The influence of positivity and self-efficacy beliefs on family functioning among young adults in Italy and Colombia.

Background: Research suggests that positivity and self-efficacy beliefs may impact adaptive behavior and developmental outcomes, such as social adjustment and subjective wellbeing. The present study explored the effect of positive dimensions (positivity and self-efficacy beliefs) and individual characteristics (gender, type of country, age, and sexual orientation) on family cohesion and flexibility in a group of Colombian and Italian young adults. Method: An online survey was administered to 949 Colombian and 2,073 Italian people aged between 18 and 40 years (M age = 24.3; SDage = 4.5; 67% women). A mediational model was performed to test the influence of positivity on family functioning via the mediational role of self-efficacy beliefs, analyzing the moderated effects of gender, type of country, sexual orientation, and age. Results: Filial self-efficacy mediated the effect of positivity on family functioning, showing stronger paths in men and Colombian participants than in women and Italian counterparts. Regulatory self-efficacy mediated the associations between positivity and family functioning for both genders and types of countries. Conclusion: The results suggest that positivity and self-efficacy beliefs may allow families to engage in more adaptive family functioning across countries and genders. Further research should focus on implications from a cross-national perspective to examine other culture-specific factors that may impact family adjustment.

Correlation between organizational support, self-efficacy, and core competencies among long-term care assistants: a structural equation model.

Introduction: Long-term care assistants are taking on more important roles in the healthcare system. The purpose of this study was to investigate what demographic factors influence the core competencies of nursing assistants, as well as to investigate the levels of organizational support, self-efficacy, and core competencies among nursing assistants in China, to explore the relationship between them. Methods: This is a cross-sectional study with prospective data collection based on a self-report questionnaire. A total of 320 long-term care assistants from two healthcare institutions. We collected socio-demographic characteristics and measured their perceived organizational support, self-efficacy, and core competency levels of the participants. Pearson correlation tests were conducted to examine the relationships among three variables, and a structural equation model was developed to test the interrelationships among these variables. Results: The results indicated that age, employment type, licensing status, monthly income, pre-job training, and training methods were associated with core competency, with nursing knowledge identified as a weak area in core competencies. There were significant associations among each dimension of perceived organizational support, self-efficacy, and core competencies (p < 0.01). The structural equation model demonstrated good fit: X 2/df = 2.486, GFI = 0.974, CFI = 0.988, IFI = 0.988, TLI = 0.977, RMSEA = 0.068, SRMR = 0.013. The direct effect of organizational support on core competencies was 0.37, with self-efficacy mediating the relationship between organizational support and core competencies, yielding an indirect effect of 0.122 and a total effect coefficient of 0.492 (all p < 0.001). Conclusion: Training in core competencies should prioritize nursing knowledge. Enhanced perceived organizational support and self-efficacy among nursing assistants were associated with higher core competencies.

The Influence of Identity Bubble Reinforcement on the Happiness Index among Chinese Medical Staff: The Mediating Role of General Self-Efficacy.

Objective: This study aimed to explore the mediating role of general self-efficacy in the influence of social media identity bubble reinforcement on the happiness index among Chinese medical staff. Methods: This study utilized data (n = 877) from the 2022 Psychological and Behavioral Investigation of Chinese Residents (PBICR) related to medical staff. Correlation analysis was performed using SPSS 26.0 software, and the relationships between general self-efficacy, social media identity bubble reinforcement, and the happiness index of Chinese medical staff were examined using AMOS 23.0 software. Results: The happiness index of Chinese medical staff was scored at 2.93 ± 1.21 for each item. Social media identity bubble reinforcement among Chinese medical staff was positively correlated with general self-efficacy (r = 0.380, P < .001), as well as with the happiness index (r = 0.330, P < .001). General self-efficacy was positively correlated with the happiness index (r = 0.575, P < .001) and was found to mediate the relationship between social media identity bubble reinforcement and the happiness index of Chinese medical staff. In terms of the mediating effect of social media identity bubble reinforcement, the direct effect's 95% confidence interval (CI) was 0.031-0.142, accounting for 34.68% of the total effect, which is statistically significant (P = .015), while the 95% CI of the indirect effect was 0.125-0.212, representing 65.32% of the total effect, also statistically significant (P = .005). Conclusion: Social media identity bubble reinforcement and general self-efficacy were found to be important factors influencing the happiness index of medical staff. Hospital managers and policymakers can thus enhance the social media identity bubble reinforcement and general self-efficacy of Chinese medical staff through effective measures to improve their happiness indices.

