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Introduction: This research explores the intricate interplay among teacher-student relationships, perceived autonomy support, peer relationships, and their collective impact on the psychological well-being of 387 university students enrolled in French language courses across diverse academic institutions in China. Methods: Employing Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM), this study aims to establish the validity and robustness of the proposed model. Data collection involved online surveys utilizing Likert scales and standardized measures to assess variables concerning educational relationships and psychological well-being. Results: The findings reveal significant associations between teacher-student relationships, autonomy support, positive peer relationships, and psychological well-being. Importantly, analyses demonstrate the influential role of positive peer relationships in mediating the effects of teacher-student relationships and autonomy support on students' psychological well-being. Discussion: These outcomes emphasize the crucial significance of educational relationships in shaping students' psychological well-being within academic settings. The findings contribute to understanding the nuanced dynamics of educational interactions and their profound implications for student well-being. This highlights the necessity of cultivating positive educational environments for enhanced student mental health.

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Purpose: The study focuses on contemporary trends in the psychological well­being of foster children residing in care homes over the past two decades. Moreover, it aims to predict future research directions by analyzing hotspots, offering valuable references for academics engaged in further studies in this field. Methods: A quantitative analysis was conducted on nine hundred and twelve documents, including research papers and reviews, from 2003 to 2023. These publications focused on the psychological well­being of foster children and were incorporated from the Scopus database. For visual analysis, we utilized the bibliometric analytical tool VOSviewer to generate a map of information on the authors, journals, organizations, nations, citations, and keywords. We also employed Microsoft Excel tables to record the essential details. Results: The psychological well­being of children and adolescents residing in foster homes is an emerging area of research. The findings show that there has been an ongoing rise in relevant research publications over time. The United States (416) and Harvard Medical School (56) were the most active countries and organizations in this study. AIDS Care: Psychological and Socio-Medical Aspects of AIDS/HIV (91 articles) and Vulnerable Children and Youth Studies (86 articles) are two prominent journals, while the Journal of Child Psychology and Psychiatry had the most co-citations (630). Nelson (52 publications) and Zeanah (50 publications) are the top two leading authors based on citation counts. Institutional care, orphans, HIV/AIDS orphans, psychological well­being, and mental health, resilience are popular research keywords in this study. Conclusion: This study indicates the prevailing interest in the specified domains over the past two decades. Our findings primarily indicate that addressing mental health concerns, along with understanding the needs of children in foster care homes, can enhance their psychological well­being. Developing effective interventions to enhance the psychological well­being of children in foster care is bound to have a profound effect on them and will serve as a key focus for future research in this field.

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Introduction: The extant study was conducted over a cross-sectional period and aimed to assess the effect of intrapersonal on the interpersonal dimensions of Emotional Intelligence among University Students. Methods: A literature survey was carried out, and the study's hypotheses were framed. Utilising a standardised Emotional Intelligence Scale, a widely accepted and validated measurement tool in the field, for measurement, the survey was disseminated in digital and physical formats. The researchers employed the snowball sampling technique to distribute the questionnaires and recruit volunteers for the study. The data collection period spanned from August 2023 through September 2023. The demographic information of the individuals was described using the SPSS 25 software, while the dataset for the personal and social competencies was analysed using the SmartPLS software. Results and discussion: The research reveals a statistically significant association between the variables under investigation. Specifically, there exists a negative correlation between Motivation and Social Skills, as well as between Self-regulation and Social Awareness. These findings open up exciting opportunities for future research, inspiring further exploration into the development of intrapersonal and interpersonal competencies among students.

