Autonomy Questionnaire Research Articles

Effectiveness of the Dyadic Coping Intervention of Social Participation (DCISP) for stroke survivors: study protocol for a randomized controlled trial

BackgroundEnhancing social participation is not only the main goal of stroke survivors' community rehabilitation but also a protective factor affecting their physical and emotional health. The current state of stroke survivors' social participation is not encouraging due to the high disability incidence of stroke. Spouses may play a facilitating role in the social participation of patients by providing them with support and assistance. However, there remains a lack of evidence specifically regarding dyadic coping interventions of social participation for stroke survivors, and the intervention strategies are still underdeveloped without clear theoretical frameworks. Therefore, this proposed study aims to develop and evaluate the effectiveness of the Dyadic Coping Intervention of Social Participation (DCISP) for survivors of first-episode homebound stroke.MethodsA single-blind (assessor-blinded), randomized controlled trial will be conducted to verify the effectiveness of DCISP. The randomized controlled trial will be preceded by a feasibility study (N = 20) of DCISP in stroke survivors. Stroke survivors will be randomly classified (1:1) into either a control (N = 50) or an experimental group (N = 50). In addition to routine care, participants in the experimental group will receive six 40 ~ 45 min sessions of guidance, once every two weeks. The primary outcome is social participation of stroke survivors, measured using Impact on Participation and Autonomy Questionnaire (IPA) and Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P), and the secondary outcomes will be measured by Knowledge Questionnaire for Stroke Patients (SPKQ), Stroke-specific Quality of Life Scale (SS-QOL), Dyadic Coping Inventory (DCI), Modified Rankin Scale (mRS) and Zarit Caregiver Burden Interview (ZBI-22). These will be measured at baseline(T0), during the intervention (T1 = 1 month), and after intervention completion (T2 = 3 months, T3 = 6 months).DiscussionFindings from the study will provide evidence of the effects of DCISP on improving the social participation of first-episode homebound stroke survivors. The results of this study may support the implementation of survivor–spouse dyads care support in stroke survivors and provide a reference for clinical rehabilitation nursing practice, offering new insights into nursing interventions for stroke patients.Trial registrationChinese Clinical Trial Registry (ChiCTR) ChiCTR2400083072. Registered on 20 July 2023.

The Influence of Self-Confidence and Parent Attachment on Student Independence at Darul Qur'an Wal Irsyad Yogyakarta Islamic Boarding School

The purpose of this study uses a quantitative approach with multiple regression analysis. The research sample was 220 students taken by probability sampling technique, namely random sampling. In this study, the author uses a measure of independence obtained from the theory put forward by Noom, Meeus, and Decovic. The author adapts and modifies the data collection instruments, namely adolescence autonomy questionnaire (AAQ), Personal Evaluation Inventory (PEI), dan Inventory of Parent and Peer Attachment (IPPA). The results of this study show that self-confidence and parent attachment have a significant simultaneous influence on the independence of students at the Darul Qur'an Wal Irsyad Islamic Boarding School Yogyakarta. The overall self-confidence variable has a significant influence, where all significant aspects are academic, appearance, athletics, romantic, social, speaking, general, and mood. Meanwhile, parent attachment is divided into two variables, namely mother attachment and father attachment, each of which consists of three dimensions, namely trust, communication, and alienation. In the parent attachment variable, there are two dimensions that have a significant influence on the independence of students, namely communication and alienation of the mother attachment variable.

Perceived autonomy support in individuals with Parkinson’s disease requiring emergency care: a cross-sectional pilot study

