PROCESS Macro Research Articles

Leader–Member Exchange (LMX) and Adjustment to the Work Mode as Protective Factors to Counteract Exhaustion and Turnover Intention: A Chain Mediation Model

In the context of the New Normal and the VUCA (volatile, uncertain, complex, ambiguous) era, organisations face adjustments to the changes brought by the COVID-19 pandemic, especially the shifting to new work modes and configurations with their consequences on employees’ wellbeing, in terms of exhaustion, resignation, and quitting tendencies. This study, rooted in the psychology of sustainability and sustainable development, employs a primary prevention perspective to examine a relational factor, the leader–member exchange (LMX), which might shield employees from exhaustion and turnover intention. Specifically, we propose a double-chained mediation model to investigate how high-quality LMX fosters a positive adjustment to employees’ specific work modes, in-person or hybrid work, subsequently reducing employees’ feelings of exhaustion and their intentions to leave the organisation. A convenience sample of 257 Italian employees participated in this study by completing an online self-report survey. Hypotheses were tested using the PROCESS macro in SPSS 25.0 (Model 6). The results indicate that positive LMX and adjustment to the work mode reduce exhaustion and turnover intention; furthermore, they highlight the existence of a more complex dynamic linking LMX to turnover intention through a double-chained mediation of adjustment to the work mode and exhaustion. Indeed, higher LMX quality favours adjustment to the work mode, decreasing employees’ feelings of exhaustion and, in turn, their turnover intention. Specifically, the findings of this study add a novel contribution to the literature on the psychology of sustainability and sustainable development by emphasising the significance of positive LMX in becoming a factor of wellbeing and sustainability in the workplace through the promotion of the adjustment to both in-person and hybrid work modes. Organisations may benefit of this approach to LMX that, through the consideration of employees’ needs, may favour their adjustment to different work modes, thus becoming a sustainable LMX, and a promoter of employees’ wellbeing and retention.

Role of transformational leadership in implementation of Education 4.0: a parallel mediation model in context of higher educational institutions (HEIs)

Purpose Transformational leadership has attained immense attraction in contemporary research for its positive contribution in implementation of Education 4.0. Drawing on social bond theory and employee stewardship theory, this study aims to examine the mediating roles of employee engagement and organisational citizenship behaviour between transformational leadership and Education 4.0 in higher educational institutions. Design/methodology/approach Data was collected through survey questionnaire by using three-wave time lagged study design from regular faculty members of Indian higher educational institutions. Hayes Process Macro was used for testing the parallel mediation model. Findings Transformational leadership has a positive and significant impact on Education 4.0. The results of this study indicate that employee engagement and organisational citizenship behaviour partially mediate the relationship between transformational leadership and Education 4.0. Furthermore, the analysis explains that employee engagement and organisational citizenship behaviour leveraged under transformational leadership act as parallel mediators, and there is no statistical difference between them. Originality/value To the best of the authors’ knowledge, this study is first in itself to consider more than one factor influencing the relationship between transformational leadership and Education 4.0, thus making ground for parallel mediation. This study addresses the urgent call by United Nations for achieving Sustainable Development Goals (SDGs) by ensuring quality education (SDG 4) and reducing inequality (SDG 10), thereby giving peaceful and strong intuitions (SDG 16).

Long and short sleep durations can affect cognitive function in older adults through the chain mediation effect of ADL and depression: evidence from CHARLS2018

BackgroundBoth long and short sleep durations may lead to cognitive decline in the elderly individuals, though the underlying mechanisms remain unclear.AimsTo explore the mediating mechanism of activities of daily living and depression on different sleep durations and cognitive function in older Chinese older adults.MethodsThis retrospective study used data from 5,899 older adults who completed the 2018 China Health and Retirement Longitudinal Surveys. We used the PROCESS macro in SPSS to determine the chain mediating effect of ADL and depression on the relationship between different sleep durations and cognitive functions.Results(1) There were significant correlations among sleep duration, ability to perform ADL, depression, and cognitive function. (2) For sleep durations ≤ 7 h/night or > 7 h/night, ADL and depression play a chain mediating role in the relationship between sleep duration and cognitive function.ConclusionsShorter or longer sleep durations were associated with cognitive decline by weakening ADL and worsening depression, which suggests that medical personnel should take action to correct abnormal sleep duration in older adults. Timely treatment of ADL impairment and depression may help prevent cognitive decline.

