Historical narratives about the COVID-19 pandemic are motivationally biased.

How people recall the SARS-CoV-2 pandemic is likely to prove crucial in future societal debates on pandemic preparedness and appropriate political action. Beyond simple forgetting, previous research suggests that recall may be distorted by strong motivations and anchoring perceptions on the current situation1-6. Here, using 4 studies across 11 countries (total n = 10,776), we show that recall of perceived risk, trust in institutions and protective behaviours depended strongly on current evaluations. Although both vaccinated and unvaccinated individuals were affected by this bias, people who identified strongly with their vaccination status-whether vaccinated or unvaccinated-tended to exhibit greater and, notably, opposite distortions of recall. Biased recall was not reduced by providing information about common recall errors or small monetary incentives for accurate recall, but was partially reduced by high incentives. Thus, it seems that motivation and identity influence the direction in which the recall of the past is distorted. Biased recall was further related to the evaluation of past political action and future behavioural intent, including adhering to regulations during a future pandemic or punishing politicians and scientists. Together, the findings indicate that historical narratives about the COVID-19 pandemic are motivationally biased, sustain societal polarization and affect preparation for future pandemics. Consequently, future measures must look beyond immediate public-health implications to the longer-term consequences for societal cohesion and trust.

Navigating the diagnostic journey of epidermolysis bullosa: a qualitative study of the lived experiences and needs of parents and patients.

BACKGROUND: Epidermolysis bullosa (EB) concerns a heterogeneous group of rare genetic skin fragility disorders that result in chronic blistering and wounding. EB significantly affects the daily lives of patients, as well as their families. While advances in diagnostics are improving the speed and accuracy of EB diagnosis, little is known about the experiences and needs of parents and patients throughout their diagnostic journey. OBJECTIVES: To explore parent and patient perspectives on the EB diagnostic trajectory to gain an in-depth understanding of their lived experiences and needs. METHODS: Participants were parents of paediatric patients with EB (n = 18) and adult patients with EB (n = 8) recruited from the Dutch EB Registry. After purposive sampling, they participated in semi-structured interviews via video calls to discuss their personal diagnostic trajectory and the subsequent impact of an EB diagnosis on their (family) life. By applying a constructivist approach, a reflexive thematic analysis was executed to facilitate a dynamic and iterative process, involving inductive open coding of transcripts and constant comparison of data. RESULTS: Ten major themes were developed, representing three distinct groups: (i) parents of children with junctional EB and recessive dystrophic EB; (ii) parents of children with EB simplex and dominant dystrophic EB; and (iii) adult patients with localized EB. The EB diagnostic process appeared to have a diversity of emotional consequences, varying from desperation and uncertainty about the future to clarification and confirmation. The urgent need for a timely diagnosis and accurate prognosis was emphasized, particularly by parents of children with an extensive presentation. Parents and patients expressed shortcomings in clinical practice, with severity ratings in current EB disease terminology, in particular, seeming to have an adverse impact on illness perception, healthcare-seeking behaviour, research participation and engagement in peer support. CONCLUSIONS: This study describes the lived experience and needs of parents of children with EB and adult patients with EB during the diagnostic process. We found a pressing need to accelerate diagnostics and urge that the EB community should continue working toward ever-faster diagnosis, public awareness and education. While guiding patients along the diagnostic journey, clinicians should focus their support strategies on tailored medical communication while refraining from value-connoted wording.

Epidermolysis bullosa (or 'EB' for short) is a group of rare genetic diseases that cause the skin to be very fragile, leading to lifelong blistering and wounds. In the Netherlands, EB affects about 22 in 1 million people. It can have a huge impact on patients and their families. Although the process of diagnosing the disease is improving, we do not know how people living with EB feel about the diagnostic trajectory. This study was done in the Netherlands. To understand their experience, we interviewed 26 adults with EB and parents of children with EB. We found that getting a diagnosis of EB and living with the disease can be challenging. Each participant had different needs, largely depending on the subtype of EB they had. Parents (especially those with children with extensive EB) needed a quick and accurate diagnosis to help them understand what to expect and how to best provide care. Participants pointed out shortcomings in daily practice, such as labelling EB and assuming how serious the disease is. This affected how parents and patients understood EB, how they sought healthcare, whether they took part in research studies and how they connected with their peers. Our findings could help improve the diagnosis and care of people living with EB and their families. Our study highlights the urgent need for a faster diagnosis of EB and to increase public awareness of the disease. Clinicians should concentrate on clear and supportive communication and avoid subjective severity labelling of the disease.

