resilience

复原力
  • 文章类型: Journal Article
    人们普遍认为,COVID-19封锁期间日常活动表现的中断影响了健康,但是需要更好地了解特定活动的受限表现如何与健康相关。这项横断面研究回答了以下问题:在COVID-19封锁期间,16项日常活动的表现与健康相关的变化如何?共有116名参与者完成了一项在线调查,对他们在COVID-19封锁之前和期间的健康状况进行了评估,并将他们对COVID-19之前16项活动的表现与封锁期间的表现进行了比较。使用多元逐步线性回归分析来估计封锁期间自我报告的活动变化与同时(封锁期间)健康状况之间的关系。同时控制前COVID-19的健康状况。最终模型中只保留了与锁定健康状况唯一且显著相关的活动变化。COVID-19之前的健康状况占COVID-19封锁期间健康状况差异的3.7%(P=0.039)。在控制COVID-19之前的健康状况后,五种类型的活动对封锁期间的健康状况有显著和独特的预测作用,合计占差异的48.3%。这些活动和它们所占的差异是休息和睡眠(29.5%,P<0.001),游戏和娱乐活动(8%,P<0.001),工作(4.8%,P=0.002),个人卫生(3.2%,P=0.01),和健康饮食(2.8%,P=0.013)。研究表明,当活动的参与受到封锁或类似因素的限制时,应在政策或干预措施中优先考虑这五种类型的活动。
    The disruption in daily activity performance during COVID-19 lockdowns is widely understood to have impacted health, but a better understanding of how restricted performance of specific activities are associated with health is needed. This cross-sectional study answers the following question: How were changes in the performance of 16 daily activities associated with health during COVID-19 lockdowns? A total of 116 participants completed an online survey rating their health before and during COVID-19 lockdowns and comparing their recollection of the performance of 16 activities before COVID-19 with their performance during lockdowns. Multiple stepwise linear regression analysis was used to estimate the relationship between self-reported changes in activities during lockdowns and concurrent (during-lockdown) health status, while controlling for pre-COVID-19 health status. Only changes in activities that were uniquely and significantly associated with lockdown health status were retained in the final model. Health before COVID-19 accounted for 3.7% (P = 0.039) of the variance in health during COVID-19 lockdowns. After controlling for health before COVID-19, five types of activity were significantly and uniquely predictive of health during lockdowns, together accounting for 48.3% of the variance. These activities and the variances they accounted for were rest and sleep (29.5%, P < 0.001), play and recreational activities (8%, P < 0.001), work (4.8%, P = 0.002), personal hygiene (3.2%, P = 0.01), and healthy eating (2.8%, P = 0.013). The study suggests that these five types of activity should be prioritized in policy or interventions when participation in activity is constrained by lockdowns or comparable factors.
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  • 文章类型: Journal Article
    背景:在法国,流产每年影响近20万名妇女。这种生活事件可能会在接下来的怀孕中对母婴关系和母亲的心理健康产生负面影响。
    目的:为了调查身体满意度的影响,合作伙伴支持,孕妇产前依恋流产的韧性和以前的经验。
    方法:这是一项横断面混合方法研究。女性在2022年11月至2023年4月期间回答了一份在线问卷。
    方法:本研究招募了267名以前经历过流产的法国孕妇。
    方法:研究结果包括产前依恋,弹性,合作伙伴支持,以前怀孕和流产的历史,目前的怀孕,以及与身体经验有关的问题。
    结果:报告在当前怀孕期间投入大量资金的参与者,高的伴侣支持和他们身体的积极形象具有较高的产前依恋水平。流产的经历似乎也会影响产前依恋:流产时的妊娠投资有积极的影响,而医疗经验没有显著影响。虽然全球弹性评分与产前依恋无关,控制感与产前依恋呈正相关。
    结论:这些结果强调了将流产视为围产期流产的重要性,并可能对妇女产生长期影响。这值得专业人士特别关注。加强伴侣支持和帮助妇女树立怀孕身体的积极形象也可以在促进胎儿的产前依恋方面发挥作用。
    BACKGROUND: In France, miscarriage affects nearly 200,000 women every year. This life event may generate negative effects on the mother-child relationship and the mother\'s mental health in the following pregnancy.
    OBJECTIVE: To investigate the influence of body satisfaction, partner support, resilience and previous experience of a miscarriage on prenatal attachment in pregnant women.
