Study demands and resources affect academic well-being and life satisfaction of undergraduate medical students in the Netherlands.

INTRODUCTION: Medical students report poor academic well-being in a context of high study demands. Study Demands-Resources theories have outlined mediating processes involving high study demands and low resources to mitigate academic well-being, which is subsequently associated with diminished overall well-being (i.e. life satisfaction). Furthermore, academic well-being and life satisfaction are also affected by interactions between study demands and resources (referred to as moderating processes). However, these mediating and moderating processes clarifying medical students' well-being still need to be investigated. Therefore, this study investigated the mediating role of academic well-being in the associations of study demands and resources with life satisfaction and the moderating role of study demands and resources in relation to academic well-being and life satisfaction among undergraduate medical students. METHODS: In this cross-sectional survey study, 372 undergraduates from Dutch medical schools participated. The survey included the Study Demands-Resources Scale (workload, growth opportunities and peer support) as well as questionnaires on academic well-being (Utrecht Burnout Scale for students and Utrecht Work Engagement Scale-Student Form) and overall well-being (single item on life satisfaction). Based on Study Demands-Resources theories, (moderated) mediation analyses were performed. RESULTS: Mediating processes were found as growth opportunities were indirectly associated with higher life satisfaction through lower academic burnout and higher academic engagement. Furthermore, workload was indirectly associated with lower life satisfaction through higher academic burnout. This association was moderated as it became weaker with more perceived peer support. DISCUSSION: A high workload and limited growth opportunities are associated with suboptimal academic well-being and life satisfaction. Perceiving support from peer students slightly buffers the unfavourable effect of workload on academic burnout and subsequently life satisfaction. To promote academic well-being and life satisfaction in medical students, universities can consider to reduce the workload, to create a supportive learning environment and to offer development opportunities.

Young women's sexual satisfaction in danger: the significance of thin-ideal internalization, positive body image, and appearance-related self-consciousness during physical intimacy.

BACKGROUND: Previous research indicated that a positive body image is indirectly related to young adult women's sexual satisfaction through protecting them from appearance-related self-consciousness during physical intimacy. The aim of the present study was to investigate thin-ideal internalization as a potential factor associated with positive body image, and subsequently appearance-related self-consciousness during physical intimacy and sexual satisfaction. PARTICIPANTS AND PROCEDURE: Using a cross-sectional design, 250 young adult Dutch women (age: M = 22.98, SD = 2.98) filled in an online survey measuring the relevant variables. RESULTS: A path analysis revealed that lower thin-ideal internalization was related to greater sexual satisfaction through a more positive body image and less appearance-related self-consciousness during physical intimacy, and also consecutively via both. CONCLUSIONS: These findings suggest that thin-ideal internalization may trigger processes that are detrimental to sexual satisfaction in women. Consequently, strengthening sociocultural pressure resistance skills in young adult women could facilitate the development and maintenance of positive sexual experiences.

Clinical leaders crossing boundaries: A study on the role of clinical leadership in crossing boundaries between specialties.

BACKGROUND: Due to the growing number of complex (multimorbid) patients, integrating and coordinating care across medical specialties around patient needs is an urgent theme in current health care. Clinical leadership plays an important role in stimulating coordination both within and between specialty groups, which results in better outcomes in terms of job satisfaction and quality of care. PURPOSE: In this light, this study aims to understand the relation between physicians' clinical leadership and outcomes, focusing on the sequential mediation of relationships and coordination with physicians within their own medical specialty group and from other specialties. METHODOLOGY: A cross-sectional self-administered survey among physicians in a Dutch hospital (n = 107) was conducted to measure clinical leadership, relational coordination at two levels (medical specialty group and between different specialties), quality of care, and job satisfaction. RESULTS: Clinical leadership was related to better quality of care through more relational coordination within the medical specialty group. Clinical leadership was related to more job satisfaction through more relational coordination within the medical specialty group, through more relational coordination between specialties, and sequentially through both kinds of relational coordination. CONCLUSION: Physicians who act as clinical leaders are important for crossing specialist boundaries and increasing care outcomes. PRACTICAL IMPLICATIONS: To improve multidisciplinary collaboration, managers should encourage clinical leadership and pay attention to the strong relationships between physicians from the same specialty.

Study-related wellbeing, behavior, and attitudes of university students in the Netherlands during emergency remote teaching in the context of COVID-19: A longitudinal study.

Introduction: During the COVID-19 pandemic, emergency remote teaching was implemented at all conventional Dutch universities; however, the degree of limitations in on-campus teaching and learning varied during the pandemic dependent on the strictness of the measures. In the present study, it will be investigated how study-related experiences of university students changed in the face of varying limitations in on-campus teaching and learning. Methods: The study had a longitudinal natural experiment design with three points of measurement during the academic year 2020-2021: November-December 2020 (t1; campuses partially open), March 2021 (t2; campuses fully closed) and June-July 2021 (t3; campuses partially open). In total, 680 Dutch university students (65.9% female; age: M = 21 years, SD = 2.06) filled in online surveys measuring study-related wellbeing (academic burnout and study-engagement), study-related behavior (study effort), and study-related attitudes (education satisfaction, online self-efficacy, and attitudes toward online education). Results: Overall, students reported moderate levels of academic burnout, study engagement, study effort, education satisfaction, and online self-efficacy; their attitudes toward online education were rather negative. Students' study-related wellbeing and education satisfaction decreased in the period when on-campus teaching and learning was impossible (t2) compared to periods in which on-campus teaching and learning was possible at a low level with several restrictions (t1 and t3). Students' attitudes toward online education and online self-efficacy slightly increased at the end of the academic year (t3); however, the attitudes toward online education remained negative. Discussion: The findings indicate that students' academic burnout, study engagement, and education satisfaction varied over the course of the academic year in the context of changing limitations in on-campus teaching and learning. To facilitate positive study-related experiences, universities are advised to offer as much on-campus education as possible in times of pandemics.

"What I thought was so important isn't really that important": international perspectives on making meaning during the first wave of the COVID-19 pandemic.

BACKGROUND: The global COVID-19 pandemic has had a significant impact on the physical and mental health of people everywhere. The aim of the study is to understand how people living in 15 countries around the globe experience an unexpected crisis which threatens their health and that of loved ones, and how they make meaning of this disruption in their narratives. METHODS: Data were collected through an anonymous online survey during May-September 2020, which was during or just after the first wave of the COVID-19 pandemic, depending on the country. The questionnaire included demographic and three open-ended questions as prompts for stories about experiences during the initial months of the pandemic. The text was analyzed through inductive thematic content analysis and quantified for full sample description, demographic and subsequently international comparisons. RESULTS: The final qualitative dataset included stories from n = 1685 respondents. The sample was 73.6% women and 26.4% men. The mean age of participants was 39.55 years (SD = 14.71). The identified four groups of overarching themes were: The presence and absence of others; Rediscovering oneself; The meaning of daily life; Rethinking societal and environmental values. We discuss the prevalence of each theme for the sample as a whole and differences by demographic groups. The most prevalent theme referred to disruptions in interpersonal contacts, made meaningful by the increased appreciation of the value of relationships, present in (45.6%) of stories. It was more prevalent in the stories of women compared to men (χ² = 24.88, p = .001). CONCLUSIONS: The paper provides a detailed overview of the methodology, the main themes identified inductively in the stories and differences according to select demographic variables. We identify several major ways of making meaning of the pandemic. The pandemic has impacted many aspects of people's lives which give it meaning, no matter where they live.

To Get Vaccinated, or Not to Get Vaccinated, That Is the Question: Illness Representations about COVID-19 and Perceptions about COVID-19 Vaccination as Predictors of COVID-19 Vaccination Willingness among Young Adults in The Netherlands.

Mass vaccination is considered necessary to reduce the spread of COVID-19; however, vaccination willingness was found to be especially low among young adults. Therefore, based on the extended Common Sense Model, the unique effects and the interplay of illness representations about COVID-19 and perceptions about COVID-19 vaccination in explaining COVID-19 vaccination willingness was investigated using a cross-sectional design. An online survey measuring the relevant variables was filled in by 584 participants (69.9% female) between 18 and 34 years. Correlation analyses showed that all illness representation dimensions except from timeline and both dimensions of vaccination perceptions were related to vaccination willingness. The mediation analysis revealed that less personal control, more prevention control, more concerns about COVID-19 as well as more perceived necessity of and fewer concerns about the vaccination were directly related to higher vaccination willingness. Additionally, prevention control was indirectly related to higher vaccination willingness through stronger perceptions of necessity of the vaccination. The extended Common Sense Model proved to be useful in the context of illness prevention. Campaigns to improve vaccination rates should aim at increasing the perception that COVID-19 is preventable through vaccination and the personal need of the vaccination as well as at decreasing concerns about the vaccination.

