The Associations among Psychological Distress, Coping Style, and Health Habits in Japanese Nursing Students: A Cross-Sectional Study

The relationship between physical activity and anxiety in college students: exploring the mediating role of lifestyle habits and dietary nutrition

Background

Physical activity has been shown to be effective in treating and improving anxiety in college students. However, no studies have been conducted to examine the relationship between physical activity and anxiety in college students through mediating factors such as dietary nutrition and lifestyle habits. Therefore, the aim of this study was to examine the mediating role of lifestyle and dietary nutrition in the relationship between physical activity and anxiety.

Methods

This study used a stratified random sampling method to survey 498 college students from three universities in Fujian, China. Data on participants' demographic characteristics, physical activity, lifestyle habits, and dietary nutrition were collected and analyzed using SPSS software. The proposed structural equation model was analyzed using Amos software.

Results

The results of the study showed that dietary nutrition and lifestyle habits had significant independent mediating effects and continuous multiple mediating effects (p < 0.01) in the effects of physical activity on college students' anxiety. Dietary nutrition and lifestyle habits played an independent mediating role, accounting for 24.9% of the total effect; there was also a continuous multiple mediating effect between dietary nutrition and lifestyle habits, accounting for 13.27% of the total effect value. In addition, physical activity had a direct effect value on anxiety in college students, accounting for 36.93% of the total effect value.

Conclusion

By increasing the behavior and awareness of college students to participate in physical activity, supplemented by guiding them to develop regular lifestyle habits and correct dietary nutritional patterns, the anxiety level of college students can be effectively improved and reduced. This type of regulation is an important reference for the self-management and rehabilitation of college students with anxiety disorders. Future studies can experimentally develop a combined intervention of physical activity, lifestyle habits, and dietary nutritional to help college students better cope with anxiety.

Tobacco and alcohol co-use: Lifestyle and sociodemographic factors, and personality aspects as potential predictors in the "Seguimiento Universidad de Navarra" cohort

Tobacco and alcohol co-use are two major lifestyle modifiable risk factors. Understanding the determinants of both behaviors helps to develop interventions to prevent these exposures. However, previous studies have focused on predictors of individual tobacco or alcohol use. This study aims to explore the potential predictors of tobacco and alcohol co-use among Spanish university graduates from the "Seguimiento Universidad de Navarra" (SUN) cohort study. A total of 7175 participants who were co-users of tobacco and alcohol were selected for this cross-sectional analysis. Their mean age was 39.1 years (12.04 SD) and 57.3% were women. Univariate regression models were used to select the potential predictors of tobacco and alcohol co-use, and the areas under the ROC curves (AUC) were calculated. Multivariable logistic regression models were used to create a predictive model. Baseline potential predictors included sociodemographic factors, lifestyle habits, and perceived personality aspects. In the multivariable model, the main significant potential predictors of tobacco and alcohol co-use were driving under the influence of alcohol (odds ratio [OR] = 1.65 [1.43-1.90]), drinking 1-2 cups of coffee daily (OR = 1.50 [1.24-1.84]), drinking three or more cups of coffee daily (OR = 1.61 [1.35-1.91]), and doing more physical activity than recommended (OR = 1.18 [1.02-1.34]) when compared with the reference group. Conversely, those who were married (OR = 0.87 [0.75-0.99], ate at home 7 days a week (OR = 0.69 [0.60-0.80]), or had a high perceived level of competitiveness (OR = 0.83 [0.72-0.95]) had a lower risk of co-use (AUC 0.61 [confidence interval 95% 0.59-0.63]), compared to the reference group. These results could be used by healthcare professionals, especially nurses, to effectively assess patients at higher risk of tobacco and alcohol co-use. [Correction added on 16 February 2024, after first online publication: The abstract section has been revised to provide more clarity in this version.].

Perceived parenting style and Chinese nursing undergraduates' learning motivation: The chain mediating roles of self-efficacy and positive coping style

AIM

The aim of this study was to examine the chain mediating effects of self-efficacy and positive coping style on the relationship between parenting style and learning motivation in Chinese nursing students.