Beyond usability: innovation in the digital age as an antidote to social isolation

The study's objective: The article aims to evaluate the impact of life satisfaction during the COVID-19 pandemic in Brazil, considering the perception of usability of intelligent personal assistants (IPAs) and investigating possible moderations of consumer innovation dimensions in this relationship. Methodology/Approach: Field research was carried out with 515 users of intelligent personal assistants (IPAs). The results were analyzed using multiple linear regression, using the SPSS software (Statistical Package for Social Science v.22), with the application of the PROCESS macro. Originality/Relevance: This study contributes to filling a gap in the literature on the diffusion of innovation and adoption of technological products by investigating aspects of innovative consumption in a pandemic and social isolation scenario. Main Results: The research results indicate that domain-specific innovativeness (DSI) moderates the relationship between usability (SUS) and life satisfaction (LS). In contrast, innovativeness behavior (IB) moderates this relationship only with DSI maintained at medium and low levels. It was observed that, with greater usability, life satisfaction increases and is moderated by domain-specific innovativeness. For higher IB levels, LS increases more quickly. Theoretical/Methodological Contributions: Integrating concepts from theories of innovative consumption and diffusion of innovations, the study offers insights into how technology affects well-being in a global crisis. This advanced approach helps understand the mechanisms underlying the impacts of usability and innovation on human behavior. Social/Managerial Contributions: This study helps understand how IPA users can experience greater life satisfaction and social isolation during a pandemic.

The Effect of Mothers Self-Efficacy on Self and Their Child Psychological Well-Being

Mother self-efficacy has been known as a key factor in promoting healthy functioning for mothers and their children. However, no study has ever explained causal relationship between mother's self-efficacy mediated by psychological wellbeing that explain the effects on child psychological wellbeing. Therefore, the present study aims the causal relationship between mother self-efficacy and child psychological wellbeing mediated by psychological wellbeing of female teachers in Jalalabad city in Afghanistan. The study participants included 250 mothers and 250 of their children who were selected by purposeful sampling. The Questionnaires for mothers used in this study were: Psychological Well-Being and Parental selfefficacy. Children also completed the Psychological Well-Being. Methods for analysing the data were: Bivariate correlation analysis, structural equation modelling for model fit indices and direct effect of the variables and process macro bootstrapping for the indirect effect of the variables. The findings of this research showed the designed model had an excellent model fit. The direct path between mother self-efficacy with mother psychological well-being and children psychological well-being were positive and significant, and between mother psychological well-being and children psychological well-being was positive and significant as also this research showed the indirect effects of mother self-efficacy mediated by mother psychological wellbeing on children psychological wellbeing is positive and significant. The results suggested that in order to increase child psychological well-being, women should become more familiar with their maternal belief in their ability to influence their child in a healthy and success-promoting manner.

부모의 부정적 양육태도가 청소년의 사이버 비행에 미치는 영향: 그릿과 공격성의 이중매개효과

Objectives The purpose of this study is to examine the dual mediating effects of grit and aggression on the relationship between adolescents’ perceptions of negative parenting attitudes and cyber delinquency. Methods The data were drawn from 2,590 first-year middle school students participating in the 2018 Korean Children and Youth Panel Survey (KCYPS 2018) conducted by the National Youth Policy Institute of Korea. Descriptive statistics were analyzed using SPSS 25.0, and Pearson's correlation analysis was conducted to examine the relationships between variables. To verify the dual mediation effects of grit and aggression on the relationship between negative parenting attitudes and cyber delinquency, Hayes’ (2022) PROCESS Macro 4.0, model 6, was used. Results First, the correlation analysis revealed that negative parenting attitudes, as perceived by adolescents, negatively influenced grit and positively influenced aggression and cyber delinquency. Grit negatively affected both aggression and cyber delinquency, while aggression positively influenced cyber delinquency. Second, grit and aggression were found to have significant mediating effects on the relationship between negative parenting attitudes and cyber delinquency. Lastly, grit and aggression demonstrated significant dual mediating effects in this relationship. Conclusions These findings underscore the importance of improving parenting attitudes to prevent cyber delinquency among adolescents. Additionally, the study highlights the need for educational intervention programs aimed at fostering grit and reducing aggression to support the healthy development of adolescents.

