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To analyze the perceptions of Primary Health Care (PHC) professionals regarding Covid-19 testing in basic health units (BHUs). This qualitative study, part of a formative research project, involved 22 semi-structured interviews and 4 focus groups with professionals working in PHC in a Brazilian capital city. Among other criteria, the professional most directly involved in pandemic response measures in each BHU was selected. Content analysis was performed using a deductive analytical approach, in which the findings were organized into categories defined based on the components of the health system (population; infrastructure; organization of services; service delivery or care model; and management). Reports commonly referred, in the population component, to the challenges arising from the limitations of PHC coverage; in the infrastructure component, the insufficiency of human resources and physical infrastructure was highlighted, which in turn required changes in the organization and provision of services, with repercussions on the care model. The contributions also revealed that at some points during the pandemic there was a disruption of the work process, especially in family health teams. In the management component, weaknesses in communication flows between the health secretariat and the BHU were identified, although this was less frequently mentioned. The perception that expanding and decentralizing testing in BHUs was necessary was confirmed. The findings point to the importance of coordinating the pandemic response and effectively decentralizing the actions adopted, of preparedness plans and strengthening PHC and its professionals, as well as investments in infrastructure and team training, and advances in actions aimed at occupational health. The pandemic revealed the importance of advancing the health economic-industrial complex and, fundamentally, strengthening and defending the Brazilian Unified Health System.

Globally, the older population is increasing rapidly, becoming one of the most significant demographic trends of the 21st century. This growth poses important social, health, and technological challenges for societies that must adapt their environments and services to promote independent and healthy aging. In Spain, the population aged 65 years and older reached 18% of the total population in 2020, and projections indicate that this proportion will continue to rise in the coming decades. Within this context, smart homes have emerged as one of the most promising avenues to support aging in place and improve the quality of life. Smart homes encompass a wide variety of functions, including environmental control, safety monitoring, communication, and other assistive technologies, that may help older people stay healthy, safe, and independent in their own homes. However, older people are not a homogeneous group. Their lifestyles, health conditions, and technological experiences differ substantially, which means that, as with any assistive technology, smart home functions must match the real and perceived needs of the target users to ensure acceptance, adoption, and long-term use. In this study, as a step forward toward the adaptability of smart home technology, we present a method to analyze the practical needs of smart home functions for older people. Specifically, we aim to understand the Spanish older population's readiness and needs for smart homes and to provide insights that can guide the design of more adaptive and user-centered solutions. We conducted an online survey focusing on residentially based lifestyles, health conditions, and preferences for smart home functions, targeting older adults living in Spain. The survey collected information about participants' demographic profiles, daily activities, health self-assessment, and attitudes toward technology. A total of 102 valid responses were analyzed. We then classified the older adults according to their residentially based lifestyles using clustering techniques and analyzed the preferences and needs for smart home functions in each identified group. Four clusters emerged based on the information provided by the participants: (1) high quality of life and independent life, (2) poor quality of life, (3) social-centered life, and (4) creative and personal-centered hobbies at home. On the basis of this classification, we explored each group's specific needs for smart homes and estimated their readiness to embrace different aspects of technology. As a result, the top-priority smart home functions for each group were identified and compared. This research contributes to understanding the practical user needs of smart homes as assistive technologies for older people. It provides a methodological approach to anticipate and prioritize functions according to user characteristics, supporting the development of personalized, adaptive, and more acceptable smart home solutions for aging populations.

