The relationship between psychological health and social support: Evidence from physicians in China

Prevalence of psychological problems among individuals and couples during assisted reproductive technology(ART) treatment: a systematic review and meta-analysis

BACKGROUND

The psychological problems of infertile couples deserve more attention given the impact on pregnancy outcomes.

AIMS

This systematic review and meta-analysis was designed to assess the prevalence of anxiety, depression, and stress in couples during assisted reproductive treatment.

MATERIALS AND METHODS

We conducted searches on PubMed, Embase, and Web of Science from the outset until September 2024. Random-effects models were conducted to estimate the pooled prevalence of anxiety, depression and stress. Subgroup analyses were performed to seek potential sources of heterogeneity. The Egger's test was utilized to assess publication bias.

RESULTS

The meta-analysis included 40 studies involving 16,042 participants. The pooled prevalence of anxiety, depression and stress symptoms in infertile women were 48.0% (95%CI 36.6%-59.9%), 35.6% (95%CI 28.0%-43.3%) and 52.2% (95%CI 13.2-91.1%) respectively, while those in infertile men were 28.4% (95%CI 15.4%-43.4%) , 18.6% (95%CI 13.4%-23.8%) and 47.2% (95%CI 16.1%-78.4%) respectively. Subgroup analysis revealed the differences in country economic level, continent, assessment instrument and sample size.

CONCLUSIONS

Many couples experienced anxiety, depression and stress symptoms during assisted reproductive therapy. It is important for healthcare professionals to develop and implement effective strategies for the prevention and intervention of psychological issues.

Knowledge, attitudes, and practices of physicians regarding multidisciplinary treatment of obstructive sleep apnea: a cross-sectional study

To investigate physicians' knowledge, attitudes, and practices (KAP) regarding the multidisciplinary treatment of Obstructive Sleep Apnea (OSA). A multicenter cross-sectional study was conducted in May 2024, enrolling physicians from southwestern China. The study collected demographic data and assessed KAP through self-administered questionnaires, with the respiratory and otolaryngology departments defined as relevant departments. A total of 329 valid questionnaires were collected. Of these respondents, 173 (52.6%) were female, and 114 (34.7%) had participated in multidisciplinary OSA-related training. The mean scores for knowledge and attitudes were 24.61 ± 8.27 (possible range: 0-34) and 39.99 ± 4.34 (possible range: 10-50), respectively. Practice scores of the physicians in departments directly and indirectly involved in OSA treatment averaged 24.28 ± 4.70 and 21.28 ± 4.24 (possible range: 6-30), respectively. Structural equation modeling results indicated that in departments directly related to OSA, knowledge had a significant positive effect on both attitudes (β = 5.53, P < 0.001) and practices (β = 5.8, P < 0.001). For departments indirectly related to OSA, knowledge had a significant positive effect on attitudes (β = 5.41, P < 0.001). Physicians showed adequate knowledge and attitudes toward OSA treatment; targeted education is recommended to enhance consistency in practices across departments.

Correlations of resilience with coping styles and quality of life in patients with malignancies

BACKGROUND

Resilience is an individual's ability and psychological rebound capacity to adapt well after experiencing adversity, trauma, etc. Patients with strong resilience can face illnesses actively.

AIM

To determine the association of resilience with coping styles and quality of life in patients with malignancies.

METHODS

This study included patients with malignant tumors who were hospitalized at Fuyang Hospital Affiliated to Anhui Medical University from March 2022 to March 2024. The Connor-Davidson Resilience Scale, Medical Coping Modes Questionnaire, Social Support Rating Scale, and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 were utilized to assess patients' resilience, coping styles, social support, and quality of life, respectively. Pearson correlation analysis was conducted to assess the correlations.

RESULTS

A total of 175 patients with malignant tumors demonstrated no marked difference in terms of age, education level, employment status, monthly household income, and disease staging (P < 0.05). Further, patients with malignancies demonstrated scores of 17.49 ± 1.20, 17.27 ± 1.46, and 11.19 ± 1.29 points in terms of coping styles in confrontation, avoidance, and resignation dimensions, respectively. Subjective support, objective support, and support utilization scores in terms of social support were 10.67 ± 1.80, 11.26 ± 2.08, and 9.24 ± 1.14 points, respectively. The total resilience score and tenacity, self-improvement, and optimism dimension scores were positively correlated with the confrontation coping style score, whereas the total resilience score and tenacity and self-improvement scores were negatively associated with avoidance and resignation coping style scores (P < 0.05). The total resilience score and the tenacity dimension score were positively associated with physical, role, cognitive, emotional, and social functions, as well as global health status (P < 0.05), and were inversely related to fatigue, insomnia, and economic difficulties (P < 0.05).

