Valid Questionnaires Research Articles

A Cross-Sectional Study of Pre-Prepared Foods Knowledge, Attitudes, and Practices of College Students in Central China.

Objectives: This study aimed to investigate knowledge, attitudes, and practices related to pre-prepared foods among college students in Central China. Methods: From the end of May 2024 to June 2024, we completed a cross-sectional study using an online questionnaire. A total of 1676 questionnaires were distributed online, and 1566 valid questionnaires were collected. Data were analyzed using Kruskal-Wallis tests or Wilcoxon rank-sum tests for univariate analysis. A multiple linear regression model was employed with knowledge, attitudes, and practices scores as dependent variables to identify factors associated with the scores on pre-prepared food knowledge, attitudes, and practices. Results: The survey results showed that 56.7% of the participants had high knowledge scores, 4% of the participants had high attitudes scores, and only 0.4% of the participants had high practices scores. Multiple linear regression analysis showed that ethnicity, the number of children in the family, academic qualifications, and monthly living expenses were associated with college students' knowledge of pre-prepared foods (p < 0.05). Gender and the satisfaction with school catering services were associated with college students' attitudes of pre-prepared foods (p < 0.05). Gender, knowledge and attitudes were associated with practices of pre-prepared foods (p < 0.05). Conclusions: College students have a relatively high level of knowledge of pre-prepared foods. However, they have more negative attitudes and practices towards pre-prepared foods, and the overall KAP levels are low.

Study on the Cognitive Status of Foodborne Parasitic Diseases and its Influencing Factors

Objective: To explore the cognitive status and influencing factors of foodborne parasitic diseases. Methods: 2301 residents were selected as samples, and CDC staff conducted questionnaire surveys on them and statistically analyzed the survey results. Results: 2285 valid questionnaires were collected, and the awareness rate of residents’ knowledge about foodborne parasitic diseases ranged from 21.3% to 59.4%. The results of the multi-factor regression analysis showed that factors influencing the awareness of foodborne parasitic diseases include education level, relatives working in medical institutions, attention to news related to food safety, history of food poisoning, satisfaction with food hygiene, degree of concern about one’s health, whether received health education on parasitic diseases and whether they actively searched for knowledge on parasitic diseases (P &lt; 0.05). Conclusion: The residents surveyed in this study have poor awareness of foodborne parasitic diseases. Health education needs to be carried out based on the influence of relevant factors, and prevention and control work should be strengthened.

Continuous adoption of online healthcare platforms: an extension to the expectation confirmation model and network externalities

BackgroundOnline healthcare platforms (OHPs) promote the accessibility of health services while integrating online and offline service delivery. Continuous adoption of these platforms can reduce the information asymmetry between patients and healthcare providers. However, existing study has rarely focused on how the network externalities of these platforms influence patients’ continuous adoption. Expectation Confirmation Model (ECM) explains the continuous behavior after initial adoption and reveal the factors influencing satisfaction and continuous adoption intention. Few studies have integrated network externalities with the ECM to understand patients’ continuous adoption of OHPs.ObjectiveThis study aims to explore what factors affect the continuous adoption of OHPs based on an extension to the ECM and network externalities. We propose a comprehensive model for the continuous adoption of OHPs by patients with chronic diseases. We extend the conceptual framework by incorporating constructs related to perceived value, habits, and switching costs.MethodsThis study utilized a web-based survey to collect data from participants in China. We selected a sample of individuals who had experience with OHPs using a random sampling method. This method ensured that participants was randomly chosen from a pool of patients without any regional bias. A total of 568 questionnaires were collected and 518 valid questionnaires were obtained. Structural equation modeling was applied to assess the relationships among the constructs. Hierarchical regression analysis was utilized to examine the moderating effects, while the mediating effects were investigated using the bootstrapping approach.ResultsDirect network externality had significant positive impacts on the confirmation (β = 0.232, p < 0.001) and perceived value (β = 0.167, p < 0.010). Cross network externality had significant positive impacts on confirmation (β = 0.307, p < 0.001) and perceived value (β = 0.120, p < 0.05). Indirect network externality had significant positive impacts on confirmation (β = 0.169, p < 0.010) and perceived value (β = 0.270, p < 0.001). Confirmation had a significant positive impact on perceived value (β = 0.205, p < 0.001) and satisfaction (β = 0.508, p < 0.001). In addition, satisfaction had a significant positive impact on continuous adoption intention (β = 0.579, p < 0.001). Continuous adoption intention had a significant positive impact on continuous adoption behavior (β = 0.547, p < 0.001). Confirmation and perceived value significantly mediate the relationship between network externalities and satisfaction. Moreover, both confirmation and perceived value enhance continuous adoption intention by positively influencing satisfaction, which serves as a mediator. Additionally, confirmation directly influences satisfaction through the mediating role of perceived value. Habits and switching costs positively moderate the relationship between continuous adoption intention and behavior.ConclusionsThis study contributes by expanding the incorporation of network externalities into the ECM. Results enrich the existing literature on the continuous adoption of professional online platforms.