BACKGROUND

Despite the abundance of literature that focuses on learning motivation, there is a lack of research that accurately and thoroughly examines the factors that influence learning motivation among nursing students.

DESIGN

This study involved a cross-sectional design.

METHODS

In total, 677 Chinese undergraduate nursing students completed the parental bonding instrument, the general self-efficacy scale, the simplified coping style questionnaire, and the learning motivation scale. A structural equation model was performed with AMOS 26.0 to explore the influence paths of variables and the mediating effects of self-efficacy and coping style.

RESULTS

Parental care positively predicted intrinsic learning motivation directly or indirectly through the mediating effects of self-efficacy (B = 0.17, 95% CI: 0.12-0.23) and positive coping style (B = 0.03, 95% CI: 0.01-0.06), and this mediating effect contributed 54.06% of the total effect. Parental encouraging autonomy positively predicted intrinsic learning motivation indirectly through the mediating effects of self-efficacy (B = 0.17, 95% CI: 0.12-0.24) and positive coping style (B = 0.03, 95% CI: 0.01-0.06), and this mediating effect contributed 71.42% of the total effect. Parental control negatively influenced intrinsic learning motivation directly or indirectly through the mediating effects of self-efficacy (B = -0.10, 95% CI: -0.15 to -0.04) and positive coping style (B = -0.02, 95% CI: -0.05 to -0.01), and this mediating effect contributed 42.85% of the total effect.

CONCLUSION

Parents should provide more care and autonomy to nursing students and reduce control over them. Nurse educators should consider targeted improvement strategies to improve the level of self-efficacy and positive coping style of nursing undergraduates to enable them to maintain a more intrinsic learning motivation.

Comparison of the psychological health of students at the higher institutes of nursing and health techniques: A Moroccan multicentre study

BACKGROUND

Mental health is essential to students' academic success as well as their ability to participate fully and meaningfully throughout all aspects of their lives and throughout their lifespan.

AIMS

This study aims to determine the psychological health status of Moroccan nursing and technique health students. In doing so, it also seeks to compare differences based on sociodemographic factors.

METHOD

A multicenter cross-sectional study with a convenience sample was conducted with 2,054 participants in the academic year of 2018/2019. A set of socio-demographic information were collected, and The General Health Questionnaire-12 (GHQ-12) was used.

RESULTS

The mean GHQ-12 score was 4.33 ± 2.61, and 58.7% respondents scored 4 and above in the GHQ-12 scores and thus were considered to be in psychological distress. Students' psychological distress was associated with female gender (60.4% for female compared to 52.4% for men, p = .003); living in parental residence (61.6% compared to 54.7% living away parental residence; p = .02 ), the second and the third training level year respectively (64.6%; 59.2%) compared to first-year (55.2%, p = .001), and midwifery and nursing students (61.6%; 60.3%) as compared to technique health students (43.6%, p = .001).

CONCLUSIONS

It appears that a substantial number of students have psychological distress and this is likely to have negative effects on students' educational attainment and wider wellbeing.

Moderating Role of Coping Style on the Relationship between Stress and Psychological Well-Being in Hong Kong Nursing Students

AIMS AND OBJECTIVES

To examine whether coping styles moderate the influence of stressors and psychological well-being in Hong Kong nursing students.

BACKGROUND

Stress could contribute to psychological distress in nursing students. Coping strategies are essential to mitigate psychological distress. So far, the moderating effects of coping between stressors and psychological well-being has not been thoroughly investigated.

DESIGN

This is a cross-sectional study conducted at four higher education institutions in Hong Kong.

METHODS

We recruited a convenience sample of 293 nursing students in February 2018. The Stressors in Nursing Students Scale-Chinese version (SINS-CN), Brief Cope Inventory-Chinese version (Brief COPE-C), and the Chinese version of the General Health Questionnaire-12 (C-GHQ-12) were used to measure the stressors, coping styles, and psychological well-being, respectively. Three multiple hierarchical linear regression models were used to identify the associations between the variables.