The Role of Risk Perception in Students' COVID-19 Vaccine Uptake: A Longitudinal Study.

Since COVID-19 vaccine uptake was found to be especially low among young adults, the present study investigated COVID-19 risk perception as predictor of COVID-19 vaccination intention and actual COVID-19 vaccine uptake among this age group. More specifically, it was tested whether cognitive risk perception predicts vaccination uptake successively via affective risk perception and vaccination intention. In total, 680 students (65.9% female) between 17 and 28 years participated in this longitudinal online study. COVID-19 cognitive and affective risk perception, COVID-19 vaccination intention, and actual COVID-19 vaccine uptake were measured in t1: November/December 2020, t2: March 2021, and t3: June/July 2021, respectively. The mediation analysis revealed a significant indirect effect of perceived severity at t1 on vaccine uptake at t3 via worry at t1 and vaccination intention at t2. Stronger perceptions of perceived severity of COVID-19 were related to more worry about COVID-19, which led to a higher vaccination intention, which, in turn, increased the chance of COVID-19 vaccine uptake. To increase vaccine uptake among young adults it might be fruitful to emphasize the severity of COVID-19. However, one should take into account that tapping into fear works best when messages also include efficacy statements.

Effects of a brief multimodal online intervention on the intention to conduct sun protective behaviours through targeting illness representations about skin cancer: a randomized controlled trial.

Objective: The incidence of skin cancer can be reduced by increasing sun protective behaviours. Based on the Common-Sense Model and the Intervention Mapping approach, a brief intervention targeting illness representations about skin cancer to increase the intention to conduct sun protective behaviours was developed and evaluated regarding its effectiveness.Design: A randomized pre-post control group design with 509 healthy participants (69% women, mean age 39 years).Main outcome measures: Changes in illness representations about skin cancer (emotional representations, illness coherence, and prevention control) and the intention to conduct sun protective behaviours, i.e. UV protection and sun avoidance.Results: ANCOVAs showed that the intervention increased illness coherence and perceived prevention control as well as the intention to conduct sun protective behaviours. Mediation analyses revealed that the increase in illness coherence and/or perceived prevention control partially mediated the effect of the intervention on the increase of the intention to use UV protection (indirect effects: .02*, .06*) and to avoid sun exposure (indirect effects: .01 ns, .04*).Conclusion: The intervention was successful in changing illness representations and thereby increasing the intention to conduct sun protective behaviours. The findings provide evidence for the usefulness of the Common-Sense Model in the context of illness prevention.

Understanding Relations Between Intolerance of Uncertainty, Social Anxiety, and Body Dissatisfaction in Women.

Body dissatisfaction (BD) is highly prevalent among young females and is associated with negative mental health outcomes. Social anxiety (SA) has been identified as an important determinant of BD; however, potential factors underlying SA-related BD remain unstudied. Research indicates that intolerance of uncertainty (IU), the tendency to respond negatively to uncertainty, may be critical for developing and maintaining SA. The current study investigated whether IU is associated with SA and whether SA, in turn, is related to BD. In a cross-sectional study, 139 women completed an online survey measuring IU, SA, and BD. Correlation analyses showed that IU, SA, and BD were strongly positively associated. A mediation analysis revealed that higher levels of IU were indirectly related to more BD through higher levels of SA. A direct effect of IU on BD was also found. These findings suggest that individuals with SA-related BD may benefit from interventions targeting IU.

Illness Perceptions and Quality of Life in Patients with Non-Small-Cell Lung Cancer: A 3-Month Follow-Up Pilot Study.

PURPOSE: Examine illness perceptions, functional health and quality of life of lung cancer patients throughout chemotherapy treatment. PATIENTS AND METHODS: Longitudinal design with baseline measure 12 days after the first chemotherapy and follow-up measure 3 months later, where illness perceptions (BIPQ), functional health, and quality of life (EORTC QLQ-C-30) were measured. A total of 21 patients with non-small-cell lung cancer took part. Non-parametric testing was performed given the pilot nature of the study and the associated relatively small sample size. RESULTS: Small to medium changes in illness perceptions and functional health between the two measurement points were detected, with both becoming more positive. More negative illness perceptions at the beginning of the treatment were associated with less functioning and lower quality of life at both beginning and end of treatment. CONCLUSION: Addressing illness perceptions seems a clinically relevant approach in improving functioning and quality of life of patients with non-small-cell lung cancer.

