Search Results (532)

Background: Malnutrition is a universal challenge in long-term care, significantly affecting vulnerable populations. Residents with Intellectual Developmental Disability (IDD) rely heavily on Direct Support Professionals (DSPs) for assisted feeding. Understanding DSP’s mealtime experiences is essential for improving nutritional care and well-being. Objective: To examine multilevel factors associated with DSPs’ mealtime experiences. Methods: This exploratory cross-sectional case study used a survey administrated to DSPs working in a long-term residential setting. Statistical analyses examined the associations between multilevel factors and DSP’s positive and negative mealtime experiences. Results: The sample included 46 DSP’s (98% women) from a single facility in Israel. Although DSPs reported high levels of positive feelings and satisfaction with their daily work efficacy, negative feelings were significantly associated with some organizational, environmental and resident-related factors. Negative feelings were higher among DSPs caring for residents who use wheelchairs compared to those working with residents who do not use wheelchairs (t = −2.99, p < 0.01). Negative feelings were negatively associated with institutional support (r = −0.49, p < 0.001), and perceived accessibility and adaptability of the environment (r = −0.46, p = 0.001), and showed a more modest association with communication with residents (r = −0.38, p = 0.01). DSPs’ seniority, education level, and prior feeding-related training were not significantly associated with mealtime experience. Conclusions: The findings highlight that negative mealtime experiences among DSPs are associated with organizational, environmental, and resident-related factors, rather than with individual DSP’s characteristics. Policy and practical adjustments to address mealtime experiences for residents with IDD are suggested. Full article

The rapid expansion of Generative Artificial Intelligence (GAI) is transforming higher education systems, particularly public institutions seeking to advance toward smart governance models and digital transformation. In this context, digital teaching competence emerges as a strategic factor for the effective, ethical, and pedagogically sound adoption of these technologies. This study assesses the level of digital competence among public higher education faculty in Paraguay and examines its predictive capacity regarding the adoption of GAI tools using machine learning models. A nationwide quantitative study was conducted with a sample of 800 faculty members from public universities across Paraguay. Data were collected through a structured questionnaire based on international digital competence frameworks, incorporating additional variables such as attitudes toward GAI, technological experience, institutional infrastructure, and perceived organizational support. Data analysis involved the application of machine learning techniques, including Logistic Regression, Random Forest, and Gradient Boosting, to identify the variables with the strongest predictive power regarding faculty readiness and willingness to integrate GAI into teaching practices. Model performance was evaluated using metrics such as accuracy, F1-scores, and the AUC-ROC. The findings identify key predictors of technological readiness and structural gaps within Paraguay’s public higher education system. This research provides empirical evidence from Latin America on the factors influencing GAI adoption in public sector educational contexts and contributes to the design of educational policies aimed at fostering smart universities and digitally sustainable academic ecosystems. Full article

Background/Aim: Cardiovascular disease (CVD) represents a relevant global public health challenge with dyslipidemia as a major modifiable cardiovascular risk factor (CVRF). Recent advances have introduced injectable lipid-lowering therapies (LLT). Their clinical effectiveness in real-world practice seems to depend not only on pharmacological efficacy but also on patients’ acceptance, adherence, and persistence, influenced directly by perceived barriers and facilitators. The main objective of this scoping review is to map the barriers and facilitators related to the use of novel injectable LLTs among adult patients with dyslipidemia or CVD. Methods: This review was conducted in accordance with JBI methodology and reported according to Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for scoping reviews (PRISMA-ScR); pre-registration on Open Science Framework (OSF) was performed. A search was conducted in MEDLINE from PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) from EBSCOhost, and Google Scholar up to June 2025. Eligible studies included qualitative, quantitative, mixed-methods, and review papers involving adult patients with dyslipidemia who reported experiences, perceptions or challenges related to the use of injectable LLT in any healthcare or community setting worldwide. Two reviewers independently screened studies, selected and extracted data. Results: Out of 665 records identified, 7 studies met the inclusion criteria. Patients’ adherence to injectable LLTs is shaped by psychological fears, prior negative experiences, and perceived efficacy. Satisfaction increases when patients feel supported and informed. Convenience, self-administration, and motivational meaning facilitate persistence. Organizational support and economic accessibility further influence uptake, highlighting that adherence depends on both patient experience and structural factors. Conclusions: Patient acceptance and persistence with injectable LLT depends on a complex interplay of emotional, clinical, organizational and economic factors, beyond pharmacological efficacy alone. Fear of injections, previous statin-related experiences, administrative complexity, and high costs remain major barriers, while shared decision-making, trust in healthcare providers, perceived efficacy, regimen convenience, and supportive structures act as strong facilitators. Addressing these challenges requires multidimensional and multidisciplinary strategies for policy makers and clinical managers. Full article

