Search Results (1,292)

Background: Clinician empathy is associated with family satisfaction and reduced anxiety, but quantitative data from the parents’ perspective in pediatric psychiatry are limited. Objective: To assess parent-perceived physician empathy in pediatric psychiatry consultations and explore its associations with clinical and demographic factors. Methods: Cross-sectional, consecutive sample of parents attending an outpatient pediatric psychiatry clinic (n = 163 parents). A 10-item behavioral empathy scale (range 10–40) was used. Analyses included reliability testing, group comparisons, correlations, OLS regression, and exploratory PCA. Results: The mean total empathy score was 34.5 (SD 4.2); most parents rated physicians as highly empathic (65%). Parents of children with ASD reported lower empathy compared to those with anxiety/depression. Empathy increased modestly with child age and was associated with a calmer state at the end of the visit. PCA suggested exploratory evidence of potential subdimensions, including child-centered communication and listening/facilitation. Conclusions: Parent-perceived empathy in this sample was generally high; however, behaviors that directly involve and facilitate the child (listening, encouraging questions) may need strengthening, particularly for children with ASD. Results should be interpreted in light of the single-center design, the absence of a recorded participation rate, parent-proxy reporting, and the exploratory nature of the PCA. Full article

Prenatal physical activity (PA) has well-established benefits for maternal mental health. However, PA levels are generally low among pregnant individuals and were even lower during the COVID-19 pandemic. Since walking is the most popular form of prenatal PA, we aimed to examine associations between walking in the third trimester of pregnancy and mental health symptoms of depression, anxiety, pregnancy-related anxiety and perceived stress during the pandemic. Relevant pandemic-related factors (e.g., COVID-19 waves, population density) associated with walking were also studied. Pregnant individuals were recruited across Quebec (Canada) between October 2020 and September 2022, as part of the Resilience and Perinatal Stress during the Pandemic (RESPPA) study. Analyses were conducted on data collected via online questionnaires during the third trimester (n = 1086). Results revealed that higher levels of walking were significantly associated with lower symptoms of generalized anxiety (β = −0.06, p = 0.035), and perceived stress (β = −0.07, p = 0.007). Living in a more densely populated area, living with fewer children at home and having a university degree were associated with higher levels of walking. Those who completed their questionnaire in the second pandemic wave also reported higher levels of walking. Our results highlight the potential of walking in the third trimester to support maternal mental health. Full article

Background: Telemedicine has gained significance, especially during the COVID-19 pandemic, offering remote healthcare solutions. However, its adoption in geriatric medical centers (GMCs) remains limited. Understanding the factors influencing telemedicine acceptance among care teams in geriatric medical centers is crucial for successful implementation. Aim: This study examines behavioral factors influencing telemedicine adoption among care teams in Israeli geriatric medical centers through the lens of the Technology Acceptance Model. Methods: A cross-sectional study was conducted with 406 healthcare professionals from four geriatric medical centers in Israel. Participants completed a self-administered questionnaire measuring self-efficacy, subjective norms, anxiety, resistance to change, perceived usefulness, perceived ease of use, and intention to use telemedicine. Structural equation modeling was used to analyze the data. Results: Perceived ease of use mediated the associations between self-efficacy and perceived usefulness and between subjective norms and perceived usefulness, demonstrating how confidence shapes technology acceptance. Perceived usefulness mediated the association between perceived ease of use and intention to use. Perceived ease of use did not mediate the relationship between anxiety or resistance to technological changes and perceived usefulness. Conclusions: The study highlights the importance of perceived ease of use and usefulness in promoting telemedicine adoption among geriatric medical center care teams, emphasizing the need for targeted interventions to enhance these perceptions. Full article

Background: Repeat induced abortion (defined as ≥two lifetime procedures) is becoming more common worldwide, yet its independent influence on women’s psychological health remains contested, particularly in settings where access to modern contraception is restricted. Objectives: This review sought to quantify the burden of depression, anxiety, stress, and generic quality of life (QoL) among women with repeat abortions and to determine how barriers to contraceptive access alter those outcomes. Methods: Following the preregistered PRISMA-2020 protocol, PubMed, Embase and Scopus were searched from inception to 31 June 2025. Results: Eight eligible studies comprising approximately 262,000 participants (individual sample sizes up to 79,609) revealed wide variation in psychological morbidity. Prevalence of clinically significant symptoms ranged from 5.5% to 24.8% for depression, 8.3% to 31.2% for anxiety, and 18.8% to 27% for perceived stress; frequent mental distress affected 12.3% of women in neutral policy environments but rose to 21.9% under highly restrictive abortion legislation. Having three or more abortions, compared with none or one, increased the odds of depressive symptoms by roughly one-third (pooled OR ≈ 1.37, 95% CI 1.13–1.67). Contextual factors exerted comparable or stronger effects: abortions sought for socioeconomic reasons elevated depression odds by 34%, unwanted disclosure of the abortion episode increased depressive scores by 0.62 standard deviations, and low partner support raised them by 0.67 SD. At the structural level, every standard deviation improvement in a state’s reproductive rights index reduced frequent mental distress odds by 5%, whereas enactment of a near-total legal ban produced an absolute increase of 6.8 percentage points. QoL outcomes were less frequently reported; where measured, denied or heavily delayed abortions were associated with a 0.41-unit decrement on a seven-point life satisfaction scale. Conclusions: Psychological morbidity after abortion clusters where legal hostility, financial hardship, or interpersonal coercion constrain contraceptive autonomy while, in comparison, the mere number of procedures is a weaker predictor. Interventions that integrate stigma-free mental health support with confidential, affordable, and rights-based contraception are essential to protect well-being in women who experience repeat abortions. Full article

Background/Objectives: Academic burnout is an emerging problem among nursing students, characterized by emotional exhaustion, cynicism, and reduced academic efficacy. Sports interventions have been shown to have a positive effect on nurses as a preventive strategy against burnout. The aim of this study was to evaluate the effect of a nature sports program on the levels of academic burnout in nursing students. Methods: A randomized clinical trial was performed. The intervention was a 12-week nature exercise program with two sessions each week. The main dependent variables were burnout (measured using the Maslach Burnout Inventory—Student Survey), stress (measured using the Perceived Stress Scale), and anxiety and depression (measured using the Hospital Anxiety and Depression Scale). The post-intervention sample size was n = 58 in the control group and n = 48 in the intervention group. Results: After the intervention, significant differences were found in respect of emotional exhaustion (p < 0.001; Cohen’s D: 0.483), stress (p < 0.05; Cohen’s D: 0.456), and mean steps per day (p < 0.001; Cohen’s D: −1.09), with the mean values being reduced in the intervention group by around three points in emotional exhaustion and stress; the intervention group also achieved a higher mean number of daily steps compared to the control group. Conclusions: A nature sports program could help to reduce emotional exhaustion and stress, and increase the number of steps per day. Full article

AI chatbots have the potential to facilitate students’ academic progress and enhance knowledge accessibility in higher education, yet learners’ attitudes toward these technologies vary amid AI-driven disruptions, with factors influencing acceptance remaining debated. The current study constructs an integrated model based on Technology Acceptance Model 3 (TAM3), an extension of the original TAM, incorporating factors including Self-Efficacy, Perceived Enjoyment, Anxiety, Perceived Ease of Use, Perceived Usefulness, Output Quality, Social Influence, and Behavioral Intention, to explore determinants and mechanisms influencing learners’ acceptance of AI chatbots. This addresses key challenges in AI-augmented learning, such as personalization benefits versus risks like information inaccuracy and ethical concerns. Results from the questionnaire survey analysis with 265 valid responses reveal significant relationships: (1) self-efficacy significantly predicts perceived ease of use; (2) both perceived enjoyment and perceived ease of use positively influence perceived usefulness; and (3) self-efficacy, perceived usefulness, and social influence collectively exert significant effects on behavioral intention. Measurement invariance tests further indicate significant differences in acceptance between undergraduate and graduate students, suggesting academic level moderates behavioral intentions. Findings offer principled guidance for designing inclusive AI tools that mitigate accessibility barriers and promote equitable adoption in educational environments. Full article

This study examines the spatial crime perception gap (SCPG), the mismatch between perceived and actual crime, which can lead to unnecessary avoidance behaviors, anxiety, or lack of vigilance. While few studies have explored this phenomenon from a spatial perspective, this research analyses the collective spatial perception of safety and unsafety in Vienna and Budapest and compares them with recorded crime patterns. Using a digital sketch map survey tool, 656 participants identified safe and unsafe areas as well as their daily routes. The responses were analyzed using spatial analytical and statistical methods to delineate the perception gaps in space, which were also diversified by crime type aggregations, including all crimes, violent crimes, property crimes, and visible crimes. Distance-based analyses were also conducted to examine the “spatial diffusion” and “spatial endowment” effects. The results show that many areas that are perceived as unsafe are not statistical crime hotspots. Perception aligns more closely with violent crime patterns than with property or visible crimes. The spatial diffusion effect illustrates that crime hotspots may influence and expand the perception of unsafety in adjacent and nearby areas. The spatial endowment effect suggests that people are more likely to perceive an area as unsafe if it is further away from their activity spaces, while overlooking crime hotspots that may intersect with it. These patterns were consistent across both cities, although the perception gap was larger in Budapest, while the endowment effect was more pronounced in Vienna. By highlighting where and how perception diverges from reality, this study provides insights that can inform strategies to reduce unfounded fear and strengthen the perceived safety and psychological resilience of urban populations. Full article

Integrating information and communication technology (ICT) into STEM education enhances instructional quality and cultivates students’ interdisciplinary problem-solving. STEM teachers’ attitudes—driven by perceived ease of use (PEOU) and perceived usefulness (PU)—are pivotal in ICT adoption, and pre-service training offers a vital opportunity to shape these attitudes. Yet, empirical studies investigating how specific training strategies influence ICT attitudes via PEOU and PU remain scarce. Using a mixed-methods approach combining questionnaires and interviews, the results indicate that pre-service training significantly improved STEM teachers’ attitudes toward ICT-enhanced teaching. Socially interactive strategies (role models and collaboration) enhanced attitudes via PEOU by boosting confidence and reducing technology-related anxiety, cognitive design strategies (reflection and instructional design) operated through PU by emphasizing ICT’s pedagogical value, and experiential feedback strategies (authentic experience and feedback) influenced attitudes through both PEOU and PU, fostering integrated technical and pedagogical development. These findings support an integrated SQD–TAM framework and provide practical guidance for designing pre-service STEM teacher programs to promote sustained ICT adoption in China, and meanwhile highlights the importance of strategically sequencing training to cultivate both technological competence and pedagogical insight among future STEM educators. Full article

Background and Objectives: Dental anxiety can hinder both treatment delivery and dental education. Few studies have examined this issue among Romanian dental students. This study assessed the prevalence, intensity, and main procedural triggers of dental anxiety, with a focus on experiences related to local anesthesia. Methods: A cross-sectional survey was conducted (January–May 2024) among 122 fourth-year students using the validated Romanian version of the Modified Dental Anxiety Scale (MDAS) and additional items on demographics, prior anesthesia and perceived complications. Data analysis included descriptive statistics, chi-square tests, and t-tests. Results: Overall, 21.3% of respondents scored in the low anxiety range, 75.4% in the moderate range, and 3.3% in the severe range (MDAS ≥ 19). No significant gender differences were identified (p > 0.05). Injections with local anesthetic were rated as the most distressing procedure, followed by drilling, whereas scaling was reported as least stressful. The majority (86.9%) had undergone previous local anesthesia, with very few adverse events recalled. Conclusions: Romanian dental students reported moderate dental anxiety overall, with local anesthesia injections as the main trigger. The lack of gender differences points to a potential buffering effect of clinical exposure. Incorporating structured anxiety management into dental curricula may enhance both student well-being and patient care. Full article

Background: This study is particularly relevant to the Romanian context, where relatively few empirical investigations have examined post-pandemic health perceptions and levels of trust in public institutions. The purpose of this study is to investigate the long-term impact of the COVID-19 pandemic on health perceptions and trust in the healthcare system by examining key socioeconomic and epidemiological factors. Methods: A cross-sectional online survey was conducted among Romanian adults (N = 423), between March and April 2025. Demographic data, lifestyle habits, mental health, and access to healthcare were assessed. Statistical analyses included both bivariate (chi-square test) and multivariable logistic regression models to identify independent associations. Results: 31.9% of participants reported increased stress and anxiety during the pandemic. Decreased trust in the healthcare system (75.6%) and a perceived reduction in life expectancy (74.3%) were also noted as a consequence of the COVID-19 pandemic. Perceived life expectancy decline was linked to lower education and inconsistent healthcare behavior. Conclusion: In our sample, the perception of decreased life expectancy reflects not only epidemiological realities but also emotional and social responses to crises. Individuals’ trust, behavior, and shared vision of the future have also been challenged during the COVID-19 pandemic. Full article

Background: During COVID-19 Arab American and Arab/Middle Eastern (AME) international students faced disproportionately higher psychosocial stressors like other racial populations that may influence their mental health and help-seeking behaviors. Objective: This study examined and compared the prevalence of depression, anxiety, and loneliness among Arab American and AME international college students in addition to how loneliness is associated with perceived mental health need and the use of digital mental health (DMH) services. Methods: Data from the 2022–2024 Healthy Minds Study (HMS) comprised a final analytic sample of 3249 AME students (2662 Arab American; 587 AME international). Logistic regression and generalized structural equation modeling (GSEM) were used to examine associations and mediating pathways. Results: Depression and anxiety were prevalent among Arab American students (44.3% and 40.0%) compared to AME international students (40.9% and 37.0%). Rates of loneliness were similar (56.2% vs. 56.9%). Loneliness was bidirectionally associated with both depression and anxiety (p < 0.001). Perceived need for care emerged as a significant mediator linking psychological symptoms to DMH service use (OR = 2.56, p < 0.001), while loneliness did not directly predict DMH utilization. Only 10% of students reported using DMH services. Conclusions: Mental health disparities among AME students exist. Institutions should prioritize culturally responsive approaches to support the mental health needs of diverse student populations. Full article

Aim: To assess the impact of the environment on the attitude and mood of pediatric patients undergoing computed tomography (CT) scans at our pediatric clinic within the colorful setting of a dedicated CT scan room. Background: In pediatric healthcare, interventions must address the specific needs of both children and their parents. While medical imaging is essential for diagnosis and management, it can cause stress and anxiety in children, potentially affecting cooperation and diagnostic quality. Creating a supportive, child-friendly environment can alleviate these challenges and improve the likelihood of successful imaging outcomes. Method: This retrospective quantitative study investigated the phenomenological experience of pediatric patients (aged 0–18) who underwent CT imaging at the “De Marchi” pediatric clinic between November 2021 and June 2024. Patients were manually selected from the clinic’s CT database. A standardized telephone survey assessed perceived environmental impact before, during, and after the procedure. Data were anonymized and recorded in Excel (Microsoft, Redmond, WA, USA). Crosstab analyses and Pearson’s chi-square tests were performed using SPSS version 25.0 (IBM, Armonk, NY, USA). Results: Between November 2021 and June 2024, 838 pediatric patients underwent 1144 CT scans at the “De Marchi” clinic. Patients were grouped as previous-CT elsewhere (12.3%), first-time CT (68.9%), and returning patients (18.8%). Most reported positive experiences: 63.3% of the first group rated the experience better than prior exams, 73.9% of first-time patients found the environment comfortable, and 85.6% of returning patients felt at ease. Overall, 94.2% would recommend the clinic for pediatric CT scans. Conclusions: Our research demonstrates that a child-friendly environment is not just a concept, but a tangible solution that effectively alleviates the stress experienced by young patients and their families during diagnostic exams. This finding should inspire optimism about the potential for creating more reassuring and comfortable hospital settings in pediatric healthcare. Full article