Namaste Care, a non-pharmaceutical daily multicomponent palliative care intervention, offers care for people with dementia, aiming to improve quality of life of those living with dementia as well as their family and caregivers. This systematic review explores the Namaste Care intervention and its clinical and economic effects in multiple care settings. The aim of this review is to consolidate existing evidence on Namaste Care's clinical and economic outcomes and examine the tools used for data collection. A systematic literature search was conducted (PubMed, Scopus and Web of Science) to identify peer-reviewed studies on Namaste Care's impact on quality of life, costs, health, economic outcomes and benefits up to 22 February 2026. Methodological quality was assessed using the Mixed Methods Appraisal Tool, while the completeness of reporting of economic evaluation studies was evaluated according to the Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS). 31 studies reported the clinical and/or economic outcomes of Namaste Care. The results for quality of life and quality of dying were mixed, while 5 of 11 studies evaluating quality of life reported significant improvements. The various quality-of-life instruments used include the Quality of Life in Late-Stage Dementia (QUALID), EQ-5D-3L and EQ-5D-5L instruments, ICEpop CAPability Measure for Older People (ICECAP-O), ICECAP Supportive Care Measure (ICECAP-SCM), Quality of Life for People with Dementia (QUALIDEM) and Carers-DEMentia Quality of Life (C-DEMQOL). The clinical outcomes considered included pain, behavioural symptoms and quality of end-of-life care. The Medication Quantification Scale and Minimum Data Set indicated reductions in antidepressant and antianxiety medication use. Seven studies reported significant improvements in well-being, and two studies reported reduced stress among family members following Namaste Care sessions. A subset of five studies reported a range of economic outcomes. The findings suggest that Namaste Care improves well-being, reduces caregiver stress and lowers the use of antidepressant and antianxiety medications at a moderate cost. The current literature is characterised by small, non-random, heterogeneous studies. Randomised controlled trials, which include economic evaluations, help to improve evidence-based research to support funding and implementation decisions on Namaste Care. CRD42024560056.

Vaccination against the human papillomavirus (HPV) is an effective way to avert cervical cancer. However, acceptance in Morocco remains inadequate. The aim of this study was to measure the prevalence of parental HPV vaccine refusal and the risk factors associated with it. Between 3 March and 30 September 2025, a multicenter cross-sectional survey was conducted among Moroccan parents of girls aged 11-14 who attended health facilities. The study looked at sociodemographic factors, knowledge regarding HPV and cervical cancer, and vaccination attitudes. A multivariate logistic regression analysis was used to identify risk factors for vaccination refusal. The research included 1,444 participants with an average age of 37.7 ± 6.6 years. Of them, 415 refused HPV vaccination for their daughters, resulting in a prevalence of 28.7%. Vaccine refusal was substantially related to higher educational levels, lower income, less faith in the healthcare system, less knowledge about cervical cancer and its symptoms, and insufficient information regarding the HPV vaccine as seen by the media. Refusal was also associated with a poor perception of the seriousness of HPV infection, fear of vaccinating daughters, noncompliance with past vaccination schedules, difficulties accessing health centers, and a lack of recommendations from healthcare professionals. In contrast, refusal was inversely associated with parents who were uninformed of the proper number of vaccination doses or uninformed regarding the availability of the HPV vaccine at health centers or who feared the vaccine may cause an adverse reaction. Parental refusal of HPV vaccination is still a substantial obstacle. To increase acceptability and enhance cervical cancer prevention in Morocco, it is critical to expand communication strategy, boost public knowledge, and assure active participation of healthcare professionals.

Bullying may have a considerable negative impact on health and well-being. Nevertheless, there is a lack of studies investigating exposure to bullying in the general population. Thus, we aimed to assess the prevalence of lifetime exposure to bullying in the adult Norwegian population and to compare health-related quality of life (HRQoL), and physical and psychological health problems between bullied and non-bullied. We measured lifetime exposure to bullying in the general Norwegian population using a self-report questionnaire. The study was part of a cross-sectional national health survey (n = 1733) conducted in 2014-2015, to which a probability sample of people in the general population was recruited. Reports on socio-demographic data, HRQoL and a wide range of mental and somatic health problems provided the basis for a comparison of those who were bullied with those who were not. Chi square tests and logistic regression analyses were used to assess associations with lifetime exposure to bullying. Across age groups, 28.2% reported exposure to bullying during their lifespan. Adjusted for other variables, the odds of bullying were higher in younger age groups, for those who lived as singles, and for those who were not working or in education. Respondents who had been bullied reported more mental problems such as depression, anxiety, insomnia, eating disorder, psychosis, self-harm, and suicide attempts, and they had lower HRQoL. They also reported more chronic pain, fibromyalgia, rheumatoid arthritis, diabetes mellitus, obesity, and musculoskeletal-, respiratory- and gastrointestinal diseases than people who had not been exposed to bullying. Bullying is common in the general Norwegian population, where more than a quarter of respondents had experienced exposure to bullying during their lifespan. Substantial more mental and somatic health problems among those exposed to bullying require a broad effort against bullying in central arenas in society.