Mounting antiscience aggression in the United States.

There is a troubling new expansion of antiscience aggression in the United States. It's arising from far-right extremism, including some elected members of the US Congress and conservative news outlets that target prominent biological scientists fighting the COVID-19 pandemic.

Key psychosocial issues in medical care.

OBJECTIVE: The aim of this review is to illustrate an innovative framework for assessing the psychosocial aspects of medical disorders within the biopsychosocial model. It is based on clinimetrics, the science of clinical measurements. It may overcome the limitations of DSM-5 in identifying highly individualized responses at the experiential, behavioral, and interpersonal levels. METHOD: A critical review of the clinimetric formulations of the biopsychosocial model in the setting of medical disease was performed. References were identified through searches from PubMed for English articles on human subjects published from January 1982 to October 2023. RESULTS: Clinimetric methods of classification have been found to deserve special attention in four major areas: allostatic load (the cumulative cost of fluctuating and heightened neural or neuroendocrine responses to environmental stressors); health attitudes and behavior; persistent somatization; demoralization and irritable mood. This type of assessment, integrated with traditional psychiatric nosography, may disclose pathophysiological links and provide clinical characterizations that demarcate major prognostic and therapeutic differences among patients who otherwise seem deceptively similar because they have the same medical diagnosis. It may be of value in a number of medical situations, such as: high level of disability or compromised quality of life in relation to what is expected by disease status; delayed or partial recovery; insufficient participation in self-management and/or rehabilitation; failure to resume healthy role after convalescence; unhealthy lifestyle; high attendance of medical facilities disproportionate to detectable disease; lack of treatment adherence; illness denial. CONCLUSIONS: The clinimetric approach to the assessment of key psychosocial variables may lead to unique individual profiles, that take into account both biology and biography. It may offer new opportunities for integrating psychosocial and medical perspectives.

The predictive power of coping strategies of pediatric oncology patients on their quality of life and their attitudes toward diseases.

BACKGROUND/OBJECTIVES: Pediatric oncology patients face several physical and psychological challenges that can significantly impact their quality of life (QoL) and attitudes toward their illness. Coping strategies are pivotal in managing the emotional and physical burdens of disease. This study aimed to examine the impact of coping strategies of pediatric oncology patients on their QoL and attitudes towards their illness. DESIGN/METHODS: The descriptive, correlational, and cross-sectional study was conducted with 112 pediatric oncology patients aged 10-18 years. The Sociodemographic Form, Pediatric Cancer Coping Scale (PCCS), Pediatric Quality of Life Inventory (PedsQL), and Child Attitude Towards Illness Scale (CATIS) were used for data collection. RESULTS: Significant correlations were identified between cognitive coping, defensive coping, and CATIS (p < .001). The PCCS and subdimensions significantly predicted CATIS (p < .001), accounting for 15.3% of the cognitive and defensive coping variation. However, there was no relationship between PCCS total and subdimension scores on PedsQL (p = .534). The PedsQL and subdimensions significantly predicted CATIS (p < .001) and accounted for 27.2% of the variation in physical health summary score, emotional functioning, psychosocial health summary score, and total PedsQL score. CONCLUSION: The study reveals that cognitive coping strategies positively predict attitudes toward illness, whereas defensive coping strategies have an inverse effect. The study proposes that comprehensive care models in pediatric oncology support effective coping mechanisms and enhance the QoL of those who receive them.

Patient attitudes and experiences towards exercise during oncological treatment. A qualitative systematic review.

