This systematic review evaluates the effectiveness of medication self-management education programs (MSEP) for older adults by analyzing the core characteristics and reported outcomes of successful interventions. Guided by King’s Goal Attainment Theory, this study identifies which program elements, such as scope, provider, and duration, are associated with positive clinical and psychosocial outcomes, aiming to provide evidence-based recommendations for practice and future research amid rising polypharmacy and inappropriate medication use. Methods: A systematic review searched seven databases (up to September 3, 2024) for randomized controlled trials and quasi-experimental studies of medication self-management education for adults 65+. Inclusion followed PICOTS-SD (Participants, Intervention, Comparison, Outcomes, Time, Setting, and Study Design). Quality was assessed (RoB 2.0, ROBINS-I). Data were narratively synthesized, mapping program characteristics to King’s theory (e.g., interaction, transaction) to analyze goal attainment pathways. Results: The 34 included studies demonstrated that MSEP are broadly effective in improving both clinical and psychosocial outcomes. Specifically, comprehensive, multi-session interventions were frequently associated with significant improvements in psychosocial outcomes such as quality of life and self-efficacy, particularly when delivered by multidisciplinary teams or nurses. In contrast, medication-specific programs (14 studies), often led by pharmacists, proved highly effective in enhancing key clinical outcomes, including medication adherence and the reduction of drug-related problems. Conclusion: MSEP effectively enhance adherence. In accord with King’s Goal Attainment Theory, effectiveness is achieved via a ‘transactional’ process. Programs strong in ‘interaction’ (multi-session, nurse-led) achieve psychosocial ‘goal attainment’, while ‘action’-focused programs (pharmacist-led, specific) achieve clinical ‘goals’. The theory may underscore the need for tailored interventions.

Objective: Adolescent depressive symptoms are increasingly recognized as a global concern for youth mental health. Female adolescents consistently report higher levels of depressive symptoms than their male counterparts, yet the psychological mechanisms underlying depressive symptoms remain insufficiently understood. Our longitudinal study examined the relationship between loneliness and depressive symptoms in female adolescents and investigated the mediating effect of subjective well-being (SWB) and the moderating influence of the parental relationship. Methods: Data were drawn from the Korean Study of Adolescent Health, a longitudinal study on adolescent mental health. The sample included 104 female high school students (mean age=15.33 years) who completed self-report surveys at three time points between April 2022 and July 2023. Measures assessed loneliness, SWB, depressive symptoms, and relationships with mothers and fathers. Mediation and moderated mediation analyses were conducted using SPSS PROCESS (Models 4 and 14), controlling for age, socioeconomic status, and baseline depressive symptoms. Results: Mediation analyses indicated that SWB fully mediated the longitudinal association between loneliness and depressive symptoms. Loneliness predicted lower SWB, which subsequently predicted more depressive symptoms. Moderated mediation analysis revealed that maternal, but not paternal, relationship quality significantly moderated the SWB-depressive symptoms link. The indirect effect was significant only among adolescents reporting stronger maternal relationships. Conclusion These findings underscore the importance of SWB in the link between loneliness and depressive symptoms among female adolescents and highlight the protective role of a positive maternal relationship. The results have implications for targeted prevention and intervention strategies to enhance emotional well-being in female adolescents.

Objective: Adult attachment style is linked to how an individual responds to threats or stress and is known to be related to the onset of psychiatric symptoms such as depression. However, as the current assessment of attachment type mainly relies on self-report questionnaires and can be prone to bias, there is a need to incorporate physiological factors along with psychological symptoms and history in this process. We aimed to predict the measurement of two important types of adult attachment with heart rate variability (HRV), early life stress experience, and subjective psychiatric symptoms. Methods: Five hundred eighty-two subjects with depressive disorder were recruited retrospectively from January 2015 to June 2021. The experience of early life stress and psychiatric symptoms were collected, and HRV measures were obtained as input for an ensembled Voting Regressor model of machine learning-based regression models, including linear regression, ElasticNet, Support Vector Machine (SVM), Random Forest, and Extreme Gradient Boosting (XGBoost). Results: Model performances evaluated with R-squared score averaged across 30 seeds were 0.377 and 0.188 for anxious- and avoidant-attachment, respectively. Mean absolute error averaged to 13.251 and 12.083, respectively. Shapley value importance analysis indicated that for both attachment types, the most important feature was the trait-anxiety, followed by emotional abuse, state-anxiety or self-reported depressive symptoms, and fear or helplessness felt in the moment of an early life stressor. Conclusion Our results provide the evidence base that may be utilized in clinical settings to predict the degree of attachment type using bio-psychological factors.

Objective: Adult attachment style is linked to how an individual responds to threats or stress and is known to be related to the onset of psychiatric symptoms such as depression. However, as the current assessment of attachment type mainly relies on self-report questionnaires and can be prone to bias, there is a need to incorporate physiological factors along with psychological symptoms and history in this process. We aimed to predict the measurement of two important types of adult attachment with heart rate variability (HRV), early life stress experience, and subjective psychiatric symptoms. Methods: Five hundred eighty-two subjects with depressive disorder were recruited retrospectively from January 2015 to June 2021. The experience of early life stress and psychiatric symptoms were collected, and HRV measures were obtained as input for an ensembled Voting Regressor model of machine learning-based regression models, including linear regression, ElasticNet, Support Vector Machine (SVM), Random Forest, and Extreme Gradient Boosting (XGBoost). Results: Model performances evaluated with R-squared score averaged across 30 seeds were 0.377 and 0.188 for anxious- and avoidant-attachment, respectively. Mean absolute error averaged to 13.251 and 12.083, respectively. Shapley value importance analysis indicated that for both attachment types, the most important feature was the trait-anxiety, followed by emotional abuse, state-anxiety or self-reported depressive symptoms, and fear or helplessness felt in the moment of an early life stressor. Conclusion Our results provide the evidence base that may be utilized in clinical settings to predict the degree of attachment type using bio-psychological factors.

Purpose: This study aimed to identify the effects of shared leadership, communication skills, and team effectiveness, as perceived by nurses and nursing assistants in comprehensive nursing service units. Methods: A cross-sectional research design was adopted, and the sample included 306 nurses, nurse assistants, and caregivers working in nine hospitals with fewer than 500 beds in two South Korean cities. The data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson’s correlation coefficient, and four-step hierarchical regression analysis. Results: The factors influencing team effectiveness in the hierarchal multiple regression analysis were shared leadership (β=.57,p<.001) and communication skills (β=.18, p<.001). These factors explained 49% of the total variance. Conclusion To enhance team effectiveness in compressive nursing service units, educational programs focusing on shared leadership and communication skills among nurses, nursing assistants, and caregivers must be developed.

Purpose: This study aimed to identify the effects of shared leadership, communication skills, and team effectiveness, as perceived by nurses and nursing assistants in comprehensive nursing service units. Methods: A cross-sectional research design was adopted, and the sample included 306 nurses, nurse assistants, and caregivers working in nine hospitals with fewer than 500 beds in two South Korean cities. The data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson’s correlation coefficient, and four-step hierarchical regression analysis. Results: The factors influencing team effectiveness in the hierarchal multiple regression analysis were shared leadership (β=.57,p<.001) and communication skills (β=.18, p<.001). These factors explained 49% of the total variance. Conclusion To enhance team effectiveness in compressive nursing service units, educational programs focusing on shared leadership and communication skills among nurses, nursing assistants, and caregivers must be developed.

Objective: Adult attachment style is linked to how an individual responds to threats or stress and is known to be related to the onset of psychiatric symptoms such as depression. However, as the current assessment of attachment type mainly relies on self-report questionnaires and can be prone to bias, there is a need to incorporate physiological factors along with psychological symptoms and history in this process. We aimed to predict the measurement of two important types of adult attachment with heart rate variability (HRV), early life stress experience, and subjective psychiatric symptoms. Methods: Five hundred eighty-two subjects with depressive disorder were recruited retrospectively from January 2015 to June 2021. The experience of early life stress and psychiatric symptoms were collected, and HRV measures were obtained as input for an ensembled Voting Regressor model of machine learning-based regression models, including linear regression, ElasticNet, Support Vector Machine (SVM), Random Forest, and Extreme Gradient Boosting (XGBoost). Results: Model performances evaluated with R-squared score averaged across 30 seeds were 0.377 and 0.188 for anxious- and avoidant-attachment, respectively. Mean absolute error averaged to 13.251 and 12.083, respectively. Shapley value importance analysis indicated that for both attachment types, the most important feature was the trait-anxiety, followed by emotional abuse, state-anxiety or self-reported depressive symptoms, and fear or helplessness felt in the moment of an early life stressor. Conclusion Our results provide the evidence base that may be utilized in clinical settings to predict the degree of attachment type using bio-psychological factors.

Objective: Adult attachment style is linked to how an individual responds to threats or stress and is known to be related to the onset of psychiatric symptoms such as depression. However, as the current assessment of attachment type mainly relies on self-report questionnaires and can be prone to bias, there is a need to incorporate physiological factors along with psychological symptoms and history in this process. We aimed to predict the measurement of two important types of adult attachment with heart rate variability (HRV), early life stress experience, and subjective psychiatric symptoms. Methods: Five hundred eighty-two subjects with depressive disorder were recruited retrospectively from January 2015 to June 2021. The experience of early life stress and psychiatric symptoms were collected, and HRV measures were obtained as input for an ensembled Voting Regressor model of machine learning-based regression models, including linear regression, ElasticNet, Support Vector Machine (SVM), Random Forest, and Extreme Gradient Boosting (XGBoost). Results: Model performances evaluated with R-squared score averaged across 30 seeds were 0.377 and 0.188 for anxious- and avoidant-attachment, respectively. Mean absolute error averaged to 13.251 and 12.083, respectively. Shapley value importance analysis indicated that for both attachment types, the most important feature was the trait-anxiety, followed by emotional abuse, state-anxiety or self-reported depressive symptoms, and fear or helplessness felt in the moment of an early life stressor. Conclusion Our results provide the evidence base that may be utilized in clinical settings to predict the degree of attachment type using bio-psychological factors.

Purpose: This study aimed to identify the effects of shared leadership, communication skills, and team effectiveness, as perceived by nurses and nursing assistants in comprehensive nursing service units. Methods: A cross-sectional research design was adopted, and the sample included 306 nurses, nurse assistants, and caregivers working in nine hospitals with fewer than 500 beds in two South Korean cities. The data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson’s correlation coefficient, and four-step hierarchical regression analysis. Results: The factors influencing team effectiveness in the hierarchal multiple regression analysis were shared leadership (β=.57,p<.001) and communication skills (β=.18, p<.001). These factors explained 49% of the total variance. Conclusion To enhance team effectiveness in compressive nursing service units, educational programs focusing on shared leadership and communication skills among nurses, nursing assistants, and caregivers must be developed.

Purpose: This study aimed to identify the effects of shared leadership, communication skills, and team effectiveness, as perceived by nurses and nursing assistants in comprehensive nursing service units. Methods: A cross-sectional research design was adopted, and the sample included 306 nurses, nurse assistants, and caregivers working in nine hospitals with fewer than 500 beds in two South Korean cities. The data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson’s correlation coefficient, and four-step hierarchical regression analysis. Results: The factors influencing team effectiveness in the hierarchal multiple regression analysis were shared leadership (β=.57,p<.001) and communication skills (β=.18, p<.001). These factors explained 49% of the total variance. Conclusion To enhance team effectiveness in compressive nursing service units, educational programs focusing on shared leadership and communication skills among nurses, nursing assistants, and caregivers must be developed.