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Burnout, characterized by exhaustion, reduced accomplishment, and devaluation, can have substantial negative implications for athletes. Notably, researchers continue to examine burnout from multiple perspectives, commonly focusing on stress-, motivation-, or commitment-related factors, with limited efforts to consider these perspectives together. In contrast, this study aimed to assess the utility of these multiple perspectives and the key predictors of burnout in the same athlete sample. Data on burnout, stress, motivation, motivational climate, and sport commitment were gathered from 370 Gaelic games athletes. Separate structural equation models incorporating stress, motivation, and commitment factors as predictors of burnout dimensions were assessed. All models showed adequate fit. However, differences in effect size suggest that stress is more strongly associated with exhaustion, while commitment and motivation showed a stronger relationship with reduced accomplishment and devaluation. Evidence of significant predictors across perspectives also supports an integrated approach and may inform integration efforts and targeted intervention strategies. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to explore the impact of AT in identity for students with disabilities in higher education and if/how this changes over time. Methods: Using a longitudinal qualitative research design, semi-structured interviews were conducted with students with disabilities (n = 13) in higher education in Ireland on two occasions during an academic year. A trajectory approach to longitudinal analysis was employed. This involved the use of matrices and identification of a through line for the study, which connects participant change over time. Results: The through line identified was feeling valued, which was central in the negotiation of identity over time across three themes: feelings of autonomy and competence; claiming disability; and feeling like you belong as a student. AT impacted experiences across the three themes which subsequently promoted or undermined students' sense of value. Reciprocally, feeling valued influenced use and perceptions of AT. Factors specific to a higher education context were also identified which influenced meanings attached to AT over time. Conclusion: Creating an environment where students feel valued is key in promoting use of and positive perceptions of AT. This should form an integral part of AT and disability policy in higher education. IMPLICATIONS FOR REHABILITATION: Assistive technology (AT) use can have significant implications for one's identity AT indirectly impacts on students with disabilities' sense of value through its influence on three areas of identity change/continuity; feelings of autonomy and competence, claiming disability and feeling like you belong Feeling valued was central to the negotiation of identity over time for students with disabilities in higher education Creating an environment where students feel valued is integral to supporting students in their pursuit of a positive sense of identity and key in promoting use of and positive perceptions towards AT. This should form a central part of AT and disability policy in higher education. [ABSTRACT FROM AUTHOR]

Adolescence is an important time in which young people take on type 1 diabetes (T1D) self-management responsibility. Parents are key facilitators of this process. Little is known about parents' experiences of communicating with their children about T1D during adolescence. Semi-structured interviews were conducted with 32 parents (24 mothers and 8 fathers) of adolescents (11–17 years) living with T1D to explore how parents communicate about T1D and self-management with their adolescent children. Parents were recruited through two national child and adolescent diabetes and endocrine clinics and online advertisement through a national diabetes advocacy organisation. Interviews were transcribed verbatim and thematically analysed. Six themes were identified: parent factors, quality of the parent–adolescent relationship, communication strategies, adolescent factors, communication triggers and family/system factors. Understanding factors that impact communication about self-management between parents and adolescents will enable healthcare professionals to provide support and targeted interventions as parent and adolescent roles change over time. [ABSTRACT FROM AUTHOR]

Background: Supported self‐management can improve clinical and psychosocial outcomes in people with cancer; the considerations required to implement self‐management support (SMS) for people living with a lower‐grade glioma (LGG)—who often have complex support needs—are not known. We aimed to identify and understand these implementation considerations through the lens of normalisation process theory (NPT), from the perspectives of healthcare professionals (HCP) and people with LGG. Methods: We conducted semistructured interviews with HCPs who support adults with brain tumours (n = 25; 12 different healthcare professions), and people with LGG who had completed primary treatment (n = 28; male n = 16, mean age 54.6 years, mean time since diagnosis 8.7 years), from across the United Kingdom. Interviews were transcribed and inductive open coding conducted, before deductively mapping to constructs of NPT. We first mapped HCP data, then integrated data from people with LGG to explore alignment in experiences and perspectives. Results: We generated supporting evidence for all four NPT constructs and related subconstructs, namely: 'Coherence', 'Cognitive participation', 'Collective action' and 'Reflexive monitoring'. Data from HCPs and people with LGG clearly demonstrated that effective SMS constitutes a collective activity. Key implementation considerations included: ensuring awareness of, and access to, support; building strong HCP‐support recipient relationships; and careful inclusion of close family and friends. We identified pertinent challenges, such as identifying support needs (influenced by the extent to which those with LGG engage in help‐seeking), resistance to support (e.g., technology literacy), training for HCPs and HCP cooperation. Conclusions: This study demonstrates the collective nature of, and provides insight into the individual roles within, supported self‐management. We outline considerations to operationalise, sustain and appraise the implementation of SMS for people with LGG. Patient or Public Contribution: People with brain tumours, and informal caregivers, were involved in the development of information materials and topic guides to ensure accessibility and pertinence. They also had opportunities to comment on interview findings. [ABSTRACT FROM AUTHOR]