Relationships between body image, sexual satisfaction, and relationship quality in romantic couples.

Previous studies found important associations between body image, sexual satisfaction, and perceived romantic relationship quality, but mainly focused on one individual's perceptions rather than both partners. To take the interdependency of romantic partners into account, the present study examined these associations in romantic couples with a dyadic approach. In a cross-sectional design, 151 Dutch heterosexual couples completed an online survey measuring body image, sexual satisfaction, and perceived relationship quality. Hypotheses were tested using the actor-partner interdependence model (APIM) and an APIM extended with a mediator (APIMeM), with couple members' body image as predictors, couple members' sexual satisfaction as mediators, and couple members' relationship quality as outcomes. Results indicated that within individuals, a more positive body image was linked to higher perceived romantic relationship quality through greater sexual satisfaction. No gender differences were found, implying that body image and sexual satisfaction are equally strongly associated with perceived relationship quality in women and men. Results revealed no associations of an individual's body image and sexual satisfaction with the partner's perceived relationship quality. These findings implicate that interventions focusing on developing and maintaining a positive body image may be helpful in building on a more satisfying sex life and higher perceived relationship quality. (PsycINFO Database Record

Negative Body Attitudes and Sexual Dissatisfaction in Men: The Mediating Role of Body Self-Consciousness During Physical Intimacy.

Previous research indicated that negative attitudes about the body and appearance are common among men and demonstrated that negative body attitudes are associated with negative sexual experiences. The present study investigated the association between body attitudes and sexual dissatisfaction and the mediating role of body self-consciousness during physical intimacy. In a cross-sectional design, 201 Dutch men completed an online survey regarding body attitudes toward muscularity, body fat, height, and genitals, body self-consciousness during physical intimacy, and sexual dissatisfaction. Hypotheses were tested using correlation analyses and a mediation analysis with body attitudes as predictors, body self-consciousness as mediator, and sexual dissatisfaction as outcome. Correlation analyses showed that negative body attitudes and body self-consciousness during physical intimacy were significantly related to sexual dissatisfaction. The mediation analysis revealed that negative attitudes toward muscularity, body fat, and genitals had indirect effects on sexual dissatisfaction through body self-consciousness during physical intimacy. Negative attitudes toward genitals additionally had a direct effect on sexual dissatisfaction. These findings indicate that body image interventions focused on male body attitudes may be beneficial in improving men's body image, which may ultimately increase sexual satisfaction.

Coping mediates the influence of personality on life satisfaction in patients with rheumatic diseases.

A rheumatic disease can severely impair a person's quality of life. The degree of impairment, however, is not closely related to objective indicators of disease severity. This study investigated the influence and the interplay of core psychological factors, i.e., personality and coping, on life satisfaction in patients with rheumatic diseases. Particularly, it was tested whether coping mediates the effects of personality on life satisfaction. In a cross-sectional design, 158 patients diagnosed with a rheumatic disease completed questionnaires assessing the Big 5 personality traits (BFI-10), several disease-related coping strategies (EFK) and life satisfaction (HSWBS). Data were analyzed using a complex multiple mediation analysis with the Big 5 personality traits as predictors, coping strategies as mediators and life satisfaction as outcome. All personality traits and seven of the nine coping strategies were associated with life satisfaction (rs > |0.16|, ps ≤ 0.05). The mediation analysis revealed that personality traits had no direct, but rather indirect effects on life satisfaction through coping. Neuroticism had a negative indirect effect on life satisfaction through less active problem solving and more depressive coping (indirect effects > -0.03, ps < 0.05). Extraversion, agreeableness, and conscientiousness had positive indirect effects on life satisfaction through more active problem solving, less depressive coping and/or a more active search for social support (indirect effects > 0.06, ps < 0.05). Personality and coping play a role in adjustment to rheumatic diseases. The interplay of these variables should be considered in psychological interventions for patients with rheumatic diseases.

Illness representations as mediators of the relationship between dispositional optimism and depression in patients with chronic tinnitus: a cross-sectional study.