Patients with disorders of consciousness (DoC) resulting from severe traumatic brain injury (TBI) may recover consciousness and independence years later. There is a prevailing belief that recovery, when limited to the restoration of independence in activities of daily living, will be accompanied by poor self-reported quality of life (QOL) and psychological health. This perception may influence early clinical decision-making related to the provision of life-sustaining treatment and access to specialized rehabilitation. In this observational study, we utilized data from the multisite TBI Model Systems (TBIMS) to evaluate the outcomes of QOL (Satisfaction With Life Scale [SWLS]), anxiety (Generalized Anxiety Disorder-7 Scale [GAD-7]), and depression (Patient Health Questionnaire-9 [PHQ-9]) in participants who were admitted to inpatient rehabilitation with DoC and recovered the ability to provide self-report on these measures by 1 year post-TBI. Among 887 TBIMS participants admitted to inpatient rehabilitation with DoC (defined as the absence of command-following; 74% male; mean [standard deviation, SD] age = 36.82 [17.87] years; days post-injury on rehabilitation admission = 33.63 [22.51]), 50% regained the capacity to respond to questions on self-report measures at the 1-year follow-up time point. The mean (SD) total scores were as follows: SWLS = 20.38 (7.81), GAD-7 = 4.00 (5.66), and PHQ-9 = 5.22 (5.04). A minority of patients endorsed dissatisfaction (15%) or extreme dissatisfaction (9%) with life, and similarly, only 14% and 16%, respectively, reported anxiety and depression symptoms above the clinical cutoff points. The results were similar at the 2- and 5-year follow-up time points. In summary, at the group level, QOL and psychological health in persons who recover from DoC are similar to those of individuals with less severe brain injuries and to the general population. These findings challenge the assumption that recovery from DoC is associated with poor QOL and psychological health. Clinicians should be aware that patients with a broad range of residual disability after DoC are unlikely to report dissatisfaction with life or have significant anxiety and depression up to 5 years post-TBI.

Sleep disturbance and quality of life have been widely studied; however, there is a lack of theory-based, nursing-specific tools that directly assess their relationship. This study aimed to develop a valid and reliable measurement tool based on Kolcaba's Comfort Theory. Methodological study. The study included 781 patients and followed standard procedures for scale development. The scale was rated on a 5-point Likert scale, and item scores were averaged to obtain overall scores. Data were collected using the Personal Information Form, the Pittsburgh Sleep Quality Index, the Visual Analog Scale (impact of sleep disturbance), the World Health Organization Quality of Life Scale, and the newly developed scale. Content validity, exploratory factor analysis, and confirmatory factor analysis were used to assess validity. Reliability was evaluated using Cronbach's alpha, McDonald's omega, and split-half reliability. The final scale consists of 23 items and two sub-dimensions: Physical-Psycho-Spiritual and Environmental-Sociocultural. Mean scores range from 1 to 5, with higher scores indicating a greater negative impact of sleep disturbance on quality of life. These findings suggest that the scale may capture the multidimensional impact of sleep disturbance on quality of life. Reliability coefficients were 0.96 for both sub-dimensions and 0.98 for the overall scale. However, the confirmatory factor analysis results indicated an acceptable yet borderline model fit, particularly with respect to the RMSEA value, and therefore should be interpreted with caution. The Effect of Sleep Disturbance on Quality of Life Scale may offer a theory-based approach to assessing how sleep disturbances relate to patients' quality of life. It may assist healthcare professionals in clinical assessment by helping to identify the multidimensional impact of sleep-related problems and could potentially contribute to clinical decision-making and care planning. The findings suggest that the scale demonstrates adequate psychometric properties and may be a useful tool for research, education, and clinical practice. In addition, criterion-related validity showed correlations ranging from weak to moderate levels, indicating partial support rather than strong evidence. These findings should therefore be interpreted with caution, as the observed correlations provide limited rather than conclusive evidence of criterion validity. The scale appears to be a valid and reliable tool for assessing the impact of sleep disturbance on quality of life. The scale may provide a theory-based framework for assessing patient needs, which may support holistic assessment and individualized care.