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BACKGROUND: Academic self-efficacy and psychological well-being play a crucial role in the mental health of nursing students and influence whether they decide to remain in the nursing profession. AIMS: This study aimed to determine the effect of laughter therapy on self-efficacy and psychological well-being in nursing students. METHODS: In this randomized controlled study, 208 nursing students were randomly assigned to an experimental (n = 102) and a control (n = 106) group. The experimental group received laughter therapy face-to-face once a week for eight weeks. No intervention was applied to the control group. In both groups, data were collected at the beginning of the study and the end of the eighth week using a Sociodemographic Questionnaire Form, the Academic Self-Efficacy Scale, and the Psychological Well-Being Scale. RESULTS: In the post-study group comparisons, there was a statistically significant difference in the scores for the total Academic Self-Efficacy Scale, the external emotion management and collegiality subscales, and the total Psychological Well-Being Scale (p > 0.05). With regard to all the scale scores, no statistically significant difference was found in the groups in the pre- and post-comparisons (p > 0.05). CONCLUSIONS: It was determined that laughter therapy increased the mean psychological well-being score in the experimental group. It was also found that after the laughter therapy, distraction and loss of interest in lectures decreased, stress and anxiety levels decreased, eating and sleeping habits were regulated, and social media use decreased. Laughter therapy can be used to increase self-efficacy and psychological well-being.

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Background and Aims: The well-being of physicians in their professional lives has a major influence on the quality of medical care and patient outcomes. This study explored how Professional Quality of Life (ProQOL) and psychological well-being are connected to workplace spirituality (WPS) and demographic factors like age and gender. It also compared the average levels of ProQOL, psychological well-being, and WPS between medical residents and interns. Methods: In a cross-sectional study, 230 medical residents and interns completed three questionnaires, including ProQOL, Ryff Scale Psychological Wellbeing-Short Form, and WPS. The data was analysed using Pearson correlation, independent t-test, ANOVA, and multiple linear regression modeling. Results: Residents and interns had moderate ProQOL levels and higher work spirituality. However, medical residents scored lower in occupational spirituality and compassionate care fulfillment compared to interns while experiencing higher levels of emotional exhaustion and secondary mental strain. Gender disparities were significant, with women scoring higher in compassionate care fulfillment but lower in secondary mental strain. Regression analysis showed that occupational spirituality positively predicted professional, compassionate care fulfillment (B = 0.910, p < 0.001) but negatively predicted emotional exhaustion in both groups. Conclusions: These findings underscore the importance of understanding factors like gender and work spirituality to enhance the well-being and quality of care provided by medical residents and interns.

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BACKGROUND: Studies in the literature mainly focus on understanding the risk factors for suicide, giving little relevance to protective variables. This study aimed at exploring the specific contribution of protective variables (resilience, coping and psychological well-being) in hospitalized suicide attempt (SA) makers. METHODS: We recruited 50 inpatients who made a SA before admission and 50 inpatients with no history of SA matched for DSM-5 diagnosis, gender and age. Protective variables were evaluated with: Brief COPE questionnaire, Dispositional Resilience Scale (DRS-15), Psychological Well-Being Scale (PWB-18). Psychopathological features and symptom severity were assessed with: Global Assessment of Functioning Scale (GAF), Rapid Dimensional Assessment Scale (SVARAD), Brief Psychiatric Rating Scale (BPRS), Clinical Global Impressions (CGI), Hamilton Depression Rating Scale (HDRS17). RESULTS: The DRS-15 total score was significantly lower in SA makers. SA makers displayed significantly lower scores on the Engagement and Cognitive Restructuring subscales of the Brief COPE. On the PWB-18, the Self-Acceptance subscale score was lower in SA makers. LIMITATIONS: The small sample size suggests the need for caution in interpreting the results. Matching was carried out by excluding diagnoses of personality disorders. CONCLUSIONS: Patients hospitalized following a SA are more often diagnosed with personality disorders, have deficit areas concerning resilience and coping, and lower psychological well-being compared to patients without a SA. When approaching a patient who has committed a SA, it may be useful to evaluate protective variables as well as risk factors, and encourage the development of adaptive coping mechanisms and positive self-evaluation through more dynamic therapeutic paths.

