The Moderating Role of Perceived Efficacy of COVID-19 Prevention Measures on the Relation Between Perceived Risk and Perceived Mental Health / El rol moderador de la eficacia percibida de las medidas de prevención frente al COVID-19 en la relación entre la percepción de riesgo y la salud mental percibida

La pandemia del COVID-19 ha llevado a los países a adoptar severas y prolongadas medidas que —junto con el alto número de contagios y muertes y la continua información negativa— ha afectado la salud mental de las personas. Este estudio analiza el impacto de la crisis sanitaria del COVID-19 en España explorando el rol moderador de la eficacia percibida de las medidas de contención en la relación que establece la percepción del riesgo del COVID-19 con el estrés y la depresión. Un total de 478 adultos residentes en España (un 66.9% mujeres; Medad = 36.30, DT = 15.32) completaron un cuestionario con escalas concebidas para medir el riesgo percibido del COVID-19, la eficacia percibida de las medidas de protección, el estrés y la depresión entre el 16 de mayo y el 6 de junio de 2021. Los resultados confirmaron el rol moderador de la eficacia percibida, la cual actuó como un factor protector del estrés y la depresión al disminuir el impacto negativo que la percepción de riesgo del COVID-19 tiene en ambas variables relacionadas con el distrés mental. La percepción que tienen los individuos sobre la efectividad de las medidas de protección parece ser un factor protector relevante en relación con la salud mental durante una pandemia. Se subraya la relevancia de intervenciones psicológicas y de políticas gubernamentales que mejoren la comunicación positiva del riesgo y la información adecuada sobre la eficacia de las medidas de protección.(AU)

The pandemic situation caused by COVID-19 led countries to adopt harsh and prolonged (over time) measures that—along with the high number of infections and deaths and continuous negative information—have affected the mental health of individuals. In this study, the impact on mental health of the COVID-19 health crisis in Spain was explored through the perceived efficacy of pandemic containment measures as a moderator of the relationship that COVID-19 perceived risk establishes with stress and depression. A questionnaire composed of scales conceived to measure COVID-19 perceived risk, perceived efficacy of COVID-19 prevention measures, stress, and depression was completed by 478 adults living in Spain (66.9% females, Mage= 36.30, SD= 15.32) between May 16, 2021, and June 6, 2021. The results confirmed the moderating role of per-ceived efficacy. Perceived efficacy acted as a protective factor for stress and depression by decreasing the negative impact that perceived risk had on both variables related to mentaldistress. Also, the perception that par-ticipants had about the effectiveness of prevention measures appeared to be a relevant protective factor regarding mental health during the pandem-ic. This study highlights the relevance of psychological interventions and government policies that improve positive risk communication and pro-vide adequate information regarding the effectiveness of health-prevention measures.(AU)

Health, Stress and Technologies: Integrating Technology Acceptance and Health Belief Models for Smartphone-Based Stress Intervention.

Work-related stress significantly jeopardizes employees' physical and mental health due to the considerable time they spend at work. Smartphone-based interventions provide a promising solution, eliminating traditional face-to-face interventions' barriers. However, the elements that influence workers' intentions to use this still remain unexplored. This study explores the link between health belief model (HBM) and technology acceptance model (TAM) factors. In this study, 336 Italian workers (64% female) answered an online questionnaire. We employed a structural equation model (SEM) to analyze the data. The results unveiled an indirect relationship: individuals perceiving health risks were more inclined to use stress-management apps, mediated by perceived utility (PU). This study underscores the significant potential of integrating the HBM with the TAM in predicting users' preparedness for smartphone-based health interventions. These findings not only hold substantial value but also illuminate a path forward for professionals and organizations, offering insights to tailor and optimize smartphone tools for stress management and the promotion of workplace well-being. Ultimately, this research paves the way for the cultivation of healthier work environments, marking a noteworthy contribution to the field.

Influence of Family Social Support and Diabetes Self-Efficacy on the Emotional Wellbeing of Children and Adolescents with Type 1 Diabetes: A Longitudinal Study.