To understand how primary healthcare providers perceive a hypothetical electricity supply interruptions (ESI) situation (electricity shortages and blackouts), and their needs for a better preparation and response. In Canton of Vaud, Switzerland, interviews with 16 experts of 13 institutions/organisations involved in ESI management were conducted to develop a locally adapted ESI scenario. Perceived risk, knowledge, capacity to adapt, and needs of 8 private practice physicians and nurses were then explored through semi-structured, scenario-based interviews. Although they considered ESI unlikely and were aware of their heavy dependence on electricity-powered administrative and medical tools, healthcare professionals were willing to continue treating their patients in their own practices or in suitable primary care centres. However, better communication with public health stakeholders, participation in training sessions and to the development of checklists closer to their needs, and a plan indicating them their best possible location would be necessary. Redefining the role of primary healthcare providers in crises through better training, information, and integration as cooperative partners could represent a key opportunity to enhance the resilience of the whole healthcare system.

Young men face unique barriers to accessing health care, contributing to poor health outcomes. We used data from 188 Australian men aged 18-34 years, who participated in a nationally representative cross-sectional survey, to examine the relationships between health literacy, health empowerment, social support, loneliness, and barriers to health care. Structural equation modeling was used to examine direct and indirect associations, adjusting for sociodemographic factors and health status. Loneliness and health literacy were consistently associated with barriers to help-seeking. Higher health literacy was linked to lower barriers (β = -0.26, p = .001), whereas higher loneliness was associated with higher barriers (β = 0.24, p = .007). Higher health empowerment was associated with lower concrete barriers and distrust of caregivers (β = -0.20, p = .007), and loneliness was found to be indirectly associated with concrete barriers and distrust of caregivers through health empowerment (β = 0.07, p = .024). Social support was not associated with barriers to help-seeking. These findings underscore the importance of health literacy and loneliness as consistent determinants of help-seeking and highlight the role of health empowerment in reducing practical and interpersonal access barriers. The results can inform the design of interventions to improve health care engagement among young men.

More than 20% of perinatal women experience depression, with suicide being a leading cause of maternal death in the United States. Professional societies emphasize the need to identify those at risk of developing perinatal depression to better target preventive care delivery during pregnancy. We evaluated receptivity to a machine learning-based predictive screener designed to identify women in the first trimester of pregnancy who were asymptomatic but were at risk for developing moderate to severe depression symptoms later in pregnancy. Our participants were adult pregnant women with negative first-trimester depression (Patient Health Questionnaire-9) screens at 1 of 4 obstetric practices. Of the 810 women who were clinically eligible, 787 were successfully contacted via their patient portal. Of these, 289 (36.7%) viewed the screener and 255 (88.2%) completed the 6-question predictive screener. In total, 51 (20%) were identified by the screener as being at risk for developing perinatal depression. Participants were asked a series of follow-up questions regarding the acceptability of the predictive screener and desired preventive resources. Chi-square tests were used to compare demographic characteristics, perceived benefits and concerns, and desired resources between those identified as at risk for depression and those who were not. Differences in acceptability ratings between the two risk groups were determined using nonparametric Mann-Whitney U tests. On a 5-point Likert scale of agreement, participants found the screener questions easy to complete (median score 5, IQR 5-5) and felt comfortable sharing their answers with their obstetric care providers (median 5, IQR 4-5). Key perceived benefits of completing the screener included opportunities to seek preventive care (75/255, 29.4%) and to receive education on depression risk (66/255, 25.9%). Primary concerns about knowing one's risk of future depression included worrying about developing depression (90/255, 35.3%) and a lack of prevention opportunities (39/255, 15.3%). Desired preventive resources included counseling (197/255, 77.3%), mind-body interventions (166/255, 65.1%) such as exercise, and prenatal classes or support groups (81/255, 31.8%). Participants found the screener acceptable and felt comfortable receiving it through their patient portal. Specific preventive care options were commonly endorsed, several of which are scalable and evidence based. A minority of participants voiced addressable concerns about knowing their risk of developing depression in the future.