Background Quantitative studies show people living with a lower-grade glioma (LGG) often report low health-related quality of life. However, it is unclear how this impact is experienced; resulting supportive care needs are also poorly understood. We explored how people experience the impact of living long-term with an LGG, to help identify potential supportive care needs. Methods We conducted semi-structured interviews with a diverse group of people with LGG (n  = 28) across the United Kingdom, who had completed primary treatment (male n  = 16, female n  = 12, mean age 54.6 years, mean time since diagnosis 8.7 years). Interviews were transcribed and inductive thematic analysis was conducted. Results Four themes relating to the impact experiences of people with LGG were generated: " Emotional response to the diagnosis ," " Living with the 'What ifs' ," " Changing relationships ," and " Faltering independence." These reflect participants' experiences with symptoms (eg, fatigue, seizures) and impairments (eg, motor dysfunction, cognitive deficits), and how these, in turn, drive impacts on daily living (including on work, relationships, social activities, and transport). Participants spoke about their experiences with profound emotion throughout. Conclusions People with LGG can experience wide-ranging everyday impacts and may have extensive supportive care needs. This study highlights how this impact is experienced and what it means to people with LGG. Best practice suggestions for conducting comprehensive needs assessments tailored to those with LGG, and the development of personalized plans to meet those needs, would be a critical step to ensure that people with LGG are best supported in living with their condition. [ABSTRACT FROM AUTHOR]

The increasing demand for equitable higher education necessitates changes in how to consider and develop inclusive university settings. Using a systems-thinking lens, this article examines the whole-campus approach to technology and inclusion of college students with disabilities in Ireland. In-depth interviews with students with disabilities and other stakeholders representing higher education, non-profit organizations, and government bodies uncovered critical areas and dynamics for understanding and building institution-wide capacity for overcoming barriers to technology and access, and creating a systemic culture of inclusion in higher education. Five themes were identified: equity of technology-based access; shared responsibility and accountability; staff knowledge development; institutional commitment and management; and student partnership. The study indicated that embedding guidance, recognition and expectations for universal design, technology-inclusive practice, and meaningful input of students with disabilities across all areas of university life would help to cultivate more equitable higher education for all. The whole-campus approach to technology and inclusion recommends that all aspects of university life are fully accessible and inclusive to all. Creating settings across institutions that can be accessed and used by all, to the greatest extent possible, and developing staff's responsibility and skills for technology and practices that include students with disabilities are important areas for further action. Greater recognition of teaching and professional development for inclusive education is required. Promoting assistive technologies and teaching and learning approaches for inclusion in terms of their wide-reaching benefits and diversity, rather than focusing exclusively on disability, may be a promising step towards making inclusion mainstream. Fully including students with disabilities in making decisions on matters that affect their experiences and technology in college is necessary to support inclusion across university campuses. [ABSTRACT FROM AUTHOR]

Purpose: Health literacy skills are vital for cancer caregivers in helping cancer survivors to navigate their diagnosis, treatment, and recovery but little is known. This study explored health literacy and eHealth literacy among cancer caregivers and the relationship between health literacy/eHealth literacy and potential associated factors. Methods: Informal caregivers who had cared for an individual with cancer completed a survey which collected demographic data and measured caregiver health literacy, eHealth literacy, self-efficacy, burden, and distress. Results: Seven percent of caregivers had inadequate health literacy. Caregivers scored lowest on health literacy domains related to caregiver social support, information seeking and understanding care recipient preferences. eHealth literacy was associated with self-efficacy and burden while, different health literacy domains were associated with burden ('Understanding care recipient needs and preferences'), self-efficacy ('Cancer-related communication with the care recipient' and 'Understanding care recipients needs and preferences') and distress ('Proactivity and determination to seek information', 'Understanding care recipient needs and preferences', 'Understanding the healthcare system'). Conclusion: Findings highlight key areas of need regarding cancer caregiver health literacy which future research can target. Given the observed relationship between aspects of health literacy and burden, distress and self-efficacy future work could be carried out on how to alleviate high levels of burden and distress and how to enhance self-efficacy among cancer caregivers by addressing health literacy skills. Implications for cancer survivors: Findings from this study will inform the development of health literacy interventions to support caregivers to build their health literacy skills and enable this group to better support cancer survivors as a result. [ABSTRACT FROM AUTHOR]