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Psychological well-being (PWB) is a combination of feeling good and functioning efficiently, and has a significant relationship with physical and mental health. Previous research has shown that PWB is associated with improvements in selective attention, mindfulness, semantic self-images, and adaptive decision making, however, it is unclear how these differences manifest in the brain. Naturalistic stimuli better encapsulate everyday experiences and can elicit more "true-to-life" neural responses. The current study seeks to identify how differing levels of PWB modulate neural synchrony in response to an audiovisual film. With consideration of the inherent variability of the literature, we aim to ascertain the validity of the previously associated with PWB. We identified that higher levels of PWB were associated with heightened stimulus driven neural synchrony in the bilateral superior parietal lobule, right planum temporale, and left superior temporal gyrus, and that lower levels of PWB were associated with heightened neural synchrony in the bilateral lateral occipital cortex and precuneus. Taken together, this research suggests that there is an association between differing levels of PWB and differential neural synchrony during movie-watching. PWB may therefore have an effect on complex, multimodal processing.

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INTRODUCTION: Social relationships offer the opportunity to provide support and resources to others. Feeling needed and useful to others has been understudied during adolescence, despite being shown to predict health and well-being during adulthood. The current study examined this underappreciated way in which family and peer relationships may shape psychological well-being during adolescence. METHOD: A cross-sectional sample of high school students across the United States completed an on-line questionnaire during school hours in the fall of 2020. The sample consisted of 1301 adolescents averaging 15.94 (SD = 1.24) years in age in the ninth through twelfth grades, with 48.4% identifying as female, 47.3% as male, and 3.2% reporting either other gender identities or preferring not to answer (1%). Participants identified as Hispanic or Latino (40.2%), European American (19.8%), African American (14.7%), Multiethnic (9.2%), Asian American (7%), Other Ethnicities (7.8%), and 1.3% did not report their ethnicity. RESULTS: Feeling needed and useful was predicted by both helping and receiving support from others, strongly predicted better psychological well-being, and mediated associations of helping and receiving support with well-being. Males reported feeling more needed by their family as compared to females, and both reported higher levels of being useful to their family than those with other gender identifications. CONCLUSIONS: Like adults, adolescents have a need to contribute and feel needed in their social worlds. Studies of close relationships should incorporate the ways in which youth provide resources and support to others in their lives as well as the sense of feeling needed and useful derived from those activities.

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BACKGROUND: Covid-19 is one of the world's major pandemics. It has affected millions of people in various ways. OBJECTIVE: This study investigates the influence of pandemic-induced shifts in eating and sleeping behaviors on the psychological well-being of university students. METHODS: The study adopted a cross-sectional research design. A total of 604 students participated in the study. The Personal Form, the Psychological Well-Being Index, and the Pittsburgh Sleep Quality Index were used to collect data. The research was conducted between October 2021 and December 2022. RESULTS: The participants reported a mean psychological well-being score of 40.76±9.38, alongside a Pittsburgh Sleep Quality Index score of 7.46±3.30. Analysis revealed a significant negative correlation between the mean psychological well-being scores and the Pittsburgh Sleep Quality Index scores (p <  0.01). Throughout the pandemic, the participants experienced a decline in physical activity, an increase in their body weight, and a change in their eating habits. While psychological well-being remained relatively high, sleep quality was notably poor. Notably, improvements in psychological well-being corresponded with enhancements in sleep quality, suggesting a reciprocal relationship between the two variables. CONCLUSIONS: The pandemic negatively impacted the physical activity and body weight of young adults. This study highlights the importance of promoting physical activity among university students during pandemics and similar crises to reduce adverse effects on body weight. It also highlights the importance of educating students about the importance of healthy sleep and how to maintain good sleep hygiene.

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OBJECTIVES: The mental health of dentists, like all health professionals, is a growing concern. The objectives of this study were to identify the mental health challenges experienced by Canadian dentists and to describe the support needs and promising practices to better support them. METHODS: This study used a mixed-methods case study design to gather data from semistructured qualitative interviews and a survey for triangulation. RESULTS: Thirty-six dentists and 17 stakeholders participated in the interviews, and 397 dentists participated in the survey. The interview and survey data revealed that dentists have experienced several challenges personally, professionally, and socially. Around 44% of participating dentists experienced a wide range of mental health issues, including depression, anxiety, and posttraumatic stress disorder. Sex/gender shaped the mental health experiences of female dentists, who reported more stress related to caring responsibilities. They had a higher percentage of mental health issues (50%) than men (37%). Caretaking emerged as the main challenge in the social and personal domain, particularly for female dentists in both survey and interview findings. The dentists' role in practice was one of the most frequently reported professional challenges. While practice owners reported challenges with staff and practice management, associate dentists experienced difficulties with the lack of autonomy and conflicts with office managers and owners. Other challenges reported by participating dentists included patient care responsibilities, loneliness, and isolation. To address these challenges and their impact, dentists and stakeholders identified several support needs and promising practices, including increasing awareness about mental health issues, expanding existing mental health resources, incorporating mental health content in dental education, and encouraging engagement in organized dentistry, particularly for women. CONCLUSIONS: The impact of mental health challenges on dentists' career trajectory and productivity is an ongoing concern in Canada. Gender-specific strategies to support the mental health of dentists should be developed. KNOWLEDGE TRANSLATION STATEMENT: This study identified the mental health challenges of dentists in Canada to inform the development of interventions and strategies to promote the health and well-being of dentists and dental students. It also highlighted the need for clinicians, students, and individuals in leadership positions in institutions and professional organizations to recognize and consider the working conditions of dentists in various positions to avoid negative consequences on their mental health, reduce the attrition from the professional, and improve patient care outcomes.

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BACKGROUND: Academic performance is influenced by a complex interplay of multiple factors whose relationships often do not follow straightforward patterns. Despite extensive research, understanding of these dynamics remains inconclusive. In particular, several studies highlight that higher emotional intelligence is associated with better academic outcomes and that people with elevated levels of psychological well-being also tend to achieve higher grades. OBJECTIVE: This study examines the associations between emotional intelligence, psychological well-being and academic performance among undergraduate nursing students. Specifically, it seeks to deepen our understanding of how emotional intelligence affects academic achievement, with psychological well-being potentially serving as a mediator. DESIGN: A cross-sectional correlational design was employed. SETTINGS: The study involved a convenience sample of undergraduate nursing students from various degree programmes affiliated with the primary author. PARTICIPANTS: 394 undergraduate nursing students participated in the study, 249 identified as female and 145 as male. METHODS: Participants completed a quantitative survey during class hours, providing data on demographics, academic average scores and self-report measures of perceived emotional intelligence and psychological well-being. Data were evaluated using Pearson's correlations and serial multiple mediation analyses. RESULTS: The findings revealed significant positive relationships between emotional intelligence, psychological well-being and academic performance. Serial mediation assessments indicated that dimensions of emotional intelligence influence academic performance both directly and indirectly through psychological well-being. Specifically, flourishing partially mediated the relationship between emotional intelligence and academic performance, directly influencing academic outcomes. CONCLUSIONS: This study underscores the critical role of emotional management skills in academic performance, with psychological well-being acting as a partial mediator in this relationship. Consequently, undergraduate nursing students with enhanced emotional management abilities and higher levels of psychological well-being are likely to achieve better academic outcomes.

