 26%; p = 0.006). Other organizational indicators such as job dissatisfaction, intention to leave, or perceived managerial support did not differ significantly. ProQoL results showed that 53% of healthcare workers had moderate to high burnout, and 47.2% scored high on compassion fatigue, while only 2.7% showed high levels of secondary traumatic stress. Conclusions: Despite distinct operational contexts, healthcare and administrative staff reported broadly similar experiences in terms of coping and organizational well-being. These findings challenge assumptions of stark differences across professional roles and suggest that workplace well-being strategies should address the needs of both clinical and non-clinical staff. Full article

Climate change disrupts lives globally and poses significant challenges to mental health. Although several scales assess climate anxiety, many either conflate symptoms with coping responses or fail to adequately capture the core symptomatology of anxiety. Hence, this study aimed to develop and validate the Brief Anxiety Scale for Climate Change (BACC), a self-report measure designed to assess symptoms of climate anxiety. A preliminary pool of 21 items was generated based on the diagnostic criteria for generalized anxiety disorder and climate-related stress. Study 1 (n = 300) explored the factor structure via an exploratory factor analysis while Study 2 (n = 400) independently validated the structure via a confirmatory factor analysis (CFA). Analyses of the internal consistency, content validity, and discriminant validity helped refine the scale to a final 13-item version with two factors: cognitive and functional impairment. The CFA results indicated that all the fit indices met the recommended thresholds, and the final version demonstrated excellent internal consistency (Cronbach’s α = 0.92). Additionally, latent correlations revealed that climate anxiety was moderately associated with generalized anxiety and depression. The BACC was developed to identify individuals in the community who experience climate anxiety beyond an adaptive level, thereby promoting sustainable mental health in the context of climate change. These findings suggest that the BACC is a promising tool for assessing climate anxiety. With better identification, mental health professionals, community practitioners, and policymakers can utilize the scale to develop climate-sensitive public health programs and tailored intervention strategies. Full article

Nursing students often face emotional challenges related to death and dying, affecting their psychological well-being, emotional intelligence, and academic success. Cultural and educational factors may influence how they experience and manage these stressors. This study aimed to compare fear of death, emotional intelligence, coping with death, and academic burnout among second-year nursing students in Spain and Portugal to identify cross-cultural differences. A cross-sectional study was conducted among 174 second-year nursing students from the University of Extremadura (Spain) and the University of Évora (Portugal) during the 2023/2024 academic year. The instruments used included the Collett–Lester Brief Fear of Death Scale, the Trait Meta-Mood Scale—24 ítems, the Bugen’s Coping with Death Scale, and the Maslach Burnout Inventory—Student Survey. Descriptive statistics were calculated, and group comparisons were performed using independent samples t-tests and Welch’s t-tests, depending on variance homogeneity. A two-way ANOVA was also conducted to explore interactions between gender and nationality. The Spanish sample comprised 86 women and 21 men, and the Portuguese sample included 58 women and 9 men. The mean age across the sample was 21.5 years (SD = 4.15). No significant differences were observed in fear of death or emotional intelligence between the two groups. However, Portuguese students showed significantly better coping with death, but also higher academic burnout and cynicism. Spanish students reported greater perceived efficacy. Although emotional intelligence and death anxiety were similar, Portuguese students demonstrated stronger coping skills but experienced more burnout. This suggests that coping alone may not buffer academic stress, emphasizing the need for culturally tailored interventions to enhance emotional readiness and reduce burnout. Full article