Patients with advanced cancer participating in phase I clinical trials often face limited survival while experiencing significant symptom burden. Despite evidence supporting early palliative care integration alongside active cancer treatment to improve quality of life, the role of palliative care in phase I trials remains unclear. To explore perspectives of patients, informal caregivers, and healthcare providers on quality of life and palliative care in phase I oncology trials, including perceived benefits, barriers, and integration strategies. We conducted a multi-perspective qualitative interview study across three Belgian university hospitals from September 2022 to July 2024, using convenience and snowball sampling. The semi-structured interviews were analyzed using qualitative content analysis. Ethical approval was gained from the relevant institutions. Participants included sixteen patients, five informal caregivers, twelve phase I staff, six oncologists, five palliative care specialists, and four general practitioners. Patients generally reported positive experiences with trial participation, often viewing it as a final opportunity that provided hope and structure. However, quality of life support was inconsistently addressed and largely reactive. While patients reported feeling supported, non-trial providers and caregivers noted limited person-centered care. No systematic approach for introducing palliative care was in place. Palliative care was rarely discussed, hindered by misconceptions such as equating palliative care with terminal care, reluctance from patients and clinicians, and lack of communication between providers. Participants suggested the introduction of routine yet flexible palliative care conversations, as well as improved communication between providers, as strategies towards integration. Despite recognized care needs, palliative care is not systematically integrated in phase I oncological trials. Quality of life remains a secondary concern. Integrating palliative care in a structured yet flexible manner could support more holistic, patient-centered care. These findings underscore the need to normalize palliative care as a complementary component of phase I oncological trials.

Postpartum depression (PPD) is a prevalent condition with important consequences for both mothers and infants. Although Cognitive Behavioural Therapy (CBT) is considered the first-line psychological treatment, Positive Psychology Interventions (PPIs) have recently emerged as promising approaches by promoting well-being alongside symptom reduction. This randomized clinical trial compared the acceptability of an online Positive Psychology programme (Maternal insights for Awareness, Thriving, Emotions and Resilience [MATER]) with a CBT programme for women with PPD. A total of 136 women were randomly assigned to one of the two conditions, both consisting of 10 weekly online group sessions. Acceptability was assessed through indicators of satisfaction and adherence. Results showed no significant differences between groups in overall satisfaction, perceived skill acquisition, perceived therapists' empathy and understanding, quality of treatment or willingness to recommend the programme. However, a significant interaction between intervention type and symptom severity emerged for perceived therapist competence: Among participants with more severe depressive symptoms, therapists in the PPI condition were rated as more competent than those in the CBT condition. Dropout rates were similar across groups, and session attendance declined over time in both interventions. Employment predicted greater retention, whereas having two or more children increased the likelihood of dropout. These findings support the feasibility and acceptability of both interventions and suggest that Positive Psychology-based programmes may be particularly well perceived by women experiencing more severe postpartum depressive symptoms. Trial Registration: ClinicalTrials.gov: Identifier: NCT05676918.