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Background/Objectives: The literature reports that emotional disorders in asthmatic children and their parents may affect asthma control. This research explores the baseline psychological well-being of asthmatic children and their mothers' and fathers' psychological functioning, focusing on the influence of the parents' anxiety and separation anxiety on children's asthma. Methods: In this cross-sectional study, we enrolled children with non-severe asthma and their parents, and a group of healthy children and their parents. The asthmatic children underwent anamnestic investigation, including asthma control and spirometry. Then, both the asthmatic and control triads filled a survey assessing their psychological functioning. Results: Among the 40 asthmatic children enrolled (8-18 years old), most had good clinical control maintained with GINA (Global Initiative for Asthma) therapy step 1-2 (14 patients, 35%) or step 3-4 (26 patients, 65%); 12 patients (30%) had at least one steroid course in the year before enrollment. They exhibited normal psychological adjustment but elevated levels of general (U = 179,500; p < 0.001) and state anxiety (U = 170,000; p < 0.001) compared to healthy peers. Additionally, the asthmatic children's mothers displayed higher levels of separation anxiety compared to the fathers (t = -2.865, p = 0.006). Increased separation anxiety in the mothers corresponded to a history of at least one exacerbation in the previous year. Conclusions: The asthmatic children exhibited normal psychological adjustment with higher general and state anxiety. Also, their mothers showed greater levels of separation anxiety compared to their fathers. Lastly, higher mothers' separation anxiety corresponded to a history of at least one exacerbation in the previous year. The influence of the parents' psychological well-being on the children's asthma control was previously unexplored.

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OBJECTIVE: The number of workers engaged in informal employment in China has reached 200 million individuals, constituting a substantial contribution to the pursuit of high-quality development and the attainment of stable employment objectives. Nevertheless, the psychological well-being of informal workers cannot be overlooked. Therefore, this study aims to investigate the impact of informal employment on individuals' psychological well-being. METHODS: Drawing on data from the 2020 China Family Panel Studies (CFPS) survey, this work employs ordinary least squares (OLS) models and instrumental variable analysis to empirically examine the impact of informal employment on the psychological well-being. Furthermore, different tests were utilised to analyse the mediating pathway through which informal employment affects the psychological well-being. RESULTS: Informal employment exhibits a significant negative impact on the psychological well-being, particularly among samples characterised by low educational levels, limited financial resources, and non-agricultural household registration. The exploration of the underlying mechanisms indicates that informal employment negatively affects the psychological well-being of workers through pathways that include reduced access to health entitlements, increased working hours, and decreased job satisfaction, particularly with the work environment. CONCLUSION: A recommendation is proposed; namely, to further establish a social security system that caters to the needs of the informal employment population and supports and regulates the development of flexible employment forms, with the aim of protecting and enhancing the psychological well-being of the informal employment population.

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AIMS/BACKGROUND: Young mothers have reported facing specific challenges such as stigmatisation and social isolation, which may be exaggerated by the increasing maternal age in industrialised countries. Despite these challenges, some young mothers have been shown to exhibit resilience and confidence during the transition to parenthood. Using strength-based psychological concepts, this study aimed to identify the facilitators of and barriers to the development of positive psychological states in young Australian mothers. DESIGN/METHODS: Using semi-structured interview questions, 11 women who had given birth between 15 and 22 were asked to share their experiences of pregnancy, birth, and motherhood. Their responses were analysed using the Framework method; initially coding the data to a priori themes such as resilience and social support, and then to higher order themes. RESULTS: Five higher order themes were developed from participant responses: 1. Everything is about to change, 2. Disrespected and disempowered, 3. Resilience, 4. It takes a village, and 5. A hopeful future. Across these themes, participants described the mixed emotional experiences of pregnancy and birth, experiences of stigma from various sources, efforts to maintain mental wellbeing, reliance on support networks, and aspirations for themselves and their children. CONCLUSION: Findings from the current study highlight several key strategies for managing the challenges of early motherhood and promoting positive psychological states. Recommendations include fostering self-efficacy, supporting identity development, and establishing strong support networks across social and healthcare contexts. Recognizing and celebrating the strengths of young mothers is essential for effectively supporting them through the complex experience of motherhood.

