The shortage of healthcare professionals increasingly challenges the provision of care for institutionalised older adults. This study investigates healthcare professionals' expectations regarding the added value of social robots in daily care, as their perspective is adamant for implementation of these robots but not yet fully investigated. Two consecutive focus group sessions were conducted across three nursing homes with 24 healthcare professionals. The first session focused on identifying potential ways in which social robots could add value for both staff and residents. After sharing suggestions across all groups, the second session facilitated cross-validation and in-depth discussion of practical implications. Data were analysed using qualitative thematic analysis. Healthcare professionals expected several benefits from using a social robot, including reduced workload and mental strain, improved work atmosphere, and potentially heightened job satisfaction. For residents, expected benefits included promotion of self-care and self-reliance through reminders and notifications, and provision of companionship during lonely periods. Reported possible barriers included limited technical knowledge and lack of support from residents' families. Participants expected that social robots could help save time and energy, enabling more focused attention on residents needing support-even those who may not actively seek it. Professionals indicated that this might enhance both residents' well-being and the quality and satisfaction of their own work. Implementing some of the specific suggestions from professionals merits further investigation.

BackgroundInformal caregivers of people living with chronic kidney disease commonly experience mental health difficulties. However, there is currently limited access to scalable psychological interventions such as those using e-mental health platforms. Furthermore, there is an absence of such interventions tailored for this group of caregivers, which may limit acceptability. ObjectiveTo inform future e-mental health intervention development, this study aimed to explore preferences for e-mental health interventions among informal caregivers of people living with chronic kidney disease. MethodsA total of 13 informal caregivers of people living with chronic kidney disease participated in semistructured interviews. Eligible informal caregivers lived in the United Kingdom and were recruited via nonprofit organizations and social media advertisements. Semistructured interviews followed a topic guide exploring caregivers’ e-mental health intervention preferences. Data were analyzed using manifest content analysis. ResultsA total of 4 categories and 13 subcategories were generated. “Design preferences” illustrates key intervention design features that were important to caregivers, such as involving caregivers and other interest-holders in the design process. “Content preferences” describes the information caregivers valued in an intervention, such as information about chronic kidney disease and resources to support caregivers. “Support preferences” reflects the characteristics of support caregivers preferred if support was available as part of the intervention, such as peer support and providing support that accommodates individual preferences. Lastly, “Dissemination preferences” describes methods caregivers recommended to promote intervention uptake, such as engaging communication strategies and trusted and accessible sources of information. ConclusionsCaregivers identified a number of e-mental health intervention design and delivery preferences that should be considered when developing e-mental health interventions for caregivers of people living with chronic kidney disease. To ensure such interventions are acceptable, feasible, and relevant, co-design approaches should be adopted during the intervention development process.

The field of psychosocial oncology faces many challenges, including the increasing number of cancer survivors in need of psychosocial support, alarming health disparities, and growing health care shortages. In 2024, Dutch psychosocial oncology researchers established the Psychosocial Oncology research COnsortium Netherlands (POCON) to better address these challenges together. In this letter, we describe the strategies we used to successfully launch POCON. After writing a mission statement, we developed a collective psychosocial oncology research agenda by (1) distributing a survey among Dutch senior researchers to determine priority themes for collaboration, (2) visualizing the current Dutch landscape of psychosocial oncology research by modeling a network of keywords based on recent publications in the field, and (3) comparing the identified priority themes and keyword network with more general cancer agendas in the Netherlands. Three overarching themes that were featured throughout these general agendas aligned with the identified priority themes but are currently underrepresented in psychosocial oncology research, as shown by the keyword network: “equity in cancer,” “implementation of innovations,” and “personalized care.” Based on these themes, we established three POCON committees. In addition, we established a fourth committee “Data Inventory” to further facilitate collaboration. Each committee is tasked with developing action plans to strengthen collaborative research efforts. Strategies that proved helpful throughout this process included prioritizing collaboration over competition, keeping up the momentum, and adopting a hands-on approach. By joining efforts and strengthening both national and international research collaborations, we strive to optimize psychosocial care for patients with cancer and their families.

This study aimed to identify trajectories of BMI, obesity-specific health-related quality of life (HR-QoL), and depression trajectories from pre-surgery to 24 months post-bariatric metabolic surgery (BMS), and explore their associations, addressing subgroup differences often hidden in group-level analyses. Patients with severe obesity (n = 529) reported their HR-QoL and depression before undergoing BMS, and at 12 and 24 months post-operation. Latent Class Growth Analysis was used to identify trajectories of BMI, HR-QoL and depression. BMI and HR-QoL improved significantly for all patients from pre-surgery to 24 months post-operation, though some patients deteriorated in their outcomes after 12 months. Three distinct trajectories of BMI were identified: Low (35.4

Background and Aims: 'Inflammatory Bowel Disease (IBD)-specific-Cognitive-Behavioral Therapy' (CBT) is effective in improving Quality of Life (QoL) and in decreasing anxiety and depression in IBD-patients with poor mental QoL, one month after completing CBT. Main aim was to examine the sustainability of treatment effects up to three years after treatment with CBT. Method: Participants (n = 118) of a previously conducted randomized-control-study on the effects of 'IBD-specific-CBT' for IBD-patients were contacted for a long-term follow-up assessment on main outcomes: generic and IBD-specific-QoL (SF-36, IBDQ), anxiety and depression (HADS, CES-D) and DSM-IV disorders (SCID-I). Change over time was examined with multilevel-regression-analyses. Results: Three years after finishing 'IBD-specific-CBT', 61 IBD-patients (response rate 52%) completed the follow-up SCID-I assessment and 52 patients (response rate 44%) completed the assessments for symptomatology. There were no differences between dropouts and participants at three year follow-up, except for a longer disease duration in dropouts. At three-year follow-up the chance of patients having a DSM-disorder significantly decreased with an estimated 48% (from 87% at baseline to 38% at follow-up). Multilevel analyses showed a significant improvement between baseline (n = 118) and follow-up measurements (n = 52) on outcomes: IBDQ-Total (Cohen's d effect-size = .89), SF-36 Physical (d = .54), and SF-36 Mental (d = .69), HADS-A (d =-.77), HADS-D (d =-.65) and CES-D (d =-.55); all p < .01. QoL outcomes showed further improvement between completion (n = 90 for IBD-specific QoL and n = 91 for generic QoL) and follow-up measurements, with significant improvements for IBDQ-Total (d = 0.31) and SF-36 Physical (d = 0.32). Conclusions: Sustainable positive effects of 'IBD-specific-CBT' for IBD-patients with poor mental QoL were found and the prevalence of mental conditions substantially decreased over three year follow-up.

Osteoarthritis (OA) is a major contributor to years lived with disability among musculoskeletal conditions, with its prevalence rising due to aging populations and increasing obesity rates. Total knee (TKA) and hip (THA) arthroplasty are common surgical interventions aimed at restoring function and improving quality of life (QoL). However, the relative contributions of sociodemographic and clinical factors to overall OoL remain insufficiently understood. This study examined the associations between pain and fatigue with the physical component summary (PCS) and mental component summary (MCS) of QoL, while controlling for functional status and sociodemographic variables. The sample consisted of 423 patients with knee OA (n = 241, mean age 65.1 ± 8 years, 40.2% male) and hip OA (n = 182, mean age 63.5 ± 10 years, 60.9% male). Correlations, multiple linear regressions, and mediation analyses were used to analyse the data. For PCS, total explained variance was 44% in TKA and 40% in THA. FS was significantly associated with PCS in both groups, with a stronger association in TKA (β = -.60, p < .001). Pain was the most significant contributor to PCS in THA patients (β = -.42, p < .001) but was not significantly related to PCS in TKA (β = -.03). For MCS, total explained variances were lower (18% in TKA and 22% in THA), with fatigue emerging as the strongest contributor in both groups (β = -.42 knee OA; β = -.48, hip OA, p < .001). Fatigue fully mediated the relationship between pain and MCS, accounting for nearly 80% of the effect. No mediation effect was observed for PCS in THA, and only partial mediation (8.4%) was found in TKA. These findings underscore the need for tailored interventions to enhance post-arthroplasty recovery and QoL improvement. Pain management should be prioritized for hip OA to improve physical well-being, whereas comprehensive, long-term strategies targeting fatigue may be may be essential for mitigating mental health burdens in both OA groups.

BACKGROUND:We aimed to assess the role of the COVID-19 pandemic in the association of clinical, physical, and psychological factors with pain in Rheumatoid Arthritis (RA) patients. METHODS:We included 103 RA patients (81.6% females; mean age 56.1 ± 13.8 years). Patients filled out the VAS-pain, GAD-7, PHQ-9, MFI-20, and B-IPQ. Paired sample t-tests, correlations, and multiple regression analyses were used to analyse the data. RESULTS:Our results showed significantly worsened pain in the data collected post-pandemic (p ≤ 0.05). Pre-pandemic, the final regression models showed an association between functional disability (β = 0.24; p ≤ 0.05), illness perception (β = 0.34; p ≤ 0.05) and pain. In post-pandemic models, significant associations were found between fatigue (β = 0.33; p ≤ 0.01) and illness perception (β = 0.36; p ≤ 0.01) with pain. Positive illness perception was able to alleviate the associations between fatigue and depression with pain before and after the pandemic. CONCLUSION:Findings indicate that patients with RA may have been negatively affected by the COVID-19 pandemic given their vulnerability. Even though pharmacological treatment was not interrupted, post-pandemic results showed significantly higher levels of experienced pain. Therefore, in addition to biological therapy, non-pharmacological interventions, including psychological support aimed at diminishing negative illness perception, may be beneficial in reducing RA-related pain, especially when dealing with a crisis.

OBJECTIVE:Social participation is an important aspect associated with health-related outcomes in chronic diseases. However, little is known about the factors that may affect participation in patients with rheumatoid arthritis (RA). We aimed to examine whether pain, fatigue, anxiety, depression, and illness perception are associated with social participation in patients with RA when controlled for clinical and sociodemographic variables. We also analysed the mediating role of illness perception in the association between physical and psychological variables on social participation. METHOD:We included 157 RA patients (84.7% females; mean age 56.4 ± 13.9 years) who completed the Participation Scale, Brief Illness Perception Questionaire, Generalized Anxiety Disorder Scale, Patient Health Questionnaire, 36-item Short Form Health Survey, and the Visual Analogue Scale. Multiple linear regressions and mediation analyses were used to analyze the data. RESULTS:In the final regression models, illness perception (β = .42; p ≤ .001) and functional disability (β = .21; p ≤ .05) were associated with social participation. Income (β = -.18; p ≤ .05) lost its significance when physical variables were added to the model, and pain (β = .24; p ≤ .05) and fatigue (β = -.24; p ≤ .05) when psychological distress was added. No significant role of anxiety, depression, disease activity, or age was identified using regression analyses. Illness perception mediated the association of pain, fatigue, anxiety, and depression with social participation, and the indirect effect varied from 65% to 98%. CONCLUSIONS:Illness perceptions may significantly diminish the impacts of pain, fatigue, anxiety, and depression on social participation in individual RA patients. Therefore, RA patients could benefit from psychological interventions aimed at tackling negative illness perceptions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background The well-being of informal caregivers of people living with chronic kidney disease is influenced by their experiences with support, however, few studies have focused on exploring these experiences. This study aimed to explore informal caregivers’ experiences accessing and receiving support while caring for someone living with chronic kidney disease. Methods Informal caregivers of people living with chronic kidney disease (n = 13) in the United Kingdom were primarily recruited via community organisations and social media adverts to participate in semi-structured interviews. Interviews explored support needs, experiences of receiving support from different groups (e.g. healthcare professionals, family/friends), and barriers and facilitators to accessing support. Support was understood as including emotional, practical, and informational support. Data were analysed using reflexive thematic analysis. Results Three themes were generated: (1) “Systems seem to get in the way” – challenges within support systems, illustrating the challenges informal caregivers encountered when navigating complex support systems; (2) Relying on yourself, describing how informal caregivers leveraged their existing skills and networks to access support independently, while recognising the limitations of having to rely on yourself to find support; and (3) Support systems can “take the pressure off”, showing how support systems were able to help informal caregivers cope with the challenges they experienced if certain conditions were met. Conclusions In response to the challenges informal caregivers experienced when seeking support, improvements are needed to better consider informal caregiver needs within healthcare systems, and to develop interventions tailored to informal caregiver needs and context. Within the healthcare system, informal caregivers may benefit from system navigation support and better integration within healthcare teams to ensure their informational support needs are met. New interventions developed to support informal caregivers should fit within their existing support systems and incorporate the qualities of support, such as empathy, that were valued. Additionally, use of an equity framework and user-centered design approaches during intervention development could help ensure interventions are accessible and acceptable.

Purpose Chronic pain and obesity often co-occur, negatively affecting one another and psychological wellbeing. Pain and psychological wellbeing improve after bariatric metabolic surgery (BMS), however, it is unknown whether psychological wellbeing improves differently after weight loss between patients with and without chronic pain. We investigated whether weight loss is associated with greater psychological wellbeing and functioning change after BMS, comparing patients with and without preoperative pain syndromes. Methods Depression, health-related quality of life, self-esteem, self-efficacy to exercise and controlling eating behaviours, physical activity, and food cravings were measured before and 24 months after BMS among 276 patients with obesity. The presence of preoperative chronic pain syndromes was examined as a moderator for the relationship between 24-month weight loss and changes in psychological outcomes. Results Chronic pain syndromes were present among 46% of patients. Weight loss was associated with greater improvement in health-related quality of life, self-efficacy to exercise and controlling eating behaviours, self-esteem and greater amelioration in food cravings. Pain syndromes only moderated negatively the relationship between the postoperative weight loss and change in self-efficacy to control eating behaviours ( b = -0.49, CI [-0.88,-0.12]). Conclusion Patients with and without chronic pain showed similar improvements in weight and psychological wellbeing and behaviours after BMS. The relationship between weight loss and the improvement of self-efficacy to control eating behaviours was weaker among patients with chronic pain syndrome. Further work, measuring pain severity over time, is needed to shed light on the mechanism underlying pain and postoperative change in psychological wellbeing and weight loss. Graphical Abstract

This is the first book to provide a comprehensive overview of the social and technological context from which eHealth applications have arisen, the psychological principles on which they are based, and the key development and evaluation issues relevant to their successful intervention. Integrating how eHealth applications can be used for both mental and physical health issues, it presents a complete guide to what eHealth means in theory, as well as how it can be used in practice. Inspired by the principles and structure of the CeHRes Roadmap, a multidisciplinary framework that combines and uses aspects from approaches such as human-centred design, persuasive technology and business modelling, the book first examines the theoretical foundations of eHealth and then assesses its practical application and assessment. Including case studies, a glossary of key terms, and end of chapter summaries, this ground-breaking book provides a holistic overview of one of the most important recent developments in healthcare. It will be essential reading for students, researchers and professionals across the fields of health psychology, public health and design technology.

This weekly diary study investigated associations of weekly dyadic coping strategies with caregivers' willingness to care and burden. Multilevel modelling was applied to assess between- and within-person associations for 24 consecutive weeks in 955 caregivers. Greater willingness to care was reported in weeks when caregivers used more collaborative (b = 0.26, p < 0.001) and supportive (b = 0.30, p < 0.001) strategies, whereas uninvolved coping was associated with lower willingness to care (b = -0.44, p < 0.001). Using collaborative coping strategies was associated with lower weekly burden (b = -0.13, p < 0.001). A greater burden was reported in weeks when caregivers used more uninvolved (b = 0.19, p < 0.001) and controlling (b = 0.13, p < 0.001) coping strategies. A full understanding of whether caregivers' willingness to care and burden may be improved owing to weekly dyadic coping is essential for developing timely support for caregivers.

Informal care is a key pillar of long-term care provision across Europe and will likely play an even greater role in the future. Thus, research that enhances our understanding of caregiving experiences becomes increasingly relevant. The ENTWINE iCohort Study examines the personal, psychological, social, economic, and geographic factors that shape caregiving experiences. Here, we present the baseline cohort of the study and describe its design, recruitment methods, data collection procedures, measures, and early baseline findings. The study was conducted in nine countries: Germany, Greece, Ireland, Israel, Italy, the Netherlands, Poland, Sweden, and the United Kingdom. The study comprised a web-based longitudinal survey (baseline + 6-month follow-up) and optional weekly diary assessments conducted separately with caregivers and care recipients. From 14 August 2020 to 31 August 2021, 1872 caregivers and 402 care recipients were enrolled at baseline. Participants were recruited via Facebook and, to a lesser extent, via the study website or caregiver/patient organisations. Caregiver participants were predominantly female (87%) and primary caregivers (82%), with a median age of 55 years. A large proportion (80%) held at least post-secondary education, and two-thirds were married/partnered. Over half of the caregivers were employed (53%) and caring for a person with multiple chronic conditions (56%), and nearly three-quarters were caring for either a parent (42%) or a spouse/partner (32%). About three-quarters of care recipient participants were female (77%), not employed (74%), and had at least post-secondary education (77%), with a median age of 55 years. Over half of the care recipients were married/partnered (59%), receiving care primarily from their spouses/partners (61%), and diagnosed with multiple chronic conditions (57%). This study examining numerous potential influences on caregiving experiences provides an opportunity to better understand the multidimensional nature of these experiences. Such data could have implications for developing caregiving services and policies, and for future informal care research.

Backgrounde–Mental health interventions can improve access to mental health support for caregivers of people living with chronic kidney disease (CKD). However, implementation challenges often prevent effective interventions from being put into practice. To develop an e–mental health intervention for caregivers of people living with CKD that is optimized for future implementation, it is important to engage professionals that may endorse or deliver the intervention (ie, potential implementers) during intervention development. ObjectiveThis study aims to explore the perspectives of potential implementers working in kidney care, in mental health care, or at nonprofit organizations regarding the design and implementation of an e–mental health intervention for caregivers of people living with CKD. MethodsPotential implementers (N=18) were recruited via National Health Service Trusts, email, and social media advertisements to participate in semistructured video interviews. Interview questions were informed by the Consolidated Framework for Implementation Research (CFIR). Data were analyzed using a deductive analysis approach using the CFIR, with inductive coding applied to relevant data not captured by the framework. ResultsA total of 29 generic categories, related to 17 CFIR constructs, were identified. The perceived fit between the intervention and implementation context (ie, existing service delivery models and work routines) and existing social networks among potential implementers were perceived as important factors in enhancing implementation potential. However, a need for capacity building among potential implementers to create systems to support the identification and referral of caregivers to an e–mental health intervention was identified. Equity concerns were raised regarding the intervention, highlighting the importance of incorporating an equity lens during intervention design to enhance accessibility and adoption. ConclusionsPotential implementers provided valuable insights into key design and implementation factors to help inform the development of an e–mental health intervention for caregivers of people living with CKD. Incorporating their feedback can help ensure the intervention is acceptable and inform the selection of future implementation strategies to enhance the implementation potential of the intervention. Potential implementers should continue to be engaged throughout intervention development.

OBJECTIVE:Although the COVID-19 pandemic has affected mental health, understanding who has been affected most and why is incomplete. We sought to understand changes in mental health in the context of transmission numbers and pandemic (social) restrictions and whether changes in mental health varied among population groups.METHODS:We analyzed data from 92 062 people (aged ≥16 years and able to read Dutch) who participated in the Corona Behavioral Unit cohort study at the National Institute for Public Health and the Environment, the Netherlands, from April 17, 2020, through January 25, 2022. Participants self-reported mental well-being through multiple rounds of surveys. We used a multivariable linear mixed-effects model to analyze loneliness, general mental health, and life satisfaction.RESULTS:As strictness of pandemic prevention measures and social restrictions increased, people's feelings of loneliness increased and mental health and life satisfaction decreased. As restrictions were relaxed, loneliness decreased and general mental health improved. Younger people (aged 16-24 y) versus older people (aged ≥40 y), people with low (vs high) education levels, and people living alone (vs living together) were more likely to have negative well-being outcomes. We observed that trajectories over time differed considerably only by age, with participants aged 16-24 years affected substantially more than participants aged ≥40 years by pandemic social restrictions. These patterns were consistent across multiple waves of SARS-CoV-2 infection.CONCLUSIONS:Our findings suggest that the social restrictions imposed by the Dutch government during the study period were associated with reduced mental well-being, especially among younger people. However, people appeared resilient as they recovered during periods when restrictions were relaxed. Monitoring and supporting well-being, in particular to reduce loneliness, may help younger people during periods of intense social restrictions.