BackgroundIndividuals with Parkinson’s disease (PD) report a diminished perceived functional autonomy as their condition progresses. For those seeking emergency care, it is unknown whether the patient-physician relationship is instrumental in respecting patient autonomy. This study evaluated patient autonomy ideals in individuals with PD requiring emergency care and the perceived support for autonomy from emergency department physicians.MethodIndividuals with PD (n = 36, average age 78.1 years) were surveyed using the Ideal Patient Autonomy questionnaire (IPA) and the Health Care Climate Questionnaire (HCCQ). A multivariable regression analysis assessed whether patients’ Hoehn and Yahr stage and IPA questionnaire results predicted HCCQ items.ResultsThe IPA questionnaire revealed that individuals with PD in need of emergency care emphasize the significance of medical expertise (IPA ‘doctor should decide’ theme 0.71) in decision-making and their desire to be fully informed about all potential risks (IPA ‘obligatory risk information’ theme 0.71). The average HCCQ values showed a decreasing trend across Hoehn and Yahr stages 1 to 5: 6.19, 6.03, 5.83, 5.80, and 5.23, respectively. HY scale values also influenced HCCQ items related to the physician’s role.ConclusionIn our cohort, individuals with Parkinson’s disease tend to rely on medical expertise for decision-making and prioritize complete risk information during emergency care. However, this autonomy support diminishes as functional disability levels increase.

Heterogeneity of social participation in patients three months after total knee arthroplasty: a latent profile analysis

BackgroundSocial participation is an important index of rehabilitation and social reintegration in patients after total knee arthroplasty (TKA). However, most existing studies focus on improving patients’ functioning and activities, with only a few examining the social participation among patients after TKA. Therefore, the study aims to investigate the heterogeneity of social participation in patients three months after TKA and analyze subgroup influencing factors, to promote functional exercise and postoperative follow-up in specific patients.MethodsThis cross-sectional study recruited 255 patients who underwent TKA in a Tertiary Hospital in Jinan City, China, from March to July 2022. Three months after having undergone TKA, participants’ data were collected using the Numeric Pain Rating Scale, the Chinese version of the Tampa Scale of Kinesiophobia, the 10-item Kessler Psychological Distress Scale, Hospital for Special Surgery Knee-rating Scale, and Impact on Participation and Autonomy Questionnaire. Latent profile analysis was used to identify categories of patients’ social participation. Multiple logistic regression analysis was used to analyze the influencing factors of the different subgroups.ResultsThree months after TKA, the patients were divided into three subgroups: low social participation group (17.9%), moderate social participation group (40.8%), and high social participation group (41.3%). The vast majority of patients who underwent TKA exhibited moderate-to-high level of social participation. The multiple logistic regression analysis results showed that age, degree of pain, knee function, and kinesiophobia were the influencing factors of the potential profiles of social participation in patients three months after TKA (p < 0.05).ConclusionThese results support a distinct categorical feature of social participation among patients three months after undergoing TKA. Medical staff need to provide targeted guidance according to the potential classification characteristics of social participation to improve the level of social participation and promote rehabilitation of patients.

Interplay of academic emotion regulation, academic mindfulness, L2 learning experience, academic motivation, and learner autonomy in intelligent computer-assisted language learning: A study of EFL learners

In the evolving landscape of second language (L2) education, Intelligent Computer-Assisted Language Learning (ICALL) stands out as a transformative force with the emergence of Artificial Intelligence (AI). Despite its growing prominence, integrating cognitive and affective constructs such as academic emotion regulation and mindfulness remains underexplored in ICALL environments. This study addresses this gap by examining their interplay with L2 learning experience, academic motivation, and learner autonomy among Iranian English as a Foreign Language (EFL) learners. Drawing on data from 398 intermediate EFL learners, this research utilized a comprehensive array of validated instruments, including the Academic Emotional Regulation Questionnaire, the Langer Mindfulness Scale, the L2 Learning Experience Scale, the Academic Motivation Scale, and the Learner Autonomy Questionnaire. Structural equation modeling (SEM) revealed significant correlations, indicating that academic emotion regulation positively influences L2 learning experience, academic motivation, and learner autonomy within ICALL settings. Furthermore, academic mindfulness emerged as a robust predictor of these educational outcomes in ICALL environments. These findings underscore the pivotal role of ICALL in L2 education and offer practical insights for teachers, curriculum developers, and policymakers to enhance teaching and learning practices.

