Higher Self-efficacy Scores Research Articles

Investigating the learning self-efficacy of a fully online teaching environment among undergraduate Chinese medical students: a cross-sectional study

BackgroundFully online learning has become a common option in many universities worldwide in the post-COVID-19 era. The study aimed to evaluate the dimensions and characteristics of the fully online learning self-efficacy among Chinese undergraduate medical and nonmedical students.MethodsA cross-sectional study was conducted from January to August 2023 at Xihua University in China. A stratified cluster sampling method was used to enroll participants of undergraduate students. The Chinese version of the online learning self-efficacy scale (OLSES) was used to collect the demographic information. Cronbach’s alpha coefficient, exploratory factor analyses, confirmatory factor analyses, and linear regression analyses were conducted in the study.ResultsA total of 203 college students were included in the study. One hundred and twenty (59.1%) of the participants were medical students and 83 (40.9%) were nonmedical students, and most of them (64.5%) were from rural areas. The Cronbach’s alpha coefficients were determined to be 0.90, 0.86, 0.87, and 0.95 for the learning in a fully online environment, time management, technology use subscales, and the whole scale, respectively. Exploratory factor analysis revealed the justifiability of factor analysis. In the confirmatory factor analysis, the majority of the goodness-of-fit indices reached an acceptable threshold (χ2/df = 3.14, RMR = 0.06, RMSEA = 0.10, NFI = 0.84, RFI = 0.80, IFI = 0.89, TLI = 0.85, CFI = 0.90). More than half of the students reported insufficient self-efficacy for learning in a fully online environment and time management, whereas 55.7% showed good self-efficacy for technology use. Although more medical students than non-medical students had higher self-efficacy scores in the three domains of self-efficacy, the proportion of students with good self-efficacy was slightly lower among medical students than non-medical students, with no significant differences between the medical students and nonmedical students.ConclusionsMost Chinese university students’ that participated to our study found self-efficacy for fully online learning as insufficient (results on the three domains, ranging from 36.5 to 55.7%) and had a good level of fully online learning self-efficacy. Medical students and nonmedical students are not differences in the self-efficacy of fully online learning. Thus, pedagogues should take measures to help students including medical and nonmedical improve their self-efficacy in online environment learning, time management and technology use, ultimately enhancing their academic success.

Sex-related differences in self-efficacy of patients with heart failure: a pooled cross-sectional study of the German Competence Network Heart Failure.

To assess the level of self-efficacy in patients with heart failure (HF), and identify differences between important subgroups including sex, and to identify the determinants of high self-efficacy. This was a pooled cross-sectional analysis of 2,030 patients from four prospective studies conducted within the German Competence Network Heart Failure. We used the Self-efficacy Subscale and the Overall Summary Score (OSS) of the Kansas City Cardiomyopathy Questionnaire (KCCQ-23) to assess self-efficacy and health-related quality of life. The cut-off of 75 score points was used for the dichotomization into high (≥75) vs low (<75) self-efficacy. Depressive symptoms were measured by the Patient Health Questionnaire (PHQ-9). A total of 1,615 patients with HF provided complete self-efficacy scores: mean age 66.6±12.3 years, 431 (27%) women. Mean self-efficacy was 67.5±24.9, with 907 patients (56.2%) showing high self-efficacy and 708 patients (43.8%) showing low self-efficacy. Men had higher self-efficacy scores than women (68.7±24.5 vs. 64.2±26.0; p=0.001). Multivariable logistic regression identified KCCQ-OSS (OR per 5-point increase 1.08, 95%CI 1.04-1.12), female sex (OR 0.72, 95%CI 0.56-0.94), depressive symptoms (OR per 3-point increase in PHQ-9 0.90, 95%CI 0.83-0.98), and acute HF (0.46, 95% CI 0.34-0.62) as important predictors of high self-efficacy. In patients with HF, women seemed to exhibit lower self-efficacy than men. Health-related quality of life and psychological well-being were dominant determinants of self-efficacy. Future studies should investigate the role of self-efficacy as a therapeutic target for tailored and sex-specific nursing interventions.

The influence of GPs' personal experience on perceived competence in depression management.