Background/Objectives: Multiple studies indicate that self-perceived health accurately reflects a person’s overall health, and that poor self-perceived health is associated with chronic diseases, the use of health services, increased health expenditure, and mortality. There is little research on this topic in people with newly diagnosed diabetes mellitus (DM). The objectives of this study were to analyse self-perceived health in adult patients with newly diagnosed DM (mostly T2DM, but also T1DM), identify associated characteristics, including a Mediterranean diet and physical activity, and examine differences by sex. Methods: This is a cross-sectional study of 796 patients. Participants were evaluated through physical examination, electronic medical records, self-perceived health assessment, lifestyle, personal and family history, and laboratory parameters. A multivariate analysis was performed on the total sample and on sex subgroups to identify factors associated with self-perceived health. Results: In total, 25.8% of participants reported poor/fair health (33.4% women, 20.2% men). The variables associated with poorer self-reported health were being female, a lack of family support, morbid obesity, low physical activity, and anxiety/depression. In women: morbid obesity, cancer, and antiplatelet therapy. In men: lack of family support, age < 60, anxiety/depression, low physical activity, and previous treatment with ACEIs/ARBs. Conclusions: Poor self-perceived health is common in patients newly diagnosed with diabetes, similar to the general population. The factors found explained 24.2% of the variance and showed different associations by sex. The cross-sectional design did not allow for inferences of causality. These findings could suggest personalised interventions to address psychosocial and lifestyle factors at the onset of diabetes. Full article

Background/Objectives: Type 1 diabetes mellitus (T1DM) during adolescence increases the risk of psychosocial difficulties. To address these challenges, the 10VIDA program was developed to support psychological adjustment, treatment adherence, and quality of life. This study examined socioemotional factors linked to chronic illness adjustment and psychological well-being in adolescents with T1DM, assessing the impact of the 10VIDA intervention. Methods: Adolescents with T1DM participated in two studies: (1) an inter-group design with experimental and control groups assessed pre- and post-intervention, and (2) an intra-subject longitudinal design with three assessments (two pre-intervention and one post-intervention). All participants completed the 10VIDA intervention delivered online through seven sessions: five targeted adolescents with T1DM, while two included primary caregivers. The program’s main objective was to enhance well-being and quality of life. Results: Girls reported higher anxiety and depression, while boys showed greater self-esteem and emotional well-being. The experimental group experienced significant reductions in discomfort, anxiety, depression, and perceived illness threat, alongside improvements in self-esteem and psychological well-being. Intra-subject analysis also revealed increased well-being and decreased discomfort after intervention. Conclusions: The 10VIDA program effectively addressed socioemotional challenges in adolescents with T1DM and reshaping illness perception. These findings underscore the importance of integrated psychological support to improve adjustment and quality of life in chronic illness during adolescence. Full article