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Living at risk of a genetically inherited disease can be a challenging experience causing psychological distress as well as the possibility of the genetic disease leading to physical health problems. Huntington's disease (HD) is a genetic, neurodegenerative condition. It causes motor dysfunction, cognitive decline and, during the progression of the disease, different psychological difficulties are common. A total of 12 participants living at risk of HD were interviewed and interpretative phenomenological analysis methodology was used to understand their experiences of maintaining psychological well-being. This resulted in three themes: (1) "you're constantly in limbo": living in two worlds; (2) "I have to live, just bloody live": managing the possibility of a time-limited lifespan; and (3) "I try and try my hardest to look past the disease": the exhausting quest to keep living well. The findings indicated a need for improved knowledge within professional settings, such as for family doctors, counselors, and other health professionals, specific strategies that genetic counselors can use to support this group, and provision of accessible support and implementation of systemic interventions that would offer support for psychological coping strategies and communication around well-being to the individual and their family unit. Future research could contribute to the formation of such knowledge and the provision of HD-aligned services to help support the psychological well-being of people living at risk of HD.

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OBJECTIVES: Translating research into practice is often a goal for evidence-based organisational researchers to help improve workplace conditions and worker wellbeing. Improving worker wellbeing can be achieved by using empirical evidence to inform organisational interventions. However, despite the well-established intervention literature, practitioners appear not to appreciate fully how research findings can inform real-world practice. Using our understanding about workplace safety and health issues, we proposed that employers themselves could undertake interventions that focus on building Psychosocial Safety Climate (PSC), an essential organisational climate that protects and promotes the psychological wellbeing of workers. METHODS: Here we present two case studies to illustrate strategies that improve psychosocial safety and to increase our understanding about how interventions help improve PSC over time. Case Study 1 was conducted in an Australia public organisation and Case Study 2 was in an international private organisation. We collected survey data using the PSC-12 scale, to assess the level of PSC of the organisation before and after the intervention, and details of the intervention and other initiatives for promoting employees' psychological health. RESULTS: Our evaluation supported the proposition that interventions that combine organisational and individual level (and the interface between the two) approaches with a focus on the core elements of PSC (such as commitment, priority, communication, and participation) improve an organisation's PSC over time. CONCLUSION: Not only does the research elucidate important practical implications for organisations trialing new psychosocial safety initiatives, but our study makes an important contribution to theory in work stress intervention on best practice and principles to build a psychologically healthy work context.