    METHODS: This is a cross-sectional mixed-methods study. Women answered an online questionnaire in the period between November 2022 to April 2023.
    METHODS: 267 French pregnant women who had previously experienced a miscarriage were recruited for this study.
    METHODS: Study outcomes included prenatal attachment, resilience, partner support, history of previous pregnancies and miscarriages, the current pregnancy, and questions relating to body experience.
    RESULTS: Participants who reported a high investment in the current pregnancy, high partner support and a positive image of their body had higher levels of prenatal attachment. The experience of miscarriage also seems to influence prenatal attachment: pregnancy investment at the time of miscarriage had a positive influence, while medical experience had no significant impact. While the global resilience score was not related to prenatal attachment, sense of control was positively linked to prenatal attachment.
    CONCLUSIONS: These results highlight the importance of considering miscarriage as a perinatal loss with potential for long-lasting impact on women, which deserves particular attention from professionals. Enhancing partner support and helping women build a positive image of their pregnant body can also have a role in fostering prenatal attachment to the foetus.
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  • 文章类型: Journal Article
    浪漫的关系是许多人生活的重要组成部分,至少部分是由童年时期的经历塑造的。在童年时期遭受家庭暴力的年轻人更有可能在以后的浪漫关系中遇到困难。然而,缺乏对有家庭暴力史的年轻人的浪漫关系的更全面的观点。运用理论和归纳主题分析,这项定性研究探讨了童年时期遭受家庭暴力的年轻人在浪漫关系中的挑战和积极经历。对18名年龄介乎16至20岁的青年进行了深入的个别访谈,他们被报告给儿童保护服务。叙述反映了青年经历了与支持有关的挑战,连接,信任,边界设置,情绪调节和冲突解决。此外,童年时期的家庭暴力在这些挑战的出现中似乎很重要,与观察学习理论和依恋理论中描述的理论机制一致。然而,青年还描述了他们浪漫关系中的积极经历,并表现出了向他人学习的能力(例如,他们当前的浪漫伴侣)如何有效沟通或解决问题。因此,有了正确的社会或专业支持,处于危险中的青年也许能够克服这些挑战。
    Romantic relationships are an important part of many people\'s lives and at least partly shaped by experiences during childhood. Youth exposed to family violence during childhood are more likely to experience difficulties in their later romantic relationships. However, a more holistic perspective on the romantic relationships of youth with a history of family violence is lacking. Using both theoretical and inductive thematic analysis, this qualitative study explored challenges as well as positive experiences within romantic relationships of youth exposed to family violence during childhood. In-depth individual interviews were conducted with 18 youth aged between 16 and 20 years, who were reported to child protection services. The narratives reflected that youth experienced challenges related to support, connection, trust, boundary setting, emotion regulation and conflict resolution. Furthermore, family violence during childhood seemed to be important in the emergence of these challenges, consistent with theoretical mechanisms described in observational learning theory and attachment theory. However, youth also described positive experiences in their romantic relationships and demonstrated an ability to learn from others (e.g., their current romantic partner) how to communicate effectively or solve problems. Therefore, with the right social or professional support, at-risk youth may be able to overcome these challenges.
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  • 文章类型: Journal Article
    阿尔茨海默病(AD)是一种病因不明、无法治愈的毁灭性神经退行性疾病。因此,必须更多地了解潜在的风险因素。由于AD是一种与年龄有关的疾病,一种方法是研究与衰老相关的因素。一个例子是睡眠中断,随着年龄的增长,并加速认知衰退的进程。然而,一些睡眠不足的人很少或没有认知障碍,被认为是有弹性的。对睡眠中断的复原力增加对AD的抗性的概念可以在具有或不具有认知障碍的衰老小鼠中建模以确定对AD的抗性或易感性。鉴于睡眠中断是一个相关且不断上升的健康问题,对韧性有更好的理解是至关重要的,以及与抗AD相关的因素,以制定成功的干预策略。
    Alzheimer\'s disease (AD) is a devastating neurodegenerative condition with unknown etiology and no cure. Therefore, it is imperative to learn more about the underlying risk factors. Since AD is an age-related disease, one approach is to look at factors associated with aging. One example is sleep disruption, which increases with age and accelerates the progression of cognitive decline. However, some people with sleep loss experience little or no cognitive impairment and are considered resilient. The concept that resilience to sleep disruption increases resistance to AD can be modeled in aging mice with or without cognitive impairment to determine resistance or susceptibility to AD. Given that sleep disruption is a relevant and rising health concern, it is essential to gain a better understanding of resilience, and factors associated with resistance to AD, in order to develop successful intervention strategies.
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  • 文章类型: Journal Article
    目的:本研究探索和了解社区成员在门诊诊所的韧性,考虑各种维度和类型的弹性。
    方法:横断面研究。
    方法:这项研究于2023年9月至12月在沙特门诊进行,包括通过系统随机抽样选择的384名个体。使用了各种工具,如社会凝聚力和信任量表,社区复原力评估工具,社区心理体验评估,环境恢复力评估,经济弹性指数,康纳-戴维森弹性量表,简短的弹性量表,成人弹性量表和医疗保健弹性指数。
    结果:参与者表现出强大的整体弹性水平,总Connor-Davidson弹性量表评分63.0±9.0。此外,他们在总短暂复原力量表中表现出了值得称赞的复原力水平(56.04±8.6),成人弹性量表(82.5±7.2)和医疗保健弹性指数(45.8±5.5)。这些发现为研究人群的心理和情感幸福感提供了重要的见解,强调他们在不同生活领域的适应能力和应对机制。
    结论:这项研究为门诊环境中韧性的多维性质提供了有价值的见解。横截面设计为未来的纵向调查奠定了基础,强调需要采取整体方法来理解和促进复原力。
    结论:这项研究对参与者及其社区具有直接意义。通过揭示值得称赞的复原力水平,强调了门诊人群中普遍存在的适应能力和应对机制。这种洞察力增强了个人的心理和情感幸福感,对整体韧性和公共力量做出积极贡献。此外,这项研究揭示了沙特阿拉伯社区成员的韧性与国际先进护理社区的关系,提供对他们工作的洞察力。
    有目的地选择在过去6个月内接受过门诊服务的患者,以确保不同年龄的患者。本研究的性别和社会经济背景。
    OBJECTIVE: This study explores and understands community members\' resilience in outpatient clinics, considering various dimensions and types of resilience.
    METHODS: A cross-sectional study.
    METHODS: This study was conducted in Saudi outpatient clinics from September to December 2023 and included 384 individuals chosen through systematic random sampling. Various tools were used, such as Social Cohesion and Trust Scale, Community Resilience Assessment Tool, Community Assessment of Psychic Experiences, Environmental Resilience Assessment, Economic Resilience Index, Connor-Davidson Resilience Scale, Brief Resilience Scale, Resilience Scale for Adults and Healthcare Resilience Index.
    RESULTS: Participants displayed a robust overall resilience level, as indicated by Total Connor-Davidson Resilience Scale score of 63.0 ± 9.0. Additionally, they demonstrated commendable levels of resilience in Total Brief Resilience Scale (56.04 ± 8.6), Resilience Scale for Adults (82.5 ± 7.2) and Healthcare Resilience Index (45.8 ± 5.5). These findings offer significant insights into psychological and emotional well-being of the study population, highlighting their adaptive capacities and coping mechanisms across various life domains.
    CONCLUSIONS: This study provides valuable insights into the multidimensional nature of resilience in outpatient settings. The cross-sectional design sets the groundwork for future longitudinal investigations, highlighting the need for a holistic approach to understanding and promoting resilience.
    CONCLUSIONS: This study holds immediate implications for participants and their communities. It underscores the adaptive capacities and coping mechanisms prevalent in the outpatient population by revealing commendable resilience levels. This insight enhances individuals\' psychological and emotional well-being, contributing positively to the overall resilience and communal strength. Additionally, this study sheds light on how resilience among community members in Saudi Arabia relates to international advanced nursing communities, providing insight into their work.
    UNASSIGNED: Patients who have received outpatient services in the past 6 months were purposively chosen to ensure a diverse representation across age, gender and socio-economic backgrounds in this study.