Psychometric evaluation of the Danish version of the Pain Self-Efficacy Questionnaire in patients with subacute and chronic low back pain.

OBJECTIVE: The Pain Self-Efficacy Questionnaire (PSEQ) is a widely used patient-reported outcome measure designed to assess the level of pain self-efficacy in patients with low back pain (LBP). Although the PSEQ has been translated into Danish, its measurement properties remain unknown in patients with subacute and chronic LBP in Danish outpatient clinics. The aim of this study was to investigate the construct validity, internal consistency, test-retest reliability, and measurement error of the Danish version of the PSEQ in a group of Danish patients with subacute and chronic LBP in a hospital outpatient setting. METHODS: Patients with LBP referred to two Danish outpatient clinics were recruited for this study. Two days after the consultation, the participants were emailed a link to a survey that included the following outcome measures: the PSEQ, the Oswestry Disability Index, the Numeric Pain Rating Scale, and the Tampa Scale of Kinesiophobia. Five days after completion of the survey, a new survey that included the PSEQ was sent to the participants. RESULTS: In total, 109 participants were included for the analysis of construct validity and internal consistency, with 94 participants included for the analysis of test-retest reliability and measurement error. Construct validity was found to be high and internal consistency was acceptable, with Cronbach's alpha = 0.93 (95% confidence interval [CI] = 0.91-0.93). Test-retest reliability was found to be good, with an intraclass correlation coefficient (ICC2.1) of 0.89 (95% CI = 0.82-0.92). The standard error of measurement was calculated to be 4.52 and the smallest detectable change was 12.5 points. CONCLUSIONS: The Danish version of the PSEQ showed acceptable measurement properties in terms of construct validity, internal consistency, and test-retest reliability in a group of patients with subacute and chronic LBP. However, further studies are needed to investigate other aspects of the measurement properties.

Too many friends, too little care: an exploration of the relational benefits and costs of friendship for academic self-efficacy, depression and anxiety in adolescence.

Our paper explores in a large Romanian sample (2168 adolescents) the relational costs and benefits of the number of friends at school. Using the MEDCURVE procedure to test the non-linear mediation effects, our results show that psychological safety, bullying and negative relations mediate the association between the number of friends and depression and anxiety, while social acceptance and bullying mediate the association between the number of friends and academic self-efficacy. In general, our results show that the relational benefits of friendship tend to diminish as the number of friends increase, in general over 9 friends (depending on the relational state) and parents, teachers and school counselors should help adolescents manage their number of friends in order to prevent the relational costs associated with engaging in too many (superficial) friendships.

Father support breastfeeding self-efficacy positively affects exclusive breastfeeding at 6 weeks postpartum and its influencing factors in Southeast China: a multi-centre, cross-sectional study.

BACKGROUND: The exclusive breastfeeding condition in China is not optimism now. Maternal breastfeeding self-efficacy stands as a pivotal factor influencing exclusive breastfeeding. Interestingly, studies have suggested that father support breastfeeding self-efficacy is a pivotal mediator in infant breastfeeding. Thus, the current research aimed to investigate the association between father support breastfeeding self-efficacy and exclusive breastfeeding at six weeks postpartum, and the influencing factors of father support breastfeeding self-efficacy. METHODS: This research was structured as a multi-centre cross-sectional study, involving 328 fathers, whose partners were six weeks postpartum, and recruited from two public hospitals in Southeast China. Self-designed demographic questionnaires, namely, Father Support Breastfeeding Self-Efficacy Scale-Short Form, Breastfeeding Knowledge Questionnaire, Positive Affect Scale and the 14-item Fatigue Scale, were applied. Descriptive statistics, Chi-square test, logistic regression univariate analysis and multiple linear regression were used to analyse data. RESULTS: Results indicate a significant difference between the infant feeding methods at six weeks postpartum and fathers with different levels of support breastfeeding self-efficacy (p < 0.05). Particularly, father support breastfeeding self-efficacy positively affected exclusive breastfeeding at six weeks postpartum after adjusting all the demographic characteristics of fathers (OR: 2.407; 95% CI: 1.017-4.121). Moreover, results show that the significant influencing factors of father support breastfeeding self-efficacy include breastfeeding knowledge, fatigue, positive affect, successfully experienced helping mothers to breastfeed, spousal relationships and companionship time. CONCLUSIONS: High-level father support breastfeeding self-efficacy effectively increased exclusive breastfeeding rate at six weeks postpartum. To enhance the exclusive breastfeeding rate, nurses or midwives can endeavour to design educational programmes or take supportive interventions customised for fathers, such as enhancing their breastfeeding knowledge education, reducing fatigue and mobilising positive emotions, thereby bolstering paternal self-efficacy in breastfeeding.

Shaping teachers' organizational citizenship behavior through self-efficacy and trust in colleagues: moderating role of collective efficacy.

BACKGROUND/PURPOSE: The aims of this study are: (1) to examine the mediating effect of teacher self-efficacy on the relationship between trust in colleagues and organizational citizenship behavior (OCB); and (2) to evaluate the moderating effect of collective efficacy on the relationships between teachers' self-efficacy and OCB, as well as between trust in colleagues and OCB. DESIGN/METHODOLOGY/APPROACH: The cross-sectional data were based on 408 sets of usable questionnaires collected from teachers who worked in government schools in Malaysia. The partial least square structural equation modeling technique was used to test the model and hypotheses. FINDINGS: The results indicate that trust in colleagues is positively related to organizational citizenship behavior (OCB) and teacher self-efficacy. Additionally, teacher self-efficacy and OCB are also positively related. Furthermore, the relationship between trust in colleagues and OCB is partially mediated by teacher self-efficacy. Moreover, collective efficacy significantly moderates the path between teacher self-efficacy and OCB but not between trust in colleagues and OCB. ORIGINALITY/VALUE: Despite earlier studies examining the relationship between trust, teacher self-efficacy, and OCB, little is known about the mediating mechanism of teacher self-efficacy and the moderating effect of collective efficacy. Thus, this present study makes significant contributions in both theoretical and practical aspects.

Rasch analysis of a palliative care self-efficacy instrument for nursing assistants.

This study used Rasch models to evaluate the psychometric properties of a self-efficacy instrument focused on psychosocial aspects of palliative care developed for nursing assistants (NAs). NAs from 6 skilled nursing facilities in Illinois, U.S. (n=102) were divided into intervention and control groups and answered 16 questions at baseline and 1-month follow-up. A total of 84 NAs completed assessments at both times. The rating scale structure improved when 3 instead of 5 response categories were used. After removing 4 items, the instrument demonstrated unidimensionality and local independence. A person-item threshold map indicated a ceiling effect. For the intervention group, 2 items and 1 item became easier and more difficult respectively post-training. With adjustments, the 12-item instrument became an adequate measure of palliative care self-efficacy. By using PCSE-NA as a tool to assess palliative care self-efficacy of NAs, geriatric nurses can identify weaknesses of and ways to improve training for NAs.

Changes in the Professional Identity and Self-Efficacy of Nursing Students Engaged in the Objective Structured Clinical Examination Using Simulation Learning.