Despite strong evidence that gender-diverse leadership improves organizational innovation and performance, women remain underrepresented in leadership pipelines worldwide, particularly in Asia. While prior research largely examines the outcomes of gender diversity at the firm level, far less is known about the psychological and social factors that shape women’s leadership aspirations in the first place. Addressing this gap, this study applies Social Cognitive Career Theory (SCCT) to explain how contextual support and developmental experiences influence women’s leadership aspirations in a collectivist business environment. Using survey data from 400 adult women in Indonesia and structural equation modelling, the study examines how parental involvement shapes personal mastery, how personal mastery strengthens leadership self-efficacy, and how self-efficacy, role models, and perceived leadership traits jointly predict leadership aspiration. The findings show that parental involvement indirectly contributes to leadership aspiration through personal mastery and self-efficacy, while role models and leadership traits also play significant roles. Among all predictors, self-efficacy emerges as the strongest driver of women’s leadership aspiration. This study makes three contributions. First, it extends SCCT beyond traditional STEM career research into the domain of leadership aspiration. Second, it provides rare empirical evidence from a collectivist Asian context, highlighting the role of family and social environment in shaping women’s leadership pathways. Third, it shifts the focus of gender diversity research from representation outcomes to the formation of the female leadership pipeline, offering actionable insight for educators, families, and organizations seeking to foster future women leaders. Full article

This study examines how disruptive technologies reshape workforce skill requirements and organizational responses. As tools such as Artificial Intelligence, the Internet of Things, and cloud infrastructures become embedded in everyday operations, employees increasingly confront evolving competence demands. Drawing on data from 622 employees across Greece, Spain, and Italy, the study proposes and tests a structural model linking disruptive technology exposure with perceived skill gaps, organizational readiness, strategic HR alignment, and skill update intention. The findings show that disruptive technology exposure is positively associated with perceived skill gaps, which in turn relate to organizational readiness, strategic HR alignment, and stronger skill update intention. These results highlight the importance of coordinated organizational and HR mechanisms in supporting continuous learning. Full article

Artificial intelligence (AI) has been increasingly incorporated into organizational functions to streamline processes and improve performance outcomes. However, prior research has primarily examined AI from a technological and operational perspective, with limited attention to the role of employees’ perceptions of AI in shaping organizational outcomes. This study develops and empirically tests a moderated mediation model examining the impact of perceived benefits of AI (PB-AI) on organizational performance (OGP), both directly and indirectly, through organizational agility (OAG), while assessing the moderating role of management commitment (MC). Data were collected from 381 managers in medium-sized enterprises in Saudi Arabia and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The results indicate that perceived benefits of AI (PB-AI) significantly enhance organizational agility (OAG) (β = 0.400, p < 0.001) and organizational performance (OGP) (β = 0.303, p < 0.001). Organizational agility also positively influences performance (β = 0.163, p = 0.001) and partially mediates the relationship between PB-AI and OGP. However, the moderated mediation effect of management commitment was not supported. The findings highlight the role of employees’ perceptions of AI as a mechanism through which AI-related benefits are translated into organizational outcomes. The study contributes to the literature by positioning perceived benefits of AI as a key explanatory construct and by demonstrating the role of organizational agility in linking AI-related perceptions to performance outcomes. It also provides insights into the role of management commitment in AI-enabled organizational contexts. Full article