Innovations of Express Companies: Adoption of Protective Wearable Artificial Intelligence Devices by Couriers

Providing couriers with wearable artificial intelligence devices to prevent accidents is not only beneficial to the courier’s safety but will also save money in terms of insurance premiums for express companies; therefore, it is worth investigating what factors can influence the acceptance of wearable artificial intelligence devices by couriers. Push–pull–mooring (PPM) theory and affective event theory (AET) are integrated, to test couriers’ adoption of wearable safety detection devices. Social influence, perceived security, personal innovativeness, and affective event reaction are applied to the research model. Questionnaires are distributed among several listed express companies and 263 valid questionnaires are used for empirical testing. Empirical results indicated that social influence, perceived safety, personal innovativeness and affective event reaction are positively related to usage with coefficients 0.218, 0.301, 0.698 and 0.309. Personal innovativeness has positive moderating effects on relationships between affective event reaction, perceived security and usage, with coefficients 0.145 and 0.106; however, it has no significant moderating effect on the relationship between social influence and usage. The research aims to help support the proliferation and adoption of wearable artificial intelligence devices to optimize the current state of the express industry and improve the interaction between couriers and managers, creating an active management strategy that will allow express companies to thrive. The study not only provides insights to help express companies reduce insurance costs, but also provides recommendations for accelerating the company’s environmental, social and governance goals, leading sustainable development and building new corporate value.

Validation of the University Student Engagement Questionnaire in the Field of Education

Validation of the University Student Engagement Questionnaire in the Field of Education

Cross-Cultural Adaptation and Clinical Validation of the Mini Sarcopenia Risk Assessment Questionnaire in Community-Dwelling Spanish Older Adults

(1) Background: The aim was to analyze the reliability and validity of the Spanish version of the Mini Sarcopenia Risk Assessment (MSRA) in older adults. (2) Methods: A total of 136 participants (72.24 ± 5.21 years, 68.38% women) took part in the study. The MSRA includes two questionnaires with seven (MSRA-7) and five items (MSRA-5). First, reliability (inter-rater and test–retest) of the Spanish MSRA was studied, and then the total scores were compared with the presence of sarcopenia according to three different diagnostic criteria and with other parameters related to sarcopenia (clinical validation). (3) Results: The analysis showed excellent inter-rater and test–retest reliability. As for the clinical validation, and regardless of the criteria, both questionnaires had a high sensitivity (81.82–88.89% for the MSRA-5 and 90.91–94.44% for the MSRA-7), while the MSRA-5 showed a better specificity (32.00–33.90%) than the MSRA-7 (20.80–22.88%). Predictive positive values ranged from 9.57–17.02% (MSRA-5) and 9.17–15.54% (MSRA-7), while predictive negative values were high for both the MSRA-5 (95.24%) and the MSRA-7 (96.30–96.43%). The accuracy was better for the MSRA-5 (36.03–41.18%) than the MSRA-7 (26.47–32.35%), as well as the area under the curve (0.67–0.76 vs. 0.65–0.73, respectively). Higher MSRA-5 and MSRA-7 total scores significantly correlated with greater muscle strength, quantity and gait speed. (4) Conclusions: The adaptation of the Spanish MSRA questionnaires was successfully performed, and they are reliable and clinically valid tools for assessing sarcopenia.

