The comparative study of chronically ill and healthy children and adolescents in the light of their general mental health.

Children's hospitalisation is difficult for the family and the immediate environment. In these cases, the provision of psychological support is particularly important. Chronically ill children who are regularly hospitalised are in a particularly difficult situation, often feeling vulnerable. Our research aims to explore and analyse in detail the psychological state, attitudes and mental health of chronically ill children and to compare patient groups (children receiving care in pulmonology, gastroenterology, onco-haematology and rehabilitation) to understand the interacting factors, which may be of great importance for quality patient care and for measures to improve patient care in the future. We studied chronically ill children (N = 107) aged 10 to 18 years (M = 14.3; SD = 2.0), cared for by the Department of Paediatric Rehabilitation, Paediatric Psychiatry and Psychosomatics of the University of Debrecen Clinical Centre, the second largest paediatric institution in Hungary. In our survey, sociodemographic questions, the Connor-Davidson Resilience Scale, the Satisfaction With Life Scale, the Cantril Ladder, the Non-Productive Thoughts Questionnaire, the Problematic Internet Use Questionnaire, the Drawing version of Pictorial Representation of Illness Self-Measure (PRISM-D), the Beck Depression Inventory-Shortened Scale, the Illness Intrusiveness Ratings Scale, the Spielberger State-Trait Anxiety Questionnaire-Child Version and the Strength and Difficulty Questionnaire were applied. One-way analysis of variance (ANOVA) was used to examine differences between groups, and Pearson rank correlation analysis was used to measure the relationships between individual variables. The results show significant differences between patient groups in terms of resilience, depression, nonproductive thoughts, problematic internet use, anxiety and coping, but no consistent pattern in the development of scores. In addition, for some psychological correlates, the role of sociodemographic background also showed significant results. The practical utility of our study is that using questionnaire methods to map patient satisfaction, compliance, and patient attitudes will provide regarding the factors that influence the mental health status of children living with chronic illnesses. In the light of this, additional methods and tools can be included to improve the quality of healthcare and to develop a set of procedures that will serve the intended purpose.

The role of animal-assisted programs in physical health improvement of children and adolescents with special education needs - a systematic review.

Programs involving animals in therapeutic programs are becoming increasingly prevalent. These programs can vary greatly in their approach, scope, and objectives, and they can significantly impact the development of healthy children and those with various disorders. In this systematic review, we sought to investigate the psychological ramifications of animal-assisted activities (AAA), therapies (AAT), and interventions (AAI). We searched for relevant studies using the EBSCO Discovery Service search engine across 85 databases, utilising appropriate keywords. Our search generated 262 results, of which 21 were selected for inclusion after title and abstract screening, as well as full-text analysis. Our findings indicate that dogs and horses are animal-assisted programs' most commonly used animals. Additionally, autism, cerebral palsy, and ADHD were found to be overrepresented in these programs. Furthermore, the length of sessions and overall program duration exhibited considerable variation, regardless of patient age or disease type. The principal measures centred on the physiological variables related to the nervous system and motorium-related indicators. The studies were generally of exceptional methodological soundness. Frequently, the studies narrowed their scope to a single segment or just the child or adolescent, but the outcomes lacked contextual interpretation. Expanding the range of studies by comparing psychological and physiological indicators and conducting follow-up analysis with a longitudinal design would be beneficial.

Integrative attitudes of Ukrainian war refugees in two neighboring European countries (Poland and Hungary) in connection with posttraumatic stress symptoms and social support.

Since February 24th, 2022, millions of Ukrainians have sought refuge in other, mainly European countries. Hungary, after Poland, is the second largest host of Ukrainian refugees. Only a portion of them are asylum seekers (~11.0% in Poland and ~ 1.1% in Hungary). The aim of the study is to compare the integrative acculturation attitudes between the war refugees residing in the two European countries. The comparison takes into account both the suffering of posttraumatic stress symptoms and social support. It is the first comparative study of this kind pertaining to the Ukrainian refugees in European countries. The data were obtained by a survey method using the modified CAPI (Computer Assisted Personal Interview) technique. The data analyzed were collected between November 21st and December 20th, 2022 from 728 adult Ukrainian individuals who crossed the borders of Poland and Hungary after February 24th, 2022. The research results show that refugees in Poland perceive significantly more social support and show stronger integrative attitudes than refugees in Hungary. The two samples do not differ regarding the presence of posttraumatic stress. The integrative attitudes proved not to be linked to gender and age, but linked to the host country. Besides social support and the host country, posttraumatic stress also proved to be a significant predictor of integrative attitudes.