CONCLUSION

The resilience of patients with malignancies is positively associated with the confrontation dimension in the coping style, the total and various social support domain scores, and the overall quality of life. Clinical medical staff need to pay attention to the effect of medical coping styles and social support on the resilience level of patients with malignancies to further improve their quality of life.

Exploring Social-Ecological Pathways From Sexual Identity to Sleep Among Chinese Women: Structural Equation Modeling Analysis

Background

Women and sexual minority individuals have been found to be at higher risk for experiencing poor sleep health compared to their counterparts. However, research on the sleep health of sexual minority women (SMW) is lacking in China.

Objective

This study aimed to examine sleep quality and social support for Chinese women with varied sexual identities, and then investigate the in-depth relationships between sexual identity and sleep.

Methods

This was a cross-sectional web-based survey. All participants completed a structured questionnaire containing a set of sociodemographic items referring to the social-ecological model of sleep health, the Pittsburgh Sleep Quality Index, the Social Support Rating Scale, and social relationships and environment domains of the World Health Organization Quality of Life-abbreviated short version. Pearson correlation coefficients were used to examine the relationship between sleep quality and social support as well as the two domains of quality of life. Structural equation modeling analysis was used to explore the social-ecological relationships.

Results

A total of 250 cisgender heterosexual women (CHW) and 259 SMW were recruited from July to September 2021. A total of 241 (47.3%) women experienced poor sleep quality and the rate was significantly higher in SMW than in CHW (55.2% vs 39.2%, P<.001). Around one-fifth of SMW reported low levels of social support, which was significantly higher than that of CHW (21.6% vs 5.6%, P<.001). Pearson correlations showed that overall sleep quality was significantly negatively associated with social support with weak correlations (r=-0.26, P<.001). The final structural equation modeling analysis with satisfactory fit indices identified 6 social-ecological pathways, showing that alcohol use, objective support, utilization of support, and perceived social relationship and environment quality of life played important roles in the sleep quality of individuals from their sexual identity.

Conclusions

SMW experienced poorer sleep quality compared to CHW. Further research is recommended to address the modifiable factors affecting sleep and then implement tailored sleep improvement programs.

Factors influencing parents' educational anxiety of primary and secondary school students: evidence from parents in China

BACKGROUND

Current research has focused on exploring the sources of parents' anxiety about children's education (PAE), and we continue in this direction by exploring the factors influencing parental educational anxiety in primary and secondary school students and the interactions among them.

METHODS

Parental Educational Anxiety Measurement Questionnaire was used to measure the level of PEA. Pearson correlation coefficient analysis was used to examine the correlation between the level of PAE and the demographic variables. The method of multiple stepwise regression analysis was used to explore the demographic factors correlated with PAE. Two-way interactions in moderated multiple regression to examine the moderating effects of educational attainment on monthly household mortgage payments and PAE.

RESULTS

Our results indicate that there were statistical differences among education level, average monthly household income, child's stage of learning and monthly household mortgage payments; PEA were negatively correlated with education level and average monthly household income, and positively correlated with monthly cost of educational inputs. The results of multiple regression analysis showed that education level, average monthly household income, monthly household mortgage payment, and monthly cost of educational inputs were direct influences on PEA. Education level has a significant moderating effect on the monthly mortgage payment and PEA.

CONCLUSION

Education level, average monthly household income, monthly household mortgage payment, and monthly cost of educational inputs were direct influencing factor of PEA.

Relieving anxiety and depression symptoms through promoting organizational identity and mitigating family-work conflict among medical professionals in digital leadership

BACKGROUND

Digital leadership might be an innovative approach to decreasing the elevated rates of anxiety and depression symptoms among medical professionals, while also enhancing their psychological well-being. This emerging pathway may offer promising strategies to support the mental health of medical professionals. This study seeks to investigate the association among digital leadership, organizational identity, family-work conflict, and anxiety and depression symptoms, and further to uncover the underlying moderating mechanisms interplay.

METHODS

A cross-sectional online survey with 657 valid data were collected from four tertiary hospitals in Harbin, Heilongjiang Province, China, with a response rate of 69.3%. The statistical analysis was conducted employing IBM SPSS Statistics 22.0. Hierarchical regression analysis was performed to scrutinize the pertinent factors associated with anxiety and depression symptoms among medical professionals, while also evaluating the moderating influence of organizational identity and family-work conflict on the nexus among those.