Managing depression in general practice is a multifaceted task, influenced by factors such as the condition's characteristics, patient-specific variables, and the personal habits of attending physicians. A study by Dumesnil et al. in France highlighted the impact of GPs' personal experiences with depression on their patient care approaches. This study investigated how the personal experiences of Belgian GPs influence their self-perceived competence in managing patients with depression. This transversal study was conducted through questionnaires distributed in a GP training (2020-2022). Statistical analyses (Chi-square test/multivariate logistic regression) were conducted using STATA-SE 17.0. Out of 325 GPs, 30.46% of GPs had experienced depression and 16.62% had taken antidepressants. After categorisation and adjustment, the personal experience of GPs does not influence self-efficacy in diagnosing and supporting depressed patients. Higher self-efficacy scores were associated with an advanced age (60-64y/o) (aOR:7,9;IC95%), working in a multidisciplinary practice (aOR:3,4), prior training on the issue (aOR:2,1), and male gender (aOR:0,5). GPs with personal experiences of depression (aOR:2,6), advanced age (aOR:4,1) and working in multidisciplinary practices (aOR:3,4) had more appropriate responses to the proposed clinical situations than other groups. This study reveals that the personal experience of depression among GPs does not influence their perceived competencies, contrary to having received prior training on the issue. However, experiencing depression is associated with more appropriate responses to clinical situations. These results are consistent with existing literature regarding socio-demographic factors and practice type. In the future, it is important to consider these factors when developing continuing education programs.

Pharmacists’ awareness and confidence in performing Pharmacists’ Patient Care Process–related activities

BackgroundThe Pharmacists’ Patient Care Process (PPCP) is a 5-step approach for patient-centered evidence-based pharmaceutical care. The PPCP was developed by the Joint Commission of Pharmacy Practitioners in 2014; however, little is known about PPCP terminology and process uptake across the profession. ObjectivesThis study aimed to explore practicing pharmacists’ awareness of and confidence in performing PPCP-related activities in various practice settings. MethodsThis is a cross-sectional observational study of practicing pharmacists using a multiphase quantitative survey research design. A previously validated instrument, the PPCP Self-Efficacy Scale, was revised and distributed. The 28-item instrument addressed activities mapped to each of the 5 PPCP components (Collect, Assess, Plan, Implement, and Follow-Up). The survey was distributed via Qualtrics to an IQVIA pharmacist e-mail listserv in 2021 and to pharmacist state license rosters containing e-mail addresses in 2022. ResultsA total 853 practicing pharmacists completed the survey. Most participants identified as female (62.5%) and white (74.6%). Almost 60% of participants reported practicing for 16 or more years. Forty-four percent practiced in a community pharmacy setting, whereas 23.6% and 15.4% practiced in a health-system setting and ambulatory care setting, respectively. Sixty-two percent indicated they had no previous knowledge of the PPCP, and 12.5% were unsure. Overall participants had relatively high self-efficacy mean scores for each of the PPCP components. Participants working in an ambulatory care setting had the highest mean self-efficacy scores across all PPCP components (P < 0.05). Participants who were affiliated with a college or school of pharmacy (e.g., faculty, preceptor) had higher mean self-efficacy scores than participants who were not affiliated (P < 0.01). ConclusionMost of practicing pharmacists are unaware of PPCP terminology. Their confidence in performing tasks associated with PPCP components is relatively high and varies based on PPCP component and practice setting.

Do Narcissists Play Solo? Differences in Self-Efficacy and Narcissism Among Band and Solo Musicians

The following study focuses on individual differences between musicians who play solo (performing individually or as leaders), and musicians performing as part of a chamber ensemble, band, choir, orchestra, etc. We predicted that soloists would be higher on grandiose narcissism and self-efficacy. The results showed that soloists (n = 59) not only were higher on narcissism, but also had higher self-efficacy scores than musicians who perform in ensembles (n = 65). However, soloist and band players are not different in narcissism and self-efficacy when the other trait is controlled, which indicates that common features of both traits differentiate solo and band musicians. Results raise further questions on what factors affect the development of a musician’s career path.