PURPOSE: Exercise and physical activity (PA) during oncological treatment have many benefits. However, PA levels and adherence are often low. This systematic review of qualitative literature aims to explore the experience and the perceived barriers and facilitators to exercise and physical activity during treatment. METHODS: A systematic search of the published literature was carried out in the Embase and Medline databases; full details for the protocol can be found in the Prospero database (CRD42022371206). Studies eligible for inclusion were qualitative and included participants that were either currently undergoing oncological treatment or had finished treatment within the last 6 months. The findings from each study were tabulated and synthesised into analytical themes. RESULTS: Eighteen full texts from 309 studies met inclusion criteria with a total of 420 participants including both curative and palliative treatment intents. Four overarching themes were generated: (1) Facilitators; (2) Barriers; (3) Experience of PA/exercise and (4) Transforming attitudes. Sub-themes that showed perceptions of PA or exercise during treatment were positive, and seeing personal positive change was highly motivating, especially in a group class setting. Barriers included lack of support or guidance from healthcare professionals (HCPs), environmental challenges and disease burden/fear or worsening symptoms. CONCLUSIONS: Despite having positive perceptions of exercise and PA during oncological treatment, there are significant barriers impacting participation. Lack of support from HCPs and fear of worsening symptoms were significant barriers. Future research should focus on impacting these barriers to ultimately improve PA and exercise levels in those undergoing oncological treatment.

Patients' attitudes toward negative appendectomies and surgery for suspected appendicitis: a qualitative interview study.

INTRODUCTION: From a surgeon's perspective, appendicitis is treated with appendectomy and sometimes a normal appendix is removed. This study aimed to investigate the patients' perspectives on having surgery but not appendicitis and their involvement in treatment decisions. METHODS: This study is reported according to the COnsolidated criteria for REporting Qualitative research (COREQ) guideline. Eligible participants either had a normal diagnostic laparoscopy with no resection of the appendix or a negative appendectomy confirmed by histopathology. Interviews were conducted using a semi-structured interview guide and transcribed verbatim. Data were analyzed using content analysis. RESULTS: This study consisted of 15 interviews. Analysis of the interviews resulted in the formulation of four categories: (1) discovering the results of the histopathology report, (2) thoughts on having a normal appendix removed or left in situ, (3) the scarce use of shared decision-making, and (4) general anesthesia and the risk of a burst appendix made the participants nervous. CONCLUSION: The amount of information communicated to the patients before and after surgery was sparse. The participants were not aware of the histopathology results and the participants were not involved in decision-making and were generally anxious about anesthesia and a burst appendix.

A Qualitative Exploration of PrEP Interests, Barriers, and Interventions Among Black and Latina Cisgender Women in the U.S.

Black and Latina cisgender women (BLCW) are disproportionally affected by HIV, particularly in the southern U.S. In Austin, Texas, Black women contract HIV 18.4 times more and Latinas 2.6 times more compared to White women. Pre-exposure prophylaxis (PrEP) is a medication that prevents contracting HIV; however, PrEP adoption among women is low. The current qualitative study aimed to explore PrEP awareness, interest, preferred PrEP administration methods, barriers to PrEP adoption, and future programs to increase PrEP adoption and adherence among BLCW. A total of 18 BLCW at high risk for HIV were enrolled. Participants completed 3 semi-structured interviews across 3 months. Interviews were transcribed verbatim, coded, and analyzed using thematic content analysis. Results demonstrated that BLCW had low PrEP awareness, high initial PrEP interest, and were interested in a long-acting injectable form of PrEP. Barriers to PrEP adoption included concerns regarding side effects, concerns about adherence to the currently available daily pill, and difficulty with insurance. Participants proposed different ideas for interventions, including support groups, education, community-level programs, and structural interventions. Future studies should focus on increasing PrEP awareness and HIV risk, consider alternative forms of PrEP, educate providers and medical staff on PrEP, and consider tailored interventions to reduce HIV risk among BLCW.

Examining illness perceptions over time: an exploratory prospective analysis of causal attributions in individuals with depressive symptoms.