RESULTS

The stressors related to clinical learning, confidence, and personal problems were significant in explaining the psychological well-being. The coping strategies also predicted the psychological well-being and explained 44.5% of the variance. The coping strategy-accommodation-moderated the relationship between personal problems and psychological well-being.

CONCLUSION

Problem-solving and accommodation types of coping were adaptive to stress and effective in promoting psychological well-being. However, using accommodation to cope with stressors related to personal problems will exacerbate the negative effects of the personal problems on the psychological well-being.

RELEVANCE TO CLINICAL PRACTICE

This study reveals the relationships between stressors, coping, and psychological well-being. Nurse educators must be aware of nursing student coping styles so they may devise strategies to promote effective coping to reduce the psychological distress among nursing students.

Do healthy habits regulate the relationship between psychosocial dysfunction by COVID-19 and bidimensional mental health?

COVID-19 has affected mental health and well-being. Lifestyles are relevant to understand the impact of psychosocial dysfunctions. The objective was to examine the role of healthy habits in the relations between psychosocial dysfunction and psychological well-being/distress during COVID-19. Participants completed measures of psychosocial dysfunction, healthy habits, life satisfaction, well-being, depression, and anxiety symptoms. Psychosocial dysfunction was associated with distress symptoms, while health habits were associated with well-being. Healthy habits were mediators: greater psychosocial dysfunction was associated with less healthy habits, which in turn were associated with lower overall well-being, and greater depression. Programs addressing healthy habits can be of great utility.

Self-Care and Sense of Coherence: A Salutogenic Model for Health and Care in Nursing Education

Background: Effective advocacy on self-care and the enhancement of a sense of coherence among nurses don’t only benefit control over one’s health and personal performance, but it may have a direct impact on clinical care and on the entire healing system. In this regard, nursing curricula grounded on a salutogenic model of health (SMH) operate with strategies to engage students in self-care and contribute to improving their mental health and wellbeing. The aim of this study was to explore the relationships between self-care agency and a sense of coherence as dependent variables and the age and self-reported academic performance as independent variables in nursing assistant students. Methods: For this cross-sectional study, data were collected from a full sample of 921 Certified Nursing Assistant (CNA) Spanish students. A self-administered questionnaire, including sociodemographic variables, the ‘appraisal of self-care agency’ (ASA), and the ‘sense of coherence’ (SOC) constructs, was administered. Results: Results: Older participants presented significantly stronger values of both constructs. Apart from a significant and positive correlation between ASAS and SOC, ANOVA analyses indicate signif-icant differences in terms of academic performance according to different ASAS and SOC de-grees. Conclusion: The findings of this study endorse the assumption that there is a consistent relationship between ASA and SOC constructs that might, indeed, have a potential effect on stu-dents’ academic performance. In practical terms, it seems relevant to try to recognise the stu-dents’ self-care agency and the sense of coherence as forceful predictive variables of mental health and wellbeing, in addition to academic success as a strength implied in the future career achievement.

Seroprevalence of COVID-19 and Psychological Distress among Front Liners at the Universiti Malaysia Sabah Campus during the Third Wave of COVID-19

In 2020, the COVID-19 pandemic struck the globe and disrupted various aspects of psychological wellbeing, more so in frontline workers. Research on assessing the seroprevalence of COVID-19 has been scarce; in addition, there are limited studies assessing the association between the seroprevalence of COVID-19 and psychological distress. Therefore, this study aimed to determine the seroprevalence of COVID-19 and the prevalence of psychological distress and to determine whether sociodemographic variables, occupational information variables, coping styles, and psychological processes might contribute to the development of psychological distress. A cross-sectional study involving 168 Universiti Malaysia Sabah (UMS) front liners was carried out to assess these issues. The Depression, Anxiety and Stress Scale (DASS-21) was employed to assess psychological distress, together with the COVID-19 Rapid Test Kit Antibody (RTK Ab) and a series of questionnaires, including a sociodemographic and occupational information questionnaire, the Balanced Index of Psychological Mindedness (BIPM) questionnaire, the Mindfulness Attention and Awareness Scale (MAAS), the Acceptance and Action Questionnaire (AAQ-II), and the Brief COPE questionnaire. The results demonstrated a seroprevalence of COVID-19 at 8.3% (95% CI = 5.0–14.0). Non-healthcare workers (HCWs) had a higher COVID-19 prevalence. Meanwhile, the prevalence of depression, anxiety, and stress among front liners was low (3.0%, 3.6%, and 1.2%, respectively). Younger people (aged 30 years old or less) and HCWs had a higher prevalence of psychological distress; being a HCW was significantly associated with a higher level of anxiety. Dysfunctional coping and psychological inflexibility were consistently found to be predictors for higher levels of the three psychological distress variables. This study suggested some alternatives that could be explored by mental health providers to address mental health issues among front liners at universities.