BACKGROUND: The Objective Structured Clinical Examination (OSCE) is widely adopted in nursing education to enhance clinical skills and professionalism. With OSCE, the learning process is important, and students who underwent OSCE felt more confident and better prepared for their next clinical training. OBJECTIVES: This study aims to clarify how the self-efficacy and professional identity of nursing students change after learning through simulation education and OSCE. Clarification of these issues will allow an OSCE design utilizing simulation-based education as will be discussed. METHODS: This study used a pre-post study design, and the participants were 74 nursing university students at one university in Japan who agreed to participate in the study. The total scores and subscale scores for professional identity and self-efficacy were compared before and after the OSCE using the Wilcoxon signed-rank test. Spearman's rank correlation coefficient was calculated to examine the relationship between professional identity and self-efficacy. RESULTS: There were significant increases in self-efficacy scores (p<0.05) after OSCE, but there were no significant changes in the total scores of professional identities before and after the OSCE. Professional identity scores, such as choosing nursing again and desire to improve nursing skills, increased. CONCLUSIONS: Simulation-based OSCE effectively enhances nursing students' self-efficacy and certain aspects of professional identity, indicating its potential for nursing education.

Assessing the Effectiveness of an mHealth Intervention to Support Men Who Have Sex With Men Engaging in Chemsex (Budd): Single-Case and Pre-Post Experimental Design Study.

BACKGROUND: This study focuses on the Budd app, a mobile health intervention designed for gay, bisexual, and other men who have sex with men who participate in chemsex. Chemsex, the use of psychoactive drugs in a sexual context, presents substantial health risks including increased HIV transmission and mental health issues. Addressing these risks requires innovative interventions tailored to the unique needs of this population. OBJECTIVE: This study aims to evaluate the effectiveness of the Budd app in promoting drug harm reduction practices among its users, focusing on knowledge, behavioral intention, risk behavior awareness, and self-efficacy. METHODS: The study used a mixed methods approach, combining a single-case experimental design and a pre-post study. A total of 10 participants from an outpatient clinic were recruited, and each attended the clinic 3 times. During the first visit, participants installed a restricted version of the Budd app, which allowed them to report daily mood and risk behavior after chemsex sessions. Phase A (baseline) lasted at least 2 weeks depending on chemsex participation. In the second visit, participants gained full access to the Budd app, initiating phase B (intervention). Phase B lasted at least 6 weeks, depending on chemsex participation, with identical data input as phase A. Participants completed pre- and postintervention surveys assessing behavioral determinants during the first and third visit. RESULTS: The study observed an increased knowledge about chemsex substances postintervention, with a mean percentage improvement in knowledge scores of 20.59% (SD 13.3%) among participants. Behavioral intention and self-efficacy showed mixed results, with some participants improving while others experienced a decrease. There was also a variable impact on awareness of risk behavior, with half of the participants reporting a decrease postintervention. Despite these mixed results, the app was generally well-received, with participants engaging with the app's features an average of 50 times during the study. CONCLUSIONS: The Budd app showed effectiveness in enhancing knowledge about chemsex substances among gay, bisexual, and other men who have sex with men. However, its impact on safe dosing behavior, behavioral intention, self-efficacy, and risk behavior awareness was inconsistent. These findings suggest that while educational interventions can increase knowledge, translating this into behavioral change is more complex and may require more participants, a longer follow-up period, and additional strategies and support mechanisms.

Correlates of Lifestyle Physical Activity Among Young Arab American Women.