RESULTS

The prevalence of anxiety and depression symptoms among medical professionals was 50.1%. Anxiety and depression symptoms were negatively correlated with digital leadership (r= -0.278, p < 0.01) and organizational identity (r = - 0.318, p < 0.01), and positively correlated with family-work conflict (r = 0.445, p < 0.01). Organizational identity (β = - 0.938, p < 0.05) and family-work conflict (β = 0.698, p < 0.05) moderate the relationship between digital leadership and anxiety and depression symptoms; The results of the simple slope analysis indicated that high organizational identity and low family-work conflict strengthened the effect of digital leadership on anxiety and depression symptoms among Chinese medical professionals.

CONCLUSIONS

The prevalence of anxiety and depression symptoms among medical professionals was noted to be high. This study posits that strengthening digital leadership could apparently improve anxiety and depression symptoms among medical professionals. Moreover, it highlights the moderating role of organizational identity and family-work conflict in the relationship between digital leadership and anxiety and depression symptoms. These discoveries underscore the significance of implementing support and interventions to enhance the mental well-being of medical professionals, encompassing the cultivation of organizational identity, reduction of family-work conflict, and acknowledgment of the potential role of digital leadership in addressing mental health challenges.

Enhancing access to specialist appointments in tertiary healthcare in Shanghai, China: a structured reservation pathway using digital health technologies

OBJECTIVE

The aim of this study is to develop, implement the precise reservation path (PRP) and investigate its prediction function for scheduling shunting patients for specialist appointment registration in Shanghai, China.

DESIGN

The PRP system was built on the hospital's existing information system, integrated with WeChat (WeCom) for user convenience. The outcome analysis employed a mixed-methods approach, integrating quantitative analysis with statistical and machine learning techniques, including multivariate logistic regression, random forest (RF) and artificial neural network (ANN) analysis.

SETTING

This study was conducted at Renji Hospital, a premier general tertiary care institution in Shanghai, China, where the innovative PRP system was implemented. The programme was designed to efficiently connect patients requiring specialised care with the appropriate medical specialists.

PARTICIPANTS

The PRP encompassed both voluntary specialists at Renji Hospital, as well as patients seeking outpatient specialist services.

PRIMARY OUTCOME MEASURES

The pass rates of patient for specialist applications.

SECONDARY OUTCOME MEASURES

Clinical department, specialists' and patients' characteristics influencing specialist review result.

RESULTS

From a data set of 58 271 applicants across 26 departments between 1 December 2020 and 30 November 2022, we noted an overall pass rate of 34.8%. The departments of urology, breast surgery and thoracic surgery, along with five others, accounted for 86.65% of applications. Pass rates varied significantly, and demographic distributions of applicants across departments revealed distinct patient profiles, with preferences evident for age and gender. We developed an RF model based on pass rates from 26 specialised departments. The RF model, with 92.31% accuracy, identified age as the primary predictor of pass rates, underscoring its impact on specialist review outcomes. Focus on patient demographics, we conducted univariate and multivariate logistic regression analyses on the 58 271 patient data set to explore the relationship between demographic factors and review outcomes. Key findings from logistic regression included significant associations with gender, age and specialist title. Results indicated that older patients were more likely to be approved in specialist reviews, while middle-aged patients had lower pass rates. The generalised linear model, enhanced with specialist and clinical department variables, showed superior predictive accuracy (67.86-68.26%) and model fit over the previous logistic model. An ANN model also identified specialist and clinical department as the most influential, achieving comparable accuracy (67.72-68.28%).

CONCLUSIONS

The PRP programme demonstrates the potential of digital innovation in enhancing the hierarchical medical system. The study's findings also underscore the value of the PRP programme in healthcare systems for optimising resource allocation, particularly for ageing populations. The programme's design and implementation offer a scalable model for other healthcare institutions seeking to enhance their appointment systems and specialist engagement through digital innovation.

The role of social support as a moderator between resilience and levels of burden of multimorbidity management among general practitioners: a cross-sectional study in Portugal

BACKGROUND

Multimorbidity management poses significant challenges for general practitioners (GPs). The aim of this study is to analyse the role of resilience and social support on the burden experienced by GPs in managing patients with multiple health conditions in Portugal.