부모의 성취압력과 진로성숙도의 관계에서 자율성의 매개효과와 학업수행능력의 조절효과

Objectives The purpose of this study is to discuss implications for improving the career maturity of children and adolescents by confirming the mediating effect of the child's level of autonomy and the moderating effect of academic performance in the relationship between parental achievement pressure and career maturity. Methods The study utilized data from the 12th (2019) and 13th (2020) waves of the Korean Children Panel Survey, with a total of 1,187 participants. The data were analyzed using SPSS 26 software, including reliability analysis, frequency analysis, descriptive statistics, and correlation analysis. Additionally, the PROCESS macro was employed to analyze the research model, specifically the 4th mediation model and the 7th moderated mediation model. Results First, parental achievement pressure had a negative impact on children's autonomy and career maturity, and autonomy had a positive impact on career maturity. Second, parental achievement pressure had a negative impact on career maturity through the mediating effect of children's autonomy. Third, a significant moderating effect of academic performance was found in the relationship between parental achievement pressure and children's autonomy. In other words, academic performance enhanced the negative impact of parental achievement pressure on autonomy. Fourth, the controlled mediating effect by academic performance ability was significant, and it was confirmed that the higher the academic performance ability, the stronger the negative mediating effect of achievement pressure on career maturity through autonomy. Conclusions Based on the analysis results, this study suggests that parents need the right parenting attitude to improve their career maturity, that supporting autonomy is helpful, and that effective parenting methods can vary depending on individual characteristics such as academic performance. In addition, the direction of follow-up research was suggested, such as comparative analysis of the effects of parenting methods according to individual characteristics, achievement pressure through qualitative research, and in-depth analysis of autonomy.

Exploring the influence of green inclusive leadership on green creativity: examining the underlying mechanisms

PurposeThis study aims to explore the impact of green inclusive leadership (GIL) on green creativity (GCRY) within the context of higher education institutions (HEIs) in China. Specifically, it aims to examine the mediating roles of green intrinsic motivation (GIM), environmental knowledge (EK) and green thinking (GT) according to the componential theory of creativity (CTC).Design/methodology/approachThe study employed a series of questionnaire surveys to collect data at three different time points from various sources. A total of 583 leader-faculty matched samples were obtained from two universities in China. The hypothesized relationships were tested using PROCESS macro in SPSS.FindingsThe findings indicate a beneficial influence of GIL on GCRY, mediated by GIM, EK and GT. Noteworthy interaction effects were observed, with GIM fostering EK and GT, and EK laying the groundwork for GT.Practical implicationsThis research contributes to the existing literature by confirming the implementation of GIL and supporting the CTC, offering insights into the motivational processes driving GCRY and with practical implications discussed for the effective management of GIL and GCRY in higher education settings.Originality/valueThe novelty of this research model lies in its operationalization of environmental sustainability within the CTC. This study is the initial investigation highlighting the role of GIL in fostering GCRY within HEIs. The key contribution of the study is the investigation of GIM, EK and GT as potential mediators in the relationship between GIL and GCRY. This expands the theoretical boundaries of the CTC framework.

The Impact of Comment Slant and Comment Tone on Digital Health Communication Among Polarized Publics: A Web-Based Survey Experiment.

