To assess oral-health literacy and test a conceptual model of the relationships among oral health-related self-efficacy, social support, illness perception, and oral-health literacy in patients with periodontitis. This cross-sectional study recruited 230 eligible adult periodontitis patients by convenience sampling at the Department of Periodontology, Fourth Military Medical University (Xi'an) from March to July 2024. Participants completed validated Chinese versions of the short-form Health Literacy Dental Scale, the Self-efficacy Scale for Self-care, the Social Support Rating Scale, and the Brief Illness Perception Questionnaire. Data analysis included descriptive statistics, nonparametric tests, correlation analysis, and Hayes's PROCESS macro (Model 4 and Model 7) to test for social support's mediation and illness perception's moderation. The study included 230 participants (121 males, 52.6%; 109 females, 47.4%), with a mean age of 39.27 ± 11.85 years. The health literacy score for periodontitis patients was 42.00 (34.00, 52.00). The direct effect of oral health-related self-efficacy on oral-health literacy was significant (β = 0.2367, 95% CI [confidence interval] = [0.1176~0.3558]), and social support played a partial mediating role between oral health-related self-efficacy and oral-health literacy (β = 0.0526, 95% CI = [0.0153~0.0980]). Illness perception did not significantly moderate the relationship between oral health-related self-efficacy and social support (β = -0.0061, 95% CI = [-0.0133, 0.0010]). This study assessed oral-health literacy at a moderate level in periodontitis patients. The tested model was partially supported: self-efficacy directly improved oral-health literacy, and social support partially mediated this relationship. Illness perception did not moderate the pathway. Therefore, self-efficacy and social support are primary targets for improving oral-health literacy.

Against the backdrop of medical tax reform and escalating doctor-patient conflicts, the workload of nurses in China has surged, with resignation rates rising year after year. Based on this context, this study draws on resource conservation, social cognition, and ecosystem theories to construct an intermediary model of ‘work pressure → self-efficacy → work engagement,’ and introduces social support as a moderating variable to establish a moderated intermediary model. In terms of sampling methods, stratified cluster sampling was employed to select 765 clinical nurses from first- to third-level hospitals in Province S, China, for a cross-sectional questionnaire survey. The study results revealed: first, work stress significantly negatively impacts work engagement (β = –0.170, p < 0.001); Second, self-efficacy partially mediated this relationship, with work stress reducing work engagement by lowering self-efficacy, accounting for 10.88% of the total effect; Third, social support significantly moderated the effect of work stress on work engagement, with social support significantly alleviating the negative impact of work stress on work engagement; Finally, the moderated mediation model holds true, with social support significantly moderating the first half of the mediation chain ‘work pressure—self-efficacy—work engagement.’ Specifically, when nurses receive higher levels of social support, the negative chain of work pressure reducing work engagement by weakening self-efficacy is significantly buffered; conversely, in low-support situations, this negative transmission is more pronounced. The findings of this study suggest that hospitals can effectively break the vicious cycle of ‘high stress—low self-efficacy—low work engagement’ by strengthening self-efficacy training and establishing blended online and offline support networks. This approach provides feasible strategies for stabilising the nursing workforce and enhancing patient experience under the DRG reform framework.

Objective This study aimed to examine the relative contributions of clinical severity indicators and psychosocial factors—including depression, anxiety, stress, emotion regulation difficulties, and perceived social support—on quality of life in patients with Chronic Obstructive Pulmonary Disease (COPD), and to test their mediating mechanisms within an integrated model. Methods A total of 120 patients with COPD were assessed using spirometry, dyspnea, and symptom severity measures (mMRC, CAT), psychological assessments (DASS-21, DERS-16, MSPSS), and the WHOQOL-BREF. Mediation models using the PROCESS macro (Model 4) for SPSS were applied to evaluate the pathways linking clinical severity and psychosocial factors to quality-of-life domains. Results Among 120 participants diagnosed with COPD, disease stages were found to be GOLD A: 25.8%, GOLD B: 35.8%, and GOLD E: 38.3%. Clinical severity measures (CAT, mMRC) were moderately correlated with both psychological symptoms and emotion-regulation difficulties (p < 0.05). CAT had a significant indirect adverse effect on physical quality of life via emotion regulation difficulties [b = –0.174, 95% CI (–0.303, –0.069)]. Perceived social support positively predicted physical quality of life via lower depressive symptoms (b = 0.52, 95% CI (0.06, 1.10)). Stress was indirectly associated with poorer psychological quality of life through reduced social support [b = –0.191, 95% CI (–0.363, –0.042)]. Conclusion Psychosocial mechanisms substantially contribute to quality-of-life impairment in COPD and operate alongside traditional clinical indicators. Emotion-regulation difficulties and social support emerge as key psychological pathways linking symptom severity and quality-of-life outcomes, suggesting that comprehensive COPD management should integrate psychosocial intervention strategies.

Alcohol Use Disorder (AUD) is a leading contributor to global morbidity and mortality, disproportionately affecting people experiencing homelessness. Managed Alcohol Programs (MAPs) represent a harm reduction-based strategy for individuals with severe AUD and homelessness, providing controlled amounts of alcohol alongside comprehensive health and social supports. While evidence of MAP benefits continues to grow, important questions remain about how best to integrate social and medical care, and how to tailor services to align with participants' goals, values, and broader social and structural contexts. This commentary explores the operational strategies and clinical practices of the Ottawa Inner City Health (OICH) MAP, which has been running since 2001. We describe how the program is embedded within supportive housing and leverages an interdisciplinary team-including peer workers and an Indigenous healer-to deliver person-centered care. Key components include structured alcohol delivery tailored to individual needs, meal provision, social supports including life skills training, medication administration and comprehensive physical and mental health services. Clinical care is tailored to participants' day-to-day circumstances, challenges, and goals in managing their AUD, with particular attention to hygiene and nutrition, proactive screening for health decline, and timely management of common health complications. The program operates through strong partnerships with community organizations, pharmacies and subspecialists, to enable integrated, coordinated care. Collaborative and trauma-informed approaches reduce reliance on emergency care and foster a sense of dignity, stability, and community. MAPs have evolved from experimental interventions into internationally recognized harm reduction models. The OICH MAP demonstrates how the integration of housing, healthcare, and social supports can address the complex needs of individuals experiencing homelessness and severe AUD. However, challenges remain in scaling these models, refining screening protocols, and developing evidence-based policy frameworks. This commentary offers practical insights to inform the effective operation of MAPs and calls for continued research and dialogue to ensure they remain adaptable, sustainable, and aligned with the realities of the populations they serve.

To identify and evaluate consumer-informed strategies that online exercise leaders can use to enhance engagement in online exercise classes for people living with cancer, using social identity leadership theory as a guiding framework. We used a participatory design involving adults with a history of blood cancer. Fourteen participants attended online co-design workshops to generate strategies that online exercise leaders could use to demonstrate their engagement in the four aspects of social identity leadership. Twenty-nine unique strategies were identified and thematically grouped using both social identity leadership theory and inductive analysis. These strategies were then rated by 18 participants on their potential to enhance commitment and appeal (0-100 scales). Strategies were categorised into four domains-The SIGN Framework: Social support and connection, Individualisation and inclusion, Goals, monitoring and feedback, and Novelty. The highest-rated strategies primarily fell within the Individualisation and inclusion and Goals, monitoring and feedback domains, including tailoring exercises, setting personalised goals, adapting sessions based on well-being, and providing regular feedback. These behaviours aligned with the social identity leadership process Identity advancement, whereby leaders act in the group's interest by supporting group members' needs and progress. Qualitative findings highlighted that leaders who validate individuals' needs and preferences strengthen their sense of inclusion and group belonging. Strategies involving Social support and connection (e.g., establishing group rules) and Novelty (e.g., weekly themes) were appreciated by some participants but received more mixed ratings. Online exercise leaders who act in the group's interest and offer personalised support may enhance engagement and group identification among cancer survivors. The SIGN framework offers a practical guide for translating social identity leadership into online exercise settings. Supporting exercise leaders to apply social identity leadership strategies may increase motivation, connection, and long-term participation in online programs for cancer survivors.

The purpose of this review was to examine socioecological risk factors for substance use among sexually and gender diverse (SGD) Latine youth and young adults (YYA). We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided search in PubMed, PsycInfo, Web of Science, and MEDLINE on July 16, 2025. Inclusion criteria were the following: (1) peer-reviewed journal article published on or after January 2014; (2) sample aged between 10 and 29 years old; (3) intersectional analysis of Latine and SGD subsample; (4) analysis for associative or predictive properties of individual-level, interpersonal-level, and/or structural-level risk factors with substance use. Studies that failed to meet all criteria were excluded. The quality of articles was assessed using the Appraisal tool for Cross-Sectional Studies and the Quality of Reporting of Observational Longitudinal Research tool. Twelve studies were included in the final synthesis, the majority being cross-sectional studies (9, 75%) with youth/adolescent samples (8, 67%). Outcomes from reviewed studies indicated that depression and psychological distress were associated with substance use among SGD Latine YYA. In addition, victimization, discrimination, and absence of social support contributed to substance use among SGD Latine YYA. Outcomes from reviewed studies prompt targeted consideration of individual-level mental health and interpersonal-level discrimination and support as it relates to substance use prevention and intervention among SGD Latine YYA. Future research should explore the intersecting cultural influences of being Latine and SGD on substance use and access to mental health and social support resources among SGD Latine YYA.

This study aims to explore the characteristics of weight management stress among combat sports student-athletes in higher education and analyze how environmental factors from the perspective of environmental psychology influence their coping mechanisms. A mixed-methods research design was adopted, combining a quantitative questionnaire survey distributed to 150-200 participants and qualitative semi-structured interviews conducted with 12-15 stratified participants. Key findings revealed that competitive pressure and nutrition control difficulty were the primary sources of weight management stress, while adaptive coping strategies (e.g., seeking professional guidance) and maladaptive strategies (e.g., extreme dieting) were both adopted by the participants. Additionally, social support, institutional nutrition policies, and physical training facilities emerged as critical environmental factors affecting their stress levels and coping choices. Theoretically, this study enriches the intersection of environmental psychology and sports psychology; practically, it provides targeted insights for optimizing the support systems for college combat sports student-athletes to alleviate their weight management burden and enhance mental health.

Romantic relationships involving a partner with a disability (PWD) present unique relational dynamics, including role shifts, communication barriers, financial strain, and social stigma, which test emotional resilience and family cohesion in the Philippine context. Grounded in Person-Centered Theory and the Social Model of Disability, this study examined the lived experiences of individuals with PWD partners, guided by the central question: “What are the lived experiences of individuals with a PWD partner?” and corollary questions on relational descriptions, identified themes, and recommendations. Employing Interpretative Phenomenological Analysis (IPA), researchers purposely selected five participants aged 18–60 from Sto. Tomas and Tanauan City, Batangas, each with at least five years in a relationship with a PWD partner (stroke, deaf, dialysis, blind). Following Coker's (2021) guidelines for phenomenological saturation, semi-structured interviews were analyzed using QDA Miner Lite, yielding five major themes: (1) Family Strength, (2) Resilience, (3) Adaptation, (4) Mutual Family Solidarity, and (5) Perseverance. Subthemes included thoughtful care, communication issues, financial burden, determination, recovery, and shared responsibilities. Narratives highlighted adaptive communication, mutual support, and role flexibility as key to sustaining relationships despite challenges like misunderstandings, external shock, and emotional exhaustion. Findings underscore that family and social support, empathy, and perseverance mitigate disability-related stressors, fostering relational stability amid societal stigma and economic hardship. The study emphasizes the need for enhanced government programs, counseling, and communication training to empower these families.

The aim of this systematic review was to (a) identify the specific information and support needs of family members caring for ABI survivors and (b) assess the effectiveness of current support systems and resources available. A comprehensive search of the literature was carried out, focusing on studies that were published between the years 2000 and 2025. Seventeen studies met the inclusion criteria. The review employed a narrative synthesis approach to collate findings across papers. The analysis identified five key themes: ABI Knowledge, The Strain of Unsupported Transitions, Emotional and Financial Cost, ABI Support Groups, and Supporting Social Connectedness. The findings indicate significant gaps in current systems of support and information for families of individuals with ABI. Inconsistencies in the delivery of ABI-related information during the acute stage create stress among family members. The post-acute stage presents challenges with instrumental support and insufficient emotional and peer support. This review demonstrates the importance of a more flexible, person-centered approach in supporting families of ABI relatives. Providing tailored interventions and information, with consistent social welfare support are vital in improving the quality of life for both caregivers and ABI survivors.

Association between domains of social support and healthcare utilisation among informal caregivers of older adults in slums, Ghana

Introduction Quality of life is a multidimensional construct influenced by social support, which acts as a protective factor in patients with chronic kidney disease. Objective: To determine the relationship between quality of life and social support in patients undergoing hemodialysis treatment at IPRESS Cipreses–EsSalud, Lima, Peru, during 2025. Materials and methods: A quantitative, non-experimental, descriptive-correlational, cross-sectional study was conducted in 76 patients undergoing hemodialysis. Quality of life was assessed using the WHOQOL-BREF questionnaire, and social support was measured with the MOS scale. Statistical analysis was performed using Pearson’s correlation coefficient, with a significance level of p < 0.05. Results: A positive and statistically significant correlation was found between social support and the environmental dimension of quality of life (r = 0.297; p = 0.010). No significant associations were observed with the physical health (p = 0.110), psychological health (p = 0.281), or social relationships (p = 0.075) dimensions. The highest transformed score corresponded to the psychological dimension (61.35), while the lowest was observed in the social relationships dimension (51.31). Conclusions: Social support was significantly associated only with the environmental dimension of quality of life, which is related to material conditions and access to services. No significant association was found with physical, psychological, or social relationship dimensions, highlighting the need for family-centered support strategies and comprehensive interventions aimed at improving the biopsychosocial well-being of patients undergoing hemodialysis.

The discourse surrounding recovery narratives of Filipinos with lived experience of mental health challenges influences public understandings of mental health and individuals’ healing journeys. This study analyzed 30 recovery narratives from Philippine media outlets using Levinson’s (1983) entailment framework and Halliday and Matthiessen’s (2004) transitivity analysis. Key entailments identified include self-awareness, medical treatment, healthy and supportive environment, self-help strategies, optimism, faith, and a sense of belonging. Transitivity analysis reveals that recovery is constructed through material, mental, verbal, and relational processes, portraying it as a multifaceted journey characterized by intentional actions, reflective understanding, emotional expression, and social support. These findings suggest that mental health recovery is not only a clinical outcome but also a socially, emotionally, and culturally embedded process that requires personal agency and meaningful engagement. The study provides evidence-based insights to inform curriculum design and policy development, aiming to promote mental health awareness, empathy, resilience, and culturally relevant approaches that support well-being.

Self-control and social support in the link between academic pressure anxiety depression and social media addiction in college students.

Attitudes toward AI in health- and non-health-related contexts: Context matters, not mood or perceived social support.

Burnout is a debilitating syndrome associated with emotional exhaustion, depersonalization, and a low sense of personal accomplishment. For medical students, studies suggest that burnout related to stress may begin as early as their first year and can be associated with poor academic performance, general distress, substance abuse, and suicidal ideation. Previous literature suggests that mindfulness training, breathing exercises, and social support can be protective against the effects of burnout. Our study aimed to evaluate the efficacy of a new wellness program consisting mainly of brief, daily, mindfulness-based micro-habit training sessions. The study adopted a single-group before-and-after design for a duration of eight weeks. Twelve medical students consented to participate (7 female); mean age = 26.25 years (SD = 4.4). The micro-habit intervention is delivered by a mobile app and is supported by weekly peer-circle meetings. The micro-habits are taught by listening to self-contained 90-second mindfulness exercises, at least once daily, five days per week. Maslach burnout inventory, a well-established 22-item self-report survey; Depression Anxiety Stress Scale (DASS21), a 21-item version of the DASS42; and Weekly Stress Scale, for which participants reported their stress level in terms of one of the categories (i.e., green, amber, or red) each week. The six participants who completed the post-intervention Maslach inventory exhibited a significant decline in emotional exhaustion (P = .03, 1-tailed) with a large effect size (d = 0.99). The five participants who completed the DASS21 at post-intervention averaged a considerable but non-significant decline in anxiety (d = 0.57). Despite the small sample size, it is encouraging that even a brief micro-habit intervention, one suited to busy medical students, can produce a considerable decrease in burnout symptoms, warranting a study with a larger cohort. burnout, mindfulness, habits, micro-habits, stress, wellness, medical students.

