Investigating the effects of tracheostomy cuff deflation timing in patients requiring prolonged mechanical ventilation - An observational study.

The university period represents a developmental stage characterized by increased autonomy, profound lifestyle changes, and heightened vulnerability to health‑related behavior disruptions. Insufficient physical activity (PA) and high sedentary time remain highly prevalent among university students worldwide []. Global surveillance data show a persistent gender gap in PA participation: women report markedly higher inactivity rates (31.7%) compared to men (23.4%), reaching up to 42.3% in high‑income Western countries []. These patterns are concerning, as physical inactivity tends to increase during early adulthood and is associated with adverse long‑term physical and psychological outcomes [,]. Concurrently, the university stage coincides with elevated susceptibility to body dissatisfaction, internalization of appearance ideals, and risk factors for eating disorders (ED). Recent epidemiological data in Spain report a point prevalence of 7.8% for EDs, with young women representing the group at highest risk []. Body dissatisfaction, exposure to unrealistic appearance ideals, and the pervasive influence of social media amplify this vulnerability [,]. Importantly, PA in this population can become maladaptive when driven by controlled motives such as guilt, social pressure, or appearance management [,]. Understanding not only whether, but why, young women engage in PA is therefore essential to prevent maladaptive patterns and promote sustained well‑being. Self-Determination Theory (SDT) provides a comprehensive framework for understanding motivational processes associated with PA engagement and psychological health [,]. SDT differentiates autonomous motivation, rooted in personal values, interest, and volition, from controlled motivation, which arises from internal or external pressures. Autonomous motivation predicts sustained PA, greater psychological well-being, and healthier body attitudes, whereas controlled motivation is associated with poorer adherence and emotional distress [,]. Central to SDT is the satisfaction of the basic psychological needs for autonomy, competence, and relatedness; meta-analytic evidence shows that interventions supporting these needs improve motivational quality and promote health-related behavioral regulation [,]. Recent analyses further demonstrate that combining multiple need-supportive strategies, autonomy-supportive communication, structure, and relational support produces the strongest effects on motivation and PA adherence [].