Psychological Health and Sleep Quality of Medical Graduates During the Second Wave of COVID-19 Pandemic in Post-epidemic Era

Recently, a COVID-19 virus variant spread rapidly in Guangzhou, China, causing public panic. This study aimed to understand the psychological and sleep-related consequences of the secondary outbreak of the pandemic on medical students. In this cross-sectional survey-based study, participants anonymously completed structured questionnaires online from June 8–22, 2021. We collected participants' demographic and general information. Anxiety, depression, and sleep quality were measured using the Zung Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Pittsburgh Sleep Quality Index (PSQI), respectively. Protective factors were assessed using the Coping Style Questionnaire (CSQ). Uni- and multivariate logistic regression analyses were performed examining factors associated with mental health and sleep quality problems. During the second wave of the pandemic in local outbreak areas in Guangzhou, China, more than one-third of medical students' mental health and sleep quality were affected. The prevalence of anxiety, depression, and poor sleep quality were 27.54%, 27.58%, and 18.19%, respectively. Students belonging to the Class of 2019, aged over 29 years, those with siblings, and those whose hometowns were in other provinces were more prone to the three health problems. Factors associated with an increased risk of mental health problems were vaccination status (adjusted odds ratio 1.603–1.839) and diet status (adjusted odds ratio 1.62–1.929). Positive coping styles served as protective factors (p < 0.05). We discovered that completed vaccination status, good diet, and positive coping styles were related to good mental health and sleep quality.

Coping strategies of healthcare professional students for stress incurred during their studies: a literature review

BACKGROUND

Stress in healthcare professional students is well-documented, however coping strategies and their relationship with stress has not been comprehensively reviewed. It is necessary for students to use positive coping strategies to effectively reduce stress levels.

AIMS

The aim of this review is to identify coping strategies of healthcare professional students and their consequences.

METHODS

Studies conducted from 2010 to 2020 on coping strategies utilised by healthcare students were reviewed. An electronic database search was performed in January 2020 of three databases CINAHL, SCOPUS and PubMed.

RESULTS

Twenty-two studies were included in this review, using a wide range of survey instruments including the Brief Coping Orientation to Problems Experienced (Brief COPE) Inventory and the Coping Behaviour Inventory Common coping strategies utilised by healthcare students include problem-focused strategies such as planning, problem-solving and active coping. Coping strategies tended to vary depending on student's location, year of their course, gender and age. Positive coping strategies, such as problem-focused strategies, were associated with reduced stress levels and improved psychological health. Other emotion-focused coping strategies identified included acceptance, self-distraction, and optimism.

CONCLUSIONS

Findings may provide direction for third-level institutions in designing interventions (such as encouraging exercise) promoting the use of positive coping strategies.

Psychological distress and its influencing factors among psychiatric nurses in China: A cross-sectional study

BACKGROUND

Psychiatric nurses often face abuse, attacks, escape, suicides, and other situations related to the care of patients with mental disorders, which are more likely to induce psychological distress.

AIMS

This study aimed to examine the relationship between coping styles and psychological distress among Chinese psychiatric nurses in Shandong and the significance of sleep quality as a mediating factor.

METHODS

A total of 812 psychiatric nurses in Shandong, China, were investigated using the Psychological Distress Scale (K10), Simplified Coping Style Questionnaire (SCSQ), Pittsburgh Sleep Quality Index (PSQI) and self-compiled general information questionnaire.