BACKGROUND: Young Arab American women are at risk for cardiovascular disease, but there is limited data on their physical activity (PA) engagement. OBJECTIVES: The aim of this study was to examine the relationship between PA and its correlates in young Arab American women. The objectives of this study were to: (1) describe self-reported lifestyle PA behaviors of young Arab American women and (2) examine the relationship between their self-reported lifestyle PA, device-measured lifestyle PA (combined moderate/vigorous and steps), and potentially associated factors (demographics, physical measures, individual factors, and behavior cognition factors). METHODS: This cross-sectional study was conducted with women 18 to 35 years of age and Arab American (n = 50) in the Midwest Region of the United States. Participants wore ActiGraph GT3X-BT monitors for 7 days; self-report measures included the International Physical Activity Questionnaire, demographics, acculturation, discrimination, religiosity, self-efficacy, and social support. RESULTS: The mean age of participants was 25.5 years (SD: 5.5; range: 18-35). Per ActiGraph, the average daily steps were 5946 (SD: 2783); only 24% met the moderate-intensity PA guidelines. Self-efficacy was significantly associated with increased moderate-to-vigorous PA (B = 0.37; P = .012). CONCLUSION: The average daily steps for the young Arab American women in this study were of low active classification. More than 75% of the women failed to meet the recommended weekly moderate/vigorous PA guidelines. Our study supports the importance of targeting and tailoring PA interventions on young Arab American women who have low self-efficacy for overcoming barriers to lifestyle PA.

Online patient-provider communication and healthy ageing: the roles of health literacy and health self-efficacy.

eHealth involves using digital technologies, like electronic health records and telemedicine, to enhance healthcare delivery and outcomes. For older adults, eHealth helps manage chronic conditions, access services remotely, and engage in preventive health, improving physical and psychological well-being. This study investigates the association between online patient-provider communication (OPPC) and older adults' quality of life (QoL, i.e. sleep quality, exercise and psychological health). The study also explores how health literacy and health self-efficacy mediate the relationship between OPPC and QoL. This study utilized data from the National Cancer Institute's Health Information National Trends Survey, collected in 2019 (HINTS 5 Cycle 3), specifically targeting individuals aged ≥ 60 (N = 2587). The associations among variables were analysed using structural equation modelling. OPPC was positively and significantly associated with health literacy (ß = 0.53, p < 0.001). Health literacy was positively and significantly related to health self-efficacy (ß = 0.02, p < 0.001). Health self-efficacy was significantly related to five dimensions of QoL: sleep quality (ß = 0.20, p < 0.001), fruit and vegetable consumption (ß = 0.13, p < 0.010), exercise (ß = 0.59, p < 0.001), sedentariness (ß = -0.58, p < 0.001) and psychological health (ß = 0.24, p < 0.001). Besides, health literacy and health self-efficacy also mediated the influence of OPPC on QoL sequentially, being identificators as two serial mediators between OPPC and older adults' QoL. This study suggests that OPPC plays an important role in older adults' QoL.

Development of the Partner Version of the Self-Efficacy to Communicate about Sex and Intimacy (SECSI-PV) Scale in the Context of Cancer Survivorship.

PURPOSE: This study aimed to develop the Partner Version of the Self-Efficacy to Communicate about Sex and Intimacy (SECSI-PV) scale. METHODS: Candidate items derived from the patient version of the instrument were refined with input from an expert panel specializing in sexual health, psychosocial oncology, and instrument development (n = 6). Partners (n = 17) of female cancer survivors participated in cognitive interviews to assess the revised scale's content validity. RESULTS: Transcripts were analyzed qualitatively. Participants endorsed the items as relevant, clear, and appropriate. CONCLUSIONS: The present work illustrates the iterative development of the SECSI-PV scale. The study highlights the importance of including partners in sexual health discussions and emphasizes the need for psychosocial interventions supporting partners' confidence communicating about sexuality and intimacy. Additional research is recommended to validate the instrument in larger samples encompassing cancer types that are not sex-based and partners from diverse backgrounds, including sexual and gender minority groups.

Effect of self-efficacy on self-management ability for colorectal cancer patients with stoma: a path analysis.