METHODS

Cross-sectional quantitative study conducted among GPs in Portugal using an online questionnaire that included validated measurement tools: Questionnaire of Evaluation of Burden of Management of Multimorbidity in General and Family Medicine (SoGeMM-MGF), European Portuguese Version of the Resilience Scale (ER14), and the Oslo Social Support Scale-3 (OSSS-3) in Portuguese. A multiple linear regression analysis was conducted to examine the factors influencing the burden of managing multimorbidity.

RESULTS

Two hundred and thirty-nine GPs were included, with 76.6% being female and a median age of 35 years. Most participants were specialists (66.9%) and had less than a decade of experience managing multimorbidity. Over 70% had not received specific training in multimorbidity. Female GPs and those with a higher proportion of multimorbid patients in the registries experienced higher burden levels. A multivariate regression model with moderation revealed that the effect of resilience on burden varied depending on the level of social support. Higher resilience was associated with higher burden in the "Poor Social Support" category, while it was associated with lower burden in the "Moderate Social Support" and "Strong Social Support" categories, although not statistically significant.

CONCLUSIONS

The study highlights the importance of GPs' social support and resilience in managing the burden of multimorbidity, with poor social support potentially worsening the effects of high resilience.

Psychological problems and related factors among primary healthcare staff in major cities in China during the COVID-19 pandemic

This study aimed to explore psychological problems and related factors among frontline primary healthcare workers who belongs to community health service centers and directly provides medical security services to community residents during the COVID-19 in Shanghai. We used a cross-sectional data analysis design to investigate the anxiety and depression levels of 929 frontline healthcare staff (primary healthcare providers, nurses, village doctors, and public health workers) during the Shanghai epidemic.The prevalence of depression among frontline primary healthcare workers was 39.7% (369 cases) and that of anxiety was 30%(279 cases). There was a significant correlation between the depression symptoms and anxiety symptoms. And factors associated with depression were being female, advanced education, expecting psychological interventions, expecting vacations as a reward, and expecting financial rewards. Factors strongly associated with anxiety were being female, expecting psychological interventions, and expecting vacations as a reward. Psychological problems among frontline primary healthcare workers merit more attention during the COVID-19 outbreak, especially those who are vulnerable (e.g., females and those with an advanced education).

Trajectory and predictors of adherence to Nucleos(t)ide analogues medication among patients with chronic hepatitis B

Objectives

To investigate the developmental trajectory of medication adherence and its predictors in chronic hepatitis B (CHB) patients taking nucleos(t)ide analogues.

Methods

A longitudinal study was conducted. Patients with CHB who met the inclusion criteria were selected using convenience sampling. Follow-ups were conducted at baseline, 3 months, 6 months, 9 months, and 12 months. Medication adherence was assessed using a medication adherence scale. Group-based trajectory modeling (GBTM) was used to explore medication adherence trajectories, and repeated measures ANOVA was used to describe changes in each trajectory. Unordered multinomial logistic regression analysis was used to explore predictive factors.

Results

A total of 305 patients completed all follow-ups. Medication adherence was categorized into four trajectory groups: low adherence (4.9 %), decreasing adherence (24.3 %), increasing adherence (48.2 %), and high adherence (22.6 %). Multinomial logistic regression results showed that HBV-infected discrimination, depression, self-efficacy, and social support were significantly different among different medication adherence levels (p < 0.05).

Conclusions

Medication adherence trajectories in patients with CHB exhibit heterogeneity. Healthcare professionals can develop personalized treatment plans based on patients' social and psychological characteristics to improve medication adherence.

What Determines Healthcare Workers to Seek Professional Psychological Support? A Cross-Sectional Study

AIM

Although healthcare workers often experience significant mental health challenges, their willingness to seek professional psychological help remains relatively low. However, the factors associated with healthcare workers' psychological help-seeking remain unclear. This study aims to identify the determinants of professional psychological help-seeking intention among healthcare workers based on the theory of planned behaviour.

DESIGN

Cross-sectional study.

METHODS

A questionnaire, incorporating demographic information and latent variable items, was developed and employed on 403 healthcare workers through online and offline surveys from December 2022 to January 2023 using convenience sampling. Structural equation modelling was applied to test the research hypotheses.

RESULTS

The model explained 46.9% of the variance in help-seeking intention. Subjective norm had the strongest total association with help-seeking intention. Attitude towards help-seeking behaviour, subjective norm and perceived behavioural control were directly positively related to help-seeking intention. Moreover, self-stigma, public stigma, perceived barriers and perceived risk were indