Facilitating positive emotions in people with challenges by combining conventional occupational training and a novel farming program: a feasibility study.

OBJECTIVE: Japan has a system of occupational therapy programs known as self-reliance training (training for daily living), which helps people with various disabilities lead more meaningful lives. Recently, it has been shown that green care farms are beneficial for dementia care and that agricultural and horticultural work has a positive impact on people with intellectual disabilities and mental disorders. This study examined the health-improving effects of farm activities and developed an attractive program for adolescents with developmental and intellectual disabilities who use independent training facilities. The program comprised agricultural and horticultural activities such as vegetable cultivation and management, flower planting, and flower arrangement. RESULTS: No significant differences were observed in any of the measures for positive mood before and after the usual program (UP). However, anger-hostility and depression-dejection improved significantly after the farm program (FP) (p < .05). Self-efficacy improved significantly after both UP and FP (p < .10). Free responses were obtained from UP (131 responses) and FP (126 responses) participants; thematic analysis of FP participants' statements revealed that positive comments included "confidence in accomplishing tasks," "anticipation and joy of growing plants," and "motivation for gardening activities."

Maintaining exercise in fitness centre settings: insights from the physical activity maintenance theory.

PURPOSE: This study examines factors that influence long-term fitness centre participation, applying the Physical Activity Maintenance Theory to assess psychological and contextual influences on exercise adherence. METHODS: Semi-structured interviews were conducted with 17 regular fitness centre attendees in Taubaté, São Paulo, Brazil. Data were analysed using Bardin's Content Analysis, exploring the participants' experiences and the factors contributing to their sustained activity. RESULTS: Autonomous motivation, such as enjoyment and satisfaction from workouts, along with self-efficacy, emerged as crucial for continued fitness centre attendance. The environment, including ambiance, social support, and facility quality, significantly impacted exercise persistence. However, challenges like time constraints, weather conditions, and personal issues occasionally hindered engagement. The study also highlights the role of personalized fitness programmes in supporting long-term adherence, suggesting that tailoring these programmes to individual goals could further enhance commitment. CONCLUSIONS: The findings underscore the importance of fitness centres creating environments that align with individual needs and preferences. Customized programmes that cater to both personal and communal needs could bolster long-term adherence. Future research should explore the impact of personalized, community-integrated fitness approaches on sustaining active lifestyles, emphasizing the importance of accommodating individual preferences in maintaining regular exercise habits.

Living together-does it help or hinder the pursuit of a healthful diet, physical activity, and weight loss among cancer survivors and their chosen partners?

PURPOSE: Parental or spousal cohabitating relationships are often targeted in behavioral interventions, but the contribution of cohabitation is poorly understood. This study explored whether cohabitation status moderated the impact of social cognitive theory constructs on adiposity, diet, and exercise in a dyadic, web-based weight loss intervention among cancer survivors and their chosen partners. METHODS: The 24-week weight loss intervention was conducted among 56 dyads, comprised of a cancer survivor and their chosen partner (n = 112). Baseline and 6-month data on social cognitive theory constructs (self-efficacy, social support, and perceived barriers), and study outcomes of adiposity (weight and waist circumference), diet (calories and diet quality), and moderate-to-vigorous physical activity (MVPA) were used to perform moderated-mediation analyses among cohabitating (n = 25) versus non-cohabitating (n = 31) dyads. RESULTS: The intervention was positively associated with dietary social support (path a1: 0.36, 95% CI [0.083, 0.659]) and inversely associated with perceived dietary barriers (path a1: - 10.57, 95% CI [- 19.109, - 3.091]) and perceived exercise barriers (path a1: - 11.29, 95% CI [- 22.098, - 3.500]) among those who did not cohabitate (effects not observed among cohabitating pairs). The intervention's mediating effects through perceived barriers on weight (indirect effect (ab): - 2.21, 95% CI [- 4.794, - 0.548]), waist circumference (ab: - 1.13, 95% CI [- 2.452, - 0.171]), caloric intake (ab: - 5.09 (2.86), 95% CI [- 12.602, - 0.709]), and self-reported MVPA (ab: 0.29 (0.18), 95% CI [0.019, 0.754]) also were stronger among non-cohabitating pairs. CONCLUSIONS: These findings suggest that social support partners outside the home substantially enhance intervention impact, though relationship quality and gender dynamics warrant further exploration. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04132219.

Investigating nurses' self-efficacy in pressure injury management within surgical services.

BACKGROUND: New research is crucial in addressing the role of nurses in preventing pressure injuries (PIs) and remedying deficiencies in their self-efficacy in this area. PURPOSE: The aim of this study was to examine the self-efficacy perceptions of nurses in managing PIs within surgical services. METHODS: The study involved 186 nurses from surgical services. Data were collected using a self-efficacy scale and a personal information form designed to assess nurses' PI management skills. Analysis involved descriptive (number, percentile) and inferential statistics (ANOVA, t- s) in SPSS-24. RESULTS: Surgical nurses reported their self-efficacy in managing PIs with a mean score of 47.38 ± 21.87 on a self-efficacy scale, indicating a broad range of perceptions. Average scores were 43.55 ± 23.47 for evaluation, 48.39 ± 25.65 for planning, 43.68 ± 25.34 for surveillance, and 50.64 ± 22.23 for decision-making. Of note, nurses reported the lowest self-efficacy scores for evaluation. No significant differences were found based on employment duration, gender, or education. Significant differences were observed based on age, service level, and post-graduate education (P < .05). CONCLUSION: This study highlights the need for enhanced nurse self-efficacy in PI management in surgical services, emphasizing the role of education programs focused on evaluation skills.

The Mediating Role of Trauma Centrality in the Correlation Between Coping Self-Efficacy and Posttraumatic Growth Level of Disaster Volunteers.

ABSTRACT: Volunteers who respond to disasters play a crucial role in disaster management. However, their indirect exposure to traumatic events during their duties can adversely affect their mental health. The aim of the study was to determine the correlation among trauma centrality, coping self-efficacy, and posttraumatic growth and trauma centrality as possible mediator role in this relationship. A total of 112 disaster volunteers participated. The data were collected with a Demographic Form, the Centrality of Events Scale, the Post-Traumatic Growth Scale, and the Coping Self-Efficacy Scale. Disaster volunteers exhibited above average event centrality, high levels of posttraumatic growth, and coping self-efficacy. A positive correlation was identified among trauma centrality, posttraumatic growth, and coping self-efficacy, with trauma centrality playing a full mediating role. This study will be instrumental in better understanding the posttraumatic processes of disaster volunteers and in strengthening coping capacities, guiding the implementation of preventive and protective psychosocial interventions.

Analysis of Burnout and Self-Efficacy of Teachers of Physical Education During Online Learning.

ABSTRACT: The research is based on interpretive phenomenological analysis and the interview method. The sample involved 100 secondary school students from five to nine grades and eight physical education teachers. All participants studied the proposed physical education program in-person for one academic semester, as well as studied the program online for one academic semester. It was found that online learning was viewed unfavorably by 87% of teachers. However, 65% of participants admitted that learning opportunities were limited, and they experienced difficulties with appropriate lesson content, equipment, and space to foster a positive learning environment and a productive working context. In addition, marginalization occurred as parents and students paid more attention to other subject areas except for physical education. The research suggested that the majority of teachers (89%) were looking forward to full-time and face-to-face physical education training because they lacked personal relationships and interaction with their students.

Efficacy of an online gatekeeper program for relatives of men at risk of suicide - a randomized controlled trial.

BACKGROUND: Men at risk for suicide are a challenging population group to reach with suicide prevention strategies. Gatekeepers hold a pivotal role in the prevention of male suicide, yet effective intervention requires them to have a level of knowledge and strategies to provide support. AIM: This study aimed to examine the efficacy of an online gatekeeper program for gatekeepers in male suicide prevention, assessing knowledge, perceived preparedness, self-efficacy, and psychopathological symptoms of gatekeepers. METHODS: Eighty-four participants were randomized to either the intervention (n = 43) or the waitlist control group (n = 41). The intervention comprised four modules providing knowledge and strategies for addressing men in suicidal crises. Outcomes included depression (PHQ-9), distress (PSS-10), burden (BAS), involvement (IEQ), as well as gatekeeper outcomes and knowledge. RESULTS: Completer analyses revealed significant improvement of depressive symptoms (d = 0.39) and an increase in gatekeeper outcomes (d = 0.58 to d = 0.84) and knowledge (d = 0.62) from baseline to post-assessment. The effects were maintained for 3 months. No significant effects could be found for burden, distress, and involvement. CONCLUSIONS: The findings indicate that a brief gatekeeper program can serve as a valuable resource. Future research should focus on examining the mental health of gatekeepers themselves and its long-term effects on intervention behavior. TRIAL REGISTRATION: German Clinical Trials Register, DRKS00030758, registered on 05.12.2022.

Mediating role of digital skills and mobile self-efficacy in the stress and academic engagement of Peruvian university students in postpandemic virtual environments.

BACKGROUND: Remote education emerged as an option during the COVID-19 pandemic; however, this modality continues to be used by various universities around the world in the postpandemic context. The aim of this study was to determine the mediating role of digital skills and mobile self-efficacy in the influence of stress on the academic engagement of Peruvian university students during remote teaching by COVID-19 using structural equation modeling (SEM). METHOD: This study involved 1,468 students from nine public and private universities in northern Peru who had undergraduate and graduate distance learning programs. RESULTS: The results showed that stress negatively influenced academic engagement (ß=-0.107*) and digital skills (ß=-0.328***). In addition, digital skills (ß = 0.470**) and mobile self-efficacy (ß = 0.684***) positively influence academic engagement. Similarly, digital skills mediate the relationship between stress and academic engagement (ß=-0.154**), and both variables act as sequential mediators in this relationship (ß=-0.348***). CONCLUSION: This study provides a deeper understanding of the factors that influence academic engagement during Remote education and lays the groundwork for the development of interventions and training programs tailored to hybrid learning contexts that promote the well-being and academic success of college students in postpandemic times.

Prediction of accident-proneness among a sample of Iranian workers: usefulness of an adjusted version of the Health Belief Model with spiritual health.

BACKGROUND: Workforce health is one of the primary and challenging issues, especially in industrialized countries. The purpose of the present study was to evaluate the ability to predict accident-proneness among Saveh Industry workers in Iran, based on an extended Health Belief Model, that included the construct of spiritual health. METHOD: This descriptive-analytical study was conducted in 2022 on 384 workers in Saveh, Iran. The study aimed to explore relationships between accident proneness behavior, spiritual health, and health beliefs. The accident-proneness questionnaire consisted of two parts: the first part included demographic questions, and the second part comprised 9 sections covering personality traits, workplace harmful factors, miscellaneous factors, musculoskeletal disorders, safety culture, safety attitudes, job stress, organization interest, and degree of risk-taking. The Health Belief Model included 31 questions, while spiritual health was measured with the 20-question Paloutzian and Ellison questionnaire. The collected data were analyzed using SPSS version 26 software. RESULTS: In terms of accident proneness, 229 (59.6%), exhibited high levels, 148 (38.5%) had medium levels, and 7 (1.8%) showed low levels of accident-proneness. Hierarchical multiple regression analysis showed that in the first model, variables of perceived self-efficacy, vulnerability, and severity independently predicted workers accident proneness, explaining a total of 43% of variance in accident proneness behavior. In the second step, perceived self-efficacy (ß = 34%), perceived sensitivity (ß = 27%), spiritual health (ß = 16%), and perceived severity (ß = 12%) were included, respectively, which explained a total of 46% of the variance of accident-prone behavior of workers. CONCLUSION: Given the high rate of accident proneness observed in this study, there is a critical need for policymakers and health planners to design policies aimed at mitigating the risks associated with occupational accidents. Furthermore, the findings highlight the potential of integrating spiritual health into the Health Belief Model, as a conceptual framework for planning effective intervention programs to enhance workplace safety.

The role of parenting stress on parenting self-efficacy and parental burnout among Turkish parents: a moderated mediation model.

OBJECTIVE: Parental burnout is a significant problem that negatively effects parent-child interaction, parenting skills, and child well-being. Research has identified parenting stress as one of the leading factors in parent burnout. Although crucial connections have been explained between parenting stress and parental burnout, not much is known about how parenting self-efficacy operates in these relationships. This study aims to investigate the roles of parenting self-efficacy and number of children in the relationship between parenting stress and parental burnout. METHODS: The participants consist of a total of 456 parents (Mage = 35.64 ± 9.28, Range = 25-65 years). The data were collected using a personal information form, the Parenting Stress Scale, the Parental Burnout Scale and the Parenting Self-Efficacy Scale. Relationships among variables were examined using Pearson's correlation, while moderated mediation analysis was carried out using Hayes's bootstrapping. RESULTS: The correlation analyses reveal a negative relationship between parenting self-efficacy and parenting stress, between parenting self-efficacy and parental burnout, and between parenting self-efficacy and number of children, while a positive significant relationship was found between parenting stress and parental burnout. The mediation analyses show parenting self-efficacy to mediate the correlation between parenting stress and parental burnout. The mediating effect of parenting self-efficacy is also moderated by number of children. CONCLUSIONS: This study provides empirical evidence for the effect of parenting stress and parenting self-efficacy on parental burnout, with fewer children in the household alleviating parental burnout.

Psychological status of medical security teams in Winter Olympic Games and Paralympics under COVID-19.

Background: Medical security work for the 2022 Beijing Winter Olympic and Paralympics faced enormous challenges under COVID-19. This study aimed to investigate the mental status of those medical team members to provide a reference for scientifically implementing medical security services for large-scale events. Methods: In this prospective cohort study, the Patient Health Questionnaire-9, Self-rating Anxiety Scale, General Self-Efficacy Scale, and Psychological Questionnaire for Emergent Events of Public Health (PQEEPH) were administered to 145 members of the medical team. A generalized mixed linear model was used to analyze the impact of work duration, position, on/off rotation, and gender on psychological status. Results: Work duration significantly impacted depression, anxiety, self-efficacy, and all dimensions of PQEEPH. Women scored higher than men in the PQEEPH dimensions of depression, neurasthenia, fear, and total score. Working status affected the dimensions of depression, neurasthenia, and total score. Deterioration in emotional state became apparent in the fourth week and recovered 1 week after the task concluded, while self-efficacy decreased from beginning to end. Conclusion: All the medical team members experienced emotional deterioration and decreased self-efficacy in medical security tasks. To maintain a medical team's psychological wellbeing during large-scale activities, rotation times should be set reasonably, and adequate mental health services should be provided.

Analysis of turnover intention and influencing factors among female nurses with two children in Grade A tertiary public hospitals in Sichuan province: a cross-sectional study.

Objective: This study aims to examine the current status of turnover intention among female nurses with two children and explore the factors influencing their decision to resign, ultimately providing a basis for reducing nurses' turnover intention and stabilizing the nursing workforce. Methods: A convenience sampling method was used to select 1,370 in-service female nurses with two children from 65 Grade A tertiary public hospitals in Sichuan Province from September to December 2023. Data was collected through a general information questionnaire, work-family behavioral role conflict scale, regulatory emotional self-efficacy, and turnover intention scale. Results: This study revealed that the average score for turnover intention among female nurses with two children was (13.11 ± 3.93). There was a positive correlation between work-family behavioral role conflict and turnover intention (r = 0.485, p < 0.01), while regulatory emotional self-efficacy showed a negative correlation with turnover intention (r = -0.382, p < 0.01). The main influencing factors for resignation among these nurses included age, number of night shifts per month, average monthly income, primary caregiver for children, work-to-family conflict and family-to-work conflict, and the ability to express positive emotions (POS), the capacity to regulate negative emotions such as despondency/distress (DES), and the skill to manage anger/irritation (ANG). Collectively, these factors explained 29.5% of the total variance in turnover intention scores. Conclusion: Turnover intention among female nurses with two children is relatively high. To address this issue, hospital managers shall implement effective measures through various channels to settle work-family conflict, enhance nurses' regulatory emotional self-efficacy, and reduce turnover intention resulting from work-family conflict. Together, these efforts will reduce nurse turnover and foster a stable nursing workforce.

Determining the predictors of preventive behaviors adopted by pregnant women against COVID-19 based on the Health Belief Model constructs: a cross sectional study.

BACKGROUND: Pregnant women face great challenges during the coronavirus disease 2019(COVID-19) pandemic. The purpose of this study was to explain the main dimensions of adoption of self-care behaviors against COVID-19 based on the health belief model(HBM) in pregnant women. METHODS: This cross-sectional and analytical study was conducted in Iran, at the end of the third wave of the COVID-19 pandemic, between January and April 2021. Two hundred and thirty pregnant women who referred to Urmia health centers were selected using multi-stage random sampling. The data were collected using an online questionnaire including items that measured the participants' demographic characteristics, the knowledge questionnaire, the HBM items, and questions assessing the adoption of self-care behaviors against COVID-19. The data were analyzed using SPSS software version 20. Descriptive statistics, bivariate Pearson's correlation test, and multiple linear regression were used to analyze the data. RESULTS: The results of this study showed that the rate of self-care behaviors against COVID-19 in the pregnant women participating in the present study was not very favorable. It was also shown that among the constructs of the HBM, knowledge, self-efficacy, and perceived barriers were the most important predictors of adopting self-care behaviors with a variance of 24% change among the pregnant women. CONCLUSION: Knowledge, self-efficacy, and perceived barriers were found in this study as the strongest predictors of self-care behaviors among pregnant women. Thus, it is suggested to implement interventions commensurate with the results of this study.

The effect of simulation-based training on problem-solving skills, critical thinking skills, and self-efficacy among nursing students in Vietnam: a before-and-after study.

PURPOSE: This study investigated the effect of simulation-based training on nursing students' problem-solving skills, critical thinking skills, and self-efficacy. METHODS: A single-group pretest and posttest study was conducted among 173 second-year nursing students at a public university in Vietnam from May 2021 to July 2022. Each student participated in the adult nursing preclinical practice course, which utilized a moderate-fidelity simulation teaching approach. Instruments including the Personal Problem-Solving Inventory Scale, Critical Thinking Skills Questionnaire, and General Self-Efficacy Questionnaire were employed to measure participants' problem-solving skills, critical thinking skills, and self-efficacy. Data were analyzed using descriptive statistics and the paired-sample t-test with the significance level set at P<0.05. RESULTS: The mean score of the Personal Problem-Solving Inventory posttest (127.24±12.11) was lower than the pretest score (131.42±16.95), suggesting an improvement in the problem-solving skills of the participants (t172=2.55, P=0.011). There was no statistically significant difference in critical thinking skills between the pretest and posttest (P=0.854). Self-efficacy among nursing students showed a substantial increase from the pretest (27.91±5.26) to the posttest (28.71±3.81), with t172=-2.26 and P=0.025. CONCLUSION: The results suggest that simulation-based training can improve problem-solving skills and increase self-efficacy among nursing students. Therefore, the integration of simulation-based training in nursing education is recommended.

Examining the Relationship Between Social Support, Self-Efficacy, Diabetes Self-Management, and Quality of Life Among Rural Individuals With Type 2 Diabetes in Eastern China: Path Analytical Approach.

BACKGROUND: Patients with type 2 diabetes (T2D) in rural China frequently exhibit inadequate diabetes self-management (DSM) and a reduced quality of life (QoL). Social support and self-efficacy are known to influence DSM and QoL. However, the pathways through which social support and self-efficacy impact DSM and QoL among patients with T2D in rural China has yet to be fully elucidated. OBJECTIVE: This study offers a foundation for developing policies in rural chronic disease management, thereby, contributing to the improvement of T2D prevention and control in China and other transitional countries. METHODS: This study used a cross-sectional design, collecting data from a survey conducted between May and July 2021 on DSM and QoL among rural patients diagnosed with T2D in 2 townships in East China. All patients with T2D were enrolled through cluster sampling from the township health center database, and a questionnaire survey was administered by investigators. Structural equation modeling and multiple regression analyses were used to explore the pathways through which social support influences DSM and QoL, as well as the mediating role of self-efficacy. RESULTS: It was found that the DSM score (mean 37.42, SD 7.70) was less than half of the maximum theoretical score. The QoL score (mean 48.92, SD 8.88) accounted for 36% of the maximum theoretical score. Social support directly and positively affected the DSM and QoL of Chinese rural patients with T2D (P<.01); an increase of 1 unit in social support was associated with a direct increment of 0.339 units in DSM and 0.397 units in QoL. Self-efficacy played a positive mediating role (P<.01), further increasing DSM and QoL by 0.147 and 0.159 units, respectively. The mediating effect of self-efficacy accounted for 30.2% and 28.6% of the total effect of social support on DSM and QoL. Furthermore, the family and friend dimension of social support, along with the symptom and disease management dimensions of self-efficacy, were significantly associated with DSM or QoL (P<.01). CONCLUSIONS: The study confirmed the direct and indirect influences of social support on DSM and QoL and elucidated the mediating effect of self-efficacy among rural patients with T2D in eastern China. Interventions should be developed to enhance both social support and self-efficacy, creating a positive cycle of mutual reinforcement to improve DSM and QoL among this group.

Exercise interventions for self-perceived body image, self-esteem and self-efficacy in women diagnosed with breast cancer: a systematic review with meta-analysis and meta-regressions.

PURPOSE: To synthesise the effectiveness of exercise interventions on self-perceived body image, self-esteem and self-efficacy in women diagnosed with breast cancer who are undergoing or have completed primary adjuvant treatments. METHODS: A systematic review was conducted with meta-analysis and meta-regressions. Five electronic databases were searched from inception to June 2023, and hand searches were performed to explore the reference lists of similar systematic reviews. The established selection criteria were randomised clinical trials that evaluated any type of physical exercise intervention with self-perceived body image, self-esteem and self-efficacy as outcomes. No restrictions were imposed with respect to the control group. Main characteristics were extracted for each study. Meta-analyses, meta-regressions and sensitivity analyses were performed. The certainty of evidence for each outcome was graded using the GRADE approach. The risk of bias was evaluated using the RoB2 Cochrane tool. RESULTS: Twenty studies, comprising 19 different samples (n = 2030), were included. In general, meta-analysis indicated that physical exercise interventions were not superior to controls for improving self-esteem and body image in women diagnosed with breast cancer. However, subgroup meta-analysis showed a significant difference in self-esteem improvement for resistance exercise (SMD = 0.31; 95% CI = 0.07, 0.55; p = 0.01; I2 = 0%) and supervised exercise (SMD = 0.25; 95% CI = 0.08, 0.42; p = 0.0004; I2 = 0%) compared with controls. Self-efficacy results were scarce and controversial. In addition, serious concerns were mainly detected in terms of the risk of bias and indirectness of the evidence, which caused the certainty of evidence to be very low for all outcomes. CONCLUSION: Supervised exercise and resistance training appear to be effective exercise modalities for improving self-esteem in women diagnosed with breast cancer. In contrast, exercise interventions are not significantly associated with improvements in body image, while results on self-efficacy are controversial. However, due to the study's limitations, further research is needed.

Unmet menstrual needs and psychosocial well-being among schoolgirls in Northern Tanzania: baseline results from the PASS MHW study.

INTRODUCTION: Improving menstrual health among schoolgirls is essential to meeting the Sustainable Development Goals (SDGs) of good health and wellbeing (SDG 03), quality education (SDG 04), and gender equality (SDG 05). School participation and wellbeing among girls in low and middle-income countries are impacted by inadequate access to quality menstrual materials and WASH facilities, taboos around menstruation, and poor knowledge. Comprehensive evidence is needed to address these challenges and guide policy and practice. METHODS: An assisted self-completed questionnaire was used to collect socio-demographic information, menstrual-related data, and school climate data from 486 girls in four mixed-gender government secondary schools in Mwanza, Tanzania. The mean (SD) of three Menstrual Practices and Needs Scale (MPNS-36) sub-scores were calculated. Specifically, the extent to which girls perceived needs for carrying and changing menstrual material in school (transport and school environment); washing and drying menstrual material (reuse needs); and privacy and drying menstrual material in school (reuse insecurity) were met. An ANOVA test compared MPNS scores for groups, and logistic regression examined the association between menstrual health and wellbeing outcomes (self-efficacy, menstrual anxiety, school attendance, and participation) and MPNS subscale scores. RESULTS: The mean age of the 486 participants was 15.6 years (SD 1.3); 87% had started menstruating; the mean age at menarche was 14.2 years (SD 1.15). The majority (75%) of girls experienced pain during the last menstrual period, 39% had menstrual-related anxiety, and 16% missed at least one day of school due to menstruation. The mean MPNS subscale score (out of 3) for the reuse needs ranged from 1.0 to 2.1 across schools; 1.6 to 2.1 for reuse insecurity; and 0.9 to 1.8 for transport and school environment needs. The MPNS subscales had sufficient reliability (Cronbach alpha = 0.74 to 0.9). The subscales also had good construct validity with menstrual-related self-efficacy: higher scores for transport and school environment were associated with confidence to seek menstrual support, participate in class, and predict when periods were about to start. CONCLUSIONS: Schoolgirls have unmet needs related to transporting and using menstrual material in school, and these needs differed across schools in northern Tanzania. Menstrual-related pain remains a major reason for poor school attendance and participation. Interventions to address menstrual practice needs in schools are required and should include a strong pain management component.

Associations between social support and proactive health behaviours among Chinese adolescents: the mediating role of self-efficacy and peer relationships.

BACKGROUND: Proactive health behaviours are crucial for enhancing adolescent health. However, there is limited evidence on the potential pathways through which social support influences adolescents' proactive health behaviours. This cross-sectional study aimed to examine the relationships between social support, self-efficacy, peer relationships and proactive health behaviours in Chinese adolescents. METHODS: From October to December 2023, we recruited 6075 adolescents from Shandong Province, China. They completed self-report questionnaires on social support, self-efficacy, peer relationships and proactive health behaviours. RESULTS: Linear regression analysis indicated that social support was positively associated with proactive health behaviours among adolescents (ß = 0.571, 95% CI = 0.542, 0.600). Further mediation analyses revealed that self-efficacy (ß = 0.085, 95% CI = 0.069,0.101) and peer relationships (ß = 0.156, 95% CI = 0.136,0.177) mediated this relationship. CONCLUSIONS: Increased social support was associated with better proactive health behaviours in Chinese adolescents. Additionally, higher self-efficacy and positive peer relationships enhanced this association. Our findings emphasised the significance of providing supportive environments at home and at school to promote proactive health behaviours in adolescents.

