Attitude Questionnaire Research Articles

The Relationship Between Rehabilitation Therapists’ Attitudes Towards Individuals With Disabilities and Job Burnout: An Empirical Investigation

Background and Objectives: This research aims to explore the interplay between rehabilitation therapists’ attitudes toward people with disabilities and their job burnout. Methods: The study population included all rehabilitation therapists in Tehran Province, Iran, in 2022, working in both public and private sectors. A sample of 261 therapists was selected using a quota sampling technique. The disability attitude questionnaire was employed to gauge attitudes towards individuals with disabilities, while therapists’ job burnout was evaluated using the Maslach burnout inventory. The therapists were approached through both in-person and online visits. Hypotheses were tested using correlation coefficients, linear regression, and analysis of variance (ANOVA), and data were analyzed using SPSS software, version 26. Results: The results revealed a significant negative relationship between job burnout and its dimensions (emotional exhaustion, depersonalization, and reduced personal accomplishment) with attitudes towards individuals with disabilities. Additionally, a negative and significant relationship was observed between job burnout and the variables of age, and work experience, while a positive and significant relationship was found with the variable of weekly working hours. Furthermore, a positive and significant relationship was observed between attitudes and the variables of age and work experience, while a negative and significant association was detected with weekly working hours. Occupational therapists exhibited more favorable attitudes compared to other rehabilitation groups. Physiotherapists displayed the highest burnout levels among the various rehabilitation disciplines. Conclusion: The study underscores the importance of integrating strategies to enhance rehabilitation therapists’ attitudes and alleviate burnout into the strategic planning initiatives of the Ministry of Health. Furthermore, efforts to reduce the work hours of rehabilitation therapists should be prioritized.

Colorectal cancer literacy and related factors in northeast of Iran: A cross-sectional study.

Colorectal cancer (CRC) is a health challenge and the second most common cancer worldwide. Increasing colorectal cancer literacy (CRCL) is one of the most effective factors in CRC prevention. The aim of this study was to determine and evaluate CRCL and its related factors in Torbat Heydarieh, northeastern Iran. This study was a cross-sectional survey conducted in 2021 in Torbat Heydarieh, a city in northeastern Iran, on 200 clients presenting to a comprehensive health service centers. In addition to collecting sociodemographic characteristics, participants were administered the Knowledge and Attitude Questionnaire and the Colorectal Cancer Literacy Questionnaire (CRCLQ). Data were analyzed with SPSS software version 25 using independent samples t-tests, one-way analysis, chi-square, and Pearson correlation coefficients. The statistical significance level was set at p < .05. The results showed that the mean age of the participants was 51.12 ± 8.45 years. The majority of participants (84%) stated that their friends and relatives had no history of CRC. Pearson correlation coefficient results showed a significant correlation between knowledge and attitude toward CRC (r = .15, p = .041). A significant correlation was also found between knowledge and CRCL (r = .4, p ≤ .001). We found low CRCL among clients of comprehensive health service centers. More targeted educational interventions are needed to promote CRCL among Iranian adults.

Psychometric evaluation of the Polish version of the Questionnaire of Attitudes of Healthcare Workers towards Reporting of Clinical Adverse Events (P-RoCAES)

Abstract Aim. The purpose of the study was psychometric evaluation of the Polish version of the Questionnaire of Attitudes of Healthcare Workers towards Reporting of Clinical Adverse Events (P-RoCAES), based on an adaptation of the Reporting of Clinical Adverse Events Scale (RoCAES) by Wilson B., Bekker H.L., Fylan F. Material and methods. A total of 101 participants took part in the study, 41.4% of whom were internal medicine nurses, the remaining percentage were nursing students. In addition to the P-RoCAES, the Author’s Survey Questionnaire, the Justice Sensitivity Inventory, the Moral Feelings Scale, the Perceived Stress at Work Scale were used. Results. P-RoCAES reliability (internal consistency: Cronbach’s alpha 0.82; McDonald’s omega 0.80) and theoretical relevance for questions from the Author’s Survey Questionnaire were found. Convergent relevance with sensitivity to justice, feelings in moral situations, work stress perception were not proven. Confi rmatory factor analysis did not provide a reinforcement of the 5-dimensional factor structure of the original RoCAES. Conclusions. The P-RoCAES achieved satisfactory psychometric properties in validation to Polish conditions, enabling to be used in research of attitudes towards adverse events among medical professionals and students, in order to educate and promote reporting culture for maintaining patient safety in healthcare. Despite possible limitations, the P-RoCAES should be considered an objective, valid, reliable tool.

Examining changes in teacher education programs: A case study approach

This study retrospectively examines teaching practice within Israeli teacher education programs. A pilot study investigates the implementation of a novel teacher education program in Israeli academia, with a focus on the freedom it grants to institutions. This program emerged during the Covid-19 crisis when e-learning dominated. The study assesses 45 respondents' perceptions of teaching practice and the academia-school relationship through a combination of qualitative and quantitative methods. On the quantitative front, the study involved the examination of several questionnaires. These included a self-efficacy questionnaire, an attitude survey regarding teaching, an evaluation of professional identity, and an attitude questionnaire centered on practical experiences within schools. In the assessment of self-efficacy, we utilized a modified version of the General Self-Efficacy Scale (GSE). Additionally, the researchers crafted the other questionnaires. The study also encompassed an exploration of student satisfaction levels concerning collaboration during practical experiences, the acquisition of various skills during school-based practice, and the correlation between the teacher training program's different courses and practical work within school settings. The research covered the documentation and formative assessment of the design and alteration processes within teacher education based on the outlined changes. The study evaluated these processes through primary documents from the academic institution, which provided evidence of the change preparation. It also analyzes the goals, learning outcomes, and teaching methods for students specializing in education. The study highlights changes in teaching practice that foster connections between academia and the field, particularly in pedagogy. These changes focus on the intensified school-based experience, paired with e-teaching workshops. Findings reveal that in evaluating teaching practice competence, interpersonal skills and professional identity rank highly among skills gained during field experiences. The research also showcases the acquisition of essential teaching and class management skills. The study raises questions regarding the program's impact on institutions, particularly concerning its role in enhancing autonomy and relevance. The study evaluates the program’s potential as a catalyst for effective teacher education and its ability to attract mission-driven, motivated individuals to the teaching profession.

A mixed-method evaluation of peer-led education about attitudes towards consumers' recovery among Mental Health Nurses working in acute inpatient psychiatric units.

Despite integrating the recovery model of care in mental health, mental health professionals still have pessimistic attitudes towards the recovery of people with mental illness. Positive attitudes towards recovery are essential components to integrate recovery-oriented practices in all areas of mental health. Evidence shows that education and training are effective while emphasising the importance of consumer-based interventions to enhance recovery attitudes. This study aimed to evaluate the effectiveness of peer-led education about recovery attitudes towards people with mental illness among Mental Health Nurses working in acute inpatient settings. The methodology used was a sequential explanatory mixed method with pre- and post-test design involving three phases. Phase 1: survey (n = 103), phase 2: post-test survey immediate (n = 17) and follow-up (n = 11) and phase 3: in-depth interviews (n = 12). The results show that Mental Health Nurses have positive recovery attitudes with some room for improvement. Most participants agreed with all items of the Recovery Attitudes Questionnaire. However, the participants had various views on the relationship between faith and recovery. The peer-led education significantly improved RAQ items 1, 2, 3, 4 and 6 statistically. Furthermore, peer-led education effectively enhanced recovery attitudes immediately after the intervention and helped to maintain sustainable attitudes 3 months later. A qualitative exploration of recovery attitudes revealed three main themes: participants' reflections, recovery hurdles and interpersonal relationships.

Koronavirüs Pandemisi Sırasında Görev Yapan Fizyoterapistlerin Pandemiye İlişkin Bilgi, Farkındalık ve Tutumlarının Değerlendirilmesi

Purpose: It was aimed to determine the change in the knowledge, attitudes, and awareness of physiotherapists working in the field of cardiopulmonary physiotherapy and rehabilitation (PWCPR), and to investigate the burnout level of PWCPR and physiotherapists working in the other fields (PWOF).&#x0D; Methods: The demographic and occupational information of the participants were recorded. The Knowledge, Awareness and Attitude Questionnaire, which was designed specifically for research, was administered only to PWCPR group, and The Turkish Adaptation of The Burnout Measure-Short Version (TA-BMS) was administered to all participants online via Google Forms. Data analysis was performed using SPSS 11.5 program. Significance level was measured to p

Writing to your past-self can make you feel better.

Self-compassionate writing has been shown to be helpful for improving the mental state in some individuals. Here, we investigated how the writer's attitude toward his/her past, present and future and the focus of the writing, i.e., social experience in the past versus self-experience, modulate these effects. In Experiment 1, 150 undergraduates wrote a compassionate letter to their past-self and to their future-self and responded to the Japanese version of the Adolescent Time Inventory-Time Attitudes (ATI-TA) questionnaire. Writing to past-self decreased negative feelings more than writing to future-self. Further, participants who had negative feelings toward their past, present, and future, as assessed by the ATI-TA, were more likely to be emotionally affected by writing a letter to their past-self. In Experiment 2, 31 undergraduates wrote a letter focusing on what they had experienced together with someone, and another 31 undergraduates wrote focusing on what they had experienced alone. Focusing on a social experience was more helpful for recovering from negative feelings than focusing on a self-experience. In conclusion, writing a compassionate letter to one's past-self can improve mood, especially in individuals with a negative time attitude who focus their writing on a social connection.

Prevalence of Pain and Factors Affecting it in Patients with Lung Cancer in Ilam

Background: Pain has been known as one of the most common, persistent, and complex symptoms of patients with lung cancer. Objectives: The aim of this research is to study the relationship between attitude to pain and the prevalence and method of pain control in patients with lung cancer. Methods: This descriptive cross-sectional study was performed through the census method in patients suffering from lung cancer in Ilam Province. For data collection, while interviewing the patients and studying their files, instruments were used including demographic characteristics form, brief pain inventory, and pain attitude questionnaire. Data analysis was performed by SPSS v.16 through descriptive statistical tests (mean, percentage, and standard deviation) and analytical tests (independent t-test, ANOVA, and linear regression). Results: Considering the severity of pain, 12 (18.8%) patients had mild pain, 43 (67.2%) had moderate pain, and 9 (14.1%) had severe pain, and all of them reported some degree of pain. According to the findings, mean ± SD of the total score of the questionnaire was 77.15 (3.18), where the minimum and maximum acquired scores were 72 and 85, respectively. Also, no significant relationship was found between any of the dimensions of the attitude to pain questionnaire and the severity of pain. Further the mean ± SD of attitude to pain was 76.58 (2.81), 77.09 (3.28), and 78.22 (3.23) for mild, moderate, and severe pain, respectively. Conclusions: In this study, there was no relationship between pain severity and attitude to pain, which may have been due to the small sample size or the specificity of the study in the group of lung cancer patients. Accordingly, conducting further studies in this regard with a larger sample size is suggested.

Training of transport drivers improves their handling of pigs during loading for transport to slaughter

Pig transport drivers’ (TDs’) handling actions are of great importance as these drivers handle a large number of finishing pigs during stressful situations. Poor handling techniques can have negative consequences for working conditions, pig welfare and meat quality. We studied the effects of a training intervention on Swedish TDs’ attitudes towards pigs and their handling actions during loading for transport to slaughter. Twenty TDs working with commercial pig transportation in Sweden were recruited and completed an attitude questionnaire. Ten of them were observed during one loading of pigs before training, and one or two loadings after training (49–265 pigs per loading), and eight of them completed the attitude questionnaire again 50–160 days after training. The cognitive-behavioural training program ProHand Pigs® was adapted and delivered to the ten TDs during a group session, followed by individual meetings. TDs’ handling actions were video recorded and summarised as binary variables per 5-s interval. Factor analysis, principal component analysis and paired t-test were conducted to investigate the effects of the training intervention on TDs’ attitudes, and mixed-effects logistic models were used to examine effects on negative and positive handling actions. Training tended to decrease TDs’ beliefs that it is important to move pigs quickly (P = 0.095). Training decreased the odds of a ‘moderately to strongly negative’ action by 55% (P = 0.0013) and increased the odds of a ‘positive’ action by 97% (P < 0.0001). This study provides valuable insights into the possibilities to improve TDs’ handling actions, and implications for pig welfare during slaughter transport. The study supports previous findings that the attitudes and behaviour of handlers can be improved by cognitive-behavioural training. While our previous research has shown reciprocal relationships between TDs’ actions and pig behaviour, further research on TDs’ attitudes towards handling that underlie the nature of their behaviour when handling pigs is necessary to fine-tune the cognitive-behavioural training program applied in the present study.

Psychometric evaluation of the Persian version of Emergency Medical Services- Safety Attitudes Questionnaire (EMS-SAQ)

AimThis study aimed to conduct a psychometric evaluation of the Persian adaptation of the Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ).MethodsIn this cross-sectional study, the validity and reliability of the EMS-SAQ were assessed among 484 Iranian pre-hospital emergency department employees between February and June 2023.ResultsFive factors were extracted namely safety climate, teamwork, job satisfaction, stress management, and working conditions with explained 38.75% of the total variance. The goodness of fit indexes confirmed the model (χ2 = 409.031, DF = 196, χ2 /df = 2.087, CFI = 0.900, IFI = 0.901, PCFI = 0.763 and PNFI = 0.701, and RMSEA = 0.069 [CI90% 0.059–0.078]).ConclusionThe Persian version of the SAQ-EMS, comprising 22 items across five factors, demonstrated good validity and reliability. It is recommended to undertake qualitative studies focusing on the concept of patient safety in pre-hospital settings, considering diverse contexts and cultural nuances to develop more robust assessment tools.

Hubungan Tingkat Pengetahuan dan Sikap Terkait Diabetes Melitus dengan Kadar Glukosa Darah Sewaktu (GDS) Lansia di Wilayah Puskesmas Tanggulangin

Diabetes mellitus (DM) was a metabolic disease characterized by an increase in blood glucose levels accompanied by a decrease in carbohydrate, protein and fat metabolism. The elderly group (elderly) was the group most at risk of developing dm because this group was a population that was susceptible to carbohydrate metabolism disorders which could lead to diabetes mellitus. This studied aims to analyze the relationship between the leveled of knowledge and attitudes regarding dm on the blood sugar levels of the elderly. This researched used an observational studied with a crossed sectional approached. The population in this studied was members of the elderly posyandu in the working area of the tanggulangin community health center used a random sampling technique of 88 respondents. Data collection used knowledge questionnaires and attitude questionnaires. Data was analyzed used univariate analysis and bivariate analysis (chi square test). The results of the analysis showed that the leveled of knowledge (p=0,011) and attitudes of the elderly (p=0,008) regarding diabetes mellitus showed a significant relationship (p&lt;0,05)

Enhancing Nutritional Status and Quality of Life in Hemodialysis Patients: The Impact of Internet-Based Cognitive Behavioral Therapy

This study examined the effects of internet-based cognitive behavioral therapy on the nutritional status and scores from the Knowledge, Attitude, and Practice questionnaire in maintenance hemodialysis patients. Patients in the traditional therapy group received standard health education, whereas those in the experimental group participated in three months of this therapy. Clinical and nutritional indicators, including blood biomarkers and Knowledge, Attitude, and Practice questionnaire scores, were recorded for both groups before and after the treatment. Post-treatment, the group receiving internet-based cognitive behavioral therapy exhibited higher blood calcium levels, increased upper arm circumference, and reduced levels of potassium and phosphorus. They also showed comparatively lower scores in Nutritional Risk Screening 2000 and Malnutrition Inflammation, along with higher Visual Analog Scale scores (P &lt; 0.05). The internet-based cognitive behavioral therapy group exhibited higher albumin and prealbumin levels, reduced transferrin, total cholesterol, creatinine, and urea levels, and modified quantitative subjective global assessment scores than the traditional therapy group (P &lt; 0.05). They also scored higher on the Knowledge, Attitude, and Practice questionnaire (P &lt; 0.05). These results indicate that internetbased cognitive behavioral therapy can improve the nutritional status, Knowledge, Attitude, and Practice questionnaire scores, and overall quality of life in maintenance hemodialysis patients, highlighting its potential benefit in patient outcomes.

Bee pollen as a functional ingredient in bread: an exploratory study based on attitudes and expectations of Brazilian consumers

This study investigated consumers' perceptions of adding bee pollen to bread. An attitude questionnaire composed of 48 statements related to "general health," "light products," "natural products," "salty products," "food as a reward," "pleasure," and "food neophobia" was answered by the participants, who indicated their level of agreement with each statement according to a 5-point Likert scale, ranging from (1) "totally disagree" to (5) "totally agree." A check-all-that-apply (CATA) questionnaire was also employed to characterize 12 visual stimuli. The creation of stimuli was carried out using a factorial design, resulting in 12 images of bread. Three clusters of consumers were identified, each associating positive attributes with stimuli containing bee pollen, regardless of the health claim, while negative attributes were associated with stimuli without added pollen. The main positive drivers of liking were "I would buy," "attractive," "pleasant color," "healthy," "light," and "natural." On the other hand, the negative drivers of liking were "unattractive," "I don't like it," "I wouldn't buy," "hard," and "unpleasant color." This study provides valuable information for developing healthier bread using natural ingredients with bioactive compounds, such as bee pollen.

Exploring Students’ Hands-On Performance, Attitudes, and Usability with Arduino Modular Boards

Utilizing Arduino development boards for learning microcontroller circuits is a prevalent practice across various educational levels. Nevertheless, the literature offers limited insights into the impact of these boards on student performance and attitudes. Therefore, this paper aims to investigate the performance of 58 university students in learning microcontroller circuits with modular boards designed for Arduino through a series of 4 exercises. Specifically, students’ performance is assessed through pre-tests and post-tests, in three learning units: (a) microcontroller, (b) coding, and (c) circuit. Additionally, the study captures students’ attitudes and measures their perceived usability of modular boards. For this purpose, the students completed a specially designed attitude questionnaire and the system usability scale (SUS) questionnaire. Statistical analysis is conducted using t-tests, ANOVA, and ANCOVA, along with bootstrapping. The findings reveal statistically significant differences between pre-tests and post-tests in all cases. Among the three learning units, the use of modular boards appears to have the most significant impact on coding. Based on students’ responses, the SUS results indicate that modular boards appear to be a quite usable approach for teaching microcontrollers. Finally, students generally express positive attitudes toward modular boards.

Relationship Between Attitude Towards Euthanasia and Perceived Social Support

The purpose of the research was to examine the relationship between attitudes toward euthanasia and perceived social support. The study also identified gender differences and their attitude towards social support. It was a cross-sectional correlation research. The sample size was 200, and the data was collected from a general population of male and female university students through a questionnaire of Attitudes Towards Euthanasia-ATE and Perceived Social Support-PSS along with an informed consent form and a demographic sheet. The study significantly highlighted a negative correlation between ATE and PSS. It predicted that social support would be stronger, and people would receive it from family members to maintain their lives instead of terminating it. Social support was a primary source to help the patients mitigate their attitude towards euthanasia. Due to gender differences, the women received less social support, and the score on the scale of attitude toward euthanasia differs among men and women. Society, parents, family, and other peer members should be supportive to help the patient maintain their life and daily functioning.

KNOWLEDGE AND ATTITUDE OF PRIMARY HEALTH CARE PHYSICIANS REGARDINGOBSTRUCTIVE SLEEP APNEA IN TABUK CITY

Obstructive sleep apnea is the most common type of sleep disorder breathing and is characterized by repeated brief episodes of upper airway obstruction during sleep for more than 10 seconds. It is a growing public health challenge with most of the cases remaining unidentified. The study aims to evaluate the general knowledge and attitude of primary health care physicians toward OSA in Tabuk city, Saudi Arabia during 2023. It is a cross-sectional study. The estimated sample size is based on comprehensive data collection in which all primary healthcare physicians are invited to participate in our research. The validated Obstructive Sleep Apnea Knowledge and Attitudes Questionnaire (OSAKA)was used. The data analysis was done by using SPSS for Windows version 21and GrpahPadPrism version 8.4.2. The level of significance is 0.05.The present study found that 65.7% of the participants (N=94) had good knowledge regarding OSA. The majority of participants had a positive attitude towards OSA. Additionally, results showed gender, nationality, and years of graduation had an association with knowledge regarding OSA (p=0.043, 0.047, 0.03 respectively). There was a statistically significant positive correlation between knowledge and attitude (Spearmans rho = 0.29, p = 0.001). Logistic regression analysis showed that females have good knowledge as compared to males (p=0.047*).

Determinants of health care worker breastfeeding experience and practices and their association with provision of care for breastfeeding mothers: a mixed-methods study from Northern Thailand

BackgroundImproving breastfeeding rates is one of the most cost-effective ways to prevent infant deaths, but most of the world falls far below WHO recommended breastfeeding practices. Confident, informed healthcare workers are an important resource to promote breastfeeding, but healthcare workers are at risk of early breastfeeding cessation themselves. Culture, ethnicity and socio-economic status impact breastfeeding rates with some of the highest and lowest rates in Southeast Asia reported from Thailand. This study explores the relationship between workplace determinants of breastfeeding, personal breastfeeding outcomes for healthcare workers, and the breastfeeding care healthcare workers provide their patients.MethodsThis study used a sequential exploratory design guided by a conceptual framework based on social ecological/ecological psychology models. Participants came from four clinical sites in Northern Thailand, from ethnically Burman or Karen communities with high breastfeeding rates, and Thai communities with low breastfeeding rates. In-depth interviews (July 2020-November 2020) were followed by a quantitative survey (November 2020-July 2021) derived from validated questionnaires (Australian Breastfeeding Knowledge and Attitudes Questionnaire and the Workplace Breastfeeding Support Scale) with minor local adaptations.ResultsInterviews highlighted the beneficial effects of supportive workplace policies, the importance of physical spaces to facilitate proximity between mothers and infants, and the problem of low milk production. Meeting the WHO recommended practices of exclusive breastfeeding to 6 months or total breastfeeding to 2 years or more was more common in sites with higher levels of breastfeeding support (aOR 7.3, 95%CI 1.8, 29.1 for exclusive breastfeeding). Exclusive breastfeeding was also higher when staff set breastfeeding goals (aOR 4.4, 95%CI 1.7, 11.5). Staff who were able to see their infants during the work day were less likely to terminate breastfeeding because of work (aOR 0.3, 95%CI 0.1, 0.8). Staff who met both WHO recommendations themselves were more likely to report high levels of confidence caring for breastfeeding patients (aOR 2.6, 95%CI 1.1, 6.4).ConclusionsWorkplace protections including supportive maternity leave policies and child-friendly spaces can improve breastfeeding outcomes for healthcare workers. These improved outcomes are then passed on to patients who benefit from healthcare workers who are more confident and attentive to breastfeeding problems.

Review: application of the Safety Attitudes Questionnaire (SAQ) in primary care - a systematic synthesis on validity, descriptive and comparative results, and variance across organisational units

Patient safety research has focused mostly on the hospital and acute care setting whereas assessments of patient safety climate in primary health care settings are warranted. Valid questionnaires as e.g., the Safety Attitudes Questionnaire (SAQ) may capture staff perceptions of patient safety climate but until now, an overview of the use of SAQ in primary care has not been systematically presented. Thus, the aim of this systematic review is to present an overview of SAQ used in primary care.Methods The electronic databases: PubMed, Embase, Cinahl, PsycInfo and Web of Science were used to find studies that used any version of SAQ in primary care. Studies were excluded if only abstract or poster was available, as the information in abstract and posters was deemed insufficient. Commentaries and nonempirical studies (e.g., study protocols) were excluded. Only English manuscripts were included.Results A total of 43 studies were included and 40 of them fell into four categories: 1) validation analysis, 2) descriptive analysis, 3) variance assessment and 4) intervention evaluation and were included in further analyses. Some studies fell into more than one of the four categories. Seventeen studies aimed to validate different versions of SAQ in a variety of settings and providers. Twenty-five studies from fourteen different countries reported descriptive findings of different versions of SAQ in a variety of settings. Most studies were conducted in primary health care centres, out-of-hours clinics, nursing homes and general practice focusing on greatly varying populations. One study was conducted in home care. Three studies investigated variance of SAQ scores. Only five studies used SAQ to assess the effects of interventions/events. These studies evaluated the effect of electronic medical record implementation, a comprehensive Unit-based Safety Program or COVID-19.Conclusion The synthesis demonstrated that SAQ is valid for use in primary care, but it is important to adapt and validate the questionnaire to the specific setting and participants under investigation. Moreover, differences in SAQ factor scores were related to a variety of descriptive factors, that should be considered in future studies More studies, especially variance and intervention studies, are warranted in primary care.Trial registration This systematic review was not registered in any register.

Exploring the complexity of commonly held attitudes and beliefs of low back pain-a network analysis.

The current study used a network analysis approach to explore the complexity of attitudes and beliefs held in people with and without low back pain (LBP). The study aimed to (1) quantify the adjusted associations between individual items of the Back Pain Attitudes Questionnaire (Back-PAQ), and (2) identify the items with the strongest connectivity within the network. This is a secondary data analysis of a previously published survey using the Back-PAQ (n = 602). A nonparametric Spearman's rank correlation matrix was used as input to the network analysis. We estimated an unregularised graphical Gaussian model (GGM). Edges were added or removed in a stepwise manner until the extended Bayesian information criterion (EBIC) did not improve. We assessed three measures of centrality measures of betweenness, closeness, and strength. The two pairwise associations with the greatest magnitude of correlation were between Q30-Q31 [0.54 (95% CI 0.44 to 0.60)] and Q15-Q16 [0.52 (95% CI 0.43 to 0.61)]. These two relationships related to the association between items exploring the influence of attentional focus and expectations (Q30-Q31), and feelings and stress (Q15-Q16). The three items with the greatest average centrality values, were Q22, Q25, and Q10. These items reflect beliefs about damaging the back, exercise, and activity avoidance, respectively. Beliefs about back damage, exercise, and activity avoidance are factors most connected to all other beliefs within the network. These three factors may represent candidate targets that clinicians can focus their counseling efforts on to manage unhelpful attitudes and beliefs in people experiencing LBP.

Impact of flipped classroom on EFL learners’ self- regulated learning and higher-order thinking skills during the Covid19 pandemic

The advent of innovative online tools has ushered in new possibilities for enhancing the quality of language learning. This study delved into the influence of the flipped classroom approach on augmenting the cognitive and meta-cognitive competence of EFL learners. Two distinct participant groups were enlisted for the study's sequential phases, necessitating varying sample sizes to compare the effects of the flipped classroom against traditional instructional modes on the improvement of EFL learners' self-regulated learning strategies and higher-order thinking. Homogeneous groups of language learners were essential for addressing the research inquiries, and participants were selected from two private language institutes in Arak, Iran. Multiple data sources, including a language proficiency test, the Self-Regulation Questionnaire, a flipped classroom attitude questionnaire, and the Higher-Order Thinking Skills Test, were employed to gather the necessary data. The results demonstrated a significant impact of flipped classrooms on learners' utilization of cognitive self-regulated learning strategies, indicating that the flipped classroom approach fosters students' development as self-directed learners. Concerning the influence of the flipped classroom on enhancing EFL learners' higher-order thinking skills, it was deduced that the flipped classroom significantly affected the learners' engagement in evaluating, analyzing, and creating. The implications of these findings underscore the potential of the flipped classroom approach to positively shape EFL learners' self-regulated learning and higher-order thinking skills, advocating for its incorporation into language education practices.