Those closest to people with lower-grade gliomas (LGGs) often assume the role of informal caregiver (IC). The additional responsibilities mean ICs of people with cancer can experience adverse impacts on their own lives. We explored the emotional impact of informal caregiving for people with LGGs. This was a descriptive qualitative study within the multi-method Ways Ahead project. We conducted semi-structured interviews with individuals from the United Kingdom, who currently, or in the past 5 years, informally cared for someone with an LGG. Interviews encompassed experiences of emotional impact as a consequence of caregiving for someone with an LGG. Inductive thematic analysis was undertaken. We interviewed 19 ICs (mean age 54.6 years; 14 females, 5 males). Participants reported substantial emotional impact. Four themes and associated subthemes were generated: Emotional responses to the illness (e.g. feeling helpless), Emotional responses to the unknown (e.g. anxiety about future uncertainty), Emotional consequences of care recipient changes (e.g. challenges of changed relationship dynamics), and Emotional weight of the responsibility (e.g. feeling burnout). Emotional impact in one area often exacerbated impact in another (e.g. future uncertainty impacted feelings of helplessness). Participants detailed the factors that helped them manage the emotional impact (e.g. being resilient). ICs of people with LGGs can experience wide-ranging emotional responses to and impacts of the illness, uncertain prognosis, care recipient changes, and the toll of caregiving. Adjustment and resilience are key protective factors, though further consideration of ways to identify and fulfil the emotional support needs of ICs of people with LGGs is required. [ABSTRACT FROM AUTHOR]

Simple Summary: Self-management interventions can improve clinical and psychosocial outcomes for cancer survivors. However, we do not know which intervention characteristics (i.e., how they are delivered) and components (i.e., what they deliver) are beneficial. This can influence the implementation of such interventions into routine cancer care. We aimed to identify existing self-management interventions for adult cancer survivors, describe their characteristics and components, and investigate associations with quality of life. We identified 32 interventions. Studies had varying quality. A total of 22 studies reported significant improvements in quality of life, associated most often with combined individual and group delivery. Self-management interventions showed promise for improving the quality of life in cancer survivors; however, caution is required because the intervention characteristics and self-management components delivered varied considerably. Still, we highlight what may be worth adapting from existing interventions. Overall, these findings provide the foundations to help inform the development and implementation of self-management interventions for cancer survivors. Self-management can improve clinical and psychosocial outcomes in cancer survivors. Which intervention characteristics and components are beneficial is unclear, hindering implementation into practice. We systematically searched six databases from inception to 17 November 2021 for studies evaluating self-management interventions for adult cancer survivors post-treatment. Independent reviewers screened for eligibility. Data extraction included population and study characteristics, intervention characteristics (TIDieR) and components (PRISMS), (associations with) quality of life (QoL), self-efficacy, and economic outcomes. Study quality was appraised, and narrative synthesis was conducted. We identified 53 papers reporting 32 interventions. Studies had varying quality. They were most often randomised controlled trials (n = 20), targeted at survivors of breast (n = 10), prostate (n = 7), or mixed cancers (n = 11). Intervention characteristics (e.g., provider, location) varied considerably. On average, five (range 1–10) self-management components were delivered, mostly "Information about condition and its management" (n = 26). Twenty-two studies reported significant QoL improvements (6 also reported significant self-efficacy improvements); these were associated most consistently with combined individual and group delivery. Economic evaluations were limited and inconclusive. Self-management interventions showed promise for improving QoL, but study quality was variable, with substantial heterogeneity in intervention characteristics and components. By identifying what to adapt from existing interventions, these findings can inform development and implementation of self-management interventions in cancer. [ABSTRACT FROM AUTHOR]