From plate to post: how foodstagramming enriches tourist satisfaction and creates memorable experiences in culinary tourism

ABSTRACT The study explores how dining environment attributes affect foodstagramming engagement, the impact of foodstagramming on tourists’ satisfaction, and the formation of memorable experiences. A total of 627 valid questionnaires were analysed employing SEM-PLS Warp8 to evaluate the proposed model. The study's findings demonstrate that the dining environment significantly influences the behaviour of tourists. This behaviour partially mediates the interaction between the dining environment, tourists’ satisfaction, and memorable culinary experiences. Additionally, it demonstrated that the overall culinary experiences of memorable tourists act as a mediator between the phenomenon of foodstagramming and the satisfaction of tourists. The research concludes by providing theoretical and practical implications, as well as suggestions for future research directions. This study integrates the theories of social cognitive, self-presentation, uses and gratifications theory, and nostalgia and memory to interpret the fascinating complex foodstagramming phenomenon. Restaurant managers should invest in the training of chefs to create visually stunning dishes and enhance the dining environment to encourage foodstagramming behaviour.

Cross-cultural adaptation and validation of the Arabic version of the knee and hip health-related quality of life (Mini-OAKHQOL) questionnaire in male Saudi patients with osteoarthritis: a methodological observational design.

Osteoarthritis (OA) is common in Saudi Arabia, has a significant impact on quality of life (QoL), and lacks a specific questionnaire to measure QoL. The primary objective of this study was to translate and cross-culturally adapt the Mini Osteoarthritis Knee and Hip Quality of Life (Mini-OAKHQOL) questionnaire into Arabic and to determine its psychometric properties among OA knee and/or hip patients in Saudi Arabia. A methodological observational design was conducted and followed standard guidelines for cross-cultural adaptation of Mini-OAKHQOL into Saudi Arabic. Two hundred and eight primary OA knee and/or hip male participants aged between 45 and 80 years with a mean age of 58.65±13.8 years and a BMI of 29.5±1.2 kg/m2 were included and performed the stages of translation to target Arabic language (forward T1 and T2), synthesized an Arabic draft (T12), then back-translated to English (BT1 and BT2), followed by expert committee review to rectify the deficiencies leading to a prefinal stage involving a pilot test on native Arabic speakers, thereby finalized a final Arabic version. The Arabic Mini-OAKHQOL, Arabic Short Form 12 (SF12), and visual analog scale (VAS) were administered to analyze internal consistency (IC), test-retest reliability at baseline as well as one week later (up to the 10th day). The construct validity was tested using Spearman's rank correlation, and factor analysis was done to establish a five-factor fit model. Homogeneity was determined using principal component analysis (PCA). Floor and ceiling effects calculated in percentages. The Arabic Mini-OAKHQOL showed an excellent Cronbach's alpha of the overall scale (α=0.931) for its internal consistency and an excellent intraclass correlation coefficient (ICC) of 0.947 for its retest reliability, with a high response rate of 93.75%. The construct validity of this scale was good with Ar-SF12 and VAS pain. A five-factor model fit was considered acceptable, and factor loading for each item found within the permissible limits confirmed the factorial validity. None of the items, dimensions, or overall scale showed either a floor or ceiling effect. The adapted and tested Arabic Mini-OAKHQOL is a reliable and valid questionnaire to measure the impact of knee and/or hip OA on quality of life in the Saudi Arabian male OA population to reduce the respondent's burden for use in clinical and prospective studies.

Validity and reliability of the Turkish version of the hearing implant sound quality index questionnaire (HISQUI19)

Objectives The aim was to construct validity and reliability of the Hearing Implant Sound Quality Index Questionnaire (HISQUI19) in Turkish. Methods This study was a methodologic study to validate HISQUI19 in Turkish. The study included 62 cochlear implant users. Guttman’s split half-coefficient and Cronbach’s alpha tests were used for construct validity and internal consistency. Pearson correlation test was used to assess the relationship of the HISQUI19 total score to the SSQ49 scales for CI users and to show test – retest reliability. Results The Cronbach’s α value was 0.94 overall score with high internal consistency (Guttman’s split-half-coefficient: 0.912). Test-retest reliability results showed high repeatability and consistency of the measure across time (r = 0.708; P = 0.002). Support for conducting factor analysis was provided by the KMO test, with a value of 0.876, which is ‘great’. Discussion Subjective evaluation of cochlear implant users’ daily life experiences is a useful tool to reveal the auditory benefits of cochlear implant usage. Conclusion Turkish version of the HISQUI19 is a reliable and valid assessment tool for adults with CIs. This questionnaire provides clinicians with a valuable, reliable, and valid tool for determining the subjective benefit of CI for patients.