General self-efficacy, not musculoskeletal health, was associated with social isolation and loneliness in older adults during the COVID-19 pandemic: findings from the Hertfordshire Cohort Study

BackgroundSocial isolation and loneliness are prevalent among older adults. This study investigated factors influencing worsening social isolation and loneliness in community-dwelling older adults during the COVID-19 pandemic, focusing on musculoskeletal conditions, falls, and fractures.MethodsWe studied 153 participants from the Hertfordshire Cohort Study. Baseline assessments (2019–20) included osteoporosis, clinical osteoarthritis, fractures after age 45 years, falls in previous year, and lifestyle factors. Self-efficacy was assessed using a shortened General Self-Efficacy Scale. Social isolation was assessed using the 6-item Lubben Social Network Scale. Follow-up (2020–21) assessments included social isolation and loneliness using the 6-item De Jong-Gierveld scale for emotional, social, and overall loneliness.ResultsBaseline median age was 83.1 years. A history of smoking predicted worsening social isolation (p = 0.046). Being married (p = 0.026) and higher self-efficacy scores (p = 0.03) predicted reduced social isolation at follow-up. Greater alcohol consumption was associated with higher overall loneliness (p = 0.026). Being married was related to a 36% (95% CI: 3%, 58%) reduction in emotional loneliness (p = 0.037). No musculoskeletal condition was associated with social isolation or loneliness. However, we observed a 22% (14%, 30%; p < 0.001) reduction in emotional loneliness and a 12% (4%, 20%; p = 0.003) reduction in overall loneliness per unit increase in self-efficacy score.ConclusionsNo musculoskeletal condition was associated with increased social isolation or loneliness, but longitudinal studies in larger samples are required. Greater self-efficacy was associated with reduced social isolation and reduced loneliness. Interventions promoting self-efficacy in older adults may reduce isolation and loneliness in this age group.

Self-efficacy of medical students in a hybrid curriculum course (traditional and problem-based learning) and associated factors

Self-efficacy consists of the judgment of one’s abilities to perform actions required to achieve a given performance, which has been considered predictive of performance. In academics, it means personal convictions in accomplishing a task to a defined degree of quality. Numerous studies have investigated medical students’ self-efficacy in traditional and PBL curricula. However, few studies have addressed the hybrid PBL scenario (Hpbl) that simultaneously contemplates PBL, traditional teaching, and practical activities. An even smaller number have evaluated the factors associated with this entity. With these considerations, we aimed to investigate the self-efficacy belief in the hPBL curriculum and the factors associated with this entity. This quantitative observational cross-sectional study was held between August 2022 and November 2022 in Fortaleza, a city in Northeast Brazil with almost 3 million inhabitants. The medical course has 12 semesters. The first two semesters use traditional teaching and cover the basic cycle, followed by the third to eighth semesters which correspond to the pre-clinical and clinical cycle. From the third semester onwards, traditional teaching and PBL are used simultaneously, which we call a hybrid model of PBL. The scale “Scale of Self-efficacy in Higher Education” was applied, a questionnaire validated for the Portuguese language consisting of 34 questions, with answers on a Likert-type scale with ten points, divided into five dimensions. To verify the association between sociodemographic factors and self-efficacy, simple and multiple linear models with robust errors were used. In total, 412 students participated in this study, most of them women (70.1%). The average age of students was 22.9 years. All domains had medians greater than 8, which means strong self-efficacy. The following factors were associated with higher self-efficacy scores in general after the multivariate analysis: female gender (8.6 vs. 8.3, p-value = 0.014), working (8.8 vs. 8.5, p-value = 0.019) and participating in extracurricular activities (8.7 vs. 8.1, p-value = 0.019). We conclude that medical students studying in hybrid learning models showed strong levels of self-efficacy. In addition, participating in extracurricular activities was associated with higher self-efficacy scores and males presented lower levels of self-efficacy.

Self-Efficacy in Patients With Hypertension and Their Perceived Usage of Patient Portals.

Self-efficacy in individuals optimizes their hypertension management. Electronic patient portals are being increasingly used to support chronic disease management, as they raise the health literacy of patients and enable them in self-management. However, the association between the use of patient portals and self-efficacy in hypertension management remains unclear. The study aimed to determine the association between self-efficacy among patients with hypertension who are managed in primary care and their demographic characteristics and usage patterns of patient portals. A cross-sectional survey was conducted at a public primary care clinic in urban Singapore. Multi-ethnic adult patients with hypertension were invited to participate in a self-administered electronic questionnaire. Chi-square test was performed for bivariate analysis; adjusted logistic regression models were used for factors with P value <.1. A total of 310 patients (66.8% Chinese, 55.5% males, mean age of 63.1 years) completed the survey. Patient portal users had higher self-efficacy scores than non-users (mean score=63 vs 60, maximum = 80, P = .011). The factors associated with increased patient portal access included younger age <65 years (absolute odds ratio [AOR] = 2.634, 95%CI = 1.432-4.847; P = .002), monthly income >$5000 (AOR = 2.324, 95%CI = 1.104-4.892; P = .026), and post-secondary education level (AOR = 3.128, 95%CI = 1.675-5.839; P < .001). Most patients (93.1%) used the portal to check medical appointments but only1.3% of them used it to record home blood pressure measurements (HBPM). Patient portal usage was associated with higher self-efficacy scores in patients with hypertension. These users were younger, more educated, and earned more than the non-users, but only 1.3% of them used it for HBPM documentation.

Influence of self-efficiency beliefs on the health and well-being of university students in COVID-19.

To analyze general self-efficacy beliefs in university students during the COVID-19 pandemic and their correlation with psychological well-being and anxiety and depressive symptoms. Cross-sectional study, carried out with nursing, medicine and psychology students from a higher education institution in the state of São Paulo, Brazil. The sample consisted of 329 students and data collection took place through a questionnaire and scales, from August to December 2020. Mann-Whitney test and Spearman's correlation coefficient were used for analysis of the variables. Participants' self-efficacy was median (34.3±7.5). Higher self-efficacy scores were correlated with better psychological well-being (p<0.001; r= -0.582) and absence of anxiety (p<0.001) and depressive (p<0.001) symptoms. High self-efficacy beliefs were associated with better mental health outcomes. Strengthening self-efficacy in universities can help improve students' health behaviors and prevent mental illness.

The Baseline Self-Efficacy Scores to Manage Chronic Diseases Amongst Nigerian Patients with Non-Communicable Diseases are Sub-Optimal.

Nigeria is one of the developing countries with a major burden of non-communicable diseases (NCDs) without a disease self-management program in its healthcare system. Thus, this study was aimed to assess the baseline self-efficacy levels of Nigerian patients with chronic NCDs at tertiary level hospitals. This is a cross sectional study of 286 NCD patients attending tertiary level clinics from 26 July to 27 October 2023. Patients were interviewed on a 10 Self-Efficacy to Manage Chronic Disease (SEMCD) item scales that were considered suitable for the Nigerian population. The 10 SEMCD questions covered: (i) Exercise regularly scale, (ii) Help from community, family and friends scale, (iii) Communication with Physician scale, (iv) Manage disease scale and (v) Manage symptom self-efficacy domains. Data were analyzed both descriptively and statistically using Student's t-tests and Chi-square tests as appropriate. The results showed that more female (59.4%) than males (40.6%) attended clinics during the study, and the mean age of the patients did not differ between gender (P > .05). About 40% of all the patients manage their NCDs with medications alone, a trend that is similar in male and female patients (P > .05). While all the patients had a relatively lower self-efficacy scores under regular exercise scale (52%-55%) and manage disease symptoms scale (53%-55%), they tended toward higher self-efficacy scores under getting assistance from community, family, and friends (79%-80%) and communication with attending physicians (81%-85%). It is concluded that Nigeria literate NCD patients registered at tertiary level institution routine clinics are less than optimal in disease self-management care. We recommend that this study population will benefit from introduction and implementation of disease self-management program in the healthcare system.

Disentangling the “crypto fever”: An exploratory study of the psychological characteristics of cryptocurrency owners

Cryptocurrencies are innovative digital assets that became significantly popular in recent years. Despite their popularity, literature about cryptocurrencies is still lacking. Specifically, little is known about the psychological profile of cryptocurrency owners. The present paper aims to investigate the role of financial literacy, self-efficacy, risk tolerance, and impulsivity in cryptocurrency ownership in a representative sample of 1,153 Italian consumers. In particular, a Latent Profile Analysis was performed on cross-sectional data to identify different psychological profiles of consumers, and test which of these profiles is more likely to hold cryptocurrencies. Results indicate the presence of six different psychological profiles and that the psychological profile that best describes those who hold cryptocurrencies is characterized by high levels of financial literacy, risk tolerance, and self-efficacy in investment domains. Instead, a configuration of low financial literacy and high self-efficacy, risk appetite, and impulsivity scores is mostly associated with having owned cryptocurrencies in the past. These findings would suggest that psychological characteristics play a key role in cryptocurrency ownership.