Objective: Cancer‐related lymphoedema is a common side effect of cancer, affecting 24%–49% of people with cancer. Body image contributes to the well‐being of individuals with this condition. This systematic review aimed to explore, for the first time, the state of the science concerning body image in cancer‐related lymphoedema, including how body image is measured and variables associated with body image concerns. Methods: Six databases were systematically searched for peer‐reviewed articles describing empirical quantitative studies where body image was measured with a reliable and valid measurement tool in adults with cancer‐related lymphoedema. Results: Nine studies with 977 participants were included. The studies involved individuals who had experienced breast, head and neck, melanoma, and urogenital cancers and developed lymphoedema. There was considerable heterogeneity in body image measures used, precluding meta‐analysis. The following variables were associated with increased body image concern: higher body integrity beliefs, experience of physical changes (e.g. pain) and differences in sensation and function, including changes in appearance related thoughts, feelings and emotions. Several studies described behavioural and psychological interventions which positively impacted body image outcomes in individuals with lymphoedema relating to specific cancers. Conclusion: Regular screening for body image concerns could encourage more positive body image awareness in individuals with cancer‐related lymphoedema and lessen some of its associated negative consequences. Future longitudinal and individual differences research in this area is important to inform intervention development. There is also need for a more standardised approach to the study and measurement of body image in people with cancer‐related lymphoedema. [ABSTRACT FROM AUTHOR]

Objective. Those closest to the patients with low-grade glioma (LGG) often become informal caregivers (ICs). Caregiving demands can impact ICs' wellbeing, meaning they themselves may require support. We explored the nature and quality of support from informal networks for ICs of LGG patients. Methods. In this cross-sectional qualitative study, semistructured interviews were conducted with individuals from the United Kingdom who currently, or in the past five years, informally cared for someone diagnosed with an LGG. Interviews explored ICs' experiences of receiving support from informal networks. Thematic analysis was undertaken. Results. Nineteen ICs were interviewed (mean age 54.6 years; 5 males, 14 females). ICs received multiple forms of support from their informal networks: emotional (e.g., "opportunities to talk"), instrumental (e.g., "opportunities for relief"), information (e.g., "information from network contacts"), and appraisal (e.g., "comparisons with similar others"). Networks comprised strong/familiar (e.g., close friends) and weaker/unfamiliar (e.g., other ICs) ties. Supportive networks were perceived to help protect ICs' wellbeing. Participants perceived challenges such as poor understanding and unsolicited advice to weaken the quality of support. Conclusion. Informal networks can provide wide-ranging support for ICs of the LGG patients. Different supports may be sought or provided from different contacts, highlighting the importance and value of extended networks. [ABSTRACT FROM AUTHOR]

Objective: Research has indicated that social support may play a protective role in the face of stress and help children and adolescents cope with the demands and challenges they face on a daily basis during their cancer journey. However, social support tends to reduce over time as survivors overcome their illness despite its ongoing importance even years after treatment has finished. The current review aimed to systematically examine existing evidence on social support in child and adolescent cancer survivors. Methods: Five databases (PsychINFO, CINAHL, EMBASE, PubMed and Web of Science) were searched systematically to identify quantitative studies which explored social support from the perspective of child and adolescent cancer survivors aged 18 years or younger. Results: A total of 10 studies met the eligibility criteria for inclusion. Findings from the review indicate that family and friends, particularly parents, are important sources of social support for survivors. Social support was positively related to posttraumatic growth, school re‐entry and physical activity, and negatively related to psychological stress, depression, anxiety and stress. Furthermore, findings relating to gender, age and group differences were mixed. A number of methodological concerns were identified in the reviewed studies including small sample sizes, as well as a lack of consistency in the measurement of social support. Conclusions: Future studies of social support for child and adolescent cancer survivors need to address these shortcomings to help inform care and support interventions promoting social support in survivors. [ABSTRACT FROM AUTHOR]

Respecting children's rights to be heard in matters that directly affect their everyday lives has become an established principle in Ireland and internationally. Accessing children's voices raises a number of important issues for researchers across a wide range of disciplines. This article reflects on the organizational, practical and ethical challenges that arose from a study that investigated hospitalized children's experiences of consultation and decision-making. The data collection process was hampered by practical and organizational factors, which consequently led to carrying out more individual interviews than focus groups as planned. Some obstacles associated with the hospital environment were practical issues that could be resolved, in contrast to ethical issues such as consent, privacy, access and the role of gatekeepers. The function of gatekeepers generally and in the healthcare setting in relation to accessing children needs to be debated and challenged because children may be silenced and excluded from the opportunity to have their voices heard. (Contains 3 notes.)