BACKGROUND: According to the Common-Sense Model of Illness Representations, illness beliefs, such as causal attributions, can influence the way people assess and cope with their illness and vice versa. To date, causal attributions in people with depressive symptoms have been studied mainly cross-sectionally, quantitatively and independently. The purpose of this study is to examine the causal attributions of people with depressive symptoms in terms of their stability over time, dependence on treatment experience, and differentiation of causal concepts. METHODS: In a population-based prospective sample, people with at least mild depressive symptoms (PHQ-9 Score ≥ 5) were interviewed via telephone at T0 and twelve months later (T1). Causal attributions were assessed using the Brief Illness Perception Questionnaire. After the open responses were qualitatively analysed using a deductive-inductive approach, stability over time was assessed for causal attributions and concepts by comparing answers between the two time points. Subsequent exploratory quantitative analyses were conducted using chi-square tests, t-tests, and logistic regression analyses. RESULTS: A total of 471 individuals (age M = 53.9, 53.6% female) with a mean PHQ-9 Score of 8.4 were included in the analyses. Causal attributions related to participants' social environment, workplace, and past are the most stable over time. However, individuals with and without a time-stable causal concept showed no differences in terms of sociodemographic characteristics, severity of depressive symptoms, risk of comorbidity, and treatment experiences. Overall, the causal concepts of people with depressive symptoms appear to be very diverse. Those with treatment experience (M = 2.21, SD = 0.80) named significantly more causal attributions compared to people without treatment experience (M = 1.98, SD = 0.81, t(471) = -3.060, p < 0.01). In addition, logistic regression analyses revealed that treatment-experienced respondents were more likely to attribute "childhood/youth/parental home" and "predisposition". CONCLUSIONS: Our study reveals that people with treatment experience tend to report treatment-congruent causal attributions, such as childhood and family environment, as well as predisposition, more frequently. Understanding how causal attributions and concepts are formed and change can be helpful for addressing causal attributions in treatment. Future studies should take into account the benefits of employing qualitative survey methods for exploring causal attributions.

Community views on active case finding for tuberculosis in low- and middle-income countries: a qualitative evidence synthesis.

BACKGROUND: Active case finding (ACF) refers to the systematic identification of people with tuberculosis in communities and amongst populations who do not present to health facilities, through approaches such as door-to-door screening or contact tracing. ACF may improve access to tuberculosis diagnosis and treatment for the poor and for people remote from diagnostic and treatment facilities. As a result, ACF may also reduce onward transmission. However, there is a need to understand how these programmes are experienced by communities in order to design appropriate services. OBJECTIVES: To synthesize community views on tuberculosis active case finding (ACF) programmes in low- and middle-income countries. SEARCH METHODS: We searched MEDLINE, Embase, and eight other databases up to 22 June 2023, together with reference checking, citation searching, and contact with study authors to identify additional studies. We did not include grey literature. SELECTION CRITERIA: This review synthesized qualitative research and mixed-methods studies with separate qualitative data. Eligible studies explored community experiences, perceptions, or attitudes towards ACF programmes for tuberculosis in any endemic low- or middle-income country, with no time restrictions. DATA COLLECTION AND ANALYSIS: Due to the large volume of studies identified, we chose to sample studies that had 'thick' description and that investigated key subgroups of children and refugees. We followed standard Cochrane methods for study description and appraisal of methodological limitations. We conducted thematic synthesis and developed codes inductively using ATLAS.ti software. We examined codes for underlying ideas, connections, and interpretations and, from this, generated analytical themes. We assessed the confidence in the findings using the GRADE-CERQual approach, and produced a conceptual model to display how the different findings interact. MAIN RESULTS: We included 45 studies in this synthesis, and sampled 20. The studies covered a broad range of World Health Organization (WHO) regions (Africa, South-East Asia, Eastern Mediterranean, and the Americas) and explored the views and experiences of community members, community health workers, and clinical staff in low- and middle-income countries endemic for tuberculosis. The following five themes emerged. • ACF improves access to diagnosis for many, but does little to help communities on the edge. Tuberculosis ACF and contact tracing improve access to health services for people with worse health and fewer resources (High confidence). ACF helps to find this population, exposed to deprived living conditions, but is not sensitive to additional dimensions of their plight (High confidence) and out-of-pocket costs necessary to continue care (High confidence). Finally, migration and difficult geography further reduce communities' access to ACF (High confidence). • People are afraid of diagnosis and its impact. Some community members find screening frightening. It exposes them to discrimination along distinct pathways (isolation from their families and wider community, lost employment and housing). HIV stigma compounds tuberculosis stigma and heightens vulnerability to discrimination along these same pathways (High confidence). Consequently, community members may refuse to participate in screening, contact tracing, and treatment (High confidence). In addition, people with tuberculosis reported their emotional turmoil upon diagnosis, as they anticipated intense treatment regimens and the prospect of living with a serious illness (High confidence). • Screening is undermined by weak health infrastructure. In many settings, a lack of resources results in weak services in competition with other disease control programmes (Moderate confidence). In this context of low investment, people face repeated tests and clinic visits, wasted time, and fraught social interaction with health providers (Moderate confidence). ACF can create expectations for follow-up health care that it cannot deliver (High confidence). Finally, community education improves awareness of tuberculosis in some settings, but lack of full information impacts community members, parents, and health workers, and sometimes leads to harm for children (High confidence). • Health workers are an undervalued but important part of ACF. ACF can feel difficult for health workers in the context of a poorly resourced health system and with people who may not wish to be identified. In addition, the evidence suggests health workers are poorly protected against tuberculosis and fear they or their families might become infected (Moderate confidence). However, they appear to be central to programme success, as the humanity they offer often acts as a driving force for retaining people with tuberculosis in care (Moderate confidence). • Local leadership is necessary but not sufficient for ensuring appropriate programmes. Local leadership creates an intrinsic motivation for communities to value health services (High confidence). However, local leadership cannot guarantee the success of ACF and contact tracing programmes. It is important to balance professional authority with local knowledge and rapport (High confidence). AUTHORS' CONCLUSIONS: Tuberculosis active case finding (ACF) and contact tracing bring a diagnostic service to people who may otherwise not receive it, such as those who are well or without symptoms and those who are sick but who have fewer resources and live further from health facilities. However, capturing these 'missing cases' may in itself be insufficient without appropriate health system strengthening to retain people in care. People who receive a tuberculosis diagnosis must contend with a complex and unsustainable cascade of care, and this affects their perception of ACF and their decision to engage with it.