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  • 文章类型: Journal Article
    目的:构建儿童白血病诊断后第一年家庭弹性过程的概念框架。
    方法:纵向定性访谈研究。
    方法:采用了扎根理论方法的纵向定性研究。在综合医院对白血病儿童的父母进行了半结构化访谈。通过目的和理论抽样招募参与者,并在白血病诊断后1、3、6和12个月进行访谈,实现纵向参与。在白血病儿童的父母入学后,核心类别和类别已饱和。同时进行数据收集和分析。
    结果:有16名白血病患儿的父母参加。“患有儿童白血病的家庭”的核心类别是指儿童白血病诊断后第一年的家庭韧性过程。包括三个阶段:(1)破坏和恢复期;(2)调整和巩固期;(3)增长和计划期。
    结论:本研究探索了动态,在诊断后的第一年,家庭应对儿童白血病的复杂和连续的弹性过程。进一步的研究应该设计量身定制的家庭干预措施,以描述家庭复原力的不同阶段,旨在支持家庭幸福,完整性和功能。
    家庭和医疗保健专业人员都必须创造一个有利的环境,以支持家庭应对困难。了解家庭韧性的不同阶段,使医疗保健专业人员能够提供满足儿童白血病家庭需求的整体护理。
    结论:在面对儿童白血病时,出现了关于家庭复原过程的独特知识,建议在理解和管理儿童白血病方面进行家庭主导的革命。因此,阶段性的发展,基于弹性的家庭干预势在必行。
    本研究使用COREQ检查表报告。
    患者通过参与研究做出了贡献。
    OBJECTIVE: To construct a conceptual framework on the process of family resilience during the first year following childhood leukaemia diagnosis.
    METHODS: A longitudinal qualitative interview study.
    METHODS: A longitudinal qualitative study following a grounded theory methodology was employed. Semi-structured interviews were conducted with parents of children with leukaemia in a general hospital. The participants were recruited through purposive and theoretical sampling and longitudinal engagement was achieved by conducting interviews at 1, 3, 6, and 12 months after the leukaemia diagnosis. The core category and categories were saturated following the enrolment of parents of children with leukaemia. Data collection and analyses were performed simultaneously.
    RESULTS: Sixteen parents of children with leukaemia participated. The core category of \'families living with childhood leukaemia\' refers to the process of family resilience during the first year following childhood leukaemia diagnosis, which includes three phases: (1) destruction and resiliency period; (2) adjustment and consolidation period; and (3) growth and planning period.
    CONCLUSIONS: This study explored the dynamic, complex and continuous processes of resilience among families coping with childhood leukaemia during the first year following diagnosis. Further research should design tailored family interventions that characterise the different phases of family resilience, aiming to support family well-being, integrity and functioning.
    UNASSIGNED: Both families and healthcare professionals must create an enabling environment that supports families coping with difficulties. Understanding the different phases of family resilience allows healthcare professionals to provide holistic care that meets the demands of families with childhood leukaemia.
    CONCLUSIONS: Unique knowledge emerged about the family\'s resiliency process when facing childhood leukaemia, suggesting a family-led revolution in understanding and managing childhood leukaemia. Therefore, the development of phased, resilience-based family interventions is imperative.
    UNASSIGNED: This study was reported using the COREQ checklist.
    UNASSIGNED: Patients contributed via study participation.
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  • 文章类型: Journal Article
    目标:本研究探讨了以前确定为整体专业学校成功的核心主题,与传统学术成就有关,弹性,和坚韧不拔的措施。
    方法:这项横断面研究调查了美国第三和四年级牙科学生。项目涉及先前确定为专业学校成功核心的主题,包括认知的需要,患者所有权,集体取向,砂砾,和韧性。传统的学术指标也包括在内。统计分析包括单向方差分析(ANOVA),简单线性回归,和逐步多元回归程序。
    结果:共有126名学生参加(81%的应答率)。集体取向,需要认知,患者所有权,弹性与平均成绩点(GPA)没有显著相关,而grit做到了,r=0.29。对认知和患者所有权的需求显著结合了预测的砂砾,解释了大约35%的差异。大约25%的弹性评分差异是由认知需求造成的,再加上集体取向。砂砾和韧性显著相关,r=0.59。
    结论:Grit显着预测了牙科学生的传统和替代成功指标,特别需要认知和患者所有权。在表现出坚韧和韧性的学生中,对认知的高度需求是一致的。韧性和成功的替代衡量标准都不能预测传统的学术指标。
    OBJECTIVE: This study explored themes previously identified as central to holistic professional school success, as related to traditional academic achievement, resilience, and grit measures.