RESULTS

Psychological distress was detected in 571 psychiatric nurses (70.3%). The psychological distress of psychiatric nurses was significantly different with respect to professional title (χ² = 10.627, P < 0.05) and shift work (χ² = 9.120, P < 0.01). Psychological distress positively correlated with negative coping style (r = 0.266, P < 0.01) and sleep quality (PSQIT) (r = 0.532, P < 0.01). A significant positive correlation was found between psychological distress and all dimensions of sleep quality (r = 0.158-0.456, P < 0.05). Professional title, positive coping style, negative coping style, sleep quality (PSQIT), subjective sleep quality, sleep disorder and daytime dysfunction predicted psychological distress in psychiatric nurses (R ² = 0.363, F = 65.343, P < 0.01). The relationship between negative coping style and psychological distress was partially mediated by sleep quality, with the mediating effect accounting for 37.97% of the total effect.

CONCLUSIONS

Psychiatric nurses have a high rate of psychological distress, which is closely related to coping styles, and sleep quality has a certain regulatory effect.

Health-Related Quality of Life and Undergraduate Nursing Students: A Narrative Review

Background:

Undergraduate nursing students are vulnerable to stressful university learning environments and poor working conditions in clinical rotations. This can result in students leaving nursing programs or abandoning the profession following graduation. As a result, the health-related quality of life of nursing students is an important indicator to monitor student quality of life adequacy. Preventing premature student nurses' departure from the profession is necessary to reduce the nursing shortage.

Objective:

To describe the body of knowledge about the health-related quality of life for undergraduate nursing students during their qualification process.

Methods:

This was a narrative review through a six-database search, including Cochrane, CINAHL, Pubmed, Medline, PsycINFO and Livivio, from between January 1990 and June 2018, with updates in the search followed until November 2019. To assess study quality, the STROBE checklist was used.

Results:

Eight studies were included in a narrative synthesis. All studies were of cross-sectional design, and none included follow-up procedures. Most of the studies recruited participants from nursing courses and only one study recruited students from a national register. Sample sizes ranged from 110 individuals to 4,033 participants in the register-based study. Common health-related dimensions evaluated included stress, social support, mental health, fatigue, quality of life, and drug abuse. Stress, the most commonly studied dimension, was associated with clinical placements, final exams, and non-prescribed drugs. Social support networks were positively associated with coping abilities and self-esteem.

Conclusion:

There is low-quality evidence of the impact of nursing courses upon student health-related dimensions (stress, self-esteem, health-related behaviors). Nurse educators should be aware of these associations and support routine screening of students and their health-related dimensions. Interventions, such as consultation and study redesign, might increase the level of health-related dimensions. Nursing schools should further collaborate to investigate these associations and tailored interventions to positively affect health-related dimensions in nursing students.

Stress, coping, resilience, and sleep during the COVID-19 pandemic: A representative survey study of US adults

INTRODUCTION

The COVID-19 pandemic is a global health emergency resulting in widespread death and substantial disruption to daily life. Previous research has shown that novel disease outbreaks are associated with high stress levels and sleep impairments that lead to neuropsychiatric consequences. Therefore, it is vital to study both stress and protective factors such as coping and resilience that may hinder or help sleep quality during the COVID-19 pandemic. Further, as gender disparities exist in sleep quality, it is important to understand the relationship between pandemic-related stress, coping strategies, resilience, and sleep in bothgenders during the COVID-19 pandemic.

METHODS

Our study examined how gender, stress, coping, and resilience were associated with sleep cross-sectionally during the COVID-19 pandemic in a representative sample of US adults (N = 393).

RESULTS

Consistent with many recent studies, we found that worsened sleep quality in women compared to men persisted during the COVID-19 pandemic. Interestingly, pandemic-related stress was not significantly associated with sleep quality, but pandemicrelated coping was associated with sleep independent of robust controls and trait resilience.

CONCLUSIONS

Greater primary control engagement coping was associated with better sleep quality, while involuntary engagement coping was associated with poor sleep quality. Future research should extend the findings with actigraphy and explore ways to enhance beneficial coping and sleep health during pandemics.

