Open Access

IntroductionA thorough understanding of the interplay of mental health (MH) and quality of life (QoL) is essential to describe, understand and support the healthy development of children and adolescents. The aim of the study is to analyze the reciprocal and predictive relationship between psychosomatic symptoms, MH problems and QoL in children and adolescents during the COVID-19 pandemic using a cross-lagged panel analysis.MethodsData of n = 323 children and n = 421 adolescents were collected at five measurement points from spring 2020 to autumn 2022 within the population-based longitudinal German COPSY study. Parent proxy ratings were assessed using the KIDSCREEN-10 index (QoL), the Strengths and Difficulties Questionnaire (SDQ; internal and external MH symptoms) and the Health Behavior in School-aged Children Symptom Checklist (HBSC-SCL; psychosomatic symptoms). Adolescents also self-rated the KIDSCREEN-10 Index and the HBSC-SCL. Cross-lagged-panel models, which offer higher internal validity than traditional cross-sectional and longitudinal analyses, were estimated using structural equation modeling (maximum likelihood).ResultsDifferent prediction models proved to be valid for children vs. adolescents (Δχ2df = 48 = 167.84, p < 0.001). For children, QoL did not cross-predict MH indicators (Δχ2df = 12 = 15.53, p > 0.05), but was the time-lagged criterion variable most strongly predicted by them (Δχ2df = 12 = 71.58, p <0.001). For adolescents, self-reported QoL cross-predicted psychosomatic symptoms (Δχ2df = 3 = 14.22, p < 0.001). For both children and adolescents, internalizing MH problems cross-predicted QoL and psychosomatic symptoms (Δχ2df = 3 = 9.58–13.69, p < 0.001).DiscussionPsychosomatic and psychological MH symptoms were proven to be significant time-lagged predictors of QoL, particularly in children. Thus, they can serve as preceding indicators for the development of QoL. Since the cross-lagged panel approach provides a higher internal validity than e.g., cross-sectional data analyses, our findings may contribute to an enhanced understanding of mental development processes and, thus may provide evidence for targeted support of healthy development under demanding conditions such as the COVID-19 pandemic.

IntroductionVaccination readiness refers to psychological motives and beliefs that decisively determine individual and collective vaccination prevention behavior. Readiness to be vaccinated depends on expected individual and social benefits and harms. Differences exist in the perception of the threat of potential influenza vs. COVID-19 infection and its significance for the social environment. The study aimed to compare the 7C components of vaccination readiness for influenza and COVID-19 vaccination in adulthood.MethodsA total of 317 adults answered the 7C vaccination readiness scale in two vaccination-specific versions (influenza vs. COVID-19) in an online survey from September 2022 to March 2023. Data were analyzed using repeated measures, including analysis of covariance, correlations, and multiple regression.ResultsFor COVID-19, there is a higher readiness to be vaccinated compared to influenza regarding complacencyR (ηp = 0.683), constraintsR (ηp = 0.684), collective responsibility (ηp = 0.782), and compliance (ηp = 0.365). However, confidence (ηp = 0.161) and conspiracyR (ηp = 0.256) indicate an enhanced readiness for influenza vaccination (interaction scales × vaccination type: ηp = 0.602). Individual influenza vaccination recommendations and age do not or only marginally moderate these effects (interaction vaccination type × recommendation: ηp = 155).DiscussionThe 7C subscales reveal a differentiated pattern of readiness for the two vaccination types. This emphasizes the relevance of the multidimensional structure of the construct of vaccination readiness as well as the relevance of moderating effects of the respective vaccination type on the underlying motives and beliefs. Vaccination attitudes are influenced by cultural and social conditions as well as medical standards of care. Comparing attitudes to different vaccinations in different countries thus represents an important research desideratum in order to understand the concept of vaccination readiness more comprehensively.