    METHODS: This cross-sectional study surveyed third- and fourth-year US dental students. Items addressed themes previously identified as central to professional school success, including need for cognition, patient ownership, collective orientation, grit, and resilience. Traditional academic metrics were also included. Statistical analyses comprised one-way analysis of variance (ANOVA), simple linear regression, and stepwise multiple regression procedures.
    RESULTS: A total of 126 students participated (81% response rate). Collective orientation, need for cognition, patient ownership, and resilience did not significantly correlate with grade point average (GPA), whereas grit did, r = 0.29. Need for cognition and patient ownership combined significantly predicted grit with approximately 35% of variance explained. Approximately 25% of variance in resilience scores was accounted for by need for cognition, coupled with collective orientation. Grit and resilience significantly correlated, r = 0.59.
    CONCLUSIONS: Grit significantly predicted both traditional and alternative metrics of success among dental students, particularly need for cognition and patient ownership. A high need for cognition is consistent among students who display both grit and resilience. Neither resilience nor the alternative measures of success predicted traditional academic metrics.
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  • 文章类型: Journal Article
    在他们从基础教育向高等教育过渡的过程中,一年级护理本科生需要平衡理论和临床要求,以及他们的社交生活。他们中有相当一部分人为此而斗争,由于缺乏应对机制,由于韧性差。这项研究旨在确定影响南非大学一年级本科护理学生韧性的因素。遵循横截面描述性研究设计,采用分层方便抽样。数据是在2023年8月期间使用经过调整的自我管理的在线问卷收集的。在本研究的背景下,确保了改编版本的可靠性和有效性。主成分分析和varimax旋转用于分析数据。共有123名参与者(校园A的47.2%和校园B的52.8%)完成了问卷。大多数(88%)是女性。这项研究表明,复原力可以取决于各种因素,例如讲师支持,父母的支持,学术成就,同行和导师支持,对未来的乐观,和自决。建议高等教育机构应考虑纳入本研究中提出的因素,作为一年级本科护理专业学生首次进入大学时更广泛方向的一部分。
    During their transition from basic to higher education, first-year undergraduate nursing students need to balance theoretical and clinical requirements, as well as their social life. A significant number of them struggle with this, due to a lack of coping mechanisms due to poor resilience. This study aimed to determine factors that influence resilience among first-year undergraduate nursing students at a South African university. A cross-sectional descriptive research design was followed, with stratified convenient sampling. Data were collected during August 2023 using an adapted self-administered online questionnaire. The reliability and validity of the adapted version was ensured in the context of this study. Principal component analysis and varimax rotation were used to analyse data. A total of 123 participants (47.2% from campus A and 52.8% from campus B) completed the questionnaire. The majority (88%) were females. This study showed that resilience can be dependent on various factors, such as lecturer support, parental support, academic achievement, peer and mentor support, optimism about the future, and self-determination. It is recommended that higher education institutions should consider incorporating the factors presented in this study as part of the broader orientation of first-year undergraduate nursing students when they first arrive at university.
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  • 文章类型: Journal Article
    背景:在有家族史或阈值下情绪症状的个体中,双相情感障碍(BD)的风险增加。然而,与这些BD风险相关的大脑结构发育尚不清楚.
    方法:这项纵向队列研究检查了BD的家族性和症状性风险的脑灰质体积(GMV)发育特征,以及他们与参与者的全球功能级别的关联。我们招募了未受影响的BD后代(N=26,年龄=14.9±2.9岁,14名女性)或无(N=35,年龄=15.3±2.7岁,19名女性)阈值下躁狂或抑郁症状,和未受影响的非BD后代(N=49,年龄=14.5±2.2岁,30名女性)或无(N=68,年龄=15.0±2.3岁,37名女性)症状。在研究之前,后代没有情绪障碍诊断。平均随访时间为2.63±1.63年。
    结果:我们在基线时发现,家族风险和阈值下症状的显着交互效应表明,有症状的后代在大脑情感和认知回路中表现出明显的GMV。随访期间,BD后代(有症状和无症状)的联合组表现出比BD非后代加速的GMV下降,在海马和前扣带皮质.相比之下,有症状的参与者(后代和非后代)的组合组表现出比无症状参与者慢的GMV下降,在腹内侧前额叶皮层.基线时GMV较大,随访期间GMV加速下降,前瞻性和纵向预测积极的全局函数变化。所有结果都经过多次测试校正。
    结论:这些研究结果表明,BD的家族性和症状性风险与不同的脑结构发育有关,并揭示了特别容易受到随后功能恶化影响的高危个体的关键大脑发育特征。
    BACKGROUND: Risk for Bipolar disorder (BD) is increased among individuals with family history or subthreshold mood symptoms. However, the brain structural developments associated with these BD risks remained unknown.
