Manuela Mihaela Ciucurel

Objective: This study examined psychological adaptation across cancer progression by following the same oncology patients from diagnosis to a terminal-phase assessment and by comparing them with survivors of severe non-cancer life-threatening events. Outcomes were state anxiety, unconditional self-acceptance, stress-related growth, psychological well-being, purpose and meaning in life, and exploratory reports of near-death experiences (NDEs), deathbed visions (DBVs), and other end-of-life experiences (ELEs). Methods: The analytic sample comprised 206 unique participants: 103 oncology patients with paired assessments at diagnosis (Time 1) and after three years in the terminal phase (Time 2), and an independent comparison group of 103 survivors of severe life-threatening events. The oncology cohort was drawn from 649 patients initially assessed in the same clinical setting; longitudinal analyses included the 103 patients with complete paired data through the final assessment. Repeated-measures ANOVA tested within-person psychological change; independent-samples t tests compared newly diagnosed oncology patients with life-threatening-event survivors; Pearson chi-square compared the frequency of documented spiritual-experience reports between the independent terminal-phase oncology and life-threatening-event groups; and McNemar’s exact test examined within-person change in spiritual-experience reporting from diagnosis to the terminal phase. Results: In the paired oncology cohort, state anxiety decreased and unconditional self-acceptance, stress-related growth, psychological well-being, and purpose/meaning increased from diagnosis to the terminal-phase assessment (all p < 0.001). Life-threatening-event survivors showed lower state anxiety and higher scores on the positive psychological outcomes than newly diagnosed oncology patients (all p < 0.001). Reports consistent with NDEs, DBVs, and ELEs were documented more frequently in terminal-phase oncology patients (94.2%) than in life-threatening-event survivors (63.1%), χ²(1, N = 206) = 29.59, p < 0.001, Cramer’s V = 0.38. Within the paired oncology cohort, spiritual-experience reporting also increased from 14.6% at diagnosis to 94.2% in the terminal phase; 85 patients changed from no report to a report and only 3 changed in the opposite direction (McNemar exact p < 0.001). Conclusion: Psychological functioning differed markedly across phases and contexts of mortality-related threat. Reports consistent with NDEs, DBVs, and ELEs were documented more frequently in the terminal phase and increased within the paired oncology cohort, but the observational design does not establish that these experiences caused or predicted psychological improvement. The findings support further longitudinal, controlled, and qualitative research on adaptation, meaning, and spiritual experience in oncology and end-of-life care.

Background/Objectives: Physical activity (PA) is a key determinant of mental and physical health, yet its relationship with affective states remains insufficiently explored. Emotional factors, such as depression, anxiety, and motivation levels, can significantly impact PA engagement. This study aims to validate the Affective State and Physical Activity Questionnaire (ASPAQ), a novel 15-item instrument designed to assess the interplay between affective states and PA in adults. Methods: A cross-sectional study was conducted with 412 adults (145 males, 267 females, aged 18–65 years). Participants completed the ASPAQ alongside the International Physical Activity Questionnaire—Short Form (IPAQ-SF) and the Patient Health Questionnaire-9 (PHQ-9) on an online platform, with the support of trained operators. The psychometric properties of the ASPAQ were evaluated using reliability tests (Cronbach’s alpha, McDonald’s omega), exploratory factor analysis (EFA), and correlational analyses to assess convergent validity. Results: The ASPAQ demonstrated excellent reliability (Cronbach’s alpha = 0.973; McDonald’s omega = 0.973) and a unidimensional structure. Convergent validity was supported by significant correlations between ASPAQ scores and established measures of PA (IPAQ-SF) and depression (PHQ-9). EFA confirmed a single-factor model, reinforcing its conceptual integrity. Conclusions: The ASPAQ is a reliable and valid instrument for assessing the relationship between affective states and PA. Its integration with established measures offers a comprehensive tool for evaluating emotional barriers to PA. Future studies should explore its predictive validity and potential applications in clinical and public health settings to inform personalized interventions promoting PA among individuals with affective challenges.