Background: Degenerative lumbar spine disease is a prevalent cause of chronic low back pain that significantly impairs daily function and quality of life. While conservative management is the first line of treatment, many patients ultimately require instrumented lumbar spine surgery. However, postoperative outcomes vary considerably, with emerging evidence suggesting that preoperative psychological factors such as anxiety, depression, and pain catastrophizing may influence recovery. The SAP-LD (Scale for Anxiety and Pain in Lumbar Degeneration) study was designed to assess the prognostic role of these psychological and physical parameters in surgical outcomes. Methods: This prospective observational study enrolled 70 adult patients with degenerative lumbar spine pathology scheduled for instrumented surgical treatment at the University of Brescia and ASST Spedali Civili di Brescia between March and December 2024. Preoperative assessments included demographic, clinical, and radiologic data along with validated scales: the Oswestry Disability Index (ODI), 36-Item Short Form Health Survey (SF-36), Visual Analogue Scale (VAS), Pain Catastrophizing Scale (PCS), and Hospital Anxiety and Depression Scale (HADS). Follow-up evaluations were performed at 45 days and at 6 months, and statistical analyses were conducted using correlation tests, ANOVA, and regression modeling. Results: The demographic analysis of the 70 enrolled patients shows a balanced gender distribution (38 females, 34 males) with a mean age of 61 years (range 23–81). The educational level distribution indicates that the majority of patients (44.29%) have a secondary education level, while 35.71% have a tertiary education level. Regarding employment status, 50% of the patients are retired or not working. Patients with clinically significant anxiety and/or depression showed higher levels of perceived pain, pain catastrophizing, and disability at baseline. These patients reported significantly worse scores on the Visual Analogue Scale (VAS), Pain Catastrophizing Scale (PCS), and Oswestry Disability Index (ODI). The Oswestry Disability Index (ODI) demonstrates a clinically significant improvement (reduction) in disability between the preoperative period (t0) and the 45-day follow-up (t2), with the median decreasing from 39.00 to 13.00. However, there is a partial regression at the 6-month follow-up (t3), with the median increasing to 27.00. For the SF-36 Health Survey, the General Health subscale shows an improvement between t0 and t2 (median increasing from 55.00 to 60.00), followed by a slight decrease at t3 (median 55.00). Similar patterns are observed in most other subscales, with initial improvement followed by partial regression. The Pain Catastrophizing Scale (PCS) shows a substantial reduction in catastrophizing between t0 and t2 (median decreasing from 16.00 to 3.00), followed by an increase at t3 (median 11.00), though still below baseline levels. Pain intensity as measured by the Visual Analogue Scale (VAS) shows a significant reduction at t2 (median decreasing from 5.00 to 3.00), but increases again at t3 (median 6.00), even exceeding the preoperative level. For the Hospital Anxiety and Depression Scale (HADS), no significant differences were observed across time points, with values indicating mild symptoms throughout the study period. Correlation analyses confirmed that higher preoperative anxiety and depression scores were predictive of poorer postoperative outcomes. Specifically, higher HADS scores at baseline are associated with higher ODI scores (increased disability) at all time points (p = 0.002), higher VAS scores (increased pain) at all time points (p = 0.015), and lower scores on SF-36 subscales, particularly Emotional Well-being (p = 0.00023) and Social Functioning (p = 0.002). Higher PCS scores at baseline are associated with higher ODI scores at all time points (p = 0.001), higher VAS scores at all time points (p = 0.008), and lower scores on SF-36 subscales, particularly Pain (p = 0.00023) and Physical Functioning (p = 0.04254). The mixed linear models analysis confirms these findings, showing that the ODI score decreases significantly between t0 and t2 (p = 0.00023) and increases between t2 and t3, though this increase is not statistically significant (p = 0.079). For VAS scores, there is a significant decrease between t0 and t2 (p = 0.00023) and a significant increase between t2 and t3 (p = 0.04254). Patients with elevated preoperative HADS scores tended to have slower recovery trajectories and reported lower satisfaction levels. These findings reinforce the prognostic value of psychological assessments in spine surgery and suggest that targeted psychological interventions could improve patient outcomes. Conclusions: By identifying psychological predictors of postoperative recovery, this study underscores the importance of integrating preoperative psychological screening into routine clinical practice. The results suggest that a multidisciplinary approach, including both surgical and psychological care, could enhance long-term functional outcomes and quality of life for patients undergoing instrumented lumbar spine surgery. Full article