Psychometric characteristics of the Chinese version of the Pregnancy Exercise Attitudes Scale (C-PEAS).

BACKGROUND: Reasonable instruction and promotion of appropriate exercise are crucial to improving the exercise status of pregnant women and safeguarding the health of both mother and fetus. However, there is a lack of validated Pregnancy Exercise Attitude Scales with a complete evaluation system in China. This study aims to assess the validity and reliability of the Pregnancy Exercise Attitude Scale (C-PEAS) in Chinese to give medical professionals a reference for carrying out pregnancy care services and promoting the health of the mother and fetus. METHODS: In this study, the scale was translated, back-translated, and cross-culturally adapted using the Brislin translation model to form the C-PEAS. 528 pregnant women were conveniently selected for the questionnaire survey to evaluate the scale's reliability. The scale's content validity was assessed by the content validity index, while its structural validity was investigated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Cronbach's alpha coefficient, McDonald's omega coefficient, split-half reliability, and retest reliability were used to evaluate the scale's internal consistency. RESULTS: The C-PEAS contains two dimensions with 37 entries. The EFA supports a two-factor structure with a cumulative variance contribution of 62.927%. The CFA model was well fitted (χ2/df = 1.597, RMSEA = 0.048, IFI = 0.955, TLI = 0.952, and CFI = 0.955). The C- PEAS' Cronbach's alpha coefficient was 0.973, and the range of Cronbach's alpha values for the dimensions was 0.976, 0.944. McDonald's omega coefficient was 0.971, the half-point reliability of the scale was 0.856, and the retest reliability was 0.966. CONCLUSIONS: The Chinese version of C-PEAS has good psychometric properties. It can be used as an effective measurement tool to evaluate the attitude of pregnant women to exercise during pregnancy.

Some young adults can maintain good oral health despite socioeconomic challenges.

The association between dental caries experience and socioeconomic status, as reflected in income and educational level, is well known. However, some individuals maintain good health despite socioeconomic disadvantage. The aim of this qualitative study was to explore salutogenic (health-promoting) factors among healthy caries-free young adults of low socioeconomic status. Seventeen participants (11 women), 19-23 years of age, who were caries-free and of low socioeconomic status were interviewed in-depth. The interviews were transcribed verbatim and analysed using qualitative content analysis with an inductive approach. The theme revealed was 'Building trust and shifting responsibility from parent to child throughout children's development lays the salutogenic foundation for oral health', comprising three categories: (i) a basis for health; (ii) creating one's own path by testing wings; and (iii) developing resources for health. A feeling of trust was expressed, participants were confident in the unconditional support of their caregivers, and caregivers were trusting participants to be able to take control over their own oral health. Health-promotive factors were established not only by instilling healthy habits during childhood, but also by parental guidance through adolescence, enabling young adults to develop resources and assets to take control over their own health independently.

Comparative assessment of attitudes and expectations: Iranian patients versus urologists in the management of benign prostatic hyperplasia.