Spinal cord injury (SCI) causes persistent physical and psychological impairments and is associated with reduced quality of life. Telemedicine may improve rehabilitation access and follow-up care, but its effectiveness across multiple outcome domains in SCI remains uncertain. This study aimed to evaluate the effects of telemedicine interventions on psychological health, quality of life, sleep, functional independence, and participation, and pain intensity in individuals with SCI. We searched PubMed, Web of Science, Embase, Ovid MEDLINE, and Cochrane CENTRAL until 17 February 2026. We included English-language randomized controlled trials (RCTs) of telemedicine interventions in individuals with SCI. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Risk of Bias 2 (RoB 2; Cochrane) tool. Random-effects meta-analyses used the Hartung-Knapp-Sidik-Jonkman method with restricted maximum likelihood estimation of between-study variance. Effects were summarized as standardized mean differences (SMD) or mean differences (MD) with 95% CIs. For main meta-analyses, 95% prediction intervals were reported when at least 5 studies were available, but not for analyses with fewer than 5 studies or for subgroup meta-analyses. Certainty of evidence was assessed using GRADE (Grading of Recommendations Assessment, Development, and Evaluation). We included 33 studies (35 reports). Telemedicine improved the World Health Organization Quality of Life-BREF (WHOQOL-BREF) social domain (MD 3.27, 95% CI 0.64 to 5.89; P=.03) and sleep quality at 3 months (MD -2.24, 95% CI -3.82 to -0.67; P=.04). Depressive symptoms also improved in the >3-≤6 months follow-up subgroup (SMD -0.31, 95% CI -0.57 to -0.04; P=.03). Overall effects for depressive symptoms were not significant (SMD -0.11, 95% CI -0.26 to 0.05; prediction interval -0.37 to 0.15; P=.16; I²=36.3%), while findings for anxiety, other WHOQOL-BREF domains, sleep quality at 1 month, functional outcomes, and pain intensity generally favored telemedicine but did not reach statistical significance. Approximately half of the studies were rated as low risk overall on RoB 2, with most remaining studies rated as having some concerns and a smaller subset rated as high risk. GRADE certainty was high for the >3-≤6-month depressive-symptoms subgroup, moderate for the WHOQOL-BREF social domain, Pittsburgh Sleep Quality Index (PSQI), and Spinal Cord Independence Measure (SCIM), and low for depressive symptoms overall, anxiety, and pain intensity. Telemedicine may improve selected outcomes in SCI, with the most consistent evidence for social aspects of quality of life, sleep after sustained intervention exposure, and a more favorable effect on depressive symptoms in midterm follow-up subgroup analyses. These results suggest telemedicine as a practical adjunct for extending SCI rehabilitation access and continuity. Further trials should focus on optimizing intervention components, intensity, and patient targeting.

Patients with nasopharyngeal carcinoma often face sleep and anxiety problems during chemoradiotherapy. These two issues interact with each other, forming a vicious cycle that seriously affects the patients' quality of life and treatment outcomes. In order to address the neglect of group heterogeneity in traditional studies, this study employs latent profile analysis and network analysis methods to explore patient subgroups and reveal the association patterns between symptoms, thereby providing a basis for precise nursing interventions. From September 2023 to March 2025, a convenience sampling method was used to select 513 patients with nasopharyngeal carcinoma who were receiving initial treatment in the Radiotherapy Department of a Grade A tertiary hospital in Nanning, Guangxi. General information questionnaires, the Pittsburgh Sleep Quality Index (PSQI), and the Anxiety Subscale of the Hospital Anxiety and Depression Scale (HADS-A) were used to assess the patients' sleep quality and anxiety. Latent Profile All assessments were conducted at the mid-stage of concurrent chemoradiotherapy (2-4 weeks after the initiation of treatment), and the specific treatment phase of each participant was recorded and summarized. Latent Profile Analysis (LPA) was applied to identify potential patient subgroups with different "sleep-anxiety" characteristics. For different subgroups, symptom networks of sleep and anxiety were constructed respectively, and the core symptoms were identified and compared. The sleep quality and anxiety symptoms of nasopharyngeal carcinoma patients undergoing chemoradiotherapy can be divided into 4 latent profiles: low distress group (43.86%), emotional distress dominant group (21.25%), sleep problem dominant group (23.59%), and high anxiety-sleep disorder group (11.31%). Network analysis shows that in the low distress group network, the association between HADS1 and PSQI2 was the strongest, and PSQI2, PSQI3, and PSQI4 had the highest centrality. In the network of the emotional distress dominant group, the association between PSQI3 and PSQI4 was the strongest, and HADS4 also had relatively high centrality. In the sleep problem dominated group network, the association between HADS1 and PSQI2 was the strongest among all subtypes, and PSQI2, HADS1, and PSQI3 were the core symptoms in this network. In the network of the high anxiety-sleep disorder group, the association between HADS3 and PSQI3 was the strongest, and PSQI3, HADS3, and HADS2 were the core symptoms with high centrality. There is group heterogeneity in sleep-anxiety symptoms among patients with nasopharyngeal carcinoma undergoing chemoradiotherapy, which can be divided into four subgroups with different core symptom characteristics. The identified symptom associations provide hypothesis-generating insights for clinical intervention, and targeted strategies for core symptoms in each subgroup may help optimize symptom management in this population.

