Mixed Methods Research Design Research Articles

An inquiry on the psychological well-being of the university students during emergency remote teaching: application of the EMPATHICS model

The current study investigated university students’ well-being during Emergency Remote Teaching (ERT) via EMPATHICS framework in the aftermath of an earthquake that struck the Eastern part of Türkiye. The study had a mixed-methods research design, where quantitative data were analyzed through descriptives of the participants’ overall happiness indices, and qualitative data were analyzed through thematic analysis of those of narrations. Gathered through convenience sampling, the participants were constituted by 18 university students recruited from the department of Foreign Language Education at a state university in Türkiye. The results scrutinized that the participants did not exhibit elevated levels of well-being within the context of ERT. Additionally, the dimensions of the EMPHATICS framework were elaborated in detail to reveal their psychological well-being during ERT, which could also provide pedagogical implications for student well-being and suggestions for further research.

The Mediating Role of Behavioural Intentions on the Relationship between Eco-Friendly Perceptions and Behaviour of Guests in Eco-Rated Camps at the Maasai Mara National Reserve, Kenya

The study sought to establish the mediating role of behavioural intentions on the relationship between eco-friendly perceptions and behaviour of guests in eco-rated camps at the Maasai Mara National Reserve (MMNR) in Kenya. The approach of the study was guided by Theory of Planned Behaviour (TPB) and a pragmatic philosophical position with an embedded mixed methods research design. Based on the visitor arrivals to the MMNR, 208, 620 visitors were targeted for the study from which 399 were selected using clustered, stratified and proportionate random sampling techniques. Data was collected using questionnaire survey method and analysed with the help of Structural Equation Modelling (SEM) based on the Partial Least Squares technique (PLS). Based on the 272 questionnaires that were returned, the results indicated that, behavioural intentions had partial mediation effect on the relationship between perceived behavioural consequences (40.8%) and perceived behavioural control (30.6%) on eco-friendly behaviour. However behavioural intentions did not have significant mediation effect on perceived subjective norms. The findings underscored the importance of understanding behavioural and control beliefs of hotel guests. Moreover, this study singled out some socio-demographic characteristics of guests which could have an indirectly link to subjective norms and proposed addition of religion, place of origin, travel companionship and monthly expenditure to the TPB. Future researches could deepen understanding of socio-demographic characteristics and their indirect link to subjective norms in different regions as well as investigating eco-friendly behaviour of guests in eco-rated hospitality facilities in Kenyan urban areas

The effect of computer science unplugged on abstraction as a sub-component of computational thinking

Since computational thinking is a high-level cognitive skill and its conceptual framework has not yet been clarified, the assessment of this skill is problematic. While there is no consensus in the literature about the components of computational thinking, the abstraction component is located at a point where opinions intersect. In addition, it is predicted that computer science unplugged activities will improve computational thinking, and there is limited research examining this effect. As a result, this research aims to demonstrate the alleged effects of computer science unplugged activities on abstraction skill which is considered the critical component of computational thinking. The study, which was planned with a mixed methods research design, lasted 8 weeks. Quantitative data were obtained from the abstraction skill test developed by the researchers, while qualitative data were obtained from observations and task- based interviews after each activity. Quantitative findings showed that computer science unplugged activities significantly improve abstraction skills and thus computational thinking. Qualitative findings not only revealed that developments in the six abstracting steps caused this significant difference but also identified abstracting steps where the effect of each activity was limited. Suggestions for organizing activities to improve these steps are given. Finally, suggestions are presented for the conceptual framework of computational thinking based on abstraction.

Influence of Principals’ Promotion of Professional Development of Teachers on Learners’ Academic Performance in Kenya Certificate of Secondary Education in Kisii County, Kenya