Anxiety among Nursing Students towards Clinical Placement during COVID-19 in a Tertiary Hospital of Nepal: A Descriptive Cross-sectional Study

Introduction:

The world is facing the pandemic of COVID-19 caused by the corona virus since December 2019 and has caused millions of death throughout the world. Exposure of nursing students in clinical placement during pandemic is fearful and stressful with high risk of infection which can cause anxiety and different levels of psychological crisis to individuals. The main objective of the study is to find out the prevalence of anxiety among nursing students during clinical placement in the pandemic of COVID-19.

Methods:

A descriptive cross-sectional study was conducted among 144 nursing students enrolled in different clinical placement of a tertiary hospital of Nepal from 20th January 2021 to 2nd February 2021. Ethical approval was received from the Institutional Review Committee. Demographic, COVID-19 related and Beck Anxiety Inventory questionnaires was used for assessing anxiety. Whole sampling was done. Descriptive statistics was conducted using Statistical Package for the Social Sciences 2016 version.

Results:

Out of 144 females enrolled in the study, all the nursing students 144 (100%) having clinical placement had anxiety. Among them, 117 (81%) had mild anxiety and 27 (19%) had moderate level of anxiety. All the students used coping strategies for the anxiety. The most commonly used strategy to cope with anxiety was religion (5.03±1.78).

Conclusions:

All the nursing students had anxiety during the clinical placement and all the students used the coping strategies for the anxiety. Majority of the nursing students had mild anxiety. Religion was most common method of strategy to cope with anxiety.

Family Coping Strategies to Improve the Health of Family Members Living with Schizophrenia

Introduction: Schizophrenia is a serious mental illness that affects the thinking, emotions, relationships, and decision-making. One of the positive effects of treating schizophrenia in patients is family health. The family welfare management strategies provide help for coping, care preparation, organizing meetings, and mentoring. This study focuses on family coping strategies for improving the health of members living with schizophrenia.Methods: A cross-sectional design was used by choosing 160 respondents randomly. The inclusion criteria were family members accompanying control schizophrenia patients to the Public Health Center, with a minimum age of 18. The independent variable was family coping, which consist of two sub-variables (problem-focused coping mechanism and emotion-focused coping mechanism), while the dependent variable was family health, which consists of three sub-variables (efficient, satisfaction, and happiness). The SMART PLS (2.0 Version) was used to prove the impact of the variables.Results: The results indicated that family coping had a significant impact  on the health of the family. The hypothesis was taken from the value of the T-test on the structural model analysis, which shows T- statistics (13.966) > T-critical (1.96). The impact of family coping on the health is equal to 0.682 (OR). This means that if family coping is given one-unit value, it will increase the family health by 0.682 times.Conclusion: The implementation of the family coping strategy will improve the capacity of the family to clarify health issues encountered, resolve family behaviors effectively and minimize risk factors. Furthermore, the coping mechanisms chosen by families in facing stress will have an impact on the reduction of illness symptoms in the members with schizophrenia.

Psychological Well-Being in Nursing Students: A Multicentric, Cross-Sectional Study

In addition to complying with strict academic standards, nursing students must acquire relevant knowledge and skills, and learn how to carry themselves in different and often stressful professional settings. These obligations could severely affect their mental health. The purpose of this study was to examine the mental health status of undergraduate nursing students and related factors. A total of 1368 nursing students from different universities in Spain and Chile were included in this study, which took place over the 2018–2019 academic year. We assessed their levels of stress related to specific learning methodologies and determined their mental health status using the General Health Questionnaire (GHQ-28). The results revealed that the more advanced the course was, the lower the total GHQ-28 score. The stress generated by different types of training activities had a significant effect on the total GHQ-28 score. These results suggest that nursing education could act as a protective factor against mental health disorders. Although a heavy academic workload could lead to higher levels of stress, overall, it seems that mental health is better in more advanced courses than in initial academic years.