Public attitudes toward health issues are becoming increasingly polarized, as seen in social media comments, which vary from supportive to oppositional and frequently include uncivil language. The combined effects of comment slant and comment tone on health behavior among a polarized public need further examination. This study aims to examine how social media users' prior attitudes toward mask wearing and their exposure to a mask-wearing-promoting post, synchronized with polarized and hostile discussions, affect their compliance with mask wearing. The study was a web-based survey experiment with participants recruited from Amazon Mechanical Turk. A total of 522 participants provided consent and completed the study. Participants were assigned to read a fictitious mask-wearing-promoting social media post with either civil anti-mask-wearing comments (130/522, 24.9%), civil pro-mask-wearing comments (129/522, 24.7%), uncivil anti-mask-wearing comments (131/522, 25.1%), or uncivil pro-mask-wearing comments (132/522, 25.3%). Following this, the participants were asked to complete self-assessed questionnaires. The PROCESS macro in SPSS (model 12; IBM Corp) was used to test the 3-way interaction effects between comment slant, comment tone, and prior attitudes on participants' presumed influence from the post and their behavioral intention to comply with mask-wearing. Anti-mask-wearing comments led social media users to presume less influence about others' acceptance of masks (B=1.49; P<.001; 95% CI 0.98-2.00) and resulted in decreased mask-wearing intention (B=0.07; P=.03; 95% CI 0.01-0.13). Comment tone with incivility also reduced compliance with mask-wearing (B=-0.44; P=.02; 95% CI -0.81 to -0.07). Furthermore, polarized attitudes had a direct impact (B=0.86; P<.001; 95% CI 0.45-1.26) and also interacted with both the slant and tone of comments, influencing mask-wearing intention. Pro-mask-wearing comments enhanced presumed influence and compliance of mask-wearing, but incivility in the comments hindered this positive impact. Antimaskers showed increased compliance when they were unable to find civil support for their opinion in the social media environment. The findings suggest the need to correct and moderate uncivil language and misleading information in online comment sections while encouraging the posting of supportive and civil comments. In addition, information literacy programs are needed to prevent the public from being misled by polarized comments.

The effect of neuroticism on mobile phone addiction among undergraduate nursing students: a moderated mediation model

BackgroundMobile phone addiction (MPA) has numerous deleterious effects on college students, including depression, anxiety, cognitive impairments, and sleep disorders. Undergraduate nursing students play a crucial role as a significant reserve workforce in clinical nursing practice, and their compromised mental health status significantly influences the quality of nursing work and nurse-patient relationships in the future.ObjectivesThis study aims to investigate the associations between neuroticism and MPA among undergraduate nursing students, the mediating effect of self-control and the moderating effect of psychological capital.MethodsA total of 900 undergraduate nursing students participated in the survey, wherein the Eysenck Personality Questionnaire Short Form Scale China Version-Neuroticism Subscale (EPQ-RSC-N), Self-Control Scale (SCS), Positive Psychological Capital Questionnaire (PPQ), and Mobile Phone Addiction Tendency Scale (MPATS) were employed for assessment. To analyze the available data, various statistical methods were utilized, including common method bias test examination, descriptive statistics, chi-square tests, independent samples t-tests, Pearson’s correlation analyses, as well as the Hayes’ PROCESS Macro models 4 and 14.Results(1) The prevalence of MPA in this study was found to be 34.89%. (2) The MPA was positively correlated with neuroticism (r = 0.287, p < 0.001), and was negatively correlated with self-control (r = -0.467, p < 0.001) and psychological capital (r = -0.260, p < 0.001). (3) Self-control played a partially mediating role in the association between neuroticism and MPA, with an effect size of 0.151, accounting for 52.98% of the total effect. (4) Psychological capital played a moderating role in the association between self-control and MPA. More specifically, with an increase in the level of psychological capital increases, the predictive effect of self-control on MPA gradually strengthens (β = -0.072, SE = 0.019, t = -3.708, p < 0.001).ConclusionThe prevalence of MPA was relatively high among undergraduate nursing students, with neuroticism exerting a direct influence on it. Self-control served as a mediating factor that could partially alleviate MPA associated with neuroticism. Psychological capital has the ability to regulate the relationship between self-control and MPA. Therefore, enhancing self-control capabilities and cultivating psychological capital levels can effectively manage MPA among undergraduate nursing students.

대학생의 완벽주의적 자기제시가 학업지연행동에 미치는 영향: 실패공포를 통한 인정욕구의 조절된 매개효과

Objectives The purpose of this study is to verify the mediating effect of the desire for recognition through fear of failure in the relationship between perfectionist self-presentation and academic delay behavior in college students. Methods For this purpose, an online survey was conducted on 252 four-year college students nationwide from December 20, 2023, to January 20, 2024, and Process Macro Model 4 of the SPSS 28.0 program was applied to verify the mediating effect of fear of failure in the relationship between perfectionist self-presentation and academic delay behavior, and Model 14 was applied to verify the controlled mediating effect of the need for recognition. Results The main results of analyzing the collected data are as follows. First, it was found that there was a significant positive correlation between perfectionist self-presentation, fear of failure, academic delay behavior, and desire for recognition. Second, as a result of analyzing the mediating effect of fear of failure in the path of perfectionist self-presentation to academic delay behavior, it was found that fear of failure completely mediated perfectionist self-presentation and academic delay behavior. Third, it was found that the desire for recognition had a moderating effect in the relationship between fear of failure and academic delay behavior. Conclusions Perfectionism self-presentation affects academic delay behavior through fear of failure, and this effect can be controlled through the desire for recognition. In other words, in the case of clients with high perfectionism self-presentation, it suggests that the intervention using the desire for recognition along with the intervention for fear of failure can be effective in alleviating academic delay behavior.