Type 1 diabetes (T1D) is a chronic disease that is usually diagnosed in childhood, underscoring the importance of early disease control for overall wellbeing. Our aim was to design an explanatory model of subjective emotional wellbeing in children and adolescents with T1D. A longitudinal study was conducted at the Reina Sofia University Hospital in Cordoba (Spain). A total of 151 patients (mean age = 14.50, SD = 2.67; 41.1% girls) participated at T1, while 97 participated at T2 (mean age = 14.93, SD = 2.56; 39.2% girls). Participants completed a self-report questionnaire. Descriptive, reliability, correlation, path, and mediation analyses were performed. The explanatory model showed excellent fit indices [χ2 (10) = 8.62, p = 0.57, RMSEA = 0.00, 95% [0.00, 0.10], CFI = 1.00, GFI = 0.98, AGFI = 0.93, and TLI = 1.01]. The results showed significant and positive relationships between family social support and subjective emotional wellbeing and improved self-care skills. Self-efficacy presented a mediating role between family social support and subjective emotional wellbeing. Given that self-efficacy is a self-regulatory mechanism and a determinant of health, it is argued that future psychoeducational interventions could aim to improve self-efficacy to manage chronic diseases, to achieve greater emotional wellbeing in children and adolescents with T1D.

Positivity and Health Locus of Control: Key Variables to Intervene on Well-Being of Cardiovascular Disease Patients.

Psychological well-being is a good predictor of several health outcomes in cardiovascular disease patients (adherence, quality of life, and healthy behaviors). The perception of health control and a positive orientation seem to have a beneficial effect on health and well-being. Therefore, the aim of this study was to investigate the role of the health locus of control and positivity in the psychological well-being and quality of life of cardiovascular patients. A total of 593 cardiac outpatients completed the Multidimensional Health Locus of Control Scale, the Positivity Scale and the Hospital Anxiety and Depression Scale at baseline (January 2017) and 9 m later (follow-up; n = 323). A Spearman rank correlation coefficient and a structural equation modeling approach were determined to explore the relationships between those variables both cross-sectionally and longitudinally. A cross-sectional correlation analysis at baseline revealed that the internal health locus of control and positivity were negatively associated with anxiety (rs = -0.15 and -0.44, ps < 0.01) and depression (rs = -0.22 and -0.55, ps < 0.01) and positively associated with health-related quality of life (rs = 0.16 and 0.46, ps < 0.01). Similar outcomes were found at follow-up and in longitudinal correlations. According to the path analysis, positivity was found to be negatively associated with anxiety and depression level at baseline (ß = -0.42 and -0.45, ps < 0.001). Longitudinally, positivity was negatively associated with depression (ß = 0.15, p < 0.01) and together with the internal health locus of control, was positively associated with health-related quality of life (ß = 0.16 and 0.10, respectively, ps < 0.05). These findings suggest that focusing on the health locus of control and especially positivity may be crucial in enhancing the psychological well-being of patients in the context of cardiac care. The potential impact of these results on future interventions is discussed.

Combining robot-assisted therapy with virtual reality or using it alone? A systematic review on health-related quality of life in neurological patients.