PURPOSE: Colorectal cancer threatens health and causes heavy social burdens. The purpose of this study is to analyze the pathway model for the effect of self-efficacy on self-management ability in colorectal cancer patients with stoma. METHODS: A cross-sectional study was conducted from December 2022 to April 2023, with a convenience sample of 422 colorectal cancer patients with stoma at six tertiary grade A hospitals in Shandong Province, China. Statistical analysis was undertaken using SPSS 26.0 and Amos 24.0 software. A pathway model based on individual and family self-management theories was developed and analyzed by collecting data through onsite survey and online survey. RESULTS: Chinese colorectal cancer patient's self-management ability score is 105.19 (17.19), which shows medium-level self-management ability. The self-efficacy of colorectal cancer patients with a stoma is influenced by social support, which ultimately leads to changes in their self-management ability. CONCLUSION: The findings may help healthcare professionals to identify the factors that influence self-management skills of colorectal cancer patients with stoma and provide a basis for developing interventions.

A Loss Cycle of Burnout Symptoms and Reduced Coping Self-Efficacy: A Latent Change Score Modelling Approach.

Police officers are frequently faced with chronic and acute stressors, such as excessive workload, organizational stressors and emotionally charged reports. This study aims to examine the relationship between a form of chronic strain (ie, burnout symptoms) and a resource (ie, coping self-efficacy) in a sample of Dutch police officers. Specifically, we aim to investigate the existence of a loss cycle of resources. We use Latent Change Score modeling to investigate the potential depletion or loss cycle of coping self-efficacy as a result of burnout symptoms in a sample of 95 police officers who completed a survey on three consecutive timepoints. The lag between the measurements was approximately one year. We found that, during both one-year intervals, within-person increases in burnout symptoms were related to within-person decreases in coping self-efficacy. Also, the results emphasize the buffering role of coping self-efficacy for burnout symptoms, as within-person decreases in coping self-efficacy during the first year were associated with within-person increases in burnout symptoms during the following year. Together, the results imply that a loss cycle of coping self-efficacy and burnout symptoms may occur. For this we used Latent Change Score modeling, which is a relatively new approach which provides researchers with the opportunity to analyse multi-wave longitudinal data while focusing on within-person changes over time. Practically, police organizations are advised to monitor personnel wellbeing and resources, to maintain and promote sustainable employability of police officers and to be able to timely provide individuals with interventions. Limitations discussed are the use of self-report measures and large intervals between the measurements. Finally, future directions of research are discussed that would circumvent the reported limitations, such as multiple wave with shorter lags and incorporating confounding factors that could affect coping self-efficacy.

Perceived social support on objective measured sedentary behavior of stroke patients: the mediating role of exercise self-efficacy.

Introduction: As stroke patients may have impaired motor function, there may have increased sedentary behavior. Factors associated with sedentary behavior need to be explored to develop targeted interventions. Although studies explore the effects of exercise self-efficacy and perceived social support on sedentary behavior, the relationship is not clear. The aim of this study was to explore the mediating effect of exercise self-efficacy on perceived social support and objective measured sedentary behavior in stroke patients. Methods: The random sampling method was adopted to select 275 stroke patients from the neurology department of a third-grade hospital of Henan Province from June 2023 to March 2024 in a cross-sectional descriptive study. A general data questionnaire, exercise self-efficacy scale, perceived social support scale, and ActiGraph GT3X accelerometer were used to investigate. The structural equation model was used to analyze the mediating effect of exercise self-efficacy between perceived social support and sedentary behavior. Results: The mean sedentary behavior time in stroke patients in this study was (479.65 ± 112.65) min, the mean score of perceived social support was (47.53 ± 17.16), and the mean score of exercise self-efficacy was (24.19 ± 6.25). The correlation analysis revealed that, the sedentary behavior of stroke patients was negatively correlated with exercise self-efficacy and perceived social support. The results of the mediation analysis showed that exercise self-efficacy played a partial mediating role between perceived social support and sedentary behavior. Conclusion: Perceived social support and exercise self-efficacy were influential factors in sedentary behavior. Moreover, the impact of perceived social support on sedentary behavior was partially mediated by exercise self-efficacy. Therefore, to decrease the sedentary behavior, it is crucial to improve the level of perceived social support in stroke patients. Patients with less perceived social support can improve their exercise self-efficacy and thus perceive more social support.