대학생의 셀프리더십과 학습몰입 간의 관계: 자기주도학습능력의 매개효과

Objectives The purposes of this study were to investigate the effect of self-leadership on learning flow of college students and to verify the mediating effect of self-directed learning. Methods Data was collected from 166 college students from nation-wide universities using survey. Mediating effect was verified through stepwise regression analysis using SPSS 29.0 and Process macro v4.0. And also, the significance of indirect effect was verified through bootstrapping test. Results The results of this study are as follows. self-leadership showed positive relationship with self-directed learning and learning flow. And also, self-directed learning showed positive relationship with learning flow. Mediating effect of self-directed learning for the effect of self leadership on learning flow showed partial mediating effect. Conclusions As a result, it was verified that higher self-leadership makes effect on learning flow of college students, self-directed learning can play a role in the alteration of learning flow as a partial mediator, and can serve as initial data of preventive and counseling intervention.

상담자의 전문직 정체성과 자기효능감이 소진에 미치는 영향: 수퍼비전 작업동맹의 조절된 매개효과

Objectives This study examined the mediating effect of counselor self-efficacy on the relationship between counselor professional identity and burnout and whether this mediating effect is moderated by the level of supervisory working alliance. Methods An online survey was conducted with a total of 421 counselors across country, and the data were analyzed with SPSS 26.0 and SPSS Process Macro. Descriptives, bivariate correlation, hierarchical multiple regression for mediation analysis and moderation analysis were conducted. Results First, counselor self-efficacy partially mediated the relationship between counselor professional identity and burnout. Second, the relationship between counselor professional alliance and self-efficacy was moderated by supervisory working alliance. Third, the mediation effect of counselor self-efficacy on the relationship between counselor professional identity and burnout was significantly differed by the level of supervisory alliance. Conclusions Based on the results, the moderated mediation effect of supervisory working alliance was found when counselor professional identity influenced burnout through counselor self-efficacy. This finding highlights the importance of counselor supervisory working alliance for preventing counselor burnout through promoting counselor professional identity and self-efficacy. Implications, limitations, and suggestions for future research are discussed.

부모의 부정적 양육태도와 청소년 학업 무기력의 관계: 스마트폰 과의존과 자아존중감의 조절된 매개효과

Objectives This study aimed to examine whether smartphone overdependence mediates the relationship between negative parenting attitudes and academic helplessness, and wthether self-esteem moderates this relationship. Methods The analysis was conducted using data from the 5th wave (2022) of the ‘Korean Children and Youth Panel Survey 2018(KCYPS 2018)’ focusing on 8th-grade students, as investigated by the National Youth Policy Institute. The study utilized SPSS 27.0 and SPSS Macro Process to examine descriptive statistics, correlation analysis, reliability analysis, mediating effects, moderating effects, and moderated mediation effects regarding negative parenting attitudes, academic helplessness, smartphone overdependence, and self-esteem. Results The research findings are as follows: First, negative parenting attitudes were positively correlated with academic helplessness and smartphone overdependence, and negatively correlated with self-esteem. Second, a partial mediating effect of smartphone overdependence was identified in the relationship between negative parenting attitudes and academic helplessness. Third, the moderating effect of self-esteem was observed in the influence of negative parenting attitudes on smartphone overdependence. Fourth, a moderated mediation effect of smartphone overdependence and self-esteem was identified in the relationship between negative parenting attitudes and academic helplessness. Conclusions This study examined the impact of negative parenting attitudes on adolescents’ academic helplessness and smartphone overdependence, highlighting the protective role of self-esteem and emphasizing the need for support for adolescents. Based on the findings the significance of the study was discussed, along with its limitations and suggestions for future research directions.