    METHODS: This longitudinal cohort study examined the brain grey matter volume (GMV) developmental features of familial and symptomatic risks for BD, and their associations with participants\' global function levels. We recruited unaffected BD offspring with (N=26, age=14.9±2.9 years, 14 females) or without (N=35, age=15.3±2.7 years, 19 females) subthreshold manic or depressive symptoms, and unaffected non-BD offspring with (N=49, age=14.5±2.2 years, 30 females) or without (N=68, age=15.0±2.3 years, 37 females) symptoms. The offspring had no mood disorder diagnosis prior to the study. The average follow-up duration was 2.63±1.63 years.
    RESULTS: We found at baseline, significant interactive effects of familial risk and subthreshold symptoms indicated the symptomatic offspring exhibited markedly large GMV in the brain affective and cognitive circuitries. During follow-up, the combined group of BD offspring (symptomatic and non-symptomatic) displayed accelerated GMV decrease than BD non-offspring, in the hippocampus and anterior cingulate cortex. In contrast, the combined group of symptomatic participants (offspring and non-offspring) displayed slower GMV decrease than non-symptomatic participants, in the ventromedial prefrontal cortex. Larger GMV at baseline, and accelerated GMV decrease during follow-up, prospectively and longitudinally predicted positive global function changes. All results survived multiple-testing correction.
    CONCLUSIONS: These findings indicated that familial and symptomatic risks of BD are associated with distinct brain structural developments, and unraveled key brain developmental features of particularly vulnerable high-risk individuals to subsequent functional deterioration.
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  • 文章类型: Journal Article
    背景:情绪智力和生活满意度是良好心理健康的重要组成部分。研究影响情绪智力的因素及其与不同心理结构的关系的研究可能对心理健康有积极贡献。因此,本研究探讨了感知压力和心理弹性在情绪智力和生活满意度之间的中介作用。
    方法:研究样本包括在Türkiye不同地区的大学学习的780名大学生(62.3%为女性)。一项在线调查包括情绪智力量表,生活满意度量表,心理弹性量表,和感知压力量表。使用了多因素复杂预测相关设计。
    结果:结果表明,情绪智力与生活满意度和心理韧性呈正相关,(ii)与感知压力呈负相关。在最终模型中,感知压力和心理韧性在情绪智力与生活满意度的关系中起中介作用。研究结果表明,较高的情绪智力可能会降低感知压力,并且似乎对生活满意度和心理韧性有积极影响。
    结论:从事心理健康领域工作的个人需要帮助个人提高其EI水平,这可能有助于降低感知压力水平,增加心理弹性和生活满意度。
    BACKGROUND: Emotional intelligence and life satisfaction are essential components for good psychological well-being. Studies examining the elements contributing to emotional intelligence and its relationships with different psychological constructs are likely to positively contribute to mental health. Therefore, the present study examined the mediating roles of perceived stress and psychological resilience in the relationship between emotional intelligence and life satisfaction.
    METHODS: The study sample comprised 780 university students (62.3% females) studying at universities in different regions of Türkiye. An online survey included the Emotional Intelligence Scale, Satisfaction with Life Scale, Psychological Resilience Scale, and Perceived Stress Scale. A multifactorial complex predictive correlational design was used.
    RESULTS: The results showed that emotional intelligence was (i) positively correlated with life satisfaction and psychological resilience, and (ii) negatively correlated with perceived stress. In the final model, perceived stress and psychological resilience played a mediating role in the relationship between emotional intelligence and life satisfaction. The findings suggest that higher emotional intelligence may lower perceived stress and appears to have a positive effect in relation to life satisfaction and psychological resilience.
    CONCLUSIONS: Individuals working in the field of mental health need to help individuals increase their level of EI, which may help reduce the level of perceived stress and increase psychological resilience and life satisfaction.
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