Effective professional development should take cognisance of the needs of teachers, learners and school context. It has been established by research studies that divergent and overlapping policies as well as dysfunctional schooling cultures have frustrated impact of professional development of teachers on good quality learning outcomes. The purpose of this study was to investigate the Influence of Principals’ promotion of teachers’ professional development on learners’ academic performance in Kenya Certificate of Secondary Education (K.C.S.E.) in Public Schools in Kisii County, Kenya The objective of this study was to: explore the influence of Principals’ promotion of professional development of teachers on learners’ academic performance in K.C.S.E.in Kisii County. This study was anchored on Karl Ludwig von Bertalanffy General Systems Theory. Mixed method research design of explanatory sequential type with a prioritized quantitative approach in phase one followed by qualitative approach in phase two was applied in the study. The target population was 4,691 participants which included: 340 Principals, 1360 Heads of Departments (H.O.Ds) and 2,991 teachers. A sample of 451 respondents participated in the study. The researcher used proportionate stratified random sampling technique to select 85 schools, 114 H.O.Ds and 252 teachers. Census sampling to select national and special schools while 85 Principals of the selected schools were purposefully sampled. Questionnaires and interview guides were used to collect quantitative and qualitative data respectively. Content validity, Criterion validity, Construct validity and Face validity, of the research instruments were ensured through evaluation by the University supervisors and other experts while internal consistency reliability was estimated by using Cronbach’s alpha coefficient formula which yielded alpha coefficient of over 0.7 which was considered adequate. Quantitative data were analysed using Statistical Package of Social Sciences (SPSS) Version 29 while qualitative data were analysed thematically and presented using word verbatim from the respondents and integrated with the findings of phase one. Descriptive statistics were presented in tables and graphs while inferential statistics were presented in terms of Pearson’s correlation coefficients, Anova and Regression coefficients. The study found out a weak positive insignificant influence between promotion of professional development of teachers (r=.011, p≤.05; 2 tailed) and learners’ academic performance in K.C.S.E. Therefore, the null hypothesis were upheld. These results were supported by Principals’ interviews which indicated that professional development programmes are not context specific. It is hoped that the findings of this study would provide information that would form a base for corrective measures towards the unexpected low academic performance in the study locale. The study recommended that further research should be done on influence of principals’ leadership skills development on academic performance in K.C.S.E.

SERVICE INFRASTRUCTURE AND CURRICULUM IMPLEMENTATION IN PUBLIC UNIVERSITIES IN NORTHERN UGANDA

This study examined the influence of service infrastructure on curriculum implementation in public universities in Northern Uganda. Service infrastructure was studied in terms of electricity, water, toilets, and healthcare facilities, while curriculum implementation was considered in terms of preparation for teaching, content delivery, and assessment of learning. It was hypothesised that service infrastructure has no significant influence on curriculum implementation in public universities in Northern Uganda. The study embraced a convergent parallel mixed-methods research design. Quantitative data was obtained from 123 respondents through questionnaires. Qualitative data was collected from 26 participants through interviews, 61 participants through FGDs, and observations. The study revealed that generally, the level of curriculum implementation was low at a mean of 2.58 (51.6%), the level of services infrastructure was moderate at a mean of 3.43 (68.6%), and the coefficient of determination (R2) was at .214, implying that services infrastructure explained 21.4% of the variations in curriculum implementation in public universities in Northern Uganda. The null hypothesis that service infrastructure has no significant influence on curriculum implementation in public universities in Northern Uganda was rejected because the P-value of 0.000 was found to be less than the level of significance of 0.05. It was concluded that service infrastructure is a vital requirement for effective curriculum implementation in public universities in Northern Uganda. Therefore, it was recommended that the public universities further improve the state of their service infrastructure, like electricity, water, toilets, and health care facilities, to improve curriculum implementation, especially in areas of preparation for teaching, content delivery, and assessment of learning. Additional studies should be carried out on other factors contributing to 78.6% of the influence of curriculum implementation in public universities in Northern Uganda.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0711/a.php" alt="Hit counter" /></p>

The effect of blended learning on 21st-Century skills and academic success in education of physical education teachers: A mixed method research

The aim of this study is to examine the effects of the teaching intervention with blended learning model on the 21st century skills, academic achievement levels and permanent learning of pre-service physical education teachers. For this purpose, the nested design was preferred among the mixed method research designs, case study approach was chosen for the qualitative dimension of the research, and quasi-experimental design method was preferred for the quantitative dimension. As regards the experimental intervention process, the experiment lasted for 12 weeks with the voluntary participation of 85 pre-service teachers who formed the control and comparison groups. As a result of the research, it is seen that blended learning affects the academic success and permanent learning levels of pre-service physical education teachers whereas it has no effect on the 21st century skills. Quantitative and qualitative findings are consistent with each other.

The Relationship between Teachers’ Motivation, Professional Development, and Mobile Technology Integration in Language Learning

This study investigates the significance of professional development and teacher motivation in the effective utilization of mobile technology in language instruction. It explores how these variables have a significant impact on the adoption and utilization of technological tools in language teaching. The study investigates the relationship between teachers’ motivation and the importance of comprehensive professional development programs that encompass pedagogical approaches and proficiency in mobile technology. The study followed a mixed-method research design with a sample of (n = 200) teachers and students. The results underscore the importance of a synergistic connection between professional development, technological integration, and teacher motivation to enhance language learning in digital learning environments. The study recommends that through targeted professional development and motivational tactics, curriculum designers and educators can optimize language instruction.

Training attitudes of primary school foreign language teachers

Abstract Schooling practices founded upon the principles of Instructed Second Language Acquisition (ISLA) do not appear to have attained widespread adoption among teachers, consequently hindering the implementation of didactic measures that foster foreign language acquisition. These measures are closely entwined with the classroom climate, wherein the fundamental element often hinges upon the attitude of the teacher. For the most part, foreign language teachers are better equipped to embrace this attitude after having personally experienced it as learners themselves. To explore this matter further, the present study adopts a mixed-methods research design to gather insights from participants (n = 74) who attended the Didactics of Foreign Language in Primary Education – German course within the Bachelor Degree in Primary Education at the University of Cádiz (Spain) during the last nine editions; that is, from 2014/15 to 2022/23. The research findings reveal a near-unanimous consensus among all participants, regardless of nationality, teaching experience, or age, on the influential role of a classroom climate in shaping their teaching attitude. Based on the results, pre-service foreign language teachers must be allowed to acquaint themselves with effective didactic measures, together with a well-defined classroom climate wherein the significance of teaching attitude is accordingly recognized as one of the most influential factors in motivating learners.

Exploring arts-health ecologies in the very remote Barkly Region of Australia.

This article explores links between arts, health, and wellbeing for diverse First Nations and non-Indigenous peoples living in the very remote Barkly Region of the Northern Territory in Australia. The article stems from a major 3-year study of the Barkly arts sector conducted in partnership with Barkly Regional Arts and Regional Development Australia Northern Territory. Key findings relate to an arts-health ecology evident in the region, the interdependence between artists' own health and their arts activity, the value of arts spaces as places of safety and refuge, and the potential of the arts to promote cultural and intercultural healing and development. We discuss these findings in the context of relevant literature and make suggestions for future arts-health and wellbeing related research, policy and practice in rural and remote contexts. This study employed an ecological mixed-methods research design, including quantitative and qualitative survey and interview data collection as well as collaborative, data-driven thematic analysis. The ecological approach was used to map a variety of creative practices through a broad range of art forms. Commercial, amateur and subsidised art and creative practices were included in this study and represented the multicultural population of the Barkly Region (both First Nations and non-Indigenous peoples). Arts and creativity in the region were recognized as a complex ecology that saw individuals, businesses, organisations and government working in different ways to sustain culture and contribute to social and economic development. Research participants from diverse cultural backgrounds recognised health and wellbeing benefits of arts and creative activity. Arts participation and engagement were reported to have intrinsic individual health and wellbeing effects such as mental health and mindfulness, emotional regulation, enjoyment, and relief of physical and emotional pain and stress alongside promoting spiritual connection to self, culture and community. The study indicates that the arts can also shape powerful determinants of health and wellbeing such as employment, poverty, racism, social inclusion, and natural and built environments. Barkly arts-health ecology featured extensive involvement from health and human service and arts organisations, which provided a strong foundation for inclusive, healing and holistic regional development. This study has outlined how arts and creative activity contribute to holistic regional development in the Barkly desert region, an area with a high percentage of First Nations peoples. Arts and creative activity were reported to have intrinsic health and wellbeing effects for individuals, which included mental health and mindfulness, emotional regulation, enjoyment, and relief of physical and emotional pain and stress as well as promoting spiritual connection to self, others and environment. Arts activities were also seen to shape powerful determinants of health and wellbeing such as employment, poverty, racism, social inclusion, and natural and built environments.

Development of a workplace breastfeeding support practice model in South Africa

BackgroundGlobally, mothers have identified work as one of the main obstacles to exclusive and continued breastfeeding. The support a woman receives in her workplace in terms of workplace arrangements can be critical to enable women to continue breastfeeding. This study aimed to develop and assess the face validity of a practice model to support exclusive and continued breastfeeding in workplaces in the Western Cape, South Africa.MethodsAn explanatory, sequential, mixed-method research design, was conducted (June 2017 to March 2019) in three distinct phases. Phase one employed a quantitative, descriptive, cross-sectional study design. Phase 2 used a qualitative, multiple case study. Phase three involved the development and face validity of a practice model to support exclusive breastfeeding in workplaces. The face validity included two Delphi rounds for experts to provide input on the draft practice model. This paper will only report on phase 3 of the study. The practice model was developed, drawing on the analysis of data from phases one and two and using programme theory approaches and a logic model.ResultsThe practice model was positively perceived. Participants viewed it as informative, well designed and easy to follow, even for those not knowledgeable about the subject. It was viewed as an ideal tool, if accompanied by some training. Participants were positive that the model would be feasible and most commended the tiered approach to implementation. They felt that workplaces would be more open to a step-by-step approach to implementation and if only a few activities are implemented it would be a start to make the work environment more conducive for breastfeeding employees. There were mixed opinions regarding commitment; a few participants mentioned commitment as a challenge they anticipated in the male-dominant environments in which they worked. The provision of space for breastfeeding at the workplace was also highlighted as a potential challenge.ConclusionsAdvocacy around creating an enabling workplace environment for breastfeeding is needed. The practice model has the potential to be internationally relevant, locally applied and may be of particular use to workplaces that want to initiate and/or strengthen breastfeeding support.

Foreign Language Anxiety: A Study on Spanish Learners

Foreign Language Anxiety: A Study on Spanish Learners

K-12 students' higher-order thinking skills: Conceptualization, components, and evaluation indicators

Higher-order thinking skills are essential for future citizens. Therefore, it is important to understand its conceptualization, components, and evaluation indicators. The aim of this study was to construct and validate a framework of indicators for evaluating higher-order thinking skills. We used a three-step mixed-method research design and collected expert opinions through a questionnaire. First, a literature review found that higher-order thinking skills include problem-solving, metacognitive, critical thinking, teamwork, and innovation development skills. Then, there was a general consensus among 11 evaluators regarding the conceptualization, components, and evaluation framework of higher-order thinking skills through two rounds of Delphi questionnaires. The framework for evaluating K-12 students' higher-order thinking skills includes five first-level indicators, 17 second-level indicators, and 55 third-level indicators. The results show that the indicator framework is scientific and reliable. In conclusion, this study not only proposes a compilation for evaluation indicators of K-12 students' higher-order thinking skills, but also provides support for the measurement and development of higher-order thinking skills.

Social Media Mobilization and Advocacy: A Case Study

This case study investigates the role of social media mobilization and advocacy in the quest for justice for Mohbad, an influential Nigerian whose death sparked rumours of foul play involving friends and relatives. Utilizing a mixed-methods research design, data was collected through surveys administered to students of Taraba State University, Jalingo, and content analysis of qualitative data. Findings reveal positive perceptions towards social media mobilization, emphasizing the influence of social media influencers and hashtag activism. Challenges such as misinformation and algorithmic biases were identified, highlighting the need for ethical guidelines and responsible engagement in online advocacy. Recommendations include enhancing digital literacy, fostering collaborative partnerships, promoting responsible hashtag activism, and establishing ethical guidelines for digital advocacy.

Perceptions and Impacts of Local Education within the ICT Field

The primary aim of this research is to uncover valuable insights into the awareness, influences, and opinions pertaining to diverse educational approaches within the ICT sector. Specifically, the study seeks to appraise and analyse the disparities, commonalities, advantages, and limitations between the two prominent educational paths prevalent in the field: academic/traditional education and vocational education. A mixed-methods research design was adopted to encompass a triangulation of perspectives. The initial viewpoint is the lead researcher’s which involved scraping 200 ICT professional profiles from LinkedIn, extensive data cleaning and analyses using MaxQDA, and applying Factor Analysis for Mixed Data (FAMD). The second viewpoint entailed the general perspective of ICT students and professionals. The collection of this perspective was through 100 online survey participants. Lastly, the third viewpoint entailed the experience of eight ICT professionals through qualitative interviews. This methodological approach facilitates the acquisition of varied insights and observations in the ICT field, both within local educational contexts and beyond.Whilst each perspective provided insights and observations pertaining to the research aim, common theories emerged which showcased the strengths and benefits of viewpoint triangulation with the adoption of mixed methods. This study makes a significant contribution to the broader comprehension of the role and significance of local education in the realm of ICT. Additionally, it embraces the concept of industrial revolution 4.0 in universities, exploring new trends and ideas while promoting collaborative efforts between students and industries in creating high-quality education.