대학생의 학습역량과 진로준비행동 간의 관계에서 대학생활적응과 진로탐색행동의 순차적 매개효과

Objectives Career development and career preparation during university are major concerns and essential processes for undergraduate students. Therefore, this study aims to explore the relationship between university students' career preparation behavior and factors such as cognition, environment, and behavior. With this study, the author proposes educational support from universities and effective educational strategies to enhance career preparation behavior. The study analyzes the sequential mediating effects of adjustment to college and career exploration behavior in the relationship between learning competence and career preparation behavior among university students. Methods A survey was conducted with 281 university students in Busan, using scales measuring learning competence, adjustment to college, career exploration behavior, and career preparation behavior. The collected data were analyzed using SPSS and Macro PROCESS for reliability testing, correlation analysis, multiple regression analysis, and bootstrapping to verify the mediating effects. Results First, significant correlations were found among learning competence, adjustment to college, career exploration behavior, and career preparation behavior. Second, the sequential mediating effects of adjustment to college and career exploration behavior were significant in the relationship between learning competence and career preparation behavior. Conclusions The findings of this study suggest that to enhance university students' career preparation behavior, it is important to develop and accumulate learning competence during the college years, which fosters better adjustment to college and promotes career exploration behavior. Step-by-step and integrated support in learning competence, environmental, and behavioral aspects is necessary to implement students' career preparation behavior effectively.

Don’t let your customers slip away: exploring the impact of perceived firm innovativeness on customer’s switching intention in transitioning market

Purpose The purpose of this study is to examine customer switching behavior in transitioning market structure. Drawing upon stimulus-organism-response theory, this study explores the impact of perceived firm attributes on customer switching intention, examines the mediating role of customer satisfaction in this dynamic and assesses the moderating effects of relationship depth and switching cost. Design/methodology/approach This study used a cross-sectional research design and a quantitative research approach. Data was collected through surveys from a conveniently selected sample of 380 telecom service users. The collected data were analyzed using confirmatory factor analysis to validate the measurement model and PROCESS macro models 2, 4 and 10 to test the hypothesized relationships. Findings The findings confirmed that perceived firm innovativeness significantly influences customer switching intention. In addition, customer satisfaction mediates the relationship between firm innovativeness and switching intention, while perceived switching costs and relationship depth moderate this relationship. Practical implications The findings highlight how perceived firm innovation shapes customer switching intentions, suggesting that firms can reduce switching by investing in innovation and managing switching costs and relationships effectively. Originality/value This study provides unique insights by examining firm innovativeness from the customer’s perspective and analyzing its impact on switching behavior within a transitioning market.

A committed brand facing moral dilemma crises: the role of inferred goodwill and self-brand connection in consumer regret

Purpose In an era of blurred moral boundaries, brands face “moral dilemma crises”, which are distinguished from traditional crises. Based on expectancy violations theory, this study aims to explore how consumers interpret (inferred goodwill) and evaluate (consumer regret) the precrisis committed brands, reinforced by corporate ability and responsibility (expectancies) during moral dilemma crises and whether self-brand connection moderates this relationship. Design/methodology/approach The main study used a scenario-based online survey with a purchased beauty brand, analyzed via structural equation modeling and PROCESS macro, to examine the effects of corporate ability and responsibility on regret, mediated by inferred goodwill and moderated by self-brand connection. A validation study with a fictitious brand used an online experimental design, analyzed with t-tests and ANCOVAs. Findings When corporate ability and corporate responsibility are considered together, corporate ability negatively impacts inferred goodwill (boomerang effect), whereas corporate responsibility positively impacts inferred goodwill (buffering effect). Inferred goodwill acts as a mediator that reduces regret. The negative impact of corporate ability on inferred goodwill and regret becomes stronger among consumers with strong self-brand connections. However, self-brand connection does not moderate the relationship between corporate responsibility and inferred goodwill. Originality/value This research extends the application of expectancy violations theory to moral dilemma crises, differentiates between the effects of corporate ability and responsibility, highlights the role of inferred goodwill and regret and explores the moderating effects of self-brand connection, providing tailored insights for brand management.