Abstract Background Attachment avoidance and anxiety have been linked to overweight and poor health behaviours, yet the mechanisms that underpin the relationship between attachment and health behaviours are not fully understood. Self-esteem and self-efficacy have been found to differ between attachment styles, rendering these variables potential mediators of the relationship. This longitudinal study investigated the serial mediation between preoperative attachment and 2-year post-operative health behaviours through self-esteem and health self-efficacy. Methods Participants were 263 bariatric surgery patients (75.7% females, aged 47.7 ± 10.4 years, BMI 38.9 ± 3.6 kg/m2) assessed before the operation and again one and two years after the surgery. Patients completed the Experiences for Close Relationships Brief Scale, Rosenberg Self-esteem scale, Weight Efficacy Lifestyle Questionnaire, Bariatric Surgery Self-Management Questionnaire, Exercise Self-Efficacy Scale and the Exercise Behaviour Scale. Results Higher preoperative attachment anxiety and avoidance were associated with lower self-esteem one year after bariatric surgery and poorer health self-efficacy two years after the surgery. Self-esteem and health self-efficacy mediated the relationships between preoperative anxious and avoidant attachment and 2- year post-operative diet adherence and physical activity. Conclusions Helping patients to feel more worthy and reinforcing their beliefs about their own competences could lead to higher engagement with healthy lifestyle and adherence to treatment protocols, ultimately helping patients to achieve their goals for bariatric surgery. Clinical trial registration BARIA: Netherlands Trial Register: NL5837 (NTR5992) https://www.trialregister.nl/trial/5837 . Diabaria: ClinicalTrials.gov identifier (NCT number): NCT03330756.

Title: Minimal Data Set for the Reproduction of Findings in "Elayan et al., Cohort Profile: The ENTWINE iCohort Study, a Multinational Longitudinal Web-Based Study of Informal Care". Study Summary: The data sets provided herein are derived from the ENTWINE iCohort Study, a multinational web-based cohort study employing an intensive longitudinal design. The study integrates a two-wave panel survey (baseline and 6-month follow-up) with optional weekly diary assessments. The cohort comprises caregivers and care recipients from nine countries: the United Kingdom, the Netherlands, Italy, Sweden, Israel, Germany, Greece, Poland, and Ireland. The study aimed to examine the influence of personal, psychological, social, economic, and geographic factors on caregiving experiences. Participants were eligible if they met the following criteria: 1) residency in a participating country; 2) capability to respond to surveys in English, Swedish, German, Dutch, Italian, Greek, Hebrew, or Polish; 3) access to the internet and ability to use it; 4) at least 18 years of age; 5) self-declared cognitive and physical capacity to complete the surveys; 6) either providing care to an adult (aged ≥ 18 years) with a chronic health condition, disability, or other care need, or receiving care from an adult due to similar conditions. The detailed methodology and results of the study can be found in the associated manuscript. For the complete survey questionnaires, please refer to: Morrison V, Zarzycki M, Vilchinsky N, Sanderman R, Lamura G, Fisher O, et al. A Multinational Longitudinal Study Incorporating Intensive Methods to Examine Caregiver Experiences in the Context of Chronic Health Conditions: Protocol of the ENTWINE-iCohort. Int J Environ Res Public Health. 2022;19. doi: 10.3390/ijerph19020821 Data files: The repository contains the following data files: "cg_minimal_dataset" (available in dta, sav, rds, and xlsx formats): This is a minimal data set containing de-identified and processed data derived from the ENTWINE iCohort Caregiver Baseline Survey. The variables present in this data set are detailed in the associated codebook, "cg_minimal_dataset_codebook". "cr_minimal_dataset" (available in dta, sav, rds, and xlsx formats): This is a minimal data set containing de-identified and processed data derived from the ENTWINE iCohort Care Recipient Baseline Survey. The variables present in this data set are detailed in the associated codebook, "cr_minimal_dataset_codebook".

The emergence of wearable sensor technology may provide opportunities for automated measurement of psychophysiological markers of mental and physical fitness, which can be used for personalized feedback. This study explores to what extent within-subject changes in resting heart rate variability (HRV) during sleep predict the perceived mental and physical fitness of military personnel on the subsequent morning. Participants wore a Garmin wrist-worn wearable and filled in a short morning questionnaire on their perceived mental and physical fitness during a period of up to 46 days. A custom-built smartphone app was used to directly retrieve heart rate and accelerometer data from the wearable, on which open-source algorithms for sleep detection and artefact filtering were applied. A sample of 571 complete observations in 63 participants were analyzed using linear mixed models. Resting HRV during sleep was a small predictor of perceived physical fitness (marginal R2 = .031), but not of mental fitness. The items on perceived mental and physical fitness were strongly correlated (r = .77). Based on the current findings, resting HRV during sleep appears to be more related to the physical component of perceived fitness than its mental component. Recommendations for future studies include improvements in the measurement of sleep and resting HRV, as well as further investigation of the potential impact of resting HRV as a buffer on stress-related outcomes.

Long-term physical activity (PA) maintenance is challenging for older adults. Equipping older adults with strategies to support long-term PA maintenance can be an effective way to tackle this problem. Moreover, there is a lack of studies regarding long-term PA maintenance among older adults from non-Western settings. This qualitative research is one of the first studies conducted in an Indian context that explores the strategies developed and utilized by older adults who have successfully maintained their PA for the long term (>1 year) in their home settings. In-depth semistructured interviews were conducted with 19 older adults, and data were analyzed using an inductive reflexive thematic analysis approach. This article reports five strategies of PA maintenance, together comprising 13 substrategies. This study highlights the importance of using strategies to support the long-term maintenance of PA among older adults in India. However, these strategies would also be useful in other sociocultural contexts.

Background Informal caregivers (i.e. family and friends) provide essential support to people with chronic kidney disease (CKD). Many informal caregivers experience mental health problems such as anxiety and depression due to the caregiving role, and commonly have unmet psychological support needs. One potential solution is cognitive behavioural therapy (CBT) self-help interventions that are less reliant on extensive involvement of healthcare professionals, which may increase access. Within the intervention development phase of the MRC framework, the study's primary objective was to examine informal caregivers' self-help intervention preferences (e.g. delivery format, content). Secondary objectives were to describe the informal caregiver's situation (e.g. type of care activities) and mental health (symptoms of depression, anxiety, and stress). Methods An online cross-sectional survey conducted in the United Kingdom. Informal caregivers of adults living with CKD were recruited via social media, websites, newsletters, magazine articles, a podcast episode, and paid Facebook advertisements. The survey examined: informal caregiver characteristics; care recipient characteristics; self-help intervention preferences; and informal caregiver's mental health using the DASS-21. Data were analysed using descriptive statistics. Results Sixty-five informal caregivers participated. The majority (85%) were female, caring for a male (77%) spouse/partner (74%). Responses indicated 58% of informal caregivers were experiencing at least mild depression. In total, 48% indicated they were likely to use a CBT self-help intervention, preferring an intervention provided via internet (e.g. website) (64%), workbook (56%), or individually in-person (54%). Regarding content, interventions should cover a wide range of topics including living with CKD, support services, informal caregiver's physical health, and diet. Overall, 48% reported a preference for a supported intervention, with support delivered in-person or via email by a trained professional at a community organisation. Conclusions Results suggest CBT self-help interventions may be an acceptable way to provide psychological support to informal caregivers, however the study is limited by the small sample size. A wide range of intervention preferences were identified indicating a need to tailor intervention content and delivery to enhance acceptability and engagement. Results will inform development of a CBT self-help intervention for informal caregivers of people with CKD.