This study examines the relationships between green workplace mindfulness, employee productivity, green work engagement, and perceptions of a green workplace climate within healthcare organizations. Green workplace mindfulness (GWM) refers to employees’ awareness of how their daily work activities influence environmental sustainability and resource use. Drawing on the Job Demands–Resources (JD-R) and Conservation of Resources (COR) theoretical perspectives, the study proposes that sustainability-oriented mindfulness may function as a personal resource associated with employee engagement and work outcomes. Data were collected through a cross-sectional survey of 473 employees working in public and private hospitals in Libya. The study employed Partial Least Squares Structural Equation Modeling (PLS-SEM) to examine the relationships among the study variables. The findings indicate that green workplace mindfulness is positively associated with employee productivity, both directly and indirectly through green work engagement (GWE). In addition, perceptions of a supportive green work climate (GWC) perception strengthen the relationships between mindfulness, engagement, and productivity. Specifically, the indirect association between mindfulness and productivity through engagement becomes stronger when employees perceive stronger environmental support within their organizations. These findings contribute to sustainability and organizational behavior research by demonstrating how individual awareness of environmental responsibility and supportive workplace climates jointly relate to employee engagement and productivity in healthcare settings. From a practical perspective, the results suggest that healthcare organizations can encourage sustainable performance by promoting environmental awareness among employees and by developing workplace climates that support environmentally responsible practices. Such initiatives may help healthcare institutions improve operational effectiveness while contributing to broader sustainability goals. Full article

Background: Workplace bullying constitutes a persistent psychosocial risk in public service settings, where hierarchical structures and limited exit opportunities may intensify employees’ psychological strain. Although previous research has documented associations between workplace bullying and burnout, less is known about the psychological processes through which bullying translates into emotional exhaustion and the contextual conditions under which these processes are activated, particularly in public sector contexts. Method: This study used survey data from 234 public service employees working in administrative, educational, and non-clinical healthcare institutions across three major cities in Türkiye (Istanbul, Ankara, and Izmir). Participants who were frequently exposed to workplace bullying were selected to examine the detrimental cycle that victims experience. A moderated mediation model (PROCESS Model 7) was tested to examine emotion-focused coping as a mediating mechanism between workplace bullying and burnout, operationalized through emotional exhaustion, and to assess whether this indirect effect was conditional on perceived bystander silence. Results: Findings indicated that workplace bullying was associated with increased reliance on emotion-focused coping only when perceived bystander silence was high. The conditional indirect effect of workplace bullying on burnout via emotion-focused coping was significant at higher levels of bystander silence, whereas no indirect effect emerged under low silence conditions. Conclusions: These findings suggest that burnout does not arise as an automatic consequence of bullying exposure but unfolds through coping processes that are activated in socially silent environments. By highlighting the conditional role of bystander silence, this study emphasizes the value of social context in shaping how public service employees respond to workplace bullying and how burnout develops. We discuss the practical implications for organizational interventions that aim to reduce bystander silence and support healthier coping processes in organizations. Full article

The increasing adoption of servitization has led many manufacturing companies to operate simultaneously in manufacturing and service activities, creating dual-sector business models characterized by heightened organizational complexity. Although prior research acknowledges that both internal capabilities and contextual conditions shape organizational outcomes, fewer studies have examined these variables within the same empirical model in companies operating under both manufacturing and service logics. Drawing on the resource-based view and contingency theory, this study examines the effects of organizational culture, organizational commitment, knowledge management, environmental uncertainty, and employee retention on organizational performance in dual-sector companies, while also assessing whether these relationships vary by company size. Survey data were collected from 433 employees working in dual-sector companies and were analyzed using confirmatory factor analysis, covariance-based structural equation modeling, and supplementary hierarchical regression analysis. The findings indicate that environmental uncertainty and employee retention did not receive empirical support as independent direct predictors in the structural model. Organizational commitment, knowledge management, and two dimensions of organizational culture—consistency and adaptability—are significant positive predictors of perceived organizational performance. The moderation analysis does not provide strong evidence that company size changes these relationships, although the interaction suggests that environmental uncertainty may be more consequential in large firms. This study contributes to research on servitization by showing that, in dual-sector companies, performance is most strongly associated with internal capabilities that support coordination, shared meaning, and knowledge integration across manufacturing and service activities. For managers, the results highlight the importance of strengthening commitment, adaptive coordination, and cross-domain knowledge processes rather than relying on retention efforts alone. Full article