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Background: Unprofessional behaviour in healthcare systems can negatively impact staff well-being, patient safety and organisational costs. Unprofessional behaviour encompasses a range of behaviours, including incivility, microaggressions, harassment and bullying. Despite efforts to combat unprofessional behaviour in healthcare settings, it remains prevalent. Interventions to reduce unprofessional behaviour in health care have been conducted - but how and why they may work is unclear. Given the complexity of the issue, a realist review methodology is an ideal approach to examining unprofessional behaviour in healthcare systems. Aim: To improve context-specific understanding of how, why and in what circumstances unprofessional behaviours between staff in acute healthcare settings occur and evidence of strategies implemented to mitigate, manage and prevent them. Methods: Realist synthesis methodology consistent with realist and meta-narrative evidence syntheses: evolving standards reporting guidelines. Data sources: Literature sources for building initial theories were identified from the original proposal and from informal searches of various websites. For theory refinement, we conducted systematic and purposive searches for peer-reviewed literature on databases such as EMBASE, Cumulative Index to Nursing and Allied Health Literature and MEDLINE databases as well as for grey literature. Searches were conducted iteratively from November 2021 to December 2022. Results: Initial theory-building drew on 38 sources. Searches resulted in 2878 titles and abstracts. In total, 148 sources were included in the review. Terminology and definitions used for unprofessional behaviours were inconsistent. This may present issues for policy and practice when trying to identify and address unprofessional behaviour. Contributors of unprofessional behaviour can be categorised into four areas: (1) workplace disempowerment, (2) organisational uncertainty, confusion and stress, (3) (lack of) social cohesion and (4) enablement of harmful cultures that tolerate unprofessional behaviours. Those at most risk of experiencing unprofessional behaviour are staff from a minoritised background. We identified 42 interventions in the literature to address unprofessional behaviour. These spanned five types: (1) single session (i.e. one-off), (2) multiple sessions, (3) single or multiple sessions combined with other actions (e.g. training session plus a code of conduct), (4) professional accountability and reporting interventions and (5) structured culture-change interventions. We identified 42 reports of interventions, with none conducted in the United Kingdom. Of these, 29 interventions were evaluated, with the majority (n = 23) reporting some measure of effectiveness. Interventions drew on 13 types of behaviour-change strategy designed to, for example: change social norms, improve awareness of unprofessional behaviour, or redesign the workplace. Interventions were impacted by 12 key dynamics, including focusing on individuals, lack of trust in management and non-existent logic models. Conclusions: Workplace disempowerment and organisational barriers are primary contributors to unprofessional behaviour. However, interventions predominantly focus on individual education or training without addressing systemic, organisational issues. Effectiveness of interventions to improve staff well-being or patient safety is uncertain. We provide 12 key dynamics and 15 implementation principles to guide organisations. Future work: Interventions need to: (1) be tested in a United Kingdom context, (2) draw on behavioural science principles and (3) target systemic, organisational issues. Limitations: This review focuses on interpersonal staff-to-staff unprofessional behaviour, in acute healthcare settings only and does not include non-intervention literature outside the United Kingdom or outside of health care. Study registration: This study was prospectively registered on PROSPERO CRD42021255490. The record is available from: www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021255490. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR131606) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 25. See the NIHR Funding and Awards website for further award information.

For this study, we asked: how, why and in what situations can unprofessional behaviour between healthcare staff working in acute care (usually hospitals) be reduced, managed and prevented? We wanted to research how people understand unprofessional behaviour, explore the circumstances leading to unprofessional behaviour and understand how existing approaches to addressing unprofessional behaviour worked (or did not work) across staff groups and acute healthcare organisations. We used a literature review method called a 'realist review', which differs from other review methods. A realist review focuses on understanding not only if interventions work but how and why they work, and for whom. This allowed us to analyse a wider range of relevant international literature ­ not only academic papers. We found 148 sources, which were relevant either because they described unprofessional behaviour or because they provided information on how to address unprofessional behaviour. Definitions of unprofessional behaviour varied, making it difficult to settle on one description. For example, unprofessional behaviour may involve incivility, bullying, harassment and/or microaggressions. We examined what might contribute to unprofessional behaviour and identified factors including uncertainty in the working environment. We found no United Kingdom-based interventions and only one from the United States of America that sought to reduce unprofessional behaviour towards minority groups. Strategies often tried to encourage staff to speak up, provide ways to report unprofessional behaviour or set social standards of behaviour. We also identified factors that may make it challenging for organisations to successfully select, implement and evaluate an intervention to address unprofessional behaviour. We recommend a system-wide approach to addressing unprofessional behaviour, including assessing the context and then implementing multiple approaches over a long time (rather than just once), because they are likely to have greater impact on changing culture. We are producing an implementation guide to support this process. Interventions need to enhance staff ability to feel safe at work, work effectively and support those more likely to experience unprofessional behaviour.

