Objectives. Persistent atrial fibrillation (AF) is an abnormal heart rhythm associated with low quality of life (QoL) and significant health-related costs. The purpose of the study was to examine patients' illness and treatment beliefs and ways of coping with AF symptoms, to provide insight into promoting better QoL and treatment-specific management.Design. Beliefs were explored across three procedural treatment groups using a qualitative cross-sectional design.Methods. Thirty semi-structured interviews were carried out with patients undertaking cardioversion (n = 10), catheter ablation (n = 11) and atrioventricular node ablation (n = 9). Interviews were transcribed and analysed using inductive thematic analysis with elements of grounded theory.Results. An overarching theme of a vicious cycle was evident, which related to perceived lack of knowledge and understanding of AF, attempts to control symptoms and negative emotional reactions to failed control attempts. This vicious cycle related to three subordinate themes: (1) unpredictability and uncertainty of AF and symptoms; (2) coping with symptoms through (a) avoidance (b) all-or-nothing-(c) slowing down behaviours; and (3) concerns and expectations about treatment.Conclusions. Patients outlined a need to gain control of unpredictable symptoms by monitoring and varying activity levels. These behaviours were often appraised as ineffective at controlling symptoms, leading to heightened uncertainty and increased activity avoidance. Treatment concerns escalated with increasing number and invasiveness of procedures. Improving AF patients' perceived understanding of their illness and treatment and promoting more effective symptom-management strategies may alleviate psychological distress and improve QoL. Themes elaborated on the common-sense model whereby patients' beliefs about illness and treatment interact with coping behaviours.

Academic motivation is recognised as a key factor for academic success and wellbeing. Highly motivated students actively engage with academic activities and maintain good wellbeing. Despite the importance of motivation in education, its relationship with engagement and wellbeing remains to be evaluated. Accordingly, this study explored the relationships between motivation, engagement, self-criticism and self-compassion among UK education postgraduate students. Of 120 postgraduate students approached, 109 completed three self-report scales regarding those constructs. Correlation, regression and moderation analyses were performed. Intrinsic and extrinsic motivation were positively associated with engagement, whereas amotivation was negatively associated with it. Engagement positively predicted intrinsic motivation. Self-criticism and self-compassion moderated the pathway from extrinsic motivation to intrinsic motivation: higher self-criticism weakened the pathway, while higher self-compassion strengthened it. Findings suggest the importance of engagement in relation to cultivating intrinsic motivation of education students. Moreover, enhancing self-compassion and reducing self-criticism can help transfer extrinsic to intrinsic motivation.

Objective: This study modified the Revised Illness Perception Questionnaire (IPQ-R) in patients with persistent atrial fibrillation (AF). Design: Qualitative interviews and think-aloud techniques informed modification of the IPQ-R to be specific to AF patients. Confirmatory Factor Analysis (CFA) (n = 198) examined the validity of the modified IPQ-R (AF-IPQ-R). Exploratory factor analysis (EFA) examined the new AF-triggers scale. Construct validity examined associations between the AF-IPQ-R, quality of life (QoL) and beliefs about medicines. Test-retest and internal reliability were examined. Results: Interviews indicated that patients viewed triggers of AF rather than initial causes of illness as more applicable. Patients believed specific behaviours such as rest could control AF. Treatment control beliefs related to pharmacological and procedural treatments. These data were used to modify the IPQ-R subscales and to develop a triggers of AF scale. CFA indicated good model fit. EFA of the triggers scale indicated three factors: emotional; health behaviours; and over-exertion triggers. Expected correlations were found between the AF-IPQ-R, QoL and treatment beliefs, evidencing good construct validity. Conclusion: The AF-IPQ-R showed sound psychometric properties. It provides more detailed specification than the IPQ-R of beliefs that may help to understand poor QoL in AF patients, and guidance for future interventions in this area.