BACKGROUND: Benign prostatic hyperplasia (BPH) is common and presents as lower urinary tract symptoms (LUTS). Understanding patient concerns and treatment preferences is essential for effective management. This study aimed to investigate the attitudes, preferences, and expectations of Iranian patients with BPH, and compare them with those of urologists in addressing this condition. METHODS: A cohort of patients diagnosed with BPH underwent assessment during their initial visit. Before any counseling, their attitudes, concerns, and expectations regarding benign prostate enlargement were evaluated using semi-structured interviews. Patient responses were analyzed based on educational levels and age. Additionally, correspondence was initiated with thirty urologists who graduated within the past twelve years to assess their attitudes toward BPH, concerns, and treatment approaches. Interview questions were constructed using the Delphi method, and their validity was confirmed. Responses from both groups were analyzed and compared. Descriptive statistics, independent t-test, Chi-squared test, Mann-Whitney U, and principal component analysis (PCA) with varimax rotation were used for statistical analysis. RESULTS: The study comprised 261 patients and 30 urologists. Findings revealed that 86.2% of patients and 86.7% of urologists perceived a lack of sufficient patient knowledge about BPH. Patients across all educational levels and age groups expressed a desire for more information about their condition. Primary concerns among patients included exacerbation of urinary symptoms, potential malignancy, and sexual dysfunction. While patients generally preferred pharmacological treatments, those older than 75 years showed a significantly higher preference for surgical options. Conversely, urologists exhibited greater concern for long-term clinical complications associated with BPH. Results indicated significant parallels between the attitudes of urologists and patients in assessing the multifaceted impact of BPH on patient well-being. CONCLUSION: This study enhances our understanding of patient attitudes and concerns regarding BPH, thereby facilitating more effective treatment strategies. Our findings encourage urologists to enhance patient perspectives by delivering comprehensive information. Furthermore, the comparison between patient and urologist attitudes towards BPH underscores the importance of tailored care and patient-centered approaches in optimizing outcomes for individuals with BPH.

Changes in attitudes to childbirth in modern times illustrated over three generations in Iraq.

OBJECTIVE: To describe changes in attitudes and expectations of labor over the previous six decades, comparing the Iraqi generation who labored at home without medical assistance with their descendants. STUDY DESIGN: We used semi-structured telephone interviews with 22 women across three generations of one extended family living and giving birth in Iraq between the 1950s and the 2010s. Qualitative data were analyzed thematically using open, axial, and selective coding. RESULTS: Each generation experienced a paradigm shift in childbirth, from exclusive home births to hospital-directed maternity care, to a trend that favors planned cesarean birth, driven by generation-specific changes in outlook. Emerging themes included social influences, changing technology, and medical professionals' recommendations; all of these affected attitudes toward childbirth and pregnancy. There were generational disconnects in perceptions concerning the reasons childbirth has changed over the past 60 years, with the youngest generation citing wider pressures regarding body image and marital relationships as two of the factors affecting preferences in childbirth options. CONCLUSIONS: Societal changes and availability of healthcare services affect women's choices and experiences of childbirth. To be successful, efforts to improve women's experiences in labor, as well as maternal and neonatal outcomes, must consider these wider sociocultural issues.

How age and health status impact attitudes towards aging and technologies in care: a quantitative analysis.

BACKGROUND: Increasing proportions of geriatric patients pose tremendous challenges for our society. Developments in assistive technologies have the potential to support older and frail people in aging and care. To reach a sustainable adoption of these technologies, the perceptions and wishes of future users must be understood. In particular, the relationships between individual health-related factors, and the perceptions of aging and using assistive technologies in severe health situations must be empirically examined. METHODS: Addressing this research gap, our quantitative study (N = 570) investigates the impact of diverse future users' age and health status on their a) perceptions of aging, b) perceptions and acceptance of using assistive technologies in aging and care, as well as c) end-of-life decisions regarding technology usage. For this, four groups were segmented for the comparison of younger (< 50 years) healthy, younger chronically ill, older (50 + years) healthy, and older chronically ill participants. RESULTS: The results revealed that health status is more decisive for age-related perceptions compared to age. The technology-related perceptions were slightly impacted by either chronological age or health status. The end-of-life decisions showed the most striking differences in the willingness to use assistive technologies, revealing older chronically ill participants to have more restrained attitudes towards technology usage than older healthy as well as all younger participants. CONCLUSIONS: The findings suggest that the benefits of assistive technologies in private or professional care contexts should be communicated and implemented tailored to the respective user group's needs. Moreover, the results allow us to derive practical implications within the geriatric care context.