Background Transgender and gender diverse (TGD) individuals experience elevated rates of emotional distress, often thought to be linked to minority stress, identity-related challenges, and limited access to affirming mental health care. Emotion regulation has emerged as a potential key therapeutic target for improving well-being in this population but less is known about how TGD individuals describe their own needs in relation to psychological treatment. Aim This study aimed to qualitatively explore the emotional and psychological needs of TGD individuals, and their experiences of an internet-delivered emotion regulation intervention (I-ER) specifically developed for TGD people. Method Ten TGD individuals who had received the I-ER treatment participated in semi-structured interviews. Data were analyzed using reflexive thematic analysis. Results Four themes were identified: (1) Emotional Exploration and Self-Understanding, (2) From Emotional Insight to Change, (3) Possibilities for and Limitations in Social Support, and (4) Barriers and Bridges to Treatment Engagement. Participants described the intervention as helpful for emotional insight, identity exploration, and behavioral change. The TGD-specific adaptation fostered a sense of recognition and belonging for most participants. However, challenges related to structure, support access, and individual fit were noted. Conclusion Emotion regulation interventions tailored to TGD individuals can be perceived as helpful and supportive when culturally grounded, flexible, and relationally sensitive. Findings highlight the importance of integrating identity-affirming content and addressing diverse support needs in digital mental health programs.

In spite of numerous advancements in HIV prevention, there are still gaps that impede reaching key populations throughout sub-Saharan Africa. Traditional approaches usually overlook personal preferences, social context and structural obstacles, often leading to subpar service uptake. Person-centred care (PCC) has emerged in recent times as an approach that shows promise; however, its implementation is still not widespread in sub-Saharan Africa. This scoping review aimed to systematically map the landscape of Person- Centred HIV prevention services in Sub-Saharan Africa, identifying intervention models, outcomes, and implementation barriers and facilitators. A comprehensive search of PubMed, ScienceDirect, Google Scholar, and AJOL identified studies published between 2010 and 2025. Following PRISMA-ScR guidance, 174 records were identified, 33 duplicates removed, and 141 records screened. A total of 128 records were excluded, 13 full texts were sought, and 12 studies from six countries met the inclusion criteria. Data were charted and synthesised narratively. Services included PrEP programmes, choice based models, peer-led outreach initiatives, and differentiated ART delivery systems. Essential elements of PCC included shared decision-making, decentralisation, social support, and counselling that takes into account stigma. Models that are community-based and peer-supported improved accessibility, trust, and adherence to treatment. Interventions that provided options for prevention methods and service locations consistently demonstrated improved uptake, satisfaction, and clinical outcomes. Nonetheless, implementation varied by region, with no representation from West and Central Africa and notable disparities in reach among adolescent boys, older adults, and sexual minorities. Evidence from the included studies indicates that person-centred strategies can enhance engagement with HIV prevention services in several settings across sub-Saharan Africa. However, the benefits were not uniform, and gaps in geographical representation, equity, and integration of broader psychosocial needs persist. Future programmes should address structural barriers, strengthen psychological safety and community trust, and ensure more inclusive design to improve the reach and consistency of person-centred HIV prevention.