Language learning strategy use and levels of autonomy in online and traditional education

The goal of this study is to investigate the level of learning strategy use and autonomy in online and traditional education. The study included 155 preparatory school students from the state university. The data were collected using Oxford's (1990) Language Learning Strategy (LLS) and a learner autonomy questionnaire (Zhang &amp; Li, 2004). SPSS22 was used to analyse the data. The findings revealed that autonomy level was high in traditional education, but moderate throughout the online education. Furthermore, the results of the LLS questionnaires revealed that students employed a moderate number of language learning strategies in both traditional and online education. Furthermore, the results of the LLS questionnaires revealed that students employed a moderate number of language learning strategies in online and traditional education. Finally, the correlation analysis utilized to determine the association between learner autonomy and LLS use revealed a positive and linear relationship between the two variables.

Randomized Controlled Trial of Occupational Performance Coaching for Adults With Multiple Sclerosis

ObjectiveTo determine if the receipt of occupational performance coaching (OPC) by adults living with multiple sclerosis (MS) improves participants’ satisfaction with performance in daily activities (primary outcome); improves perceived performance in daily activities, resilience, autonomy, and participation; and reduces illness intrusiveness and effect of MS (secondary outcomes). DesignTwo-group randomized clinical trial with a waitlist control. SettingCommunity. ParticipantsConvenience sample of adults with MS were recruited through a research registry. Eighty-three individuals were approached; 35 were assessed for eligibility and 31 were enrolled and 30 completed baseline assessment (Final sample size, N=30). Participants were English-speaking, were without serious cognitive impairment or severe depression, and were not receiving other coaching interventions. InterventionsSix telephone sessions of OPC were delivered by a trained facilitator over 10 weeks. Initial sessions focused on goal setting, prioritization, and action planning. Subsequent sessions involved goal and action plan review, discussion of facilitators and barriers, and goal and plan refinement. Main Outcome MeasuresPrimary outcome was participants’ satisfaction with performance in daily activities, as measured by the Canadian Occupational Performance Measure (COPM). Secondary outcome measures included the COPM performance rating, Connor-Davidson Resilience Scale, Impact on Participation and Autonomy Questionnaire, Adapted Illness Intrusiveness Rating Scale, and MS Impact Scale. Measures were administered by a blinded assessor at baseline, 10 weeks, and 2 months. ResultsParticipants in the intervention and waitlist control groups were equivalent on demographic and outcome measures at baseline. At 10 weeks, the intervention group had significantly higher COPM ratings for both satisfaction (P<.001) and performance (P=.002). No other outcomes were significantly different. For the intervention group, the benefits of OPC were maintained at 2 months. ConclusionsOPC led to improved satisfaction with performance and performance in daily activities. Future research with a larger sample is needed to determine other effects and who benefits most from OPC.

Study Regarding the Dimensions of Personal Autonomy Among Students Aged 13-14 Years Old

Personal autonomy is crucial in developing the personality of teenagers. The COVID-19 pandemic constrained adolescents' wishes and choices by imposing isolation at home. This constraint diminished individual autonomy regarding the purpose of choices, the direction of actions and the freedom to carry out particular tasks. The study aims to assess this personality trait by applying the personal autonomy questionnaire with four dimensions: cognitive autonomy, behavioural autonomy, value autonomy and emotional autonomy. The subjects of this research were 62 seventh-grade students with an average age of 13.5±0.29 years old. The results showed that the pandemic period impaired the students' personal autonomy, and some subjects avoided expressing their feelings and lacked confidence in their strengths.

Participation and autonomy, independence in activities of daily living and upper extremity functioning in individuals with spinal cord injury

Improvements in care and rehabilitation have resulted in a higher proportion of people living with spinal cord injury (SCI), which calls for an increased focus on participation and autonomy. This observational cross-sectional study investigated the impact of SCI on autonomy and how it correlates to activity performance and upper extremity functioning. A total of 25 adults (mean age 58 years) with chronic cervical or thoracic SCI were included. Self-perceived autonomy was measured with Impact on Participation and Autonomy questionnaire, independence in activities of daily living (ADL) with Spinal Cord Independence Measure, upper extremity functioning with Action Research Arm Test (ARAT) and kinematic measures of the drinking task. The results showed that most participants perceived injury-related restrictions in outdoor autonomy (80%), family role (76%), and in indoor autonomy (72%). Independence in self-care (r = 0.72), mobility (r = 0.59) and upper extremity kinematics of movement time (r = 0.63) and smoothness (r = 0.49) were correlated to indoors autonomy. Social life autonomy was correlated to self-care (r = 0.50) and ARAT (r = 0.41). In conclusion, autonomy was perceived restricted after SCI in several major life areas and correlated with independence in ADL and upper extremity functioning. The aspects of autonomy should be considered more in goal setting and clinical decision-making.