Abstract PO1-11-04: Breast cancer patient perspectives on the need for psychotherapy and the roll of physician referrals for improved quality of life during and post treatment

Abstract Objective: The purpose of this mixed methods study was to examine what factors may influence emotional suppression and emotional expression in breast cancer patients and how coping styles relate to beliefs about physician-driven referrals to therapy during the cancer treatment process to improve quality of life during and after breast cancer treatment. Methods: A mixed method research design consisting of quantitative methods including a demographics survey, the Courtauld Emotional Control Scale and treatment preference questionnaires followed by optional participation in a semi-structured interview. Sixty-nine participants who met the inclusion criteria were selected as the quantitative study sample and 27 participated in interviews to further discuss their personal views on therapy during breast cancer treatment, beliefs about physician-driven referrals and experiences of coping throughout and post-cancer treatment. Results: Demographic variables including age, marital status, income, and experience of psychotherapy prior to breast cancer diagnosis are statically significant factors that influence CECS scores and coping styles. Thematic narrative analysis of interviews revealed both Expressers and Suppressors recounted experiencing the ‘Elsa effect’, a term coined to describe emotional concealment as a form of emotionally protecting self and others and reported that a physician driven referral to therapy would have been helpful in terms with coping and improving quality of life. Participants universally believed that there should be some level of psychotherapy referrals for supportive mental health care during and after the treatment process. Types of supports to which they wanted to be referred, how referrals are made, why referrals are needed, language used when making referrals, what medium through which therapeutic support should be offered, and whether or not therapy referrals should be mandated were all discussed. Physician stigma related to psychotherapy was also suggested as a possible barrier. Conclusions: Overwhelmingly, participants who fell into either category of emotional suppressor or emotional expresser believed that there should be physician driven referrals to therapy during the breast cancer treatment process as part of best practices for improved quality of life. Both those identified as suppressors and expressers indicated high rates of concealing one’s true emotional experience. This highlights the need for psychological therapy referrals to be integrated as a best practice, regardless of patient’s identified coping style or demographic identities. Referral sources should be mindful of language used, patient ability to access to services and other factors as part of the referral process. Citation Format: Joyce Williams, Beth Counselman-Carpenter, William Burak. Breast cancer patient perspectives on the need for psychotherapy and the roll of physician referrals for improved quality of life during and post treatment [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-11-04.

African Union Mission in Somalia Considerations for Transition and Kenya’s National Security

This study assessed the implications of the African Union Mission in Somalia (AMISOM) on Kenya's national security within the context of AMISOM's transition to the African Union Transition Mission in Somalia (ATMIS). The objective of the study was analyse achievement of African Union Mission in Somalia mandates, to examine the effects to Kenya's National security and assess transition strategies of national security. The study was guided by Functionalist, Strategic and Securitisation theories. The research employed a mixed-methods research design using questionnaire surveys and interviews with respondents in Kenya's border counties most affected by Somali instability. Study findings established that, while a majority (52%) believe AMISOM has achieved its mandate to a moderate extent, concerns remain regarding the capacity of Somali Security Forces (SSF) and the overall stability of Somalia. In addition, study findings established that while progress has been made in degrading Al-Shabaab and supporting the Somali Federal Government (FGS). However, only a third of respondents believe the SSF has been adequately mentored by AMISOM. Despite success in facilitating humanitarian assistance and Civil-Military Cooperation (CIMIC) projects, nearly two-thirds believe Somalia lacks the conditions necessary for long-term stability. The study concludes that AMISOM's transition strategy inadequately addresses governance and security aspects essential for Kenyan security. Weak SSF and FGS capacity pose a threat of failed stabilization after AMISOM's withdrawal. Additionally, Kenya's current border security measures are insufficient to manage potential spill over effects. ANOVA indicated an F statistic of 134.318 and a p value of 0.000<0.05 thus the Somalia PSO strategies significantly predict Kenya’s National Security. Regressions weight model (β = -0.451, P = .000<.05) implied that Nature of Somalia PSO strategies negatively influences Kenya’s National Security. The study recommends a revision of the AMISOM transition strategy to include capacity building for FGS and SSF, including forces in federal member states like Jubaland; allocation of sufficient time for a well-monitored transition with clear benchmarks; an exploration cautious negotiations with Al-Shabaab, contingent on a strong FGS and a hybrid AU-UN peacekeeping mission to succeed ATMIS to ensure Kenya's long-term security.