Unlock your creative potential: A creativity course for cultivating creative self-efficacy among undergraduate students in Pakistan

This four-wave longitudinal study entailed fostering creative self-efficacy among Pakistan's undergraduate students through a creativity course: Unlock Your Creative Potential. To ensure its effectiveness, the course was implemented based on various intervention best practices from educational, positive and vocational psychology. The study comprised 162 participants randomly allocated to an intervention (n = 81) and wait-list control (n = 81) group. Results of the growth curve analysis indicated that creative self-efficacy augmented at a greater rate over each time interval between the pretest and follow-up measurement 2 in the intervention group than in the control group. The analysis provided a comprehensive view of the development of creative self-efficacy in the two groups over time. There were significant variations in students' initial status (intercepts) and growth trajectories (slopes). The effect of students' initial creative self-efficacy scores indicated that those having high initial creative self-efficacy scores had a slower increase in linear growth over time than those having low initial creative self-efficacy. The qualitative component also sheds light on the effectiveness of the creativity course, as it provided insights into how participants practised creativity in their academic and personal lives during the eight months after the posttest and what sustained their belief in their creative abilities during this period. The theoretical contribution and practice implications of the findings are discussed in the paper.

Self-Efficacy of Parents of Boys in Sports Clubs on Meal Preparation and Boys' Dietary Intake: A Cross-Sectional Study of Soccer Clubs.

This study examined the relationship between parents' self-efficacy for preparing meals combining the five food groups (grains, fish and meat, vegetables, milk, and fruits) and the dietary intake of their children who were elementary and junior high school students belonging to a sports club. A total of 365 children completed a self-reported dietary intake form, and their parents completed a questionnaire on self-efficacy for preparing meals combining the five food groups. Logistic regression analysis was conducted to assess the relationship between the children's intake of the combined five food groups and parents' self-efficacy score, with frequency of meals combining the five food groups as the dependent variable and the self-efficacy score as the independent variable. In a multivariate logistic regression analysis that was higher self-efficacy scores were associated with a higher frequency of meals that contained all five food groups, with an odds ratio of 1.06 (95% confidence interval: 1.00-1.12; p=0.036). Significant positive correlations were also found between parents' self-efficacy and the number of times children consumed four food types (fish and meat, vegetables, milk, and fruits) at breakfast and three food types (grains, milk, and fruits) at dinner. These findings suggest that parents' self-efficacy for preparing meals combining the five food groups was associated with the number of meals with all five food groups consumed by their children, who were fifth and sixth graders in elementary and junior high school and belonged to sports clubs.

Telehealth Satisfaction in Patients Receiving Virtual Atrial Fibrillation Care: Quantitative Exploratory Study.

Telehealth can optimize access to specialty care for patients with atrial fibrillation (AF). Virtual AF care, however, may not fit with the complex needs of patients with AF. This study aims to explore the correlation among attitudes toward health care technologies, self-efficacy, and telehealth satisfaction as part of the future planning of virtual AF clinic care. Patients with AF older than 18 years from an urban-based, highly specialized AF clinic who had an upcoming telehealth visit were invited to participate in a web-based survey. The survey asked about demographic characteristics; use of technology; general, computer, and health care technology self-efficacy (HTSE) and health care technology attitudes, using a validated 30-item tool; and telehealth satisfaction questionnaire using a validated 14-item questionnaire. Data were analyzed with descriptive statistics, correlational analyses, and linear regression modeling. Participants (n=195 of 579 invited, for a 34% response rate) were primarily older, male, and White, had postsecondary schooling or more, and had high self-reported overall and mental health ratings. A variety of technologies were used in their daily lives and for health care, with the majority of technologies comprising desktop and laptop computers, smartphones, and tablets. Self-efficacy and telehealth satisfaction questionnaire scores were high overall, with male participants having higher general self-efficacy, computer self-efficacy, HTSE, and technology attitude scores. After controlling for age and sex, only HTSE was significantly related to individuals' attitudes toward health care technology. Both general self-efficacy and attitude toward health care technology were positively related to telehealth satisfaction. Consistent with a previous study, only HTSE significantly influenced attitudes toward health care technology. This finding confirms that, in this regard, self-efficacy is not a general perception but is domain specific. Considering participants' predominant use of the telephone for virtual care, it follows that general self-efficacy and attitude toward health care technology were significant contributors to telehealth satisfaction. Given our patients' frequent use of technology and high computer self-efficacy and HTSE scores, the use of video for telehealth appointments could be supported.