OBJECTIVE: Both dispositional optimism and illness representations are related to psychological health in chronic patients. In a group of chronic tinnitus sufferers, the interplay between these two variables was examined. Specifically, it was tested to what extent the relationship between dispositional optimism and depression is mediated by more positive illness representations. METHOD: The study had a cross-sectional design. One hundred and eighteen patients diagnosed with chronic tinnitus completed questionnaires assessing optimism (Life Orientation Test-Revised [LOT-R]), illness representations (Illness Perceptions Questionnaire-Revised [IPQ-R]) and depression (Hospital Anxiety and Depression Scale [HADS]). RESULTS: Correlation analysis showed that optimism was associated with more positive illness representations and lower levels of depression. Simple mediation analyses revealed that the relationship between optimism and depression was partially mediated by the illness representation dimensions consequences, treatment control, coherence, emotional representations and internal causes. A multiple mediation analysis indicated that the total mediation effect of illness representations is particularly due to the dimension consequences. CONCLUSION: Optimism influences depression in tinnitus patients both directly and indirectly. The indirect effect indicates that optimism is associated with more positive tinnitus-specific illness representations which, in turn, are related to less depression. These findings contribute to a better understanding of the interplay between generalised expectancies, illness-specific perceptions and psychological adjustment to medical conditions.

When the ringing in the ears gets unbearable: Illness representations, self-instructions and adjustment to tinnitus.

OBJECTIVE: Chronic tinnitus can severely impair a person's quality of life. The degree of impairment, however, is not closely related to tinnitus loudness. Applying the common sense model (CSM) of self-regulation of health and illness, this study investigated to what extent psychological factors, i.e. illness representations and positive/negative self-instructions, are associated with the degree of tinnitus-related complaints. METHODS: In this cross-sectional study, 118 patients diagnosed with chronic tinnitus filled in questionnaires assessing illness representations (IPQ-R), positive and negative self-instructions (TRSS), and tinnitus-related complaints (TQ). RESULTS: The regression analysis yielded a number of significant associations between illness representations and tinnitus-related complaints, particularly for the IPQ-R dimensions identity, consequences, coherence, and emotional representations. With regard to self-instructions and tinnitus-related complaints, significant effects were found only for negative self-instructions. Moreover, multiple mediation analyses revealed that the effects of consequences and emotional representations on tinnitus-related complaints were (partially) due to the use of negative self-instructions. CONCLUSION: Psychological factors are strongly related to the extent of tinnitus-related complaints. The findings provide an indication of which aspects should be targeted in psychological and psychotherapeutic tinnitus treatment.

Illness representations of depression and perceptions of the helpfulness of social support: comparing depressed and never-depressed persons.

BACKGROUND: Interactions between depressed persons and persons within their social network are often characterized by misunderstanding and unsuccessful social support attempts. These interpersonal problems could be fostered by discrepancies between depressed and never-depressed persons' illness representations of depression and/or discrepancies in the perceived helpfulness of supportive behaviors. METHODS: Illness representations of depression (IPQ-R) and perceptions of the helpfulness of different social support behaviors (ISU-DYA and ISAD) were assessed in 41 currently depressed persons and 58 persons without a history of depression. RESULTS: Never-depressed persons perceived depression as more controllable by treatment and as less emotionally impairing than depressed persons, but also as having more severe consequences. Never-depressed persons considered activation-oriented support (motivation to approach problems) as more helpful and protection-oriented support (allowance to draw back) as less helpful in comparison to depressed persons. LIMITATION: Data were collected in unrelated samples of depressed and never-depressed persons. CONCLUSIONS: Discrepancies in illness representations and perceptions of the helpfulness of social support do exist and may be the origin of problematic social interactions between depressed patients and persons within their social network. Therapeutic interventions should address the issue of conflicting perceptions and encourage depressed patients to acknowledge and discuss this topic within their social network.

The spirited, the observant, and the disheartened: social concepts of optimism, realism, and pessimism.

The social concepts of optimism, pessimism, and realism were investigated by assessing the prototypical acts (thoughts, feelings, goals, and actions) that laypersons assign to optimists, pessimists, and realists responding to a controllable and an uncontrollable situation. Optimists and realists, but not pessimists, were seen as adjusting their behavior to the situation. However, whereas optimists were characterized by flexibility in thoughts and feelings but invariance in goals and actions (i.e., they pursued their goals in both controllable and uncontrollable situations), the act profiles assigned to realists varied on all of these dimensions. The profile assigned to pessimists was characterized by cognitive, affective, motivational, and behavioral invariance, encompassing negative construals of the situation, giving up, and a focus on distress.