The Levels and Associated Factors for Participation and Autonomy Among People with Parkinson´s Disease: A Cross-Sectional Study.

Promoting participation and autonomy (PA) in society has been highlighted as an ultimate goal of rehabilitation for people with chronic diseases by the World Health Organization, but few studies have focused on PA in people with Parkinson's disease (PD). Therefore, this study aimed to determine the level of PA in PD patients and investigate the associated psychological and behavioural factors. PD patients were recruited from the Department of Neurology of the First Hospital Affiliated with Dalian Medical University using convenience sampling for this cross-sectional study. A questionnaire covering social-demographic and disease-related characteristics, Chinese version of Impact on Participation and Autonomy (IPA) Questionnaire, Connor-Davidson Resilience Scale (CD-RISC), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Medical Coping Modes Questionnaire (MCMQ), Social Support Rating Scale (SSRS), Hoehn-Yahr Staging System and Unified Parkinson's Disease Rating Scale (UPDRS) were used for investigation. A multivariate stepwise linear regression analysis was used to determine the factors that influence IPA. A total of 326 PD patients responded to all the questionnaires. The patients had a mean IPA score of 46.6 (SD 21.79). Multiple linear regression analyses revealed that UPDRS II (β = 0.35, p < 0.001) had the strongest correlation with IPA, followed by tenacity, which was the second strongest factor (β = -0.25, p < 0.001). Hoehn-Yahr stage (β = 0.19, p < 0.001) and availability of social support (β =-0.12, p =0.001) were also strong factors. The average level of PA among PD patients was at the lower middle-level. Among PD patients, physical function, psychological resilience and social support were the strongest factors associated with PA. These findings provide valuable insights into PD patients' PA and can help medical professionals identify the early risks of restricted PA among PD patients, implement interventions to promote PA and ultimately achieve rehabilitation.

A preliminary validation of the impact on participation and autonomy questionnaire in an Iranian sample of patients with type 2 diabetes.

This study aimed to determine the face, convergent validity, internal consistency, and stability reliability of the impact on participation and autonomy-Persian version (IPA-p) scale for using among Iranian patients with type 2 diabetes. Trained experts interviewed 227 type 2 diabetes patients who were registered in out-patient Diabetes Clinic of Ali-Ibn Abi-Talib Hospital, (Rafsanjan, Southeast Iran from May 2018 to February 2019) and their relatives to assess the face and convergent validity, internal consistency, and stability reliability of the IPA-p scale. A checklist was used to collect demographic information and also to record expert's̛̛̛̛̛̛ points of view about the scale to assess face validity. Internal consistency was measured using Cronbach's alpha, and stability was assessed using interclass correlation coefficients (ICCs). Test-retest method was used to detect the reliability of the questionnaire. Respondents completed the IPA-p scale on the two occasions with an interval of 30-45 days. In relation to convergent validity, the confirmatory model showed an acceptable fit and the scale had a highly convergent validity. Exploratory factor analysis showed that the IPA-p scale has a ten-factor structure that explained 77.42% of the variance. Cronbach's alpha between the mean IPA-p scores achieved on the two occasions ranged from 0.65 to 0.92. Test-retest ICCs for the ten domains were between 0.64 and 0.81. The IPA-p questionnaire can be a relatively valid and reliable instrument for assessing self-reported participation among Iranian type 2 diabetes patients. However, some improvement is needed to make it fully suitable for using among Persian-language diabetic patients.

A voyage of discovering the impacts of teacher immunity and emotion regulation on professional identity, autonomy, and work motivation in Iranian EFL landscape.