The circular economy (CE) can help businesses use resources more efficiently, but empirical evidence on CE adoption among non-European SMEs remains limited. This study examines CE practices, benefits, challenges, and future intentions in 220 Saudi Arabian SMIs. A structured survey collected data on four CE practice domains (resource efficiency, waste management, eco-design, and reverse logistics), four benefit dimensions (economic, environmental, operational, and reputational), four challenge dimensions (financial, organizational, technical, and regulatory), and six future intention items. CE adoption was moderate (M = 3.29 on a five-point scale) and balanced across all four practice domains, with resource efficiency scoring highest (M = 3.32). Benefit scores averaged 3.46, far outpacing challenges (M = 2.78). This benefit surplus of 0.68 points (on a five-point scale) indicates that Saudi SMIs perceive CE as worthwhile and view its barriers as manageable rather than prohibitive. Together, perceived benefits and perceived challenges explained 54.3% of the variance in CE adoption (R² = 0.543) in multiple regression analysis. Reducing perceived challenges may be a more effective lever for promoting CE adoption than amplifying perceived benefits, as challenges exerted a larger absolute standardised effect (β = −0.50) than perceived benefits (β = 0.39). Once perceptions were controlled, perceived benefits and challenges significantly predicted future CE intentions, but current CE practices did not. According to the Theory of Planned Behavior’s attitudinal pathway, firms without CE experience can develop strong forward-looking intentions if the business case is convincing and barriers are perceived as manageable. Technical and organizational barriers outweighed financial ones, indicating the need for capacity-building interventions over supplementary financing, unlike European findings. About 79% of respondents were neutral or positive about government-supported CE expansion. CE adoption did not differ significantly by firm size, geographic location, or ownership structure, suggesting that Vision 2030’s sustainability messaging has established a broad baseline of CE awareness across Saudi SMIs. Full article

Background: Healthcare professionals are exposed to high emotional demands, including repeated contact with suffering, death, moral distress, and organizational pressure. These factors are associated with psychological distress, burnout, and secondary traumatic stress. Expressive Writing (EW) has been proposed as a psychological intervention, but evidence of its effectiveness among healthcare professionals remains heterogeneous. Objectives: To examine the effects of EW on psychological health, psychophysical well-being, and professional satisfaction among healthcare professionals. Methods: A systematic review was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA 2020 guidelines. Searches were performed in PubMed, CINAHL, CENRAL, CENTRAL Scopus, Embase, and PsycINFO from database inception to January 2025. Quantitative studies involving healthcare professionals and evaluating structured expressive writing interventions were considered for inclusion, including randomized and non-randomized, controlled and uncontrolled designs. Studies reporting psychological, psychophysical, or work-related outcomes were eligible. Only full-text articles published in English or Italian were considered. The review protocol was registered and archived in the Open Science Framework. Methodological quality was assessed using CASP checklists, the RoB 2 tool, and the Newcastle–Ottawa Scale. Results: Seven studies published between 2017 and 2023 were included. EW interventions were associated with reductions in psychological distress, particularly perceived stress, depressive symptoms, and post-traumatic stress symptoms. Findings regarding burnout and compassion fatigue were mixed. Organizational and job-related outcomes, such as job satisfaction and organizational commitment, showed limited and heterogeneous improvements. No consistent effects were observed for resilience or social support. Overall, the methodological quality of the included studies was generally good. Conclusions: EW appears to be a promising, low-cost intervention for reducing psychological distress among healthcare professionals. However, heterogeneity in study designs, intervention protocols, and outcome measures limits the strength of the evidence. Further high-quality, controlled studies using standardized EW protocols are needed. Full article