Objective: This study aims to examine the effect of time on psychological variables such as anxiety as a state, posttraumatic development, unconditional acceptance of oneself, psychological well-being and a dimension thereof, namely the purpose and meaning of life in the case of oncological patients upon diagnosis and in the terminal phase of the disease. We also aimed to study the differences in terms of the same psychological variables between oncological patients in the terminal stage of the disease and those who have faced a life-threatening experience, just as we wanted to establish whether spiritual experiences (NDEs/DBVsS/ELEs) mainly characterize a certain group among the three evaluated. Methods: A community sample of 309 participants, 103 subjects in each category, of which 181 males (58,6%) and 128 females (41,4%), with ages between 19-76 years. The 103 participants with a cancer diagnosis who reached the terminal phase of the disease after 3 years were 68 males (66%) and 35 females (34%) aged between 31-76 years, and the 103 participants recovering from life-threatening events were 45 males (43.7%), 58 females (56.3%) aged between 19-59 years, the study being conducted between January 2022-January 2025. The instruments were: Posttraumatic Development Scale – SGRS, State Anxiety – Trait Inventory (STAI), USAQ Scale, Ryff's Psychological Well-Being Scale (PWB-R). Results: The results showed significant differences between oncology patients at diagnosis and in the terminal phase, indicating a significant effect of time on state anxiety F(1; 102) = 1290.33, p = .000, η2 = .92, unconditional self-acceptance F(1; 102) = 749.58, p = .000, η2 = .88, posttraumatic development F(1; 102) = 1618.86, p = .000, η2 = .94, psychological well-being F(1; 102) = 86.72, p = .000, η2 = .46, purpose and meaning in life F(1; 102) = 1092.05, p = .000, η2 = .91.

Objective: This study examines the relationship between anxious thoughts and well-being, with physical symptoms and sadness rumination as mediators, in young people who suffer from anxiety in the first two years after the COVID-19 pandemic. Methods: A community sample of 198 participants, 94 males and 104 females, aged between 19 and 35 years, all of them experiencing an anxiety disorder in their past, answered an online survey during the years 2022–2023. The instruments were the Rumination of Sadness and Anger Questionnaire, The Burns Inventory, and Ryff’s Psychological Well-being Scale. The data analysis used hierarchical regression. Results: The results show that the conditional indirect effects of anxious thoughts on well-being are statistically significant (β = −0.29, SE = 0.08, p < 0.001) for high physical symptoms of anxiety (β = 0.25, SE = 0.11, p < 0.001) and for high sadness rumination (β = −0.82, SE = 0.04, p < 0.001). Physical symptoms of anxiety (β = 0.25, SE = 0.11, p < 0.001) and sadness rumination (β = 0.05, SE = 0.07, p < 0.001) have a partial serially mediating effect on the relationship between anxious thoughts and well-being (β = −0.74, SE = 0.02, p < 0.001).

(1) Background: This research aims to compare social networks among institutionalized and aging-in-place (AIP) older adults through the validation of a new questionnaire. (2) Methods: The cross-sectional study included 100 older adults (mean age: 73.53 ± 5.49 years; age range: 65–85 years), with 48 institutionalized subjects and 52 AIP subjects. We developed, validated, and administered a new questionnaire, the Social Network Assessment for Older People Questionnaire (SNAOPQ), to assess older adults’ social networks using descriptive and inferential statistical methods. (3) Results: The SNAOPQ demonstrated excellent internal consistency (Cronbach’s alpha of 0.91 and McDonald’s omega of 0.91). Statistical analysis revealed significant associations between variables, highlighting differences in social networks between institutionalized and AIP individuals (p ≤ 0.001). Sociodemographic factors like age, education, living arrangement status, and number of descendants significantly influenced SNAOPQ scores (p ≤ 0.001). Age and residence type notably impacted participants’ scores, indicating reduced social network size with age. Tertiary education and living in a couple were associated with more extensive social networks, while a higher number of descendants correlated with social network expansion. (4) Conclusions: Our study highlights significant differences in social networks among older adults based on residence type, emphasizing the impact of sociodemographic factors such as age, education, living arrangement, and the number of descendants.