The literature has widely recognized the significance of examining the influence of teacher professional identity (TPI), teacher autonomy (TA), and teacher work motivation (TWM) on teacher well-being. However, there is a noticeable gap in the research regarding the role of teacher immunity (TI) and teacher emotion regulation (TER) in TPI, TA, TWM among English as a foreign language (EFL) teachers. In light of this gap, the present study aimed to investigate the association between TI and TER with TPI, TA, and TWM of EFL teachers. A sample of 433 EFL teachers completed the Language Teacher Immunity Instrument, the Language Teacher Emotion Regulation Inventory, the Teacher Professional Identity Scale, the Teacher Autonomy Questionnaire, and the Multidimensional Work Motivation Scale. The Confirmatory Factor Analysis and Structural Equation Modeling were conducted to analyze the data. Findings disclosed that TI and TER were strong predictor of TPI, TA, and TWM among the EFL teachers. The study concludes by offering some pedagogical implications for different stakeholders and discussing potential areas of research that can be developed based on the findings.

Research on the impact of parental self-affirmation on educational anxiety: a moderated chain mediation model

Based on the data of parents of primary school students in Lianyungang City, Jiangsu Province, China, this paper explores the impact of parental self-affirmation on educational anxiety, as well as the mechanism of parental trust in children’s autonomy, parental expectation, and family intimacy. A total of 983 parents of primary school students were surveyed using the GHQ-Self-Affirmation Scale, Parental Expectation Questionnaire, Parental Trust in Children’s Autonomy Questionnaire, Parental Education Anxiety Questionnaire, and the Chinese Version of FACES II, focusing on the dimension of close relationships. There is a significant positive correlation between parental self-affirmation and educational anxiety (r=0.17, p&lt;0.01), and self-affirmation positively predicts educational anxiety (β=0.07, P&lt;0.05). In other words, the higher the level of parental self-affirmation, the higher the degree of parental educational anxiety. Parental trust in children’s autonomy, and parental expectation play a chain mediating role between parental self-affirmation, and educational anxiety. The effect of parental self-affirmation on parental expectation is moderated by family intimacy. The study shows that parental trust in children’s autonomy, and parental expectation, serve as a mediating bridge between parental self-affirmation and educational anxiety, and family intimacy can significantly positively moderate the impact of parental self-affirmation on parental trust in children’s autonomy.

Social participation in older people with hearing impairment in Chinese community: A latent profile analysis

ObjectivesHearing impairment may lead to increased communication difficulties for older people, making their social participation less optimistic. However, there is little research on the social participation of older people with hearing impairment, especially based on the characteristics of their social participation. This study aimed to identify different social participation profiles in older people with hearing impairment and to explore sociodemographic characteristics, disease-related characteristics and psychosocial factors with different social participation profiles. MethodsA cross-sectional study of 300 older people with hearing impairment using the sociodemographic questionnaire, the Impact on Participation and Autonomy Questionnaire, the Lubben Social Network Scale-6, Medical Outcomes Study Social Support Survey and Geriatric Depression Scale-15 from May to August 2023 in a community of Beijing, China. Latent profile analysis was used to analyse the latent profiles of social participation in elderly with hearing impairment. Multiple logistic regression was used to explore the predictors of different profiles. ResultsThe social participation of older people with hearing impairment in the community can be classified into three potential profiles: Profile 1 - high social participation group (76.05 %), Profile 2 - moderate social participation group (17.34 %), Profile 3 - low social participation group (6.61 %). Age, types of chronic diseases, self-reported health, severity of hearing impairment, social network, social support and depression were predictors of different profiles. ConclusionsNurses should pay attention to the characteristics, depression, social network and support of older people with different hearing impairment to improve social participation in different profiles. Implications and recommendationsThis was the first study exploring latent profiles of social participation in older people with hearing impairment. Insights from this study are useful for gerontological nursing to distinguish different profiles and further identify the characteristics of different profiles in older people with hearing impairment by characterizing the level of social participation in the community and better implement interventions according to profiles.

Assessing perceived participation among older adults total hip arthroplasty and total knee arthroplasty patients six months post-surgery: a cross-sectional study.