Effectiveness of Childbirth Self-Efficacy Enhancing Classes on Labor Length and Outcomes among Egyptian Primiparous Women: A Quasi-Experimental Study.

Introduction: Childbirth self-efficacy has repeatedly been shown to raise satisfaction with childbirth, reduce the need for analgesic, and promote the use of different childbirth alternatives. However, the measures to improve the childbirth self-efficacy had rarely been investigated among Egyptian primiparous women. Aim: The aim of this study is to evaluate the effectiveness of childbirth self-efficacy enhancing classes on labor length and outcomes among Egyptian primiparous women. Methods: A quasi-experimental research approach was carried out on prospective, consecutive sample of 148 pregnant women at the end of pregnancy. A prenatal education study group (n = 74) and a control group receiving standard antenatal care (n = 74) make up the first and second groups, respectively. Between October 2021 and October 2022, the study was conducted at the antenatal clinic. The following four tools were employed to fulfill the study's objective: A structured interviewing form, a childbirth self-efficacy inventory, a follow-up checklist for monitoring maternal and neonatal outcomes during labor, and three antenatal education sessions to boost childbirth self-efficacy are all examples of tools that can be used. All statistical analyses were performed using SPSS for windows version 20.0. Results: Approximately 68.9% of women in the experimental group gave birth vaginally, compared to 29.7% of those in the control group with (p = .001), according to the study's findings. In the experimental group, regular labor took an average of 8 to 12 h, but it took more than 12 h in the control group. Birth weight (>3000g) in the experimental group compared to (2000-3000 g) in the control group, as well as the Apgar score at 1 min and 5 min, were highly statistically significance between two groups with (p = .001). The means±SD of the childbirth self-efficacy result scores were better in the study group than in control groups regarding length of delivery and vaginal delivery (248.2 ± 19.4 versus 144.6 ± 21.6 and 250.1 ± 18.2 versus 137.9 ± 21.5, respectively). Conclusion: According to the findings of this study, antenatal education classes have a real chance of assisting primiparous women in increasing their childbirth self-efficacy and improving maternal and neonatal outcomes.

The "flipped visit": an innovative method to improve medical student self-efficacy through a structured approach in clinic.

BACKGROUND: Specialty clinics can be challenging for students on the internal medicine clerkship. They often lack the specialized knowledge necessary to fully engage in the clinic and may be pushed into an observational role, rather than being afforded meaningful opportunities. These peripheral roles undermine self-efficacy, and, therefore, education and interest. We sought to improve self-efficacy of students attending non-malignant hematology clinic, as well as to enhance interest in hematology and internal medicine. METHODS: We developed a flipped visit model analogous to the flipped classroom. Students each received pre-readings accompanied and pre-assigned cases with delineated reasons for referral and learning objectives. This model allowed students to prepare the hematology content for visits prior to arrival and then focus their time in clinic on executing visits. Participating students completed pre- and post-clinic surveys. These surveys covered core concepts in self-efficacy and interest in hematology and internal medicine on a five-point Likert scale. RESULTS: Of 103 students attending hematology clinic, 38 students (37%) opted to participate. Two of the 38 did not complete the post-clinic survey. Students had a statistically significant increase in four of six measures of self-efficacy: evaluation of research relevant to patient care and practicing cost-effective care (p = 0.008 and 0.001, respectively); and creation of a differential diagnosis and treatment plan specific to hematology (both p < 0.001). While pre-clinic student responses expressed interest in more exposure to hematology or a possible career in hematology or internal medicine, this was not changed post-clinic. When comparing their experience to other clinics, 75% and 71% students rated hematology clinic slightly or much better than other medicine clinics and non-medicine clinics, respectively. The flipped visit improved self-efficacy both specific to hematology and more generally. While students rated the experience more highly than other clinics, there was no impact on career interest in hematology or internal medicine. CONCLUSION: A flipped visit approach to incorporating medical students into hematology clinic that included pre-assigned cases and readings improved self-efficacy and was preferred by students. They may be adopted easily in other ambulatory education settings.