Abstract 4123886: Health Disparities in Quality of Life Among Black Patients with Heart Failure: The Roles of Depressive Symptoms and Functional Status

Background: Black patients with heart failure (HF) have a higher physical and psychological distress which disproportionately worsens their health and quality of life (QOL) than those from other racial/ethnic groups. Black patients less commonly receive optimal therapy for HF than white patients, which can result in poorer functional status. Black patients report higher levels of depressive symptoms. Higher levels of depressive symptoms can further worsen functional status and lower QOL. Hypothesis: We hypothesized that depressive symptoms would predict QOL in Black patients with HF and that this relationship would be mediated by functional status. Methods: Using the RICH Heart Program HF Database, we included all 226 Black patients (57±12 years old, 49% male) with HF, who completed the Patient Health Questionnaire-9 to measure depressive symptoms, the Duke Activity Status Index for functional status, and the Minnesota Living with Heart Failure Questionnaire for QOL. Mediation analysis was performed using the PROCESS macro. Results: Depressive symptoms were directly associated with QOL (effect coefficient [c’] =2.386, 95% confidence interval [CI] = 2.549, 3.450). There was a significant indirect effect of depressive symptoms on QOL mediated by functional status (ab=0.614, 95% CI [0.406, 0.856]). Those with worse depressive symptoms had lower functional status (a = -0.901, p&lt; 0.001), in turn, lower functional status was associated with worse QOL (b = -0.681 p&lt;0.001). Conclusions: Depressive symptoms are directly associated with QOL and there also is an indirect association, mediated by functional status in Black patients with HF. Inequities in the management of HF among Black patients that contribute to these findings must be explored as the causes of the disparity in depressive symptoms are not yet known.

Influence of perceived stress on professional identity among nursing students: a chain mediating role of self-control and self-directed learning ability.

A positive professional identity is key for nursing students in determining career direction and predicting future engagement in the profession. Despite its complexity and susceptibility to various influences, the factors shaping nursing students' professional identity remain poorly understood. This study aims to investigate how perceived stress can directly and indirectly influence professional identity among nursing students, with self-control and self-directed learning ability as mediators. A cross-sectional survey was conducted from October to December 2023, collecting data from 675 nursing students across five tertiary hospitals in Xi'an, Shaanxi Province, China. The survey captured detailed data on sociodemographic characteristics, perceived stress, self-control, self-directed learning ability, and professional identity among the participants. Descriptive analysis and correlation matrices were used to analyze participant characteristics and assess bivariate correlations. The mediation model was analyzed using the PROCESS macro for SPSS. Perceived stress showed a direct and negative influence on professional identity among nursing students; self-control was shown to play a mediating role between perceived stress and professional identity; self-directed learning ability was shown to play a mediating role between perceived stress and professional identity; and self-control and self-directed learning ability were shown to play a chain mediating role between perceived stress and professional identity. Self-control and self-directed learning ability have a chain mediating role in between perceived stress and professional identity among nursing students. It suggests that nursing managers and educators can improve the self-control and self-directed learning ability of nursing students to mitigate the negative impact of perceived stress on professional identity.

Sequential Dual Mediating Effects of Smartphone Dependence and Aggression on the Relationship Between Negative Parenting Attitudes and Depressive Symptoms Among Adolescents

ABSTRACTThis study examined the sequential dual mediating effects of negative parenting attitudes, smartphone dependence and aggression on depressive symptoms among adolescents. Data were obtained from the 2018 Korean Children and Youth Panel Survey (KCYPS) conducted by the National Youth Policy Institute. Using a multistage stratified cluster sampling method, the 2018 KCYPS comprehensively examined various aspects of the growth and development of children and adolescents. The study sample included a nationally representative sample of 2541 adolescents. PROCESS macro Model 6 was used to examine the sequential dual mediating model that not only examines the effects of negative parenting attitudes on smartphone dependence and aggression but also establishes the sequential causal relationship between smartphone dependence and aggression, ultimately confirming the direct and indirect effects on depressive symptoms of adolescents. The significance of the mediation effect was verified by applying the bootstrapping method. The findings demonstrated that negative parenting attitudes increased smartphone dependence, which, in turn, elevated depressive symptoms among adolescents. Furthermore, negative parenting attitudes increased smartphone dependence, which heightened aggression, ultimately contributing to depressive symptoms among adolescents. Based on these findings, this study has practical and policy implications for preventing depressive symptoms among adolescents. Prioritizing efforts to reduce smartphone dependence and aggression among adolescents while promoting positive parenting attitudes can play a crucial role in addressing this issue.