{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T16:02:22Z","timestamp":1789488142373,"version":"build-2803163510"},"reference-count":48,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Evidence Based Medicine"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Academic adjustment is essential for medical students facing rigorous academic demands. While individual and instructional factors have been well\u2010studied, the role of family functioning remains underexplored. This study examined the association between family functioning and academic adjustment, explored the mediating role of coping styles, and compared these pathways between at\u2010risk students (those who had failed at least one final examination) and controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional study was conducted using validated scales for assessment of academic adjustment, family functioning, and coping styles. Structural equation modeling and bootstrap analyses were used to test mediation effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      1022 Chinese medical students (293 at\u2010risk, 729 controls) were included. Family functioning was significantly and positively associated with academic adjustment (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Positive coping mediated this relationship in both groups (at\u2010risk:\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 0.13, 95% confidence interval [CI] [0.068, 0.218]; controls:\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 0.21, 95% CI [0.182, 0.243]), while negative coping mediated the effect only in at\u2010risk students (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 0.12, 95% CI [0.090, 0.167]). At\u2010risk students showed significantly lower academic adjustment (\n                      <jats:italic>t<\/jats:italic>\n                      = \u20136.56,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001, Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      = \u20130.45) and relied on distinct coping mechanisms compared to controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study reveals distinct mediating pathways of coping styles between at\u2010risk and other students, deepening our understanding of family influences and providing practical guidance for targeted interventions in medical education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jebm.70105","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T10:32:23Z","timestamp":1767868343000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Family Functioning and Academic Adjustment in Medical Students: Coping Styles as Mediators and Differences in At\u2010Risk Students"],"prefix":"10.1111","volume":"19","author":[{"given":"Huibing","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Student Affairs Management West China School of Medicine\/West China Hospital Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danmei","family":"Liang","sequence":"additional","affiliation":[{"name":"West China School of Medicine Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yibei","family":"Wang","sequence":"additional","affiliation":[{"name":"West China School of Medicine Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaohan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Student Affairs Management West China School of Medicine\/West China Hospital Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Student Affairs Management West China School of Medicine\/West China Hospital Sichuan University  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"issue":"5","key":"e_1_2_8_2_1","first-page":"762","article-title":"The Development of a Test About Learning Adjustment of Undergraduate","volume":"38","author":"Feng T. 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