Plasma Arginase-1 Level Is Associated with the Mental Status of Outpatients with Chronic Liver Disease

While plasma arginase-1 has been suggested as a biomarker of mental status in healthy individuals, it has not been evaluated in patients with chronic liver disease. This cross-sectional study investigated the utility of plasma arginase-1 for screening mental status in patients with chronic liver disease. This study included outpatients with chronic liver disease who underwent regular check-ups at Okayama University Hospital between September 2018 and January 2019. In addition to the standard blood tests, the plasma arginase-1 level was analyzed. The patients’ mental status was assessed using the Japanese version of the General Health Questionnaire-28 (GHQ-28). The associations between mental status and various parameters, including plasma arginase-1, were investigated using logistic regression analysis. Among 114 participating patients, 8 were excluded, comprising 6 with insufficient blood samples for plasma arginase-1 measurement and 2 with incomplete questionnaires. Multivariate binomial logistic regression analysis revealed that plasma arginase-1 was significantly and negatively associated with the GHQ-total score, especially somatic symptoms. Therefore, plasma arginase-1 may be a useful biomarker for assessing the mental status of outpatients with chronic liver disease.

Self-Regulation and Regulatory Teaching as Determinants of Academic Behavioral Confidence and Procrastination in Undergraduate Students

The combination of student Self-Regulation (SR) and the context of Regulatory Teaching (RT), each in varying degree, has recently been demonstrated to have effects on achievement emotions, factors and symptoms of stress, and coping strategies. The aim of the present research study is to verify its possible further effects, on academic behavioral confidence and procrastination. A total of 1193 university students completed validated online questionnaires with regard to specific subjects in their degree program. Using an ex post facto design, multivariate analyses and structural equation modeling (SEM) were carried out in order to test the relationships predicted by the model. SR and RT had a significant joint effect in determining the degree of academic behavioral confidence and of procrastination. Academic behavioral confidence also significantly predicted reasons for procrastinating, and these in turn predicted activities of procrastination. Conclusions are discussed, insisting on the combined weight of the two variables in determining academic behavioral confidence, reasons for procrastinating and activities subject to procrastination, in university students. Implications for guidance and educational support of university students and teachers are analyzed.

Predictors of burnout among Belgrade veterinary students: A cross-sectional study

Background

To the best of our knowledge, studies are lacking on burnout among veterinary students in Serbia, and this is the first study trying to address such a problem. Therefore, the aim of this cross-sectional study was to investigate the predictors of burnout among Belgrade veterinary students.

Methods

Maslach Burnout Inventory (MBI) and anonymous structured questionnaire addressed to personal data, health habits and stressful influence of educational process were applied among 496 respondents from a total of 1113 students from all grades in spring semester 2014 (response rate 44.6%).

Results

The prevalence of burnout was 43.3%. High scores on depersonalization and emotional exhaustion scales of MBI were found among 79.4% and 45.0% students, respectively; low personal accomplishment was reported by 50.5% students. Female students reported higher levels of emotional exhaustion compared to males (p = 0.012). A low score on personal achievement scale of MBI was least frequent among the freshmen and most frequent among sophomores (41.1% and 65.3%, respectively; p = 0.986). There were more students with burnout who considered their health as a worsened vs. pre-study period compared to students with no burnout, both concerning mental (61.4% vs. 38.6%) and physical health (61.1% vs. 38.9%; both p<0.001). There were more smokers among students who suffered from burnout compared to students who did not (52.0% vs. 48.0%; p = 0.013). A multiple regression revealed an independent dose-response effect of perceived stress at exams on the onset of burnout (moderate stress OR = 2.164 and high stress OR = 3.878). Also, students with the moderate and high stressful effect of communication with teaching staff, as well as, those with worse self-perceived physical and mental health had more than two times higher presence of burnout.

Conclusions

The prevalence of burnout among Belgrade veterinary students is relatively high. Primary prevention should be focused on the revealed predictors of burnout.