How Does Aesthetic Design Affect Continuance Intention in In-Vehicle Infotainment Systems? An Exploratory Study

With the digitalization of automobile cabins, in-vehicle infotainment systems play an increasingly pivotal role in vehicles. This study aims to understand how the interface aesthetics of the in-vehicle infotainment system affect users’ continuance intention in in-vehicle infotainment systems. Based on a literature review, a theoretical model was constructed, encompassing seven latent variables: simplicity, colorfulness, diversity, craftsmanship, functional value, emotional value, and continuance intention. Analysis of 243 valid questionnaires revealed that both functional and emotional values serve as crucial mediators in encouraging users to continue using the in-vehicle infotainment system, with functional quality being the core element. Moreover, simplicity, diversity, and craftsmanship indirectly affect continuance intention by influencing both functional and emotional values. These findings underscore the need for future designers of in-vehicle infotainment systems to focus on interface functionality and emotional needs, and to ensure that content is concise, engaging, user-friendly, and visually polished, thereby enhancing the user experience and fostering the intention to continue usage.

Personal Attributes Contributing to Chinese EFL Students' Well‐being: Uncovering the Role of Mindfulness and Grit

ABSTRACTThe role of students' well‐being in their academic development and growth has been reported in the literature. Nonetheless, most of the previous studies have revolved around the predictive role of interpersonal factors in students' well‐being, and the influence of personal factors is overlooked. To bridge this gap, this study probed the role of two personal attributes, namely mindfulness and grit, in English students' well‐being. To accomplish this, three valid questionnaires were sent to 623 Chinese English as a foreign language (EFL) students chosen from different language institutes in China. Following that, confirmatory factor analysis (CFA) and structural equation modelling (SEM) were implemented to analyse the potential associations between mindfulness, grit, and well‐being, as well as the role of mindfulness and grit in Chinese students' well‐being. The results demonstrated that Chinese students' well‐being was tightly associated with their mindfulness and grit. Students' grit and mindfulness could uniquely predict 59% and 64% of students' well‐being changes, respectively. The complexity and dynamic nature of positive emotions and personal attributes may also be reasons for the obtained predicting role. It is asserted that L2 practitioners should strike a balance between personality‐related factors and psychological ones to facilitate their students' well‐being.

ICD-11 adjustment disorder: Translation and validation of the Danish international adjustment disorder questionnaire among a working population of social educators

Adjustment disorder is frequently used as a diagnostic category for work-related stress disorders in Denmark. However, the diagnostic category is poorly delineated in ICD-10 which has hampered clinical practice as well as research studying the development of work-related adjustment disorders. In ICD-11, the diagnostic category of adjustment disorder has been refined and a new self-report measure is available to operationalize symptoms. The aim of the current study is to translate the International Adjustment Disorder Questionnaire (IADQ) to Danish and test the psychometric properties of the scale in a sample of social educators. A total of 609 social educators in current employment participated in an online survey including the IADQ and data was analyzed using confirmatory factor analysis. Findings suggested that a two-factor model reflecting the distinction between preoccupation and failure to adapt as part of the diagnostic criterion fitted the data best, although strong factor correlations and one cross-factor loading suggests that differentiating between the dimensions of preoccupation and failure to adapt is difficult. Relationships to burnout, posttraumatic stress and general distress support the validity of the Danish translation of the IADQ. Further research should explore the structure of adjustment disorder among other working populations.