Correction: Kovács et al. The Effects and Types of Parental Involvement in School-Based Sport and Health Programs Still Represent a Knowledge Gap: A Systematic Review. Int. J. Environ. Res. Public Health 2022, 19, 12859.

In the original article [...].

Family-SEN School Collaboration and Its Importance in Guiding Educational and Health-Related Policies and Practices in the Hungarian Minority Community in Romania.

Special education practice allows for the educational principles of parental involvement, pointing to a common dialogue on health issues and general well-being. Special education professionals primarily empower the families of children with atypical development by relying on the organizational factors of individual support and services. The decision-making/partnering factors of the educational and general health processes, on the other hand, receive less attention. The present study aims to explore the place of the parent-school relationship within the framework of a special educational institution in Romania. Involving Hungarian special education teachers (N = 12) from Romania, we analyze the school involvement of the parents of students with special educational needs in Bihor County, Romania, concerning their children's academic achievement and well-being. The qualitative research data were recorded through semistructured interviews and were organized through deductive categorization, as well as being analyzed thematically using Atlas.ti. The results highlighted the essential elements of the parent-school relationship, e.g., communication practices, active inclusion programs, support services, and peer acceptance plans. We believe it is important to emphasize that, in the study, families frequently better understood their child's situation and health-related issues and advocated more effectively for the recognition of their rights. However, as an active player in everyday education, the teacher can better organize development activities for the child's specific needs and plan complex habilitation/rehabilitation. To sum up, a parent-educator team approach can result in more successful educational and health outcomes, as well as a more accepting social image in the cognitive, emotional, and social development fields.

The Effects and Types of Parental Involvement in School-Based Sport and Health Programs Still Represent a Knowledge Gap: A Systematic Review.

BACKGROUND: Health-related behaviours and attitudes acquired in childhood significantly shape health behaviours in adulthood and play an important role in preventing children from becoming overweight. Interventions incorporating parental involvement can provide outstanding support in shaping a child's health-related behaviour. However, parental involvement has not been investigated from the perspective of efficacy except for obesity. Therefore, this systematic review investigates school-based physical activity intervention programmes incorporating parental involvement. We aim to explore the impact of these programmes and the parental involvement they provide on behaviours that influence child health, which are essential for preventing children and adults from becoming overweight and promoting health-conscious lifestyles. METHODS: This systematic literature review follows PRISMA guidelines. The EBSCO Discovery Service Search Engine was used for searching for literature. Papers included met the following inclusion criteria: (1) reported original, empirical research or systematic review published in a peer-reviewed journal; (2) primary or secondary school age (6-18 years) as the target population; (3) examined school-based sport or health prevention and intervention programs; (4) only healthy children and youth in the indicated age group; (5) school-based prevention or intervention program; (6) examines parental involvement; (7) in the English language, and (8) in disciplines of education, psychology, social work, sociology, social sciences and humanities. RESULTS: An extremely limited number of interventions of sufficient quality address the role of parental involvement (N = 17). The forms of parental involvement show a huge variety, ranging from leaflets, home packs, sports organisations "forced" by the pandemic, parent meetings, programmes, courses, and school programmes with diverse children over several months (cooking together, gardening, playing sports together, etc.). Therefore, it is difficult to measure their effectiveness and impact. CONCLUSIONS: The impact of parental involvement on children's health behaviour, especially physical activity and nutrition, as two of the most important factors in preventing them from becoming overweight, are unclear, and other correlations, e.g., academic achievement, are scarce.

Sport Motivation from the Perspective of Health, Institutional Embeddedness and Academic Persistence among Higher Educational Students.