Dementia is more prevalent in Puerto Rico than in the U.S. mainland, increasing demands for caregiving. However, research on the mental health impact of dementia caregiving among island Puerto Ricans is sparse. We examined caregiver burden and depressive symptoms among Puerto Rican dementia caregivers while also considering behavioral and psychological symptoms of dementia (BPSD). Using data from the Puerto Rican Elder: Health Conditions (PREHCO) study (Wave 3), 132 caregivers of PREHCO participants requiring care completed an ancillary data collection, of whom 101 cared for PREHCO participants with dementia. Measures included the 15-item Geriatric Depression Scale (depressive symptoms), Neuropsychiatric Inventory Questionnaire (NPI-Q; BPSD), and Zarit Burden Interview (ZBI-6; caregiver burden). Caregivers were 63 ± 10 years of age on average, and 77% were women. Exploratory factor analysis yielded two BPSD factors: Emotional Dysfunction/Behavioral Instability and Perceptual Disturbances/Apathy. In linear regression models adjusted for age, sex, education, marital status, self-rated health, hours of caregiving per week, and perceived social support, caregiver burden was positively associated with depressive symptoms (β = 0.68, p<.001), as were BPSD factors Emotional Dysfunction/Behavioral Instability (β = 0.50, p<.001) and Perceptual Disturbances/Apathy (β = 0.50, p<.001). Only Perceptual Disturbances/Apathy significantly moderated this association (β = 0.24, p=.032), with the burden-depression link strengthening as BPSD increased. Appetite/Eating Symptoms (β = 0.42, p=.007) emerged as the main BPSD item driving this moderation effect. In this Puerto Rico-based sample, perceptual disturbances/apathy, and appetite/eating symptoms specifically, were most likely to magnify the caregiver burden-depressive symptoms link.

ABSTRACT The aim of this study is to determine the relationship between pain, psychological resilience, and perceived social support in liver cancer surgery cases. This is a descriptive and correlational study with a cross-sectional design. The research was conducted between May 2025 and August 2025 in the liver transplant unit and outpatient clinics of Y Medical Center, with a total of 45 patients. Data were collected using the Descriptive Characteristics Form, the Numeric Pain Rating Scale (NPRS), the Brief Resilience Scale (BRS), and the Multidimensional Scale of Perceived Social Support (MSPSS). For data analysis, independent samples t-test, analysis of variance (ANOVA), Pearson correlation analysis, and simple linear regression analysis were used. The study revealed a strong negative correlation between psychological resilience and pain levels (r = -0.842, p = 0.001), and a strong negative correlation between perceived social support and pain levels (r = -0.821, p = 0.002). In addition, a strong positive correlation was found between perceived social support and psychological resilience (r = 0.873, p = 0.001). Regression analysis indicated that perceived social support predicted 32% of the variance in pain levels and 42% of the variance in psychological resilience. The study found that as psychological resilience and perceived social support increased, pain levels decreased in liver cancer surgery cases. Furthermore, higher levels of perceived social support were associated with increased psychological resilience. Therefore, a holistic approach that includes not only physical but also psychological and social care should be adopted in the postoperative care process of these patients.

Background/Objectives: Breastfeeding is widely acknowledged for its benefits to child development and maternal well-being. Yet breastfeeding practices often decline during early childhood transitions, particularly when children enter early childhood education and care (ECEC) services. Research has largely concentrated on healthcare contexts, leaving the educational domain comparatively underexplored in its potential to sustain or hinder breastfeeding continuation. This cross-sectional study examines associations between maternal beliefs regarding the value of breastfeeding and personal, relational, and contextual factors related to breastfeeding continuation within ECEC settings. It also incorporates educators’ perspectives and situates breastfeeding practices within the broader framework of parental ethnotheories. Methods: The study formed part of a pilot parental engagement initiative involving 17 childcare centers in Northern Italy, designed to promote dialogue and supportive practices around breastfeeding within ECEC services. This context is acknowledged when interpreting findings related to organizational climate and educator perspectives. Participants included 490 mothers of children enrolled in ECEC services and 118 educators. Mothers completed questionnaires assessing breastfeeding beliefs and experiences, co-sleeping practices, perceived social support, and parental ethnotheories (independence versus interdependence). Educators reported on their experiences in supporting breastfeeding within the childcare context. Analyses included descriptive statistics, analyses of variance, chi-square tests, and binary logistic regression to examine factors associated with breastfeeding continuation. Results: Mothers strongly endorsed the developmental benefits of breastfeeding and expressed greater alignment with caregiving practices emphasizing interdependence and physical proximity. Continued breastfeeding within childcare settings correlated with interdependence-oriented ethnotheories, younger child age, and higher engagement in co-sleeping practices. Educators reported generally positive views of breastfeeding in childcare, highlighting its contribution to children’s emotional security and maternal calm, alongside its negligible impact on educational organization. Conclusions: ECEC services play a crucial role in sustaining breastfeeding beyond the domestic sphere. Relational practices and organizational climates that welcome breastfeeding can foster continuity of care, strengthen parental engagement, and promote child well-being.