Background: Internationally, colorectal cancer screening participation remains low despite the availability of home‐based testing and numerous interventions to increase uptake. To be effective, interventions should be based on an understanding of what influences individuals' decisions about screening participation. This study investigates the association of defensive information processing (DIP) with fecal immunochemical test (FIT)–based colorectal cancer screening uptake. Methods: Regression modeling of data from a cross‐sectional survey within a population‐based FIT screening program was conducted. The survey included the seven subdomains of the McQueen DIP measure. The primary outcome variable was the uptake status (screening user or nonuser). Multivariable logistic regression was used to estimate the odds ratio (OR) for screening nonuse by DIP (sub)domain score, with adjustments made for sociodemographic and behavioral factors associated with uptake. Results: Higher scores (equating to greater defensiveness) on all DIP domains were significantly associated with lower uptake in the model adjusted for sociodemographic factors. In the model with additional adjustments for behavioral factors, the suppression subdomains of "deny immediacy to be tested" (OR, 0.53; 95% confidence interval [CI], 0.43–0.65; p <.001) and "self‐exemption" (OR, 0.80; 95% CI, 0.68–0.96; p <.001) independently predicted nonuse of FIT‐based screening. Conclusions: This is the first study outside the United States that has identified DIP as a barrier to colorectal cancer screening uptake, and it is the first focused specifically on FIT‐based screening. The findings suggest that two suppression barriers, namely denying the immediacy to be tested and self‐exempting oneself from screening, may be promising targets for future interventions to improve uptake. Defensive information processing, in the form of suppression, is associated with lower fecal immunochemical test‐based colorectal cancer screening uptake. Two suppression barriers, denying the immediacy to be tested and self‐exempting oneself from screening, are promising targets for future interventions. [ABSTRACT FROM AUTHOR]

Increasing numbers of students with disabilities are accessing higher education each year, yet little is known about their assistive technology (AT) needs and its influence on relevant outcomes. The aim of this study was to examine met/unmet AT needs on educational engagement, academic self-efficacy and well-being and the impact of AT use in the areas of competence, adaptability and self-esteem for students with disabilities in higher education in Ireland. One hundred and eleven students with disabilities completed a cross-sectional online survey comprising the College Learning Effectiveness Inventory, the Student Course Engagement Questionnaire, the Self-Efficacy for Learning Form Abridged, the Psychosocial Impact of Assistive Devices Scale, and the Warwick-Edinburgh Mental Well-Being Scale. AT use was found to have a positive psychosocial impact in the areas of competence, adaptability and self-esteem. Those whose AT needs were fully met scored significantly higher on academic self-efficacy, well-being, and on 4 of the 10 educational engagement subscales compared to those who had unmet AT needs. Met/unmet AT needs were not predictive of educational engagement. These findings highlight the importance of AT from both educational engagement and psychosocial perspectives for students with a wide variety of disability diagnoses. The wide-reaching benefits of AT must be considered by governmental departments when making funding allocations to disability services within higher education institutions. Students with disabilities can face many additional challenges within the higher education environment. Findings from this research show that access to appropriate assistive technology can support students' educational engagement, increase well-being and academic self-efficacy and have a positive impact in the areas of competence, adaptability and self-esteem. Disability and Assistive Technology Officers in higher education should be cognizant of both the educational and psychological benefits of assistive technology across diverse students with various disability diagnoses. Policy makers should consider the wide-reaching benefits of assistive technology when making funding allocations to higher education institutions. [ABSTRACT FROM AUTHOR]

Recent research indicates that gay/lesbian identified sexual minority individuals report lower social anxiety than their counterparts who identify as bisexual or indicate an emerging identity label (e.g., queer, pansexual, or asexual). The current study advances the knowledge base by comparing levels of social anxiety across both sexual and gender identity subpopulations in a sexual minority sample residing in the Republic of Ireland. Six hundred two sexual minority adults participated in an online survey in which they completed measures of sociodemographic variables (including sexual and gender identity) and social anxiety. Across gender identity subpopulations, transgender/non-binary individuals were more likely to report elevated social anxiety symptoms than both cisgender men and cisgender women; further, cisgender women were more likely to report elevated social anxiety symptoms than cisgender men. Within each of these gender identity groups, there was no significant difference in odds of elevated social anxiety symptoms across sexual identity subgroups (gay/lesbian, bisexual, and emerging identity) when adjusted for sociodemographic variables. Results highlight the necessity to represent the mental health experiences of diverse sexual minority subpopulations, especially in population-based studies of sexual minority mental health. Additionally, future studies should aim to explore the potentially distinctive and complex social stressors encountered by the diverse groups within the sexual and gender minority population. [ABSTRACT FROM AUTHOR]