Investigating consumer preferences and experiences of telehealth services in Australian allied health practice: a study protocol

IntroductionTelehealth service provision and uptake has rapidly increased since the COVID-19 pandemic, allowing healthcare to be delivered safely and reducing non-essential face-to-face (F2F) contact. In Australia, the expansion of subsidisation...

Exploring the status of argumentative essay writing strategies and problems of Iranian EFL learners

The present study explores the status of argumentative essay writing strategy use and identifies the problems a convenient sample of Iranian EFL learners face while writing argumentative essays in English. Adopting a complementary process-genre approach and a mixed-methods research design, the researcher designed a genre-specific argumentative essay-writing strategy use questionnaire and pilot-tested it in an essay-writing course. The necessary data were collected using the designed questionnaire, students' argumentative texts written in the classes and their responses to the open-ended survey and semi-structured interviews. The results indicated a rather low status of strategy use in the sample since the students mostly depended on their previous writing competencies rather than following the conventions of working on this new genre of writing. The results of the open-ended survey, semi-structured interviews, and the analyses of students' argumentative texts indicated significant problems in the students' essay writing performance, categorized as cognitive, linguistic and discourse, and psychological problems, which were further attributed to the newness and complexities imposed by this genre of writing, students’ inadequate linguistic and discourse competence and their inefficient use of writing strategies. Finally, it was suggested that to assist the students in writing better argumentative texts, writing instructors must ensure students have a fundamental understanding of what an argument is, including the components like claims, evidence, warrants and counterarguments, and encourage critical thinking by teaching students how to evaluate evidence, find logical fallacies and analyze the strengths and weaknesses of different arguments. They also need to share well-written argumentative essays as models for students to analyze and learn from, incorporate strategy instruction in their practices, offer further opportunities for writing and practicing in this genre of writing, and provide appropriate scaffolding and timely feedback on the students’ argumentative writing performance.

Understanding the Decline in Work Motivation among Hong Kong's Gen Z

This study employed a mixed methods research design to explore the factors that influence Gen Z employees' motivation in the workplace. The study involved a literature review, an analysis of news and tr ends, and an exploration of potential impacts and solutions.

Factors and Coping Styles Related to Breast Cancer Patients’ Preferences About Referrals to Psychotherapy as part of Treatment

Background: The purpose of this mixed methods study was to examine what factors may influence emotional suppression and emotional expression in breast cancer patients and how coping styles relate to beliefs about physician-driven referrals to therapy. Methods: A mixed method research design consisting of quantitative methods including a demographics survey, the Courtald Emotional Control Scale and treatment preference questionnaires followed by optional participation in a semi-structured interview. Results: Demographic variables including age, marital status, income, and experience of psychotherapy prior to breast cancer diagnosis are statically significant factors that influence CECS scores and coping styles. Participants universally believed that there should be some level of psychotherapy referrals for supportive mental health care during and after the treatment process. Conclusion: Participants who fell into either category of emotional suppressor or emotional expresser believed that there should be physician driven referrals to therapy during the breast cancer treatment process. Both those identified as suppressors and expressers indicated high rates of concealing one’s true emotional experience. This highlights the need for psychological therapy referrals to be integrated as a best practice, regardless of patient’s identified coping style or demographic identities. We suggest that all breast cancer patients be screened at multiple points and offered a referral by every member of their treatment team: regardless of how they seem to cope and that future research focus on the most efficient and holistic ways to decrease barriers to receiving psychological support during and after breast cancer treatment.