Background: The aim was to explore the association between coping strategies (CSs) and health-related quality of life (HRQoL) in breast cancer (BC) survivors and to analyze the role of relevant sociodemographic and clinical variables. Methods: A cross-sectional study involving 305 women under follow-up for surgically treated BC in Spain. CSs were measured using the Brief Coping Orientation to Problems Experienced Scale and the HRQoL with the Short-Form Health Survey (SF-12). Results: The mean age at BC diagnosis for participants was 57.4 years, with 60.3% of diagnoses at the local stage. Most frequent complementary treatments were radiotherapy (53.4%) and chemotherapy (33.1%). Adaptative CS scores were positively associated both with higher physical HRQoL (adjusted regression coefficient: 2.19; 95% confidence interval: 0.11; 4.27, p-value: 0.039) and mental HRQoL scores (coef.: 2.65: 95%CI: 0.25; 5.04, p-value: 0.030). Maladaptive CS scores were inversely associated with mental HRQoL scores (coef.: −3.92; 95%CI: −6.62; −1.22, p-value: 0.005). The effects were stronger among women with a favorable BC prognosis. Conclusions: Adaptive CSs positively affected the physical and mental HRQoL, while maladaptive CSs negatively affected the mental HRQoL. Therefore, psychosocial interventions that promote adaptive CSs and avoid maladaptive ones could improve the well-being of women with a favorable BC prognosis. Full article

Background: The mental health of physicians has become a pressing global concern. High rates of depression, anxiety, and burnout are reported in the literature, with each condition linked to reduced job satisfaction, increased medical errors, and ultimately suicidal ideation (SI). Although research on physicians’ mental health is emerging in Saudi Arabia, data on suicidality remain scarce. Objective: This study aims to determine the prevalence of SI and its determinants among physicians in Saudi Arabia. Methods: A cross-sectional study was conducted with 423 physicians across all medical specialties of all ranks, who were recruited using a convenience sampling technique. The study tool comprised three main sections. The first section included questions regarding sociodemographic factors, lifestyle, and work-related factors. The second section included items on suicidality and the Patient Health Questionnaire-9 to screen for depressive symptoms. The third section included the Brief Resilient Coping Scale (BRCS) to measure the coping mechanisms of the participants. Results: SI was disclosed by 9.7% of the respondents, with 0.5% reporting previous suicide attempts. Suicidal ideation was independently associated with low income (OR = 3.94, 95% CI 1.32–11.76, p = 0.014) and higher depression scores (OR = 1.09 per point, 95% CI 1.02–1.16, p = 0.008). Moreover, knowing a colleague with suicidal behavior (i.e., knowing a colleague who had contemplated suicide or had attempted suicide/died by suicide) was significantly associated with SI among our participants (p < 0.001 and p < 0.006, respectively). Higher scores on the BRCS, specifically with respect to growing from adversity and actively replacing losses, were linked to lower odds of SI (p < 0.001 and p < 0.045, respectively). Conclusions: Physicians in Saudi Arabia experience an alarming level of SI that is associated with low income and depression. The results of this study underscore the importance of additional research to evaluate the effectiveness of intervention programs designed to enhance mental health support for physicians, encourage adaptive coping mechanisms, foster peer support networks, and combat stigma associated with mental illnesses. Full article

Intimate partner violence (IPV) is a widespread issue with severe consequences for women’s well-being. This scoping review synthesizes research on coping strategies among female IPV survivors, evaluates measurement approaches, and assesses the applicability of the 11 families of coping framework. Analyzing 27 studies (2017–2022) from the Scopus database, we identified key coping patterns. In response to the first research question, the review revealed methodological diversity, with qualitative interviews predominating (55.56% of studies) alongside quantitative measures such as the Brief-COPE and IPV Strategies Index. All documented coping strategies were successfully categorized using Skinner’s framework, demonstrating its comprehensive utility for IPV research. This complete categorization directly answers our second research question, confirming the framework’s effectiveness for classifying IPV coping strategies. By using this framework, we identified key coping patterns, with seeking social support emerging as the most prevalent strategy (88.89% of studies), followed by escape–avoidance (55.56%) and problem-solving (44.44%). The findings underscore the value of adopting a standardized classification system to enhance consistency across studies and improve comparative analyses. The study contributes to theoretical development by validating Skinner’s model in IPV contexts and offers practical guidance for future research design. By demonstrating the universal applicability of the 11 families of coping, this scoping review provides a foundation for systematic investigations of coping mechanisms and informs targeted support interventions for survivors. Full article