Enhancing Fire Safety Knowledge among Underwater Road Tunnel Users: A Survey in China

In recent years, the number of underwater road tunnels in Chinese cities has increased. However, the current situation of personal fire safety literacy as it pertains to these tunnels remains unclear. To address this gap, a questionnaire survey was conducted to investigate people’s awareness of escape slides, evacuation signs, and the correct evacuation paths for fire escape. A total of 1049 respondents in Changsha, China, were surveyed, with 791 valid questionnaires collected and analyzed. The findings revealed that a significant proportion of respondents (81.80%) were unaware of the presence of escape slides in underwater road tunnels, while 87.86% could not recognize them and 93.05% could not use them. Only 42.04% of respondents could identify evacuation signs in underwater road tunnels. In the event of a fire, just half of the respondents could select the appropriate escape or evacuation path. Additionally, demographic differences among respondents also influenced their level of fire safety literacy. Based on these findings, it is recommended that the government and relevant organizations should enhance the dissemination of knowledge regarding escape slides and evacuation signs in underwater road tunnels.

Attitude of Students and Professors Toward Quality of Residency Medical Education at the Selected University of Medical Sciences in Tehran in 2023

Background: Clinical education is one of the most essential components of medical student education, as it significantly impacts students' professional futures and the training of healthcare experts. Objectives: This study aimed to assess the quality of clinical teaching from the perspective of residents and professors at selected medical schools in Tehran city. Methods: A descriptive cross-sectional study was conducted using the census technique on 81 residents and 48 faculty members from internal medicine, surgery, radiology, anesthesia, and physical medicine in 2023. The data collection instrument was a reliable and valid questionnaire. After gathering the data, SPSS software computed the score for each item and reported it as a percentage. Results: The research findings showed that residents reported morning reports are always held in 94% of the internal medicine group and 60% of the surgical group. Additionally, 80% of the residents and 100% of the professors in the surgery department stated that the group held regular mortality and morbidity meetings. Thirty-three percent of radiology and physical medicine residents mentioned that the hospital amenities are of good quality. The residents of the physical medicine department reported that theory classes are always held 83% of the time. Conclusions: According to the present findings, the quality of education in internal medicine and surgical courses is optimal from the perspective of both professors and students. Periodic studies on the sustainability and improvement of current educational conditions are recommended.

Perceptions and Satisfaction With the Use of Digital Medical Services in Urban Older Adults of China: Mixed Methods Study.

In an aging and information-driven society, older adults have distinct perceptions of and specific demands for digital medical services. It is essential for society to understand these needs and develop a more thoughtful approach to digital health care. This study aims to evaluate the behavioral intention and satisfaction of older adults with digital medical services by identifying the perceived factors and the pathways through which these factors influence their behavior. This study used a mixed methods approach, combining qualitative and quantitative analyses. A focus group interview was conducted with 30 randomly selected older adults, and the interviews were transcribed verbatim and coded using grounded theory. In addition, 876 valid questionnaires were collected to describe older adults' perceptions of and satisfaction with digital medical care. Then, t tests and ANOVA were used to explore differences among various demographic groups, while hierarchical multiple regression was conducted to identify the factors most closely related to satisfaction. Structural equation modeling was used to identify multiple mediating effects. The qualitative study identified the core category of "medical service relief and transformation paths for older adults in the context of digital reform." Quantitative analysis revealed that more than half of the older adults were satisfied with digital medical services, and behavioral intentions were higher among those with higher incomes and education levels. Structural equation modeling confirmed that external variables, such as digital skills training, positively influenced perceived ease of use (β=.594, P<.001), perceived usefulness (β=.544, P<.001), and promoted digital medical behavioral intentions (β=.256, P<.001), while also reducing perceived risk (β=-.295, P<.001). Additionally, perceived ease of use (β=.168, P<.001) and perceived usefulness (β=.508, P<.001) positively impacted behavioral intention, whereas perceived risk (β=-.05, P=.037) exerted a negative influence. Furthermore, behavioral intention (β=.641, P<.001) significantly and positively affected older adults' satisfaction with digital medical care. The mediation test identified 4 significant paths: (1) external variables → perceived ease of use → behavioral intention (effect size of 13.9%); (2) external variables → perceived usefulness → behavioral intention (effect size of 38.4%); (3) external variables → perceived ease of use → perceived usefulness → behavioral intention (effect size of 10.1%); and (4) a direct effect (35.5%) from external variables to behavioral intention. Based on the study's findings, addressing the needs of older adults and enhancing perceived usefulness are the most effective ways to encourage the use of digital health care devices. Community support plays a crucial role in helping older adults integrate into digital health care, and adapting the design of services and products to suit their needs improves their perceptions of digital health care. This, in turn, promotes usage behavior and satisfaction, while the negative impact of perceived risk remains minimal.