Investigation of Special Education Teachers' Technology Integration Self-Efficacy Levels

The aim of this study is to determine the technology integration self-efficacy of special education teachers. Within the scope of the study, it was examined whether the technology integration self-efficacy of special education teachers varies according to gender, professional seniority, in-service training and postgraduate education variables. Two measurement tools, technology integration self-efficacy scale and personal information form, were used in the study. The study was conducted with 206 special education teachers working in public and private special education institutions in different cities in Turkey. The results show that special education teachers' technology integration self-efficacy is at a moderate level. When it was examined whether the technology integration self-efficacy of special education teachers differed according to gender and professional seniority, no significant difference was found in the self-efficacy of the participants according to these two variables. Male special education teachers and those with low professional seniority had high technology integration self-efficacy scores. Finally, in-service training and post-graduate education of teachers appear to be an important factor in their technology integration competencies. Teachers who received in-service training or postgraduate education were found to have a very high level of technology integration self-efficacy perception.

Indonesian Teachers' Self-Efficacy on Implementation Cooperation and Class Management towards Inclusive Education

In inclusive education, teachers' self-efficacy represents their self-assessment of the capability to organize classroom learning with students' various learning needs, including disabilities. The teacher's self-efficacy is observed in three aspects, namely instruction efficacy, collaboration efficacy, and managing behaviour. This study examines the effects of differences in working units, experiences of teaching students with special needs, and teacher training on inclusive education on teacher self-efficacy in the inclusive education context. The participants of this study were 233 teachers, in which most of them were women and had master's degrees. For the data analysis, we used Multi-Variate Analysis of Variance (MANOVA). This study concludes that only the teacher work unit variable induces different teacher self-efficacy scores. Teachers in elementary schools have the highest self-efficacy scores in instruction, collaboration, and managing behaviour efficacy.

Characteristics and health outcomes associated with activation for self-management in patients with non-specific low back pain: A cross-sectional study

BackgroundResearch has shown that the course of non-specific low back pain (LBP) is influenced by, among other factors, patients' self-management abilities. Therefore, clinical guidelines recommend stimulation of self-management. Enhancing patients' self-management potentially can improve patients’ health outcomes and reduce future healthcare costs for non-specific LBP. ObjectivesWhich characteristics and health outcomes are associated with activation for self-management in patients with non-specific LBP? DesignCross-sectional study. MethodPatients with non-specific LBP applying for primary care physiotherapy were asked to participate. Multivariable linear regression analysis was performed to analyze the multivariable relationship between activation for self-management (Patient Activation Measure, range 0–100) and a range of characteristics, e.g., age, gender, and health outcomes, e.g., self-efficacy, pain catastrophizing. ResultsThe median activation for self-management score of the patients with non-specific LBP (N = 208) was 63.10 (IQR = 19.30) points. The multivariable linear regression analysis revealed that higher self-efficacy scores (B = 0.54), female gender (B = 3.64), and a middle educational level compared with a high educational level (B = −5.47) were associated with better activation for self-management in patients with non-specific LBP. The goodness-of-fit of the model was 17.24% (R2 = 0.17). ConclusionsPatients with better activation for self-management had better self-efficacy, had a higher educational level, and were more often female. However, given the explained variance better understanding of the factors that influence the complex construct of self-management behaviour in patients who are not doing well might be needed to identify possible barriers to engage in self-management.

Development of a Measure of Parent Concussion Management Knowledge and Self-Efficacy.