Abstract Background Allergic diseases are among the most common chronic diseases in childhood. Early childhood allergy prevention (ECAP) behaviors of those caring for the infant during pregnancy and the first months of life may influence the risk of allergy development over the life course. Motivation and intention to use appropriate primary ECAP measures are thus of critical importance. Aims To characterize parental ECAP motivation, (a) valid indicators will be developed and (b) typical parental characteristics will be identified. (c) According to socio-cognitive models, the predictive value of parental risk perception, control belief and self-efficacy for parental ECAP motivation shall be determined. Method A sample of N  = 343 (expectant) mothers of infants completed a questionnaire on self-reported ECAP motivation, risk perception, control belief, and self-efficacy. The cross-sectional data were analyzed using latent class analysis and structural equation modelling including nominal regression models. Results Four typical maternal response profiles (motivated to a customary degree, 70%; motivated to use primary preventive measures, 17.8%; reluctant towards new prevention measures, 6.4%; highly motivated to apply preventive measures in case of an existing allergy, 5.8%) could be identified for the items on ECAP motivation. After splitting the model variables “risk perception” (allergy vs. allergy-associated general health problems) and “self-efficacy” (trust vs. insecurity) a satisfactory model-fit was achieved (CFI = .939; RMSEA = .064). Particularly, increased “risk perception-allergy” (OR = 1.655) and “self-efficacy-insecurity” (OR = 2.013) as well as lower “risk perception-general health” (OR = 0.555) and “control belief” (OR = 0.217), respectively, are associated with higher ECAP motivation. Conclusion The use of ECAP-measures by parents to protect their newborns from allergies is important, but there are deficiencies in their implementation. Based on a social cognitive model approach, predictive characteristics could be identified, which are associated with increased motivation to implement ECAP-measures. For public health our findings provide a promising basis for conception of behavioral and environmental ECAP prevention measures and their motivated implementation by parents.

Abstract Background Mental health and health-related quality of life (HRQoL) in children and adolescents deteriorated during the COVID-19 pandemic. The aim of this population-based longitudinal study was to explore whether distinct mental health trajectories in youths can be identified over the course of the pandemic. Methods Mental health problems (MHP), psychosomatic symptoms and HRQoL were assessed at five time points between May 2020 and October 2022 in 744 children and adolescents aged 7 to 20 years using established instruments. We used generalized mixture modeling to identify distinct mental health trajectories and fixed-effects regressions to analyse covariates of the identified profiles of change. Results We found five distinct linear latent trajectory classes each for externalising MHP and psychosomatic symptoms and four trajectory classes for internalising MHP. For HRQoL, a single-class solution that indicates a common development process proved to be optimal. The largest groups remained almost stable at a low internalising and externalising symptom level (64 to 74%) and consistently showed moderate psychosomatic symptoms (79%), while 2 to 18% showed improvements across the pandemic. About 10% of the youths had consistently high internalising problems, while externalising problems deteriorated in 18% of youths. Class membership was significantly associated with initial HRQoL, parental and child burden, personal resources, family climate and social support. Conclusions The mental health of most children and adolescents remained resilient throughout the pandemic. However, a sizeable number of youths had consistently poor or deteriorating mental health. Those children and adolescents need special attention in schools and mental health care.

Objectives To validate the patient-reported measure of Social Support Perceived by Patients Scale-Nurses (SuPP-N). Design/setting A secondary data analysis based on a cross-sectional breast cancer patient survey in 83 German hospitals. Patients were asked to give written informed consent before they were discharged. If they agreed to participate, the questionnaire was sent via mail to their home address after discharge. Participants Of 5583 eligible patients, 4841 consented to participate in the study and 4217 returned completed questionnaires (response rate: 75.5 %). For the data analysis n=3954 respondents were included. On average, participants were 60 years old and mostly in cancer stages I and II Primary and secondary outcome measures Perceived social support was assessed with a three-item patient-reported scale (SuPP-N). Convergent validity and criterion-related validity were tested using the following constructs: trust in nurses, trust in the treatment team (Wake Forest Physician Trust Scale, adapted), quality of life (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire), processes organisation, availability of nurses. Results The structural equation model (SEM) assuming a one-dimensional structure of the instrument showed acceptable goodness of fit (root mean square error of approximation=0.04, Comparative Fit Index=0.96 and Tucker-Lewis Index=0.96; factor loadings ≥0.83). Hypothesis–consistent correlations with trust in nurses (beta=0.615; p<0.01) and trust in the treatment team (beta=0.264; p<0.01) proved convergent validity. Criterion-related validity was proved by its association with patients’ quality of life (beta=−0.138; p<0.01), processes organisation (beta=−0.107; p<0.01) and the availability of nurses (beta=0.654; p<0.01). Conclusion The results of the SEM identify potential important factors to foster social support by nurses in cancer care. In patient surveys, the SuPP-N can be used efficiently to measure patient-reported social support provided by nurses. The use of the scale can contribute to gain a better understanding of the relevance of social support provided by nurses for patients and to detect possible deficits and derive measures with the aim of improving the patient–nurse interaction.