Breastfeeding Basic Competence in Primary Care: A Spanish Translation and Cross-Cultural Validation of the CAPA Questionnaire.

The number of validated questionnaires that assess the level of breastfeeding competence of primary care professionals who attend lactating mothers is limited. To validate the CAPA (Competència en l'Atenció Primària sobre Alletament [Breastfeeding Competence in Primary Care]) questionnaire into Spanish in collaboration with professionals from the primary care services of the Comunidad de Madrid (Spain). In this multicentric study, four bilingual healthcare professionals translated the CAPA questionnaire into Spanish and back-translated it into Catalan. The cross-cultural adaptation included a discussion by an expert committee, a review by a philologist, and a pilot study that involved 13 healthcare residents. We randomly selected professionals from specialties involved in breastfeeding. The re-test was conducted 3 weeks later, aiming to avoid changes in the studied population. We performed a factor analysis to identify underlying constructs and hypothesis-testing to assess the validity of the questionnaire and estimated the Cronbach Alpha and intraclass correlation coefficient (ICC) to assess its reliability. A total of 198 professionals participated by responding to the questionnaire. Factorial analysis showed that the questionnaire was unidimensional. Hypothesis testing showed that, of all the considered professional groups, midwives achieved the highest mean score (M = 131.7, SD = 10.9, p < 0.001). Amongst the other professionals, only 26.5% achieved a basic level of breastfeeding competence. The Cronbach alpha and ICC were 0.852 (95% CI [0.821, 0.880]) and 0.890 (95% CI [0.800. 0.937]). The Spanish CAPA questionnaire is a valid and reliable tool for assessing breastfeeding basic competence among primary care professional groups who attend lactating mothers.

The impact of smartphone dependence on college students' sleep quality: the chain-mediated role of negative emotions and health-promoting behaviors.

Sleep disturbances among college students have become a significant issue affecting their daily lives. This study aims to explore the relationship between smartphone dependence and sleep quality and examine the mediating roles of negative emotions and health-promoting behaviors. A total of 23,652 college students were included in the study, and 21,314 valid questionnaires were collected. The survey assessed demographic factors, smartphone dependence, sleep quality, negative emotions, and health-promoting behaviors. A chain mediation analysis was conducted to examine the relationships among these factors. Smartphone dependence was significantly positively correlated with sleep quality (r = 0.272, p < 0.001) and negative emotions (r = 0.414, p < 0.001), and significantly negatively correlated with health-promoting behaviors (r = -0.178, p < 0.001). Sleep quality was positively correlated with negative emotions (r = 0.472, p < 0.001) and negatively correlated with health-promoting behaviors (r = -0.218, p < 0.001).Smartphone dependence was a significant positive predictor of sleep quality. Moreover, negative emotions and health-promoting behaviors influenced the relationship between smartphone dependence and sleep quality. The total effect, direct effect, and indirect effect values were 0.304, 0.122, and 0.170, respectively. Different demographic factors (such as gender and place of residence) can lead to variations in different variables. Smartphone dependence and negative emotions have a positive impact on sleep quality among college students, while health-promoting behaviors have a negative impact. Smartphone dependence directly and positively affects sleep quality and can also influence it indirectly through the mediating effects of negative emotions and health-promoting behaviors, both individually and in a chain-like manner.

A Non-Compensatory Index of Community Participation in Cross-Border Tourism Development Processes

We propose a composite index to measure and benchmark community participation in cross-border tourism development processes. The index synthesizes information regarding three dimensions of this construct, deemed as very important by the extant literature: residents’ engagement in the planning process and willingness to proactively welcome tourists and provide tourist services directly through sharing-economy platforms. The latter aspect is crucial to develop a local tourist supply able to combine environmental sustainability and financial feasibility in marginal areas, where public funding is scarce and private investments are unprofitable. This study offers a methodological innovation using response rates to open-ended questions to measure residents’ engagement in tourism planning. By applying the ELECTRE III algorithm, which is non-compensatory and ensures reliability in the presence of a high degree of uncertainty, survey information is aggregated in a single figure, which can be easily interpreted by destination managers and policymakers. After COVID-19, in readying for the next pandemic, decision makers should find our index as a very relevant and useful tool for tourism recovery and innovation planning, including compliance with measures to prevent the spread of future infections. We apply the proposed index to ten Croatian and Italian lands involved in a European development project. Data were collected through face-to-face interviews with residents, according to an availability sampling design. We obtained 879 valid questionnaires. The robustness of the resulting index is tested through an uncertainty and a sensitivity analysis.

