Terapia de Aceptación y Compromiso en conducta suicida: una revisión sistemática / Acceptance and Commitment Therapy on suicidal behavior: a systematic review

El suicidio se ha convertido en un problema social y de salud pública a nivel mundial. En este sentido, la Terapia de Aceptación y Compromiso (ACT) podría ser eficaz en su abordaje, existiendo evidencia sobre la relación entre algunos de sus componentes y la conducta suicida. Así, el presente estudio tuvo por objetivo realizar una revisión sistemática sobre la eficacia de ACT en conducta suicida. Para ello se siguió el protocolo PRISMA, empleando las siguientes bases de datos: PsycInfo, PubMed, Scopus y PsicoDoc. Inicialmente se obtuvieron 108 publicaciones potencialmente relevantes, de las cuales, finalmente, 13 fueron incluidas en la revisión. La calidad de los estudios se analizó a través de un instrumento de evaluación de riesgo de sesgos. Como resultados, a nivel general se observaron disminuciones estadísticamente significativas en ideación suicida (IS) y factores de riesgo de suicidio. Además, algunos estudios señalaron relaciones estadísticamente significativas entre un aumento de flexibilidad psicológica y la disminución de IS. Si bien los datos apuntaron a una posible eficacia de ACT en la reducción de IS, es necesario llevar a cabo mayor número de estudios experimentales que contemplen la complejidad de la conducta suicida y exploren los procesos de cambio implicados.(AU)

Suicide has emerged as a pressing global issue affecting both so-ciety and public health.In this context, Acceptance and Commitment Therapy (ACT) could prove effective in its approach, supported by evi-dence of the relationship between certain components of ACT and suicidal behavior. Thus, the present study aims to conduct a systematic review on the efficacy of ACT in suicidal behavior. For this, the PRISMA protocol was followed, using thefollowing databases: PsycInfo, PubMed, Scopus and PsicoDoc. Initially, 108 potentially relevant publicationswereobtained,13ofwhichwerefinallyincludedinthereview.Weanalyzedstudy qualityus-ingariskofbiasassessmentinstrument.Asaresult,statisticallysignificantdecreases in suicidal ideation (SI) and suicide risk factors were observed. In addition, some studies indicated statistically significant relationships be-tween increased psychological flexibility and decreasedSI.WhilethedatasuggestedthepotentialeffectivenessofACTinreducingsuicidal ideation (SI), more experimental studies are needed to consider the complexity of suicidal behavior and explore the processes of changeinvolved.(AU)

The effectiveness of the DNA-V program on reducing anxiety among Chinese adolescents: Outcomes of the face-to-face and web-based versions.

Many studies have indicated an alarming prevalence of anxiety among Chinese adolescents, highlighting the critical need for prevention protocols. DNA-V (Discoverer, Noticer, Advisor-Values model) is an adapted version of Acceptance and Commitment Therapy designed to prevent mental health problems in adolescents. This study investigated the effects and underlying mechanisms of DNA-V. The DNA-V prevention program was culturally adapted and optimized in both content and form specifically for Chinese adolescents, with the aim of reducing anxiety levels. A total of 139 participants (59 females) from six eighth-grade classes at an average middle school in Beijing were randomly assigned to one of three groups consisting of the DNA-V face-to-face group (two classes), the DNA-V web-based group (two classes), or the active control group (two classes). Adolescents' anxiety and cognitive fusion were measured before (Time 1), immediately after (Time 2), and 2 months after (Time 3) the program using the Chinese Secondary School Students Anxiety Scale (CSSSAS) and Cognitive Fusion Questionnaire (CFQ). Results showed that in the DNA-V face-to-face group, the anxiety score at Time 3 was significantly lower than the scores at Time 1 (p < .001, Cohen's drm = 0.56) and Time 2 (p = .043, Cohen's drm = 0.24). The cognitive fusion score at Time 3 was significantly lower than the scores at Time 1 (p = .001, Cohen's drm = 0.51) and Time 2 (p = .003, Cohen's drm = 0.37). The results of the study suggest that the DNA-V prevention program could serve as an effective tool for reducing anxiety in adolescents.

Forging green Horizons: Revealing Catalysts of pro-environmental behavior in emerging market.

In recent years, environmental pollution has started to threaten global economies. The understanding of consumer behavior within the context of sustainable development has become increasingly important to deal with this growing ecological complexity. Urbanization has accelerated in Pakistan, resulting in urban consumers raising more environmental concerns and promoting eco-friendly products. These concerns have demonstrated their commitment to sustainability and pro-environmental behaviors, such as reducing waste materials (e.g., plastics) and pollutants (i.e., smoke, dust, etc.), thus supporting eco-friendly behaviors. Today, Pakistan's urban consumers are well-aware of environmental complexities. As such, environmental knowledge is the driver of consumers' pro-environmental behavior, affective commitment and social capital also compel individuals to acquire ecological knowledge to enhance consumer behavior. This research considers customers' environmental knowledge and affective commitment, both of which actively contribute to pro-environmental activity. It explores the relationship between environmental knowledge, affection commitment, social capital, and environmental behavior in Pakistan. Data was gathered from Pakistan's urban customers and analyzed using Covariance-based Structural Equation Modeling (CB-SEM). The results indicate that affective commitment and social capital have a positive and significant effect on environmental knowledge and behavior. Notably, the relationship between social capital, affective commitment, and environmental behavior is mediated by knowledge of environmental issues. Through its findings, this study fosters an understanding of environmental behavior and explains the sense of responsibility and greater commitment in individuals, which thus leads them toward sustainability.

Development of competencies in secondary education through the motivational style of autonomy support.

Background: The aim of the study was to test the effect of a meta-disciplinary intervention based on the motivational style of autonomy support on the development of competencies in secondary school students. It was carried out by means of a quasi-experimental design and lasted for three months. Methods: A total of 62 students between the ages of 12 and 16 (M = 13.61; SD = 1.16) participated, with 33 in the experimental group and 29 in the control group, along with 12 teachers (7 in the intervention group and 5 in the control group). The study measured teaching motivational style, satisfaction of basic psychological needs, motivation, and key competencies. Results: The results demonstrate improvements in the autonomy-supportive motivational style, satisfaction of the basic psychological need for autonomy, autonomous motivation, and competencies in the experimental group, while the control group exhibited an increase in the chaos style. Conclusions: These findings reveal the positive impact of the supportive motivational style on the development of key competencies establishing it as an active, valid, and reliable methodology to motivate secondary school students.

Choosing to Provide: Early Medical Abortion and Clinician Conscience in Ireland.

Providers are essential to the delivery of abortion care. Yet, they often occupy an ambiguous space in political discourse around abortion. The introduction of a new abortion service in Ireland invites us to look afresh at providers. Since the Health (Regulation of Termination of Pregnancy) Act 2018 came into force, by far the most common form of abortion care has been early medical abortion (EMA). This is typically provided by General Practitioners (GPs), with approximately 10% of GPs having chosen to provide EMA. This article draws on an empirical study of providers to investigate their motivations for, and experiences of, provision and their views on colleagues who have not chosen to provide. The study shows that for many providers, the choice to provide was grounded in a moral commitment to protecting women's rights to autonomy and health and ensuring that the harms of the past were not repeated. The article argues that notwithstanding increased normalisation of EMA in Ireland, conscience still has a role to play in abortion care provision and it is important to reflect on the various aspects of this role.

Development and Validation of Ikhlaas Scale for Pakistani Muslim Adults.

Ikhlaas refers to the capacity of having sincere intentions in both acts of worship (ibadah) dedicated to God and our dealings with others, as we strive to seek God's pleasure. The present research was primarily conducted to develop a psychometrically sound measure of ikhlaas and establish its construct validity. Using an exploratory sequential mixed methods design, it comprised two studies. Study 1 was conducted in three phases. In Phase 1, an initial set of 17 items for the Ikhlaas Scale (IS) was developed through the thematic analysis of Quranic verses, semi-structured interviews, and focus group discussions. Phase 2 was related to the translation and cross-language validation of scales. Phase 3 involved administering this item pool to a sample of Pakistani Muslim adults (N = 300) and conducting an exploratory factor analysis (EFA) that revealed a two-factor structure (item loading 0.45-0.89) for the 12-item IS, accounting for 43.65% of the variance. The first factor measured ikhlaas in worship (7 items), while the second factor measured ikhlaas in dealings with others (5 items). Ikhlaas had a significant positive correlation with taqwa and significant negative correlations with materialism, providing evidence for the convergent validity of the IS. In Study 2, confirmatory factor analysis (CFA) conducted on a sample of Muslim adults (N = 702) confirmed the 12-item, two-factor structure of the IS observed in the EFA. Ikhlas was positively related to religious commitment and religious emphasis. In the final measurement model, the average variance extracted (AVE) of all constructs (ikhlaas, religious emphasis, and religious commitment) was > 0.50, the values of maximum shared variance (MSV) were lower than those of AVE, and the diagonal values of the square root of the AVE were higher than the intercorrelations. The heterotrait-monotrait correlation ratio (HTMT) ranged from 0.51 to 0.61, which testified to the discriminant validity of IS. Overall, the IS is a robust measure of ikhlaas that needs to be further studied for developing its nomological network across global Muslim populations.

Traumatic experiences, quality of life, and organizational commitment among midwives: A cross-sectional study.

BACKGROUND: The work of midwives is emotionally challenging. Midwives share moments of joy, when a baby is born, and attend complex events of loss and trauma. Exposure to childbirth complications, emergencies, and loss can affect their professional quality of life and functioning. This aspect of midwives' practice has not been sufficiently researched. AIM: To examine the associations between exposures to traumatic events, post-traumatic symptoms, and personal resilience with professional quality of life and organizational commitment among hospital midwives. METHODS: Participants in this cross-sectional study conducted in 2020 included 131 midwives from three large hospitals in central Israel. Data were collected using a structured self-administered questionnaire that examined socio-demographic characteristics, exposure to traumatic events during childbirth, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. RESULTS: The three most traumatic events for midwives were: neonatal death or feared death, maternal death or feared death, and stillbirth. The more frequent the exposure to traumatic events, the more numerous and intense the post-traumatic symptoms. The more numerous and intense the post-traumatic symptoms, the higher the level of professional burnout and compassion fatigue and the lower the compassion satisfaction. Higher compassion satisfaction and lower professional burnout were associated with higher organizational commitment. Personal resilience, country of birth, post-traumatic symptoms, and organizational commitment predicted compassion satisfaction. CONCLUSIONS: Midwives' exposure to traumatic events is associated with the onset of post-traumatic symptoms, impaired professional quality of life, and reduced organizational commitment, and is accompanied by burnout and compassion fatigue. There is a need to address this issue in training programs and to develop organizational support and policies to improve midwives' well-being and quality of care.

Impact of Psychological Capital on Organizational Commitment and Turnover Intention: Evidence from Korean Flight Attendants.

Background: We analyzed the effects of psychological capital on organizational commitment and turnover intention among flight attendants at a Korean airline and the mediating effect of organizational commitment. Methods: Data were collected through a 2022 survey of Korean flight attendants, yielding 297 responses. Model reliability and validity were assessed to confirm hypotheses. Results: Hope had a significant negative effect on turnover intention P<0.05), whereas optimism and resilience did not have significant effects on turnover intention. Additionally, hope had a significant positive effect on normative and continuance commitment, unlike optimism and resilience, which did not have significant effects on normative commitment or continuance commitment. Both normative commitment and continuance commitment negatively influenced turnover intention. Organizational commitment mediated the relationship between psychological capital and turnover intention, reinforcing the positive impact of psychological capital on reducing turnover intention. Conclusion: This study underscores the significance of psychological capital in shaping organizational commitment and reducing turnover intention among Korean flight attendants. Strengthening psychological capital and fostering organizational commitment can bolster airline stability, competitiveness, and service quality.

Survey dataset of factors affecting Islamic donation intention in Malaysia.

The present dataset investigates the factors that influence Malaysian Muslims' Islamic donation intentions. The research model was developed based on the integration of the theory of planned behavior (TPB) and social capital theory with six latent variables. A self-administrated survey of 400 Muslims with various demographic characteristics yielded the dataset in February 2024. The dataset was the basis for identifying factors that influence Muslims' Islamic donation intentions, thereby helping scholars and Islamic non-profit organisations understand how Malaysian Muslims participated in donation activities by interacting with religious commitment, institutional trust, attitude, subjective norms, and perceived behavioral control.

The relationship between nurses' professional commitment and missed nursing care: a cross-sectional study in Iran.

BACKGROUND & AIMS: Missed nursing care is a global challenge that can have many consequences and it's known as a common threat to the patient safety and quality of nursing care. The nurses' professional commitment plays the final role in the occurrence of this issue. This study aimed to investigate the relationship between nurses' professional commitment and missed nursing care in Iran. MATERIALS & METHODS: This cross-sectional descriptive-analytical study was conducted on 270 nurses working in two hospitals affiliated to Tehran University of Medical Sciences (Sina & Shariati) from September to December 2023. The research community included all nurses working in medical-surgical wards in the designated hospitals. The research samples were included in a targeted and quota method after obtaining organizational permits, ethical approval and informed consent. Data collection was done using three questionnaires including demographic information form, Nursing Professional Commitment Scale, and MISSCARE Questionnaire. The collected data was analyzed in SPSS software, version 25. RESULTS: The results of Pearson's correlation test showed that there is a significant negative relationship between nurses' professional commitment and missed nursing care scores (r=-0.23) (p < 0.001). The mean score of nurses' professional commitment was reported at a moderate to high level (83.72 ± 16.02) and the mean score of missed nursing care was reported at a low level (47.84 ± 16.48). Nurses over 40 years old, morning shift and employed nurses showed higher professional commitment. Also, nurses under 29 years old and male nurses had more missed nursing care other than their participants. No relationship was observed between other demographic variables with nurses' professional commitment and missed nursing care. CONCLUSION: The results of this study showed that higher nurses' professional commitment leads to higher quality of care and less missed nursing care. Based on findings of this research, it is recommended for health care providers and nursing managers to adopt programs to increase nurses' professional commitment and consequently reduce missed nursing care.

Investigating the relationship between missed/rationed nursing care and organizational commitment in Iranian nurses.

BACKGROUND AND OBJECTIVE: The primary objective of the nursing profession is to provide comprehensive and appropriate nursing care that meets the individual needs of patients. However, instances of missed/rationed nursing care can jeopardize the delivery of complete and safe healthcare, potentially putting patients' lives at risk. The level of organizational commitment demonstrated by nurses is likely to impact various personnel and organizational factors. Therefore, this study aims to predict instances of missed/rationed nursing care by examining the influence of organizational commitment. METHOD: This descriptive and cross-sectional study will be conducted in 2023. Three hundred nurses working in general and intensive critical care units at Tehran University of Medical Sciences hospitals were randomly selected. Data collection included Allen and Mayer's organizational commitment questionnaires, Kalish's missed care questionnaire, and demographic variables. A multiple linear regression model was used to analyze the prediction of missed care by commitment and other variables. The relationship between these variables was also explored using SPSS version 26 software. FINDINGS: Half of the nurses reported occasionally missing nursing care. Moreover, more than half of the nurses reported moderate organizational commitment in all dimensions. The most significant reasons identified by nurses for missed care were financial resources, human resources, and communication (p < 0.001). There was a significant relationship between missed/rationed nursing care and organizational commitment (p = 0.042). In the multiple regression equation, a significant portion of missed care due to commitment was predicted when considering demographic variables (p < 0.001). CONCLUSION: By understanding the relationship between organizational commitment and missed care, and identifying the factors contributing to missed/rationed care, managers can improve the efficiency of human resources and allocate appropriate financial resources. Establishing effective communication with employees can also enhance their commitment to addressing neglected care, ultimately reducing instances of oversight.

Drop-out rates in animal-assisted psychotherapy - Results of a quantitative meta-analysis.

INTRODUCTION: Animal-assisted psychotherapy is an emerging field with great potential and growing popularity. However, empirical research on its effectiveness is insufficient, and consistent evidence about patients' commitment is missing. The present meta-analysis addresses this gap by systematically comparing drop-out rates in animal-assisted psychotherapy and by relating the resulting across study drop-out rate to across study drop-out rates reported in meta-analyses on conventional psychotherapy. METHOD: Fifty-seven studies published until August 2022 were identified as eligible for meta-analytic comparison, that is, they conducted animal-assisted psychotherapy on at least one group of psychiatric patients and reported drop-out rates. Potential moderating influences of the type of animal and patients' disorder were considered, as well as multiple other demographic and study design variables. RESULTS: The across study drop-out rate in animal-assisted psychotherapy was 11.2%. This was significantly lower than the across meta-analyses drop-out rate of conventional psychotherapy (d = -.45, p = .0005). Although effects of moderator variables could not be evaluated statistically due to too small and heterogeneous data sets, descriptive results suggest influences of the type of animal and patient disorder. However, study quality ratings identified serious shortcomings regarding proper research design, most critically concerning the report of effect size measures, the use of standardized intervention plans and Open Science practices. CONCLUSION: Drop-out constitutes a major problem of psychotherapeutic research and practice. By proposing that the inclusion of an animal in the psychotherapeutic setting can enhance patients' commitment and by outlining challenges and opportunity of animal-assisted psychotherapy, this meta-analysis offers a starting point for future research in this evolving field.

Being a focused employee: Effects of job reattachment on cyberloafing.

Cyberloafing, the use of the Internet for non-work-related activities while at work, has become a growing problem in the workplace. Since cyberloafing is commonly regarded as counterproductive, anticipating and controlling employees' cyberloafing behaviour is becoming increasingly important. Previous research suggests that individuals who engage in cyberloafing may have difficulties regulating their attention to important tasks. Based on self-regulation theory, our study examines the influence of job reattachment on cyberloafing through the mediating role of mindfulness and the moderating role of goal commitment. Data for this study were collected in China through surveys conducted with 275 employees at three different time points. The results showed that: (1) job reattachment was significantly negatively associated with cyberloafing; (2) mindfulness mediated this relationship between job reattachment and cyberloafing; and (3) goal commitment moderated the direct effect of job reattachment on mindfulness as well as the indirect effect of job reattachment on cyberloafing through mindfulness. Overall, our research findings emphasize the importance of the impact of job reattachment on cyberloafing through mindfulness. Theoretical and practical implications of this study are discussed.

Investigating the correlation between organizational ethics and professional ethics with job burnout and organizational commitment: a cross-sectional study in the nursing staff.

BACKGROUND: Adherence to ethical principles and standards in all health professions, especially in the nursing, can have positive outcomes. This study was conducted with the aim of investigating the correlation between organizational ethics and professional ethics with organizational commitment and job burnout in nursing staff. METHODS: This cross-sectional study was conducted on the nurses working in Shahid Montazeri hospital in Najafabad city. Participants were selected by census method. An online questionnaire was used to collect the data, which consisted of demographic information, Hunt et al.'s organizational ethics questionnaire, Petty's professional ethics inventory, Maslach and Jackson's job burnout questionnaire and Allen and Mayer's organizational commitment questionnaire. Data were analyzed using t-test, one-way analysis of variance, Pearson correlation coefficient and structural equation modeling (SEM) with SPSS-27 and Amos-23 statistical software. RESULTS: A total of 197 subjects with the mean age of 34.67 ± 7.74 years participated in this study. Most of the participants were female (89.3%) and married (77.2%). The majority of them had a bachelor's degree (86.3%) and 61.4% of the participants participated as a nurse. There were significant positive correlations between organizational ethics (r = 0.551, p < 0.01) and professional ethics (r = 0.44, p < 0.01) with organizational commitment. Also, there were significant negative correlations between organizational ethics (r=-0.532, p < 0.01) and professional ethics (r=-0.602, p < 0.01) with job burnout. CONCLUSION: Considering the importance of compliance with ethics in the workplace by nursing staff and its consequences such as increasing organizational commitment and reducing job burnout, it is suggested that hospital managers emphasize the compliance with ethics in the workplace as a model. They can also familiarize nursing staff with the principles and basics of organizational and professional ethics by holding training courses.

"BrainHeart": Pilot Study on a Novel Application for Elderly Well-Being Based on Mindfulness Acceptance and Commitment Therapy.

The rising prevalence of mental illness is straining global mental health systems, particularly affecting older adults who often face deteriorating physical health and decreased autonomy and quality of life. Early detection and targeted rehabilitation are crucial in mitigating these challenges. Mindfulness acceptance and commitment therapy (ACT) holds promise for enhancing motivation and well-being among the elderly, although delivering such psychological interventions is hindered by limited access to services, prompting exploration of remote delivery options like mobile applications. In this paper, we introduce the BrainHeart App (v.1.1.8), a mobile application tailored to improve physical and mental well-being in seniors. The app features a 10-day ACT program and other sections promoting healthy lifestyle. In a pilot study involving twenty participants, individuals engaged in daily mental exercises for 10 days using the app. Clinical evaluations, including assessments of psychological flexibility, overall cognitive profile, mindfulness disposition, cognitive fusion, and heart rate collected with Polar H10, were conducted at baseline (T0) and one month post-intervention (T1). Analysis revealed significant improvements in almost all neuropsychological scores, with high usability reported (system usability scale average score: 82.3 ± 9.31). Additionally, a negative correlation was found between usability and experiential avoidance (r = -0.51; p = 0.026), and a notable difference in heart rate was observed between baseline and post-intervention (F-value = 3.06; p-value = 0.09). These findings suggest that mindfulness-ACT exercises delivered via the BrainHeart App can enhance the well-being of elderly individuals, highlighting the potential of remote interventions in addressing mental health needs in this population.

A Randomized Trial Evaluating Acceptance and Commitment Therapy and Smart Phone Care Management Application to Augment Buprenorphine Therapy for Opioid Use and Chronic Pain.

There is high comorbidity of opioid use disorder (OUD) and chronic pain (CP), which is often addressed by prescribing buprenorphine (BUP). While BUP is effective in preventing overdose, it does not address the psychological aspects of OUD and CP comorbidity and treatment retention rates are as low as 50%. The Virtual Opioid use disorder Integrated Chronic Pain Treatment (VOICE) study (NCT05039554) is a novel effectiveness-implementation trial to test a 12-week virtual group Acceptance and Commitment Therapy (ACT) protocol and a care management smartphone application (app; Valera Health) on pain and opioid use in patients with OUD and CP receiving BUP. Using a 2 × 2 factorial design, participants (expected N = 280) are randomized into: ACT, Valera app, ACT + Valera, or Treatment as Usual arm. This study is taking place in the Bronx, NY, a racially/ethnically diverse community that faces numerous socioeconomic stressors and is one of the nation's epicenters of the opioid epidemic. We created a culturally responsive ACT group protocol, and Valera psychoeducational material. Outcome measures include NIH HEAL Common Data Elements and ACT and Valera-specific measures. We are conducting a novel 2 × 2 trial investigating augmenting BUP treatment with ACT and Valera, with the goal that improved mental health and access to care will result in decreased and opioid use and pain interference.

The relationships among career adaptability, career commitment, career identity, and career well-being in Chinese nursing undergraduates: A longitudinal study.

Exploring the longitudinal relationship between career adaptability, career commitment, career identity, and career well-being among Chinese undergraduate nursing students. A mediation effect analysis was performed. The Career Adaptability Scale, the Chinese version of Career commitment, the Career identity Scale, and the Career well-being Scale were used as research instruments. Six hundred ninety-two nursing students were followed up in two waves to explore the relationships among career adaptability, career commitment, career identity, and career well-being. Model comparison was performed to explore the differences in such relationships between low and high-career interests. Career commitment at T1 mediated the relationship between career adaptability at T1 and career identity at T2 and that between career adaptability at T1 and career well-being at T2. Significant differences were observed between the mediation models of nursing students with high and low career interests. Career commitment plays a longitudinal mediator role in the relationship between career adaptability and career identity and the relationship between career adaptability and career well-being.