Regular physical activity from an early age is an important part of a healthy life because if we incorporate exercise early into our lifestyle, we are more likely to maintain our commitment to sport into adulthood and even throughout our lives. In our research, we used the PERSIST 2019 database, which contains data from students at higher education institutions in Hungary, Slovakia, Romania, Ukraine, and Serbia. We used factor analysis to isolate four sports motivation factors (intrinsic, introjected, extrinsic, and amotivation). Factors influencing the different types were measured using linear regression analysis, involving the variables in four models. The results show that the effects of the sociodemographic variables are significant for gender, country, and mother's job, especially in terms of intrinsic, introjected, and extrinsic motivation. The role of coping is salient for health awareness factors, with a positive effect on intrinsic motivation and a negative effect on the other types. The impacts of quality of education and support are typically negative, while the positive effect of satisfaction with infrastructure is noteworthy. The effect of persistence in sport on intrinsic and introjected motivation is positive. Frequency of training increases intrinsic motivation, while practical sport embeddedness generates extrinsic motivation. In terms of relationships, a mainly teacher-oriented network within the institution typically has a negative effect on intrinsic motivation, while peer relationships outside the institution typically increase intrinsic and extrinsic sport motivation. Academic persistence has a positive effect on intrinsic motivation and a negative effect on introjected motivation. Our research highlights the complexity of factors influencing sport motivation and the role of coping, which typically remains strong when relationship-related variables are included. In addition, we must emphasise the dominant role of relationship network patterns, which may even reduce commitment to sport.

Correction: Kovács, K.; Kovács, K.E. Using the Behavioural Regulation in an Exercise Questionnaire (BREQ-2) in Central and Eastern Europe: Evidence of Reliability, Sociocultural Background, and the Effect on Sports Activity. Int. J. Environ. Res. Public Health 2021, 18, 11834.

In the original publication [...].

Using the Behavioural Regulation in an Exercise Questionnaire (BREQ-2) in Central and Eastern Europe: Evidence of Reliability, Sociocultural Background, and the Effect on Sports Activity.

The factors influencing sports motivation create a complex system, integrating internal drivers, such as the love of sport and the need for competence, and external segments, such as the environment, institutions, or the media. In our research, we examined the sports motivation of students studying in higher educational institutions in five countries (Hungary, Romania, Serbia, Slovakia, and Ukraine) using the Behavioral Regulation in Exercise Questionnaire (BREQ-2). This research aims to explore the socioeconomic and institutional factors influencing students' sports motivation and the effect of sociocultural, demographical, motivational, and societal factors on the frequency of participating in sports. Based on factor analysis, instead of the original five factors, three factors could be detected in the sample: intrinsic and identified motivation, introjected motivation, extrinsic motivation, and amotivation. Based on the results, higher social status facilitates intrinsic motivation, while lower socioeconomic status facilitates extrinsic motivation and amotivation. The strongest effect is exerted by individual variables, of which intrinsic and identified motivation support regular physical activity as a significant factor among students in all countries. This can also be seen in the frequency of sporting activities, as the highest frequency of sports activity was detected among people with high intrinsic motivation.

Factors Influencing Adherence Among Youth with Type-1-Diabetes Mellitus - The Hungarian Case.

Background and Introduction: Due to the increasing prevalence of type-1-diabetes, an increasing number of studies have drawn attention to its psychological effects and long-term consequences. As Type 1 Diabetes Mellitus is a chronic, non-curable, yet maintainable condition, with the affected children and their families facing a lifelong challenge, our research focuses on the factors influencing adherence. METHODS: The adherence of youth was examined in a sample involving 114 patients treated in the Medical and Health Science Centre at the University of Debrecen by employing a new adherence questionnaire (DAQ abbreviated version, Munkácsi et al. 2019) (DAF 2017; N=114). The influence of socio- demographic variables and those related to the disease (age at the time of diagnosis, the time elapsed since diagnosis, method of treatment, the time elapsed since the use of the pump) was measured by linear regression. Furthermore, the between-group comparisons were made by independent sample t-tests and variance analysis. The investigation was carried out between September 2017 and May 2018. RESULTS: The effect of using insulin pump as therapy turned out to be significant and positive (0.36. p=0.045). It was observed that the adherence of the patients using insulin pump was higher while the effect of the age at the diagnosis had a significantly negative effect (-.247, p=0.035). Thus, earlier detection of the disease may lead to a higher level of adherence. The effects of the socio-demographic variables (gender, family structure, educational level, type of the settlement, owning sibling and birth order) were not significant (p>0.05). Regarding the between-group comparisons, a significant difference could be pointed out concerning the siblings and birth-order as the adherence of those with siblings was higher (p=0.044). Moreover, concerning insulin pump therapy, the adherence of patients using pump was significantly better (p=0.048). Also, regarding the age of the diagnosis, the adherence of those diagnosed before 12 was seemingly higher (p=0.039). Concerning the other socio-demographical and disease-related variables, no significant differences could be detected. CONCLUSION: The results suggest that the treatment has an outstanding role in the adherence of the disease. Moreover, the role of the appropriate treatment, living conditions as well as the early diagnosis is relevant.