Algorithm-based Mobile Texting Platform for the Self-management of Interstitial Cystitis/Bladder Pain Syndrome: Pilot Study Evaluating Feasibility, Usability and Potential Utility.

INTRODUCTION: We developed an algorithm-based mobile texting platform for promoting self-management in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Our aim was to measure the feasibility, usability, and potential utility of the platform. MATERIAL AND METHODS: A texting platform that delivered four treatment modules (education and behavioral modification, cognitive behavioral therapy, pelvic floor physical therapy, and guided mindfulness practices) and an automated weekly message over six weeks was developed. Feasibility and usability were determined using patient engagement (proportion of platform messages to which patients responded) and System Usability scale. Satisfaction with patient-physician communication questionnaire, Pain Self-Efficacy Scale, and Interstitial Cystitis Symptom and Problem Index were administered before and after the intervention. RESULTS: Engagement with the platform in 52 female patients with IC/BPS [median age (IQR) 40 (30-48) years] was 76.9%. The commonest module selected by patients was pelvic floor physical therapy (50%) followed by cognitive behavioral therapy (34%), and guided mindfulness (15%). System Usability score (median, IQR) was 87 (83-95), indicating high usability. Satisfaction with patient-physician communication improved significantly (median change 4, IQR 1-9, p< .001). Pain self-efficacy score improved from moderate impairment at baseline to minimal impairment at six weeks (median change 10, IQR 2-18, p < .001). Urinary symptoms scores also improved (median change Interstitial Cystitis Symptom Index -3, IQR -5, -1.5, p < .001, Problem Index -2, IQR 5.5, -0.5, p <.001). CONCLUSION: An automated mobile platform has the potential for improving access to self-management strategies and easing clinicians' challenge of counseling IC/BPS patients during time-limited in-person visits.

The relationship between physical activity and mental health of middle school students: the chain mediating role of negative emotions and self-efficacy.

Objective: To explore the relationship between mental health and physical activity (PA) in middle school students, and examining the roles of negative emotions and self-efficacy in the relationship. Methods: Data from 1,134 Chinese middle school students (50.2% females, 49.8% males; M age = 15.18, SDage = 2.00) were collected using the Physical Activity Rating Scale (PARS-3), Positive and Negative Affect Scale (PANAS), General Self-Efficacy Scale (GSES), and Middle School Student Mental Health Scale (MSSMHS). Results: (1) There is a significant positive correlation between PA and mental health (r = 0.16, p < 0.01), and the direct path of PA on mental health is significant (t = 2.101, p < 0.01). (2) PA negatively predicts negative emotions (r = -0.12, p < 0.01), and is significantly positively correlated with self-efficacy (r = 0.24, p < 0.01). Negative emotions negatively predict self-efficacy (r = -0.23, p < 0.01) and mental health (r = -0.67, p < 0.01). Self-efficacy positively predicts mental health (r = 0.30, p < 0.01). (3) Negative emotions and self-efficacy play a significant mediating role between PA and mental health. The mediating effect includes three paths: PA → negative emotion → mental health (effect value: 0.130); PA → self-efficacy → mental health (effect size: 0.052); PA → negative emotions → self-efficacy → mental health (effect size: 0.006). Conclusion: PA among middle school students can indirectly affect mental health through negative emotions and self-efficacy. Middle school students should be encouraged to participate in PA to reduce their negative emotions and increase their self-efficacy, thus improving their mental health.