The risk of falls is a global public health issue, with over 38 million disability-adjusted life years lost annually due to falls. However, older adults with mild cognitive impairment (MCI) are more likely to fall and suffer more severe injuries compared to cognitively normal older adults, which also has an impact on their quality of life. This study was a randomized, controlled trial with two parallel groups, allocated in a 1:1 ratio using a concealed allocation mechanism and assessor blinding. 53 participants were randomly assigned to the 12-week Wuqinxi exercise group or the 12-week stretching exercise group. Overall cognitive function, risk of falls, and quality of life were assessed at baseline and at post. Independent t-tests and non-parametric tests were used to compare the outcome variables between the two groups. There were no significant differences in baseline demographic characteristics or assessment indicators between Wuqinxi exercise group and stretching exercise group (P&#x2009;>&#x2009;0.05), indicating comparability between the groups. After 12 weeks of intervention, the Wuqinxi exercise group showed significant improvements in primary outcome measures, including cognitive function and risk of falls (P&#x2009;<&#x2009;0.001). In the SF-12 quality of life, Wuqinxi exercise group showed statistically significant improvements in six dimensions (P&#x2009;<&#x2009;0.05), including general Health (GH), physical Function (PF), role Physical (RP), body Pain (BP), role Emotional (RE), and mental Health (MH). In two dimensions insignificant vitality (VT, P&#x2009;=&#x2009;0.649) and social function (SF, P&#x2009;=&#x2009;0.089). The median and interquartile range after intervention were also overall better in the Wuqinxi exercise group. In addition, the Mini-Mental State Examination (MMSE) was significantly negatively correlated with Timed Up and Go TestTimed Up and Go Test (TUG) (r&#x2009;= -0.52, p&#x2009;<&#x2009;0.01) and significantly positively correlated with Modified Falls Efficacy Scale (MFES) (r&#x2009;=&#x2009;0.463, p&#x2009;<&#x2009;0.05). The improvement in quality of life in the BP and SF dimensions was significantly positively correlated with the increase Montreal Cognitive Assessment (MoCA) and MMSE respectively (BP-MoCA: r&#x2009;=&#x2009; 0.406, p&#x2009;<&#x2009;0.05; SF-MMSE: r&#x2009;= 0.399, p&#x2009;<&#x2009;0.05). The Wuqinxi exercise is a feasible and acceptable intervention for improving cognitive function, preventing falls, and enhancing quality of life in older adults with MCI. Our study's findings emphasize the importance of Wuqinxi exercise in older adults' health management and confirm the feasibility of a large-scale andomized controlled trial.

Understanding the availability of various supportive care services for patients and caregivers is essential for informing national healthcare strategies and research priorities. Given the crucial role of healthcare professionals (HCPs) in delivering supportive care, this study examined their perspectives on assessing cancer-related unmet needs and differences in service provision for patients versus caregivers in T&#xfc;rkiye, a lower-middle-income country. Data were drawn from the Turkish subsample of the International Psycho-Oncology Society Survivorship Online Survey who provided valid responses (n&#xa0;=&#xa0;52). Participants reported on institutional practices related to the assessment and service provision for 13 kinds of unmet needs for patients and caregivers. Most institutions systematically assessed (&#x2265;&#xa0;50%) and provided services to address unmet needs (&#x2265;&#xa0;51.9%) for patients, whereas only few did so for caregivers (19.2%, &#x2264; 23.1%, respectively). Medical concerns for patients (78.8%) and psychosocial issues for caregivers (19.2%) were most frequently assessed, and services for emotional distress were most frequently provided for both patients and caregivers (82.7% and 23.1%, respectively). Sexuality/intimacy and financial concerns were least assessed and addressed (&#x2264; 50.0% for patients, &#x2264; 15.4% for caregivers). Differences in assessments and service provision between patients and caregivers were significant across all unmet needs with large effect sizes (all p&#xa0;<&#xa0;0.001, Cramer's V&#xa0;=&#xa0;0.52 - 0.62). Findings highlight both strengths and gaps in supportive care service provision and guide the development of integrated, comprehensive, and equitable programs for populations affected by cancer in T&#xfc;rkiye. These results also provide an initial foundation for future large-scale and longitudinal studies aimed at addressing the unmet needs of individuals affected by cancer.