Abstract Assessing parent readiness to support their child's post-concussion management requires valid and reliable measures. Therefore, the objective of this study was to develop and conduct preliminary tests of reliability and validity of survey measures of parent concussion management knowledge and self-efficacy. Additionally, we tested the hypothesis that among parents of youth who had sustained a concussion, higher scores on measures of knowledge and self-efficacy would predict greater likelihood of engaging in recommended concussion management behaviors during their child's recovery. Measure development occurred with reference to parenting behaviors included in the Center for Disease Control and Prevention's Pediatric Mild Traumatic Brain Injury (mTBI) Management Guidelines. A multi-stage mixed- methods approach was employed, including expert review, cognitive interviews with parents, quantitative item reduction, and tests of reliability and validity. All participants were English-speaking parents of school-aged children in the United States. A stepwise measure development process was followed, with different participant groups across steps (including opt-in web-based survey panels and in-person recruitment from the population of parents of pediatric patients seen in a large pediatric emergency department). In total, 774 parents participated in study activities. The final knowledge index had 10 items, and the final self-efficacy scale had 13 items across four subscales (emotional support, rehabilitation support, monitoring, and external engagement). Internal consistency reliability was 0.63 for the knowledge index and 0.79-0.91 for self-efficacy sub-scales, and validation tests were in the hypothesized directions. In a test of predictive validity, we observed that among parents of youth patients with recent concussion, higher self-efficacy scores at the time of discharge from the pediatric emergency department were positively correlated (r = 0.12) with greater likelihood of engaging in recommended support behaviors at 2-week follow-up. There was no association between concussion management knowledge at discharge and parenting behaviors at follow-up. Parents have the potential to play an important role in concussion management. The measures of knowledge and self-efficacy developed in this study can help identify parent needs and evaluate interventions aiming to support parenting post-concussion.

Influencing factors analysis of adaptability of cancer patients to return-to-work

To clarify the adaptability of cancer patients to return to work and explore its influencing factors. A cross-sectional study. From March to October 2021, 283 cancer patients in the follow-up period were recruited from the oncology departments of four secondary and above hospitals and cancer friendship associations in Nantong city using self-developed scale of adaptability to return to work for cancer patients by convenience sampling method. The contents included general sociodemographic data, disease-related data, cancer patients' readability to work Scale, Medical Coping Style Questionnaire, Social Support Rating Scale, Family Closeness and Readability Scale, General self-efficacy Scale and Social impact Scale. Paper questionnaires were used for face-to-face data collection, and SPSS17.0 was used for statistical analysis. Univariable analyses and multiple linear regression analysis were conducted. The overall score of cancer patients' adaptability to return to work was (87.05±20.255), (22.54±4.234) for the dimension of focused rehabilitation, (32.02±9.013) for the dimension of reconstruction effectiveness, and (32.49±9.023) for the dimension of adjustment planning. Multiple linear regression analysis showed that the current return to full-time work (β =0.226, P 0.05), the current return to non-full-time work (β =0.184, P 0.05), yield response (β = -0.132, P 0.05), and general self-efficacy (β =0.226, P 0.05) could affect their return to work adaptation. The results of status quo and influencing factors showed that the adaptability of cancer patients to return to work was generally higher in this study. Cancer patients who had participated in work, had lower yield coping scores and stigma scores, and higher self-efficacy scores and family adjustment and intimacy scores had better adaptability to return to work again. It has been approved by the Human Research Ethics Committee of the Affiliated Hospital of Nantong University (Project No.202065).

Evaluating a Telephone and Home Blood Pressure Monitoring Intervention to Improve Blood Pressure Control and Self-Care Behaviors in Adults with Low-Socioeconomic Status.

Hypertension (HTN) affects nearly 75 million in the United States, and percentages increase with low socioeconomic status (SES) due to poor access to, and quality of, care, and poor self-care behaviors. Federally Qualified Health Centers (FQHCs) employ evidence-based strategies, such as telehealth interventions, to improve blood pressure (BP) control in under-resourced communities, yet a southeastern FQHC could achieve a BP control rate of only 27.6%, well below the Health People 2020 goal of 61.2%. This pilot project used a pre/post, matched-cohort design to evaluate the effect of a telehealth intervention on BP control and self-care behaviors. Secondary outcomes included self-efficacy and perceived stress. Frequency and percentage, Wilcoxon signed-rank, and McNemar tests were used for statistical analysis of results from a convenience sample of 27 participants. Baseline HTN management guidance that incorporated home blood pressure monitoring (HBPM) was reinforced through telephone counseling every two weeks. Although BP control was not achieved, average scores for systolic and diastolic blood pressures decreased significantly: 13 mm Hg (p = 0.0136) and 5 mm Hg (p = 0.0095), respectively. Statistically significant differences were also seen in select self-care behaviors. Greater BP reduction aligned with higher self-efficacy scores and call engagement. Overall, telephone counseling and HBPM were feasible and effective in reducing BP and increasing self-care behaviors. The inability to control BP may be attributable to under-recognition of stress, lack of medication adherence/reconciliation, and underutilization of guideline-based prescribing recommendations. Findings elucidate the potential effectiveness of a sustainable telehealth intervention to improve BP in low-SES populations.