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The COVID-19 pandemic impacted the mental, emotional, and physical health of healthcare professionals around the world. Despite research efforts to examine the experiences of physicians, nurses, and other professionals in healthcare, little has been shared about the experiences of pharmacists during the pandemic. A review of current evidence is needed to better understand the mental health experiences of pharmacists during the pandemic. This review aimed to understand the perceptions, experiences, and impacts on the mental, emotional, and psychological well-being of practicing pharmacists during the COVID-19 pandemic. A review of the literature was carried out by searching several electronic databases, which included Google Scholar, ScienceDirect, PubMed, DOAJ, JSTOR, PsycINFO, the ERIC Database (via EBSCOhost), and Academic Search Complete for studies published between 2020 and 2022. The search was conducted from September 10, 2022, to November 18, 2022, using Boolean operations and the following terms: Kansas, pharmacist, pharmacy, mental health, psychology, burnout, and well-being. Nine studies exploring the lived experiences of practicing pharmacists worldwide during the COVID-19 pandemic were included in this review. The literature surveyed includes three international studies, five national (USA) studies, one study from the Midwestern region of the USA, and one study from Kansas specifically. These studies revealed increased burnout prevalence, mental health distress, feelings of negativity related to the job, and an overall lack of wellness among pharmacists across the world during the pandemic. There is limited research on the perspectives and experiences of practicing pharmacists during the COVID-19 pandemic. Additional research is necessary to thoroughly understand pharmacists' experiences and how to further support their well-being.

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Introduction: Mental health nurses (MHNs) are categorized as demanding specialists with high levels of stress, and their career is recognized as a high-risk career. Objective: The study aims to assess the relationships between psychological well-being (PWB), mental distress, and resilience among MHNs. Also, it aims to identify the significant predictors of the psychologic well-being of MHNs. Methods: The study utilized a cross-sectional survey design with a random sample of 250 MHNs who were requested to complete DASS 21, Ryff's scale of PWB and Connor Davidson's resilience scale. Results: The results revealed that two-thirds of nurses reported either a severe or extreme level of stress (n = 166, 66%), and more than half experienced a severe to extreme level of anxiety (n = 140, 56%). Approximately 25% of MHNs reported a severe to extreme level of depression (n = 62, 25%). The results also indicated that there is a statistically significant negative relationship between PWB subscales and DASS 21. The results indicate that the depression subscale is significantly varied based on the demographic characteristics of nurses. Similarly, this is the case for the anxiety and stress subscales. Conclusion: The study showed that MHNs' resilience intervenes with perceived mental distress. Enhancing MHNs resilience would improve PWB and mental health. The study results conclude that MHNs with a high level of resilience reported lower mental distress and a better working environment. Thus, MHNs should be introduced to crisis intervention in order to improve resilience levels.

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Background COVID-19 has profoundly affected pharmacists, causing burnout from heavier workloads, personal stressors, and disrupted healthcare delivery. Research on pharmacists' mental health during the pandemic, especially in rural areas like Kansas, remains limited. Objectives This study aimed to understand perceptions, experiences, and impacts on the mental, emotional, and psychological well-being of active Kansas pharmacists during the COVID-19 pandemic, including evaluating workplace modifications on mental health. Methods Kansas licensed pharmacists were recruited via email distributions through five Kansas pharmacy organizations and informal referrals among colleagues. After consenting, respondents completed a 15-minute, 28-question survey via Qualtrics. The survey included 11 questions concerning demographics and employment characteristics, along with 17 questions designed to assess the impact of COVID-19 on mental health, structured according to existing literature. Participation was uncompensated, and incomplete surveys were omitted from the analysis. Results One hundred and seven respondents (83.59% completion) represented 3.25% of Kansas's 3,290 pharmacists. They were aged 26-66 (M=38.7), the majority female (72.57%) and white (84.84%), with 14.24 years average practice duration (SD=10.94). Data covered 12 rural and 11 urban counties, with 50.91% staff pharmacists and 22.73% pharmacy managers. Many worked over 40 hours weekly in 13 settings. Findings showed increased workload (24.68%), medication shortages (24.03%), and burnout (24.32%) affecting job considerations. Workplace changes impacted personal mental health, with the main stressors being work-related factors (19.21%), social distancing (18.95%), and health concerns (12.63%). Conclusion This study underscores the pandemic's profound toll on Kansas pharmacists' mental, emotional, and physical health, leading to burnout, job dissatisfaction, and decreased effectiveness. It emphasizes the urgency of organizational interventions.