This study aimed to develop and validate the Parental Mental Health Literacy (PMHL) Scale for caregivers of children aged 0-6 years. Initial items were developed based on established mental health literacy and health literacy frameworks and were piloted among 1074 caregivers of children aged 0-6 years in Shanghai, China. Exploratory factor analysis using principal axis factoring with oblique rotation identified a four-factor structure. Confirmatory factor analysis was subsequently conducted to examine the dimensionality of the scale and to compare alternative models, including one-factor, higher-order, and bifactor models. The bifactor model demonstrated the best fit to the data (RMSEA&#xa0;=&#xa0;.088, CFI&#xa0;=&#xa0;.931, TLI&#xa0;=&#xa0;.917). The final version consisted of 28 items across four dimensions: recognition, help-seeking, awareness of parenting and parent-child interaction. Criterion validity was examined using the Strengths and Difficulties Questionnaire (SDQ) and the Early Warning Signs Checklist (WSC). PMHL scores showed modest negative correlations with children's emotional and behavioral difficulties. Internal consistency was high (Cronbach's &#x3b1;&#xa0;=&#xa0;.98; &#x3c9;h&#xa0;=&#xa0;.89). These findings suggest that the PMHL may serve as a useful instrument for assessing parental mental health literacy in early childhood, although further validation in more diverse samples is warranted.

Addressing the demands of an ageing population requires a shift from individualised to collective prevention. Collective prevention adopts a socio-ecological approach, mobilising communities to improve population health. This study explores community nurses' (CNs) perceptions of their role as health promoters. A qualitative study using participatory action research was conducted among 58 CNs from 18 community nursing care teams over 3&#x2009;years. Data collection included 11 focus groups, a World Caf&#xe9; session, and participant observations. Data were analysed through iterative thematic content analysis. From the analysis, 3 themes emerged: (1) CNs understanding of prevention, (2) their views on their roles and competencies, and (3)what are the facilitating and hindering factors to implement collective prevention. CNs' understanding of prevention evolved from individual "aversion" of disease to a community-based vision centred on social connection. Four key roles for CNs were identified: detector, motivator, facilitator, and organiser. While a shared vision within teams facilitated progress, significant barriers included time pressure, productivity-based funding, and a lack of training in nursing curricula. CNs role in collective prevention is important, transitioning from task-oriented nursing care to community empowerment. However, sustainable implementation requires integrating collective prevention into national policy funding, and nursing education.

The risk of neonatal respiratory distress increases in planned cesarean section (CS), due to elevated lung liquid resulting from the absence of labor. The knee-to-chest flexion (KCF) maneuver is a novel, low-resource technique intended to mimic the uterine contraction by flexing the newborn's legs against the chest to aid lung fluid expulsion. Although the maneuver has shown to be feasible and safe, its acceptability among healthcare providers is unknown. The study aimed to understand how healthcare providers perceive and accept the KCF intervention for preventing neonatal respiratory distress following planned CS. The study used an exploratory qualitative approach, with semi-structured interviews at a tertiary referral hospital in Moshi, Tanzania. Fifteen interviews were conducted with obstetricians and resident doctors who had observed and/or performed the maneuver as part of an ongoing clinical trial which aims to test effectiveness of KCF maneuver in reducing newborn respiratory distress (ClinicalTrials.gov: NCT06270823). The data was first analyzed thematically using the Theoretical Framework of Acceptability as guidance, and later by inductive coding. The KCF maneuver was generally viewed as acceptable, supported by its simplicity, compatibility with routine workflows, and observed clinical benefits, such as visible lung fluid expulsion. Its physiological rationale further contributed to clinicians' confidence in the procedure. However, acceptability remains closely tied to perceptions of effectiveness, with several providers awaiting trial results before they would endorse its use. This study suggests that the KCF maneuver could be an acceptable intervention for improving newborn outcomes following planned CS, provided that efficacy is confirmed.