BACKGROUND: In the field of neurorehabilitation, robot-assisted therapy (RAT) and virtual reality (VR) have so far shown promising evidence on multiple motor and functional outcomes. The related effectiveness on patients' health-related quality of life (HRQoL) has been investigated across neurological populations but still remains unclear. The present study aimed to systematically review the studies investigating the effects of RAT alone and with VR on HRQoL in patients with different neurological diseases. METHODS: A systematic review of the studies evaluating the impact of RAT alone and combined with VR on HRQoL in patients affected by neurological diseases (i.e., stroke, multiple sclerosis, spinal cord injury, Parkinson's Disease) was conducted according to PRISMA guidelines. Electronic searches of PubMed, Web of Science, Cochrane Library, CINAHL, Embase, and PsychINFO (2000-2022) were performed. Risk of bias was evaluated through the National Institute of Health Quality Assessment Tool. Descriptive data regarding the study design, participants, intervention, rehabilitation outcomes, robotic device typology, HRQoL measures, non-motor factors concurrently investigated, and main results were extracted and meta-synthetized. RESULTS: The searches identified 3025 studies, of which 70 met the inclusion criteria. An overall heterogeneous configuration was found regarding the study design adopted, intervention procedures and technological devices implemented, rehabilitation outcomes (i.e., related to both upper and lower limb impairment), HRQoL measures administered, and main evidence. Most of the studies reported significant effects of both RAT and RAT plus VR on patients HRQoL, whether they adopted generic or disease-specific HRQoL measures. Significant post-intervention within-group changes were mainly found across neurological populations, while fewer studies reported significant between-group comparisons, and then, mostly in patients with stroke. Longitudinal investigations were also observed (up to 36 months), but significant longitudinal effects were exclusively found in patients with stroke or multiple sclerosis. Finally, concurrent evaluations on non-motor outcomes beside HRQoL included cognitive (i.e., memory, attention, executive functions) and psychological (i.e., mood, satisfaction with the treatment, device usability, fear of falling, motivation, self-efficacy, coping, and well-being) variables. CONCLUSIONS: Despite the heterogeneity observed among the studies included, promising evidence was found on the effectiveness of RAT and RAT plus VR on HRQoL. However, further targeted short- and long-term investigations, are strongly recommended for specific HRQoL subcomponents and neurological populations, through the adoption of defined intervention procedures and disease-specific assessment methodology.

Regulatory emotional self-efficacy and anxiety in times of pandemic: a gender perspective.

Objectives: The COVID-19 pandemic and resultant lockdown and containment measures have instigated substantial changes in our daily lives and have affected many people's mental health. This paper reports two studies exploring gender-based differences with regard to the impact of COVID-related confinement on individuals' self-efficacy to regulate negative emotions (RESE-NE) and anxiety. Methods: Study 1 (cross-sectional; 269 participants; 52% women) explored the evolution of RESE-NE and anxiety. To this end, participants assessed their status at two time points: a retrospective assessment of the period before confinement in Spain, and a current assessment during confinement. Study 2 (longitudinal; 114 participants; 72.2% women) explored the evolution of the variables by adding a post-confinement time point and analyzed the mediating role of RESE-NE in the positivity-anxiety and resilience-anxiety relationships. Results: The results confirmed that: (a) RESE-NE decreased and anxiety increased more among women than among men during confinement (Study 1); (b) women recovered their pre-pandemic levels of mental health more slowly than did men following confinement; and (c) the mediating role of RESE-NE could be observed in the two relationships under analysis. Conclusion: In practical terms, the research highlights the need to pay special attention to women undergoing mental health interventions related to the COVID-19 pandemic, as well as to the differential burden that the pandemic may entail for men and women and to the contrasting social roles traditionally attributed to them. From the gender differences identified, it is possible to infer how stereotypes and social roles influence the behavior and mental health of men and women, leading them to cope differently with stressful situations such as confinement.

Effectiveness of an eHealth intervention to improve subjective well-being and self-efficacy in cardiovascular disaease patients: A pilot non-randomized controlled trial.

AIM: To evaluate the effectiveness of a multicomponent, eHealth-based self-efficacy intervention to promote subjective well-being and self-efficacy in patients with cardiovascular disease, exploring sex differences. DESIGN: A pilot study of a two-arm non-randomized controlled trial. METHODS: Forty-two cardiovascular patients (31% women) participated in the study. The experimental group received a personalized psychoeducational session and a 14-days eHealth intervention. Subjective well-being (positive and negative affect) and self-efficacy (chronic and cardiac) were assessed at baseline, post-psychoeducational session, post-eHealth intervention and at two follow-ups. RESULTS: The levels of the experimental group in positive affect, at post-eHealth and follow-up 1, and self-efficacy, at post-eHealth, and both follow-ups, were statistically significantly higher compared to the control group (all ps < .05). When considering sex, the intervention was effective only for men. The results highlight the potential of eHealth interventions for cardiac patients and underline the importance of considering a gender perspective in their treatment.