This research sought to assess the perceived levels of participation and autonomy in senior patients who had received total hip arthroplasty (THA) or total knee arthroplasty (TKA) in Hangzhou, China. Furthermore, the study aimed to identify the factors linked to these outcomes. This investigation will utilize a cross-sectional study design to assess perceived participation and autonomy among older adults total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients. The research was conducted in Hangzhou, China, at a tertiary hospital. Convenient sampling was utilized to select 139 patients who underwent THA or TKA between March 2022 and March 2023 and met the inclusion criteria at a tertiary hospital in Hangzhou. The Impact on Participation and Autonomy Questionnaire, Hip/Knee Injury and Osteoarthritis Outcome Score (HOOS/KOOS), 5-Item Geriatric Depression Scale, Multidimensional Scale of Perceived Social Support, and Elders Health Empowerment Scale were used to assess perceived participation, hip/knee-related symptoms and functional restrictions, depression symptoms, social support, and health empowerment. The mean score for perceived participation and autonomy was 22.554 (SD: 13.042). The mean scores for participation in indoor autonomy, outdoor autonomy, family roles, and social relations were 0.654 (SD: 0.608), 1.324 (SD: 0.792), 1.053 (SD: 0.657), and 0.664 (SD: 0.542), respectively. Negative correlations were observed between perceived participation/autonomy scores and HOOS/KOOS, social support, and health empowerment scores. Conversely, a positive correlation was found between perceived participation/autonomy scores and depression scores. The detrimental effect of HOOS/KOOS, social support, and health empowerment scores on perceived participation and autonomy was notable, while the impact of depressive symptoms was comparatively minor. Older Chinese patients, at first six months post THA/TKA surgery, reported higher levels of perceived participation compared to individuals with other conditions, such as stroke patients. Functional limitations resulting from hip/knee-related symptoms, as well as social support and health empowerment, emerged as significant influencing factors for perceived participation and autonomy. This research enhances our comprehension of the elements influencing perceived participation among older adults individuals who have undergone THA/TKA procedures.

Mapping the association between productive immunity, emotion regulation, resilience, and autonomy in higher education

In recent years, more attention has been paid to the psychological and physical well-being of educators. Nevertheless, inadequate attention has been paid to the mediator function of teacher immunity (TI), teacher emotion regulation (TER), teacher resilience (TR), and teacher autonomy (TA) in higher education. This study developed a model to demonstrate the interplay between TI, TER, TR, and TA in an effort to solve the existing research gap. To compile this information, 492 university academics who are currently working in the position of English as a foreign language teacher at various universities throughout Iran have participated in an online survey. They were asked to expressed their opinions with respect to four instruments: the language teacher immunity instrument, the language teacher emotion regulation inventory, the teacher resilience scale, and the teacher autonomy questionnaire. Confirmatory factor analysis and structural equation modelling indicated that university professors who developed productive immunity and emotion regulation are more resilient and autonomous. In conclusion, the implications as well as the future direction of the study were presented to enthusiastic researchers as well as educators. This can help increase the researchers’ and educators’ understanding of the connection between TI, TER, TR, and TA and how it can produce positive results for students.

Predictors of resilience for people with spinal cord injury over two periods of COVID-19 social distancing restrictions: a 12-month longitudinal study using structural equation modelling