Attitudes towards seeking psychological help among community dwelling older adults enrolled in primary care in Chile.

BACKGROUND: Depression and anxiety are common mental disorders among older adults, but they are frequently underdiagnosed. Attitudes towards seeking professional mental health care is one of the barriers to access to treatment. This study was aimed at assessing the attitudes towards seeking psychological help among older adults who are enrolled in primary care in Chile, and to determine the associated factors. METHODS: This cross-sectional study recruited 233 primary care users aged 65 or more years. The Attitudes Towards Seeking Professional Psychological Help was used. Reliability and factor analysis of this scale were carried out. The average scores of the scale and factors were calculated and compared, by selected variables. Multivariate linear regression was estimated to determine factors associated with attitudes towards seeking psychological help. RESULTS: Three factors were identified in the attitudes towards seeking psychological help: confidence in psychologists, coping alone with emotional problems, and predisposition to seek psychological help. On average, participants had a favorable attitude towards seeking psychological help, compared with previous research. Lower level of education, and risk of social isolation were inversely associated with these attitudes. CONCLUSION: Strategies to improve mental health literacy and social connection among older adults, could have an impact on factors that mediate the access to mental health care, such as attitudes towards seeking psychological help, among people who have a lower level of education or are at risk of social isolation.

Children's and adolescents' views of health and mental health concepts - A qualitative group interview study.

BACKGROUND: Definitions and perceptions of health and mental health have not remained static over time. This is also true for statistics over Swedish children's and adolescents' health and mental health status. The majority of Swedish school-aged children and adolescents report good physical health and good life satisfaction. However, there are some warning signs when it comes to children's and adolescents' health and mental health status, for instance, an increased overweight or obesity in children and adolescents, as well as a higher proportion reporting psychological problems and stress. There is also a need for knowing more about the younger population's voices in this matter. The aim was therefore to explore children's and adolescent's conceptualizations and perceptions of health in general, and mental health in particular. METHODS: Open semistructured group interviews with 44 Swedish children and adolescents (10-14 years old) recruited from four schools were conducted. The interviews were conducted between April 2022 and January 2023. Data were analyzed with qualitative content analysis. RESULTS: Children's and adolescents' conceptualizations of health included aspects of both the body and the mind, with a focus on the latter. Mental health was expressed as a state of being, illustrated by various lived experiences of emotions, moods, and thoughts. The social world was ever present in their understanding of health, e.g., through the lenses of social and gender norms. CONCLUSIONS: This study revealed children's and adolescents' recognition of health terms and their ability to observe nuances between mental health problems and everyday struggles. The participants discussed mental health problems to a greater extent than positive mental health. An implication of this study is the highlighted need to focus more on mental health promotion in future preventive programs. These findings might potentially influence how school staff and student health teams communicate with children and adolescents about these concepts.

General hospital patients' attitude towards systematic health risk behavior screening and intervention.

BACKGROUND: Systematic counseling on behavioral health risk factors (HRFs) may be suitable to promote health among general hospital patients. This study aimed to investigate the openness of patients towards systematic screening and intervention of HRFs, its relation to actual participation in a multi-behavioral intervention, and whether socio-economic characteristics, HRFs and health indicators are related to approval. METHODS: All 18- to 64-year-old patients hospitalized in five medical departments at the University Medicine Hospital Greifswald in Germany were asked between May and July 2022 to participate in a survey and in a subsequent pre-post intervention study. Among all eligible patients, 225 (78.9%) participated in the survey. Patients' approval of systematic screening and intervention of HRFs was assessed using five statements with a total sum score of 0-20 (i.e., scores of 0-6, 7-13, 14-20 referring to low, medium and high approval). Associations with intervention participation, socio-economic, behavioral and health-related patient characteristics were analyzed using logistic and multivariable linear regression analyses. RESULTS: The mean total approval of screening and intervention was 13.8 (SD = 4.8). Of the 125/ 73/ 16 patients with high/ medium/ low approval, 88.0%/ 78.1%/ 50.0% participated in the subsequent intervention, respectively. Approval was independent of socio-demographic and -economic characteristics and self-rated general health. Current tobacco smoking was the only HRF negatively (p = 0.02) and diabetes mellitus was the only disease positively (p = 0.01) associated with approval. CONCLUSION: High approval of HRF screening, which was rather independent of socio-economic characteristics and worse self-rated general health, speaks in favor of proactively approaching and motivating all general hospital patients to participate in health behavior change intervention. Tobacco smokers might need higher efforts to motivate participation than non-smokers. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT05365269 on May 9, 2022.