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High rates of mental health problems are a growing concern in Czech higher education, negatively impacting students’ performance and wellbeing. Despite the serious nature of poor mental health, students often do not seek help because of negative attitudes and shame over mental health problems. Recent mental health research reports self-compassion is strongly associated with better mental health and reduced shame. However, relationships between those constructs remain to be evaluated among Czech students. This study aims to appraise the relationships between mental health problems, negative mental health attitudes, mental health shame, and self-compassion in this population. An opportunity sample of 119 psychology students from a Czech university completed questionnaires regarding these constructs. Correlation, regression, and path analyses were conducted. Mental health problems were positively associated with negative mental health attitudes and shame, and negatively associated with self-compassion. Self-compassion negatively predicted mental health problems, while negative attitudes and shame did not. Last, self-compassion fully mediated the negative attitudes-mental health problems relationship, and partially mediated the shame-mental health problems relationship. Findings suggest self-compassion is essential for mental health in Czech students and associated with negative mental health attitudes and mental health shame. Czech universities can benefit from incorporating self-compassion training into their curricula to protect students’ mental health.

Purpose Few studies have examined specific cognitive and behavioural responses to symptoms, which may impact health-related outcomes, in conjunction with illness representations, as outlined by the Common-Sense-Model. Patients with atrial fibrillation (AF) report poor quality-of-life (QoL) and high distress. This cross-sectional study investigated patterns/clusters of cognitive and behavioural responses to illness, and illness perceptions, and relationships with QoL, depression and anxiety. Methods AF patients (N = 198) recruited at cardiology clinics completed the AF-Revised Illness Perception Questionnaire, Atrial-Fibrillation-Effect-on-Quality-of-Life Questionnaire, Patient Health Questionnaire-8 and Generalized Anxiety Disorder Questionnaire. Cluster analysis used Ward’s and K-means methods. Hierarchical regressions examined relationships between clusters with QoL, depression and anxiety. Results Two clusters of cognitive and behavioural responses to symptoms were outlined; (1) ‘high avoidance’; (2) ‘low symptom-focussing’. Patients in Cluster 1 had lower QoL (M = 40.36, SD = 18.40), greater symptoms of depression (M = 7.20, SD = 5.71) and greater symptoms of anxiety (M = 5.70, SD = 5.90) compared to patients in Cluster 2 who had higher QoL (M = 59.03, SD = 20.12), fewer symptoms of depression (M = 3.53, SD = 3.56) and fewer symptoms of anxiety (M = 2.56, SD = 3.56). Two illness representation clusters were outlined; (1) ‘high coherence and treatment control’, (2) ‘negative illness and emotional representations’. Patients in Cluster 2 had significantly lower QoL (M = 46.57, SD = 19.94), greater symptoms of depression (M = 6.12, SD = 5.31) and greater symptoms of anxiety (M = 4.70, SD = 5.27), compared with patients in Cluster 1 who had higher QoL (M = 61.52, SD = 21.38), fewer symptoms of depression (M = 2.85, SD = 2.97) and fewer symptoms of anxiety (M = 2.16, SD = 3.63). Overall, clusters of cognitive and behavioural responses to symptoms, and illness perceptions significantly explained between 14 and 29% of the variance in QoL, depression and anxiety. Conclusion Patterns of cognitive and behavioural responses to symptoms, and illness perceptions are important correlates of health-related outcomes in AF patients.

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While the Indonesian higher education has been growing rapidly, poor student mental health including a high level of mental health shame is a cause for concern in Indonesia. This study aimed to evaluate their mental health, shame, and self-compassion. One hundred fifty six participants completed self-report measures regarding mental health problems (depression, anxiety, and stress), mental health shame (negative attitudes, and external, internal, and reflected shame), and self-compassion. Data were first compared with 145 U.K. students, then correlation and regression analyses were performed. Indonesian students showed higher levels of mental health problems, family-related mental health shame, and self-compassion than U.K. students. Each type of mental health problem and mental health shame were positively associated with each other. Self-compassion was negatively associated with mental health problems, but not with mental health shame. Self-compassion was consistently the strongest predictor of mental health problems. Among the mental health shame types, only family external shame predicted the level of depression. Self-compassion training and mental health education for their family are recommended to protect the mental health of university students in Indonesia.