A Structural Equation Model of Achievement Emotions, Coping Strategies and Engagement-Burnout in Undergraduate Students: A Possible Underlying Mechanism in Facets of Perfectionism

Achievement emotions that the university student experiences in the learning process can be significant in facilitating or interfering with learning. The present research looked for linear and predictive relations between university students' achievement emotions, coping strategies, and engagement-burnout, in three different learning situations (classroom, study time, and testing). Hypotheses were identified for a possible model that would analyze the two facets of perfectionism based on these relations. In the case of perfectionistic strivings, the test hypothesis was that positive emotions would predispose the use of problem-focused coping strategies and an emotional state of engagement; in the case of perfectionistic concerns, however, negative emotions would predispose the use of emotion-focused strategies and a state of burnout. A total of 654 university students participated in the study, using an online tool to complete validated questionnaires on the three study variables. All students provided informed consent and corresponding permissions. Given the ex-post facto linear design, the predictions could be verified for each situation by means of logistic regression analyses and Structural Equations Models (SEM). Empirical results lent support, in varying degree, to the proposed theoretical relations. The testing situation was of particular interest. We discuss implications for perfectionism research and for the practice of prevention, education and health care in the university setting.

Effects of Levels of Self-Regulation and Regulatory Teaching on Strategies for Coping With Academic Stress in Undergraduate Students

The SRL vs. ERL TheoryTM predicts that regulation-related factors in the student and in the context combine to determine the student's levels in emotional variables, stress, and coping strategies. The objective of the present research was to test this prediction in the aspect of coping strategies. Our hypothesis posed that students' level of self-regulation (low-medium-high), in combination with the level of regulation promoted in teaching (low-medium-high), would determine the type of strategies students used to cope with academic stress; the interaction of these levels would focus coping strategies either toward emotions or toward the problem. A total of 944 university students completed validated questionnaires on self-regulation, regulatory teaching, and coping strategies, using an online tool. ANOVAs and MANOVAs (3 × 1; 3 × 3; 5 × 1) were carried out, in a quasi-experimental design by selection. Level of self-regulation and level of regulatory teaching both had a significant effect on the type of coping strategies used. The most important finding was that the combined level of self-regulation and external regulation, on a five-level scale or heuristic, predicted the type of coping strategies that were used. In conclusion, the fact that this combination can predict type of coping strategies used by the student lends empirical support to the initial theory. Implications for the teaching-learning process at university and for students' emotional health are discussed.

Relationship between psychological health and quality of life of people affected by leprosy in the community in Guangdong province, China: a cross-sectional study

BACKGROUND

This paper investigates the relationship between psychological health and quality of life (QOL) of people affected by leprosy (PAL) living in a community in Guangdong province, China.

METHODS

A population-based cross-sectional survey was conducted from April to October 2016 in Guangdong province, China. The 12-item general health questionnaire (GHQ12) and World Health Organization Quality of life-BREF (WHOQOL-BREF) were used to evaluate the psychological health and QOL of the participants. PAL recruited for this study included those who were (1) registered in LEPMIS by the end of 2015 and living in the community, (2) able to be contacted by investigators, and (3) willing to provide informed written consent for enrolling in the study. Proportions, medians, and ratios were used to describe the demographics of the participants and χ2 test was used to compare groups with different psychological health states. Pearson's correlation coefficient and logistic regression analyses were used to assess the relationship between GHQ12 and QOL score.

RESULTS

A total of 7230 PAL (5527 males and 1701 females, average age 67.3 ± 13.1 years) living in the community participated in the study. The participants averaged 1.7 ± 2.7 points on the GHQ12. Of these, 23.5% had scores meeting a psychological disorder (≥3 points). The scores for the physical, psychological, and social relationships, and environment dimensions of QOL were 17.2 ± 2.4, 20.6 ± 2.7, 9.7 ± 1.7, and 24.6 ± 4.0, respectively. Gender, age, employment, profession, and the four dimensions of QOL were independent factors associated with psychological health of PAL.

CONCLUSION

In addition to focusing on the factors associated with poor QOL and psychological health amongst PAL, there is an urgent need for stigma reduction, rehabilitation programs and social integration. This may be achieved by engaging community members together with PAL to design a locally tailored intervention program.