Resident Participation in Environmental Governance of Sustainable Tourism in Rural Destination

The rapid development of rural tourism has placed significant pressure on the rural environment, and relying solely on the government and market forces is insufficient for effective governance. It is urgent to integrate endogenous rural forces into environmental governance. The development of social behavior theory offers new insights into exploring sustainable approaches for resident participation in environmental governance in rural tourism areas. This paper, based on the Stimulus-Organism-Response (SOR) theoretical framework from social behavior theory, outlines the entire process of rural tourism residents transitioning from individual stimuli to psychological responses and ultimately to participation in environmental governance. This study combines the Motivation-Opportunity-Ability (MOA) model to analyze the stimulus factors affecting local residents and jointly constructs a path mechanism model for resident participation in environmental governance in rural tourism areas. A total of 462 valid questionnaires were collected through a survey, and the Partial Least Squares Structural Equation Modeling (PLS-SEM) method was used for empirical testing to determine the path coefficients between variables. On this basis, a system dynamics model was constructed to simulate the dynamic evolution of the relationships between variables. This study found the following: (1) In the process of rural tourism, residents’ participation in environmental governance relies on motivational factors at the stimulus level to play a core leading role; opportunity factors act as catalysts, and ability factors serve as auxiliaries; participation willingness at the organism level plays a crucial role. (2) Material pursuit and formal institutions are the strongest single sustainable factors for residents’ participation in environmental governance in rural tourism areas; combinations of variables such as local attachment, governance knowledge, and governance identity have significant effects. It is recommended that future rural tourism leverage government guidance, coordinate interests, and adhere to a collaborative development approach to ensure the sustainable development of the rural tourism environment.

Knowledge, attitude, and practice toward nutrition support and management among hemodialysis patients

Nutrition support is an important care component for patients on hemodialysis. Also, patient self-management is important to maintaining proper nutritional intake during hemodialysis. This cross-sectional study investigated the knowledge, attitude, and practice (KAP) towards nutrition support and management among hemodialysis patients treated at the West China Hospital of Sichuan University between January and March 2023. Among 445 (95.91%) valid questionnaires, 58.43% were filled out by male patients. The knowledge, attitude, and practice scores were 11.44 ± 1.80 (possible range: 0–13), 30.29 ± 3.22 (possible range: 8–40), and 31.27 ± 5.67 (possible range: 8–40), respectively. Age > 60 years (OR = 0.487, 95%CI: 0.260–0.913, P = 0.025) and junior college or undergraduate or above (OR = 2.606, 95%CI: 1.621–4.189, P < 0.001) were independently associated with adequate knowledge. The knowledge (OR = 1.151, 95%CI: 1.024–1.294, P = 0.018) and female gender (OR = 0.632, 95%CI: 0.419–0.953, P = 0.029) were independently associated with positive attitude. The knowledge (OR = 1.404, 95%CI: 1.221–1.614, P < 0.001), attitude (OR = 1.146, 95%CI: 1.069–1.227, P < 0.001), age 51–60 years (OR = 1.879, 95%CI: 1.093–3.229, P = 0.022), and BMI of 24.0–27.9 kg/m2 (OR = 0.434, 95%CI: 0.269–0.700, P = 0.001) were independently associated with proactive practice. Hemodialysis patients showed adequate knowledge, positive attitudes, and proactive practice; however, there were also several gaps in knowledge and misconceptions regarding proper nutritional self-management. Accordingly, addressing these gaps and misconceptions through carefully designed and effectively implemented education is crucial for providing comprehensive guidance on optimal nutrition and self-management strategies.