The effects of mass media messages, perceived susceptibility and self-rated health on public attitude towards COVID-19 in South Africa.

OBJECTIVES: South Africa was the worst affected country in Africa by the COVID-19 pandemic and it is important to interrogate the attitude of the populace towards the pandemic for future interventions. Therefore, this study examined effects of mass media messages, susceptibility to COVID-19 and self-rated health on the attitudes of South Africans towards the COVID-19 pandemic. METHODS: Data was from the National Income Dynamics Study - Coronavirus Rapid Mobile Survey (NIDS-CRAM) of 2021 which is a nationally representative panel survey of about 7,000 South African individuals in all the nine provinces. Analyses of data were through descriptive statistics, chi square test and logistic regression models. RESULTS: The results showed that 61.28% of the resondents did not take COVID-19 test while 91.09% of them engaged in behavioral changes such as social distancing and wearing of face masks. In addition, 74.27% of the respondents had access to mass media information, 70.44% believed they have good physical health while 32.43% felt they were not susceptible to COVID-19. The chi-square results of attitude towards COVID-19 showed significant differences in access to mass media messages on COVID-19, race, and province of residence. Furthermore, respondents who had access to mass media information on COVID-19 (OR = 1.469; p = 0.001) and respondents who believed that they were susceptible to COVID-19 infection (OR = 1.443; p = 0.001) were significantly associated with increased likelihood of engagement in behavioral changes to avoid the COVID-19. CONCLUSION: These findings therefore emphasize the need for increased awareness and sensitization of the people about the susceptibility and adverse effects of diseases to ensure that they adopt the appropriate attitudes that will safeguard them from such diseases outbreak.

Parents' attitudes towards the No Jab No Play legislation in Western Australia: a mixed methods study.

BACKGROUND: Mandates provide a relatively cost-effective strategy to increase vaccinate rates. Since 2014, five Australian states have implemented No Jab No Play (NJPlay) policies that require children to be fully immunised to attend early childhood education and childcare services. In Western Australia, where this study was conducted, NJNPlay legislation was enacted in 2019. While most Australian families support vaccine mandates, there are a range of complexities and unintended consequences for some families. This research explores the impact on families of the NJNPlay legislation in Western Australia (WA). METHODS: This mixed-methods study used an online parent/carer survey (n = 261) representing 427 children and in-depth interviews (n = 18) to investigate: (1) the influence of the NJNPlay legislation on decision to vaccinate; and (2) the financial and emotional impacts of NJNPlay legislation. Descriptive and bivariate tests were used to analyse the survey data and open-ended questions and interviews were analysed using reflexive thematic analysis to capture the experience and the reality of participants. RESULTS: Approximately 60% of parents intended to vaccinate their child. Parents who had decided not to vaccinate their child/ren were significantly more likely to experience financial [p < 0.001] and emotional impacts [p < 0.001], compared to those who chose to vaccinate because of the mandate. Qualitative data were divided with around half of participants supporting childhood immunisation and NJNPlay with others discussing concerns. The themes (a) belief in the importance of vaccination and ease of access, (b) individual and community protection, and (c) vaccine effectiveness, safety and alternatives help understand how parents' beliefs and access may influence vaccination uptake. Unintended impacts of NJNPlay included: (a) lack of choice, pressure and coercion to vaccinate; (b) policy and community level stigma and discrimination; (c) financial and career impacts; and (d) loss of education opportunities. CONCLUSIONS: Parents appreciation of funded immunisation programs and mandates which enhance individual and community protection was evident. However for others unintended consequences of the mandate resulted in significant social, emotional, financial and educational impacts. Long-term evidence highlights the positive impact of immunisation programs. Opinions of impacted families should be considered to alleviate mental health stressors.