BackgroundThe novel coronavirus (COVID-19) pandemic is disproportionately impacting the health of people with disability. Resilience has remained an important health promoting characteristic during periods of social distancing restrictions. Factors promoting resilience for people with disability under the context of the pandemic remains poorly understood. Studies have yet to investigate evidence-based factors that promote resilience over multiple periods of restrictions for people with disability.MethodsA longitudinal study developed via a collaborative partnership between peer-support workers with lived experience of spinal cord injury (SCI) and university researchers was undertaken to fill knowledge gaps around factors promoting resilience for people with SCI during two periods of stringent social distancing restrictions within Victoria, Australia. Over 12-months, participants with SCI completed two surveys, towards the end of two lockdown periods. Evidence-based factors associated with resilience were measured. The Impact on Participation and Autonomy Questionnaire, the International SCI Quality of Life scale, and the 10-item Conor Davidson Resilience Scale, respectively measured autonomy and participation limitations, life satisfaction and psychological health, and resilience. A structural equation modelling (SEM) approach established factors directly and indirectly associated with resilience.ResultsA model with excellent fit was produced. During two extended lockdowns over the 12-month period, increased family role limitations and favourable psychological health were respectively, negatively (Lockdown 1 [n = 127]: β = -.251, p < .01, Lockdown 2: β = -.400, p < .01) and positively (Lockdown 1: β = .601, p < .01, Lockdown 2 [n = 65]: β = .430, p < .01) associated with resilience. Indirect negative associations between resilience and increased outdoor autonomy limitations (Lockdown 1: β = -.195, p < .01, Lockdown 2: β = -.255, p < .01) and social life limitations (Lockdown 1: β = -.217, p < .01, Lockdown 2: β = -.142, p < .05) existed, and these relationships were moderated by psychological health.ConclusionsPsychological health, and participation and autonomy are determinants of resilience during periods of crisis. Health and social care providers and public health departments should prioritise programs promoting these domains, to counter the negative impact of social distancing.

Changes on clinical and participatory outcomes in people with severe-to-profound hearing loss after cochlear implantation: protocol of a multicentre prospective observational cohort study – Societal Merit of Intervention on Hearing Loss Evaluation (SMILE)

IntroductionCochlear implantation (CI) is a (cost-)effective intervention for people with severe or profound hearing loss. Since its introduction experience increased and the technology evolved, leading to better results and relaxation...

Learner autonomy and English achievement in Chinese EFL undergraduates: the mediating role of ambiguity tolerance and foreign language classroom anxiety

Abstract For Chinese EFL students, learning English has always been a great challenge, and research has shown that cognitive and affective factors increasingly become important issues in the field of foreign language learning and teaching (Naderifar and Esfandiari 2016). This study is designed to investigate the relationship between learner autonomy, ambiguity tolerance, foreign language classroom anxiety (FLCA) and English achievement. It also explores the inner mechanism of the relationship between learner autonomy and English achievement in Chinese EFL undergraduates. A sample of 291 third and fourth grade undergraduates in China was assessed for their levels of learner autonomy, ambiguity tolerance and foreign language anxiety using the Learner Autonomy Questionnaire (LAQ), Second Language Tolerance of Ambiguity Scale (SLTAS) and Foreign Language Classroom Anxiety Scale (FLCAS), respectively. Participants’ scores of the College English Test Band Four (CET-4) were used to measure their achievement in English. The results revealed a link between learner autonomy, ambiguity tolerance, FLCA, and English achievement. Ambiguity tolerance and FLCA mediated the relationship between learner autonomy and English achievement, accounting for 36.58 % of the total effect. These findings suggest a process through which ambiguity tolerance can decrease FLCA and identify the mediating effects of ambiguity tolerance and FLCA in the relationship between learner autonomy and English achievement in Chinese EFL undergraduates. Pedagogical implications of the study are presented and discussed.

The effect of collaborative activities on tertiary-level EFL students’ learner autonomy in the Turkish context

Abstract This quasi-experimental study investigates the effects of collaborative activities on tertiary-level EFL students’ learner autonomy in Turkey. To achieve this aim, both quantitative and qualitative data were collected with the help of a learner autonomy questionnaire, index cards filled out by the students, the instructor’s journal, and an interview with the instructor of the experimental group. Two groups of 40 students in total from the preparatory program of a central Anatolian university were appointed as experimental and control groups. The results of the quantitative data analysis revealed that, after the implementation of collaborative activities in three consecutive weeks, there was a statistically significant difference between the groups in terms of their autonomy level; the students in the experimental group scored higher than those in the control group, which implies that they showed more autonomous skills in areas such as motivation, curiosity to learn, risk-taking, problem solving and decision making skills to improve learning. The results of the qualitative data analysis revealed that collaborative activities employed in this study (e.g., problem-solving activity, role-play, games) allowed participants to learn from each other, and gain a sense of responsibility. The overall results suggested that collaborative learning practices could be implemented to help EFL students increase their learner autonomy level. Additionally, curriculum and assessment methods of educational institutions might be revised to include more collaborative activities.