Effectiveness of Mindfulness and Positive Strengthening mHealth Interventions for the Promotion of Subjective Emotional Wellbeing and Management of Self-Efficacy for Chronic Cardiac Diseases.

Intervention in health prevention and treatment via mobile phones is becoming a key element on health promotion. Testing the efficacy of these mobile health (mHealth) psychological interventions for cardiovascular health is necessary as it is a chronic pathology, and it can influence the affective and cognitive states of patients. This research aimed to analyze the effectiveness of two brief psychological interventions-mindfulness and positive strengthening-to promote subjective emotional wellbeing and disease management self-efficacy using mHealth. This was a three-arm intervention and feasibility study, with a pre-post design and three follow-up measures with 105 patients (93 completed all phases) with cardiovascular diseases. Group 1 and 2 received the mindfulness or strengthening intervention, and Group 3 was the control group. The positive-negative affect and management self-efficacy for chronic and cardiovascular diseases were analyzed over time, while anxiety and depression levels were assessed at the beginning of the study. The results showed that mindfulness and positive strengthening interventions both had a positive effect on participants' affective state and management self-efficacy for the disease in comparison with the control group over time, even after controlling for baseline anxiety and depression levels. Positive strengthening seems to be more effective for improving cardiac self-efficacy, while mindfulness practice was significantly more effective at reducing negative affect at the first face-to-face evaluation.

Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review.

Background: The prevalence and comorbidity of anxiety disorders are significantly different between women and men, with research showing a greater impact on women. The aim of this review was to identify the psychosocial and biological factors that have been considered to explain this gender and sex difference in prevalence and determine whether these factors are related to any anxiety comorbidity differences between men and women. Methods: Following the PRISMA guidelines, we carried out a systematic review of studies published between 2008 and 2021 in PsycINFO and PubMed databases. Empirical and review studies evaluating psychosocial and biological factors that could influence the difference in prevalence and comorbidity between men and women were included. A qualitative narrative synthesis was performed to describe the results. Results: From 1012 studies, 44 studies were included. Retrieved articles were categorized depending on their object of study: psychosocial factors (n = 21), biological factors (n = 16), or comorbidity (n = 7). Results showed that differences in anxiety between women and men have been analyzed by psychosocial and biological factors but rarely together. Among the psychosocial factors analyzed, masculinity may be a protective factor for anxiety development, while femininity can be a risk factor. In the studies that took biological factors into account, the potential influence of brain structures, genetic factors, and fluctuations in sexual hormones are pointed out as causes of greater anxiety in women. Concerning comorbidity, the results noted that women tend to develop other internalizing disorders (e.g. depression), while men tend to develop externalizing disorders (e.g. substance abuse). Conclusions: For an accurate understanding of differences between women and men in anxiety, both biological and psychosocial factors should be considered. This review highlights the need to apply the biopsychosocial model of health and the gender perspective to address differences in anxiety between sexes.

A Brief mHealth-Based Psychological Intervention in Emotion Regulation to Promote Positive Subjective Well-Being in Cardiovascular Disease Patients: A Non-Randomized Controlled Trial.

The emotional impact that a cardiovascular disease may have on a person's life can affect the prognosis and comorbidity of the disease. Therefore, emotion regulation is most important for the management of the disease. The aim of this study was to analyze the effectiveness of a brief mHealth psychological intervention in emotion regulation to promote positive subjective well-being in cardiovascular disease patients. The study sample (N = 69, 63.7 ± 11.5 years) was allocated to either the experimental group (n = 34) or control group (n = 35). The intervention consisted of a psychoeducational session in emotion regulation and an mHealth-based intervention for 2 weeks. Positive subjective well-being as a primary outcome and self-efficacy to manage the disease as a secondary outcome were assessed at five time points evaluated over a period of 6 weeks. The experimental group showed higher improvement in positive subjective well-being and self-efficacy for managing the disease compared to the control group over time. The experimental group also improved after the intervention on all outcome measures. Brief mHealth interventions in emotion regulation might be effective for improving positive subjective well-being and self-efficacy to manage the disease in cardiovascular patients.