Background/Objectives: Digital health interventions are increasingly used to support person-centered care (PCC) in chronic disease management, yet it remains unclear which PCC components are most consistently enabled by digital tools and how these relate to outcomes. This study synthesized evidence on digitally supported PCC for adults with chronic conditions, examining how interventions operationalize PCC and which clinical, patient-reported, and implementation outcomes are reported. Methods: A structured literature synthesis was conducted according to PRISMA guidelines across a heterogeneous evidence base, including randomized and pragmatic trials, observational studies, qualitative studies, and systematic reviews. The review protocol was pre-registered in the Open Science Framework (OSF) Registries. Results: Across 16 included studies, digital solutions most consistently supported PCC through enhanced situational awareness via self-monitoring, strengthened partnership through two-way communication and coaching, and reinforced shared documentation through co-created health plans. Benefits were reported most consistently for process and experience outcomes, such as perceived access to support, engagement, and empowerment. Evidence for sustained long-term clinical improvements, such as glycemic control, was mixed and frequently limited by short follow-up periods and variation in intervention integration. Conclusions: Digitalization can strengthen PCC when embedded within relational care models and organizational workflows that translate patient-generated data into meaningful action. Future work should utilize clearer PCC operationalization, longer follow-up, and routine reporting of equity outcomes, alongside targeted training for healthcare professionals delivering PCC in digital encounters. Full article

Background: This study reports the results of a project evaluation (2021–2024) that aimed to integrate self-help friendliness within the Swiss healthcare system and foster collaboration between hospitals, self-help centers, and self-help groups (SHGs). Methods: A mixed-methods design was used, comprising document analysis, standardized online surveys of hospital staff involved in 56 cooperative projects at two time points with repeated group comparisons (T0: n = 530, T1: n = 281), and in-depth case studies at four cooperation sites. Results: The descriptive findings indicate that the implemented measures contributed to achieving project objectives. Hospital staff increasingly perceived SHGs as complementary to professional care and reported more frequent provision of information to patients and their relatives. In addition, SHGs became more visible within hospitals. Conclusions: This study provides descriptive insights into the implementation of self-help friendliness in practice and suggests that introducing self-help friendliness in hospitals is both feasible and beneficial. Long-term, sustainable collaboration requires clear roles and responsibilities, organizational support, and recognition of the experiential expertise of SHGs. Full article

Background/Objectives: Patient-Reported Experience Measures (PREMs) help us understand how patients perceive healthcare quality. Yet most studies look at complaints in isolation, without tying them to the structural features of medical practice. This study asks whether the nature of clinical work—shaped by diagnostic pathways, interaction patterns, and professional focus—predicts what patients complain about. Methods: We analyzed 18,492 negative reviews from infodoctor.ru, collected between 2012 and 2023 across 16 Russian cities with populations over one million. We used a mix of methods: machine learning (logistic regression) to classify complaints as medical (M-type) or organizational (O-type), statistical tests (chi-square, proportion analysis), and expert validation by nine independent specialists. We also built a novel multidimensional classification of medical practices based on three criteria: diagnostic pathway length, frequency and duration of patient interaction, and whether the work is mainly technical or communicative. Results: Technical specialties received far more medical complaints than communicative ones (39.8% vs. 29.3%, p < 0.001), while communicative specialties received more organizational complaints (45.7% vs. 35.0%, p < 0.001). Specialties that manage chronic conditions over the long term had the highest share of organizational complaints (41.6%). At the city level, the share of communicative specialists correlated negatively with complaints per capita (r = −0.541, p = 0.0306). We found no meaningful gender differences in complaint patterns. Conclusions: The type of medical practice systematically shapes what patients complain about. Technical specialties draw criticism on clinical quality; communicative specialties draw criticism on how care is organized. Long-term care faces challenges rooted more in administrative friction than in clinical competence. These findings show that PREMs, when analyzed through a practice-based lens, can support targeted quality improvement—moving from simply tracking complaints to acting on them in specialty-specific ways. Full article

This study explores how school leadership styles are perceived to relate to teacher resilience during crises in Arab schools in Israel. Drawing on twenty semi-structured interviews with principals and vice-principals, findings show that transformational and participative leadership, characterized by emotional support, accessibility, active listening, and shared decision-making, are perceived to foster teachers’ sense of security, self-efficacy, and collective resilience. In contrast, authoritarian and rigid approaches are described as contributing to increased stress, reduced motivation, and diminished coping capacity. The study highlights the significance of socio-cultural and political contexts, indicating that effective leadership in crises involves not only professional guidance but also cultural awareness, flexibility, and responsiveness to staff needs. These findings underscore the value of integrative leadership approaches and targeted professional development to support teacher well-being and organizational resilience in crisis-prone settings. By focusing on leaders’ perspectives, the study contributes to understanding how culturally sensitive and adaptive leadership practices may support educational stability under conditions of uncertainty. Full article