[Investigation of the adherence of children with diabetes through the validation of the child version of the Diabetes Adherence Questionnaire]. / Cukorbeteg gyermekek együttmuködésének vizsgálata a Diabetes Adherencia Kérdoív gyermekváltozatának validálása során.

Introduction: Most of the adolescents suffering from type 1 diabetes mellitus (T1DM) can be described with HbA1c values below the target level. Several research investigated the impact of diabetes on the quality of life, however, no complex questionnaire has been developed to examine each area of the disease. Aim: The aim of the present study is to create a Hungarian, reliable and valid questionnaire which can cover each aspect of the adherence related to type 1 diabetes mellitus. Method: In the present study, the attention was drawn to the introduction of a new questionnaire related to diabetes adherence which can be applied among children and adolescents as well. To test the questionnaire and to reduce the number of the items and to determine the scales, reliability analysis (Cronbach's α) and factor analysis was applied. Results: The new measurement, which was created through the translation of English language international questionnaires, their pre-test, and its reduction by factor and reliability analysis, containing 9 subscales with 58 items, is stated as reliable regarding the results of the Cronbach's α index. Conclusion: It can be stated that the created Diabetes Adherence Questionnaire can be reliably applied on child and adolescent population and it can be adapted for people suffering from other types of chronic diseases. Orv Hetil. 2019; 160(29): 1136-1142.

The associations between mental health, health-related quality of life and insulin pump therapy among children and adolescents with type 1 diabetes.

Background Diabetes has previously been linked to mental health problems in children and adolescents, but more recent studies have yielded mixed findings. The aim of the current study was to compare symptoms of mental health problems in children and adolescents with and without type 1 diabetes (T1DM). Methods Life quality, subjective well-being, self-rated health, depression and somatic symptoms in children and adolescents with diabetes (n=130) were measured and compared to the results of a socio-demographically joined control group (n=177) which consists of healthy children and adolescents. Results A significant difference could be observed between the groups in well-being and depressive symptoms as according to the results, the research sample namely the children with T1DM could be described with significantly higher subjective well-being and mood, but with less physical symptoms and lower level of depression as those in the control group. Conclusions These findings suggest that T1DM is not associated with an increased risk of psychosocial problems, and confirm that even a severe disease of a child can lead to personal growth.

[The investigation of attitudes toward health behaviour among high school and university students]. / Egészség-magatartással kapcsolatos attitudök vizsgálata középiskolás és egyetemista fiatalok körében.

INTRODUCTION: Health awareness plays an important role in our life, which contains attitudes as well behavioural components. Social factors influencing health awareness were the basis of many previous investigations, measuring the effect of demographical and psychological factors. However, investigation of these factors usually happened with separated questions. AIM: The aim of the present study is to test a new questionnaire, which measures health behaviour and attitudes related to health awareness. METHOD: In present study, the attention was drawn to the introduction of a new questionnaire related to health behaviour, attitudes toward health awareness and factors influencing those and measured on population in Debrecen (SHTE 2017; n = 256). RESULTS: the new measurement proved to be reliable based on Cronbach α analysis. This was created on the basis of focus content analysis of group conversations with 10 subscales and 35 items. CONCLUSIONS: It can be stated that gender, father's educational level, objective and subjective financial status has a significantly negative effect; while sport, subjective health and fitness as well as subjective religiosity have a significantly positive effect which reflects previous findings and confirm the reliability of our questionnaire. Orv Hetil. 2017; 158(44): 1754-1760.