Empowering medical students: bridging gaps with high-fidelity simulations; a mixed-methods study on self-efficacy.

BACKGROUND: High-fidelity simulations play a crucial role in preparing for high-mortality events like cardiopulmonary arrest, emphasizing the need for rapid and accurate intervention. Proficiency in cardiopulmonary resuscitation(CPR) requires a strong self-efficacy(SE); training for both is crucial. This study assesses the impact of Advanced Life Support(ALS) simulation on SE changes in final-year medical students. METHODS: This mixed-methods prospective simulation study involved medical students in emergency medicine internships, examining self-efficacy perceptions regarding ALS technical skills(ALS-SEP). A comparison was made between students who underwent scenario-based ALS simulation training and those who did not. Competencies in chest compression skills were assessed, and the concordance between ALS-SEP scores and observed CPR performances were evaluated. Focus group interviews were conducted and analyzed using content analysis techniques. RESULTS: The study involved 80 students, with 53 in the experimental group(EG) and 27 in the control group(CG). The EG, underwent simulation training, showed a significantly higher ALS-SEP change than the CG(p < 0.05). However, there was low concordance between pre-simulation SEP and actual performance. Compression skills success rates were inadequate. Qualitative analysis revealed main themes as"learning"(32.6%), "self-efficacy"(29%), "simulation method"(21.3%), and "development"(16.5%). DISCUSSION: Post-simulation, students reported improved SEP and increased readiness for future interventions. The findings and qualitative statements support the effectiveness of simulation practices in bridging the gap between SEP and performance. Utilizing simulation-based ALS training enhances learners' belief in their capabilities, raises awareness of their competencies, and encourages reflective thinking. Given the importance of high SEP for ALS, simulation trainings correlating self-efficacy perception and performance may significantly reduce potential medical errors stemming from a disparity between perceived capability and actual performance.

Gestational diabetes knowledge improves with interactive online training modules.

BACKGROUND: The risk of developing type 2 diabetes mellitus (T2DM) is up to 50% among women with gestational diabetes mellitus (GDM). However, diabetes education during and after pregnancy is limited. To bridge this gap, our team developed four training modules on GDM for nurses and community health workers. This pilot study assesses changes in knowledge, self-efficacy for providing diabetes education, attitudes, and intentions to recommend diabetes prevention before and after training completion. METHODS: Interactive online modules were disseminated to clinical staff providing care for women with GDM in the United States. Optional pre- and post-training surveys were conducted to gauge the effectiveness of the modules. GDM knowledge (scoring 0-100) was evaluated with a 23 question assessment with total score and individual module scores reported [(# correct/# total)*100]. Self-efficacy for providing diabetes education (scoring 1-10) was evaluated with a 15-question survey and intention to recommend diabetes prevention (scoring 1-5) was assessed with an 8-item survey. Attitudes were assessed with three subscales of the Diabetes Attitude Scale (scoring 1-5). Changes in scores on each scale before and after training are reported using non-parametric Wilcoxon matched-pair signed rank tests. RESULTS: Eighty-two individuals completed baseline evaluation and 20 individuals accessed all modules and completed post-training assessments. Among those completing the training, improvement was noted in GDM knowledge [56.5 (16.0) v. 78.3 (22.0), p < 0.001], self-efficacy for providing diabetes education [6.60 (2.73) v. 9.33 (0.87), p < 0.001], attitudes toward the value of tight control [4.07 (0.79) v. 4.43 (0.86), p = 0.003], and intentions to recommend diabetes prevention measures [4.81 (0.63) v. 5.00 (0.00), p = 0.009)]. CONCLUSIONS: Completion of our interactive online modules improved knowledge, intention to recommend diabetes prevention, self-efficacy to provide diabetes education, and attitudes toward the value of tight control among individuals caring for women with GDM. TRIAL REGISTRATION: This study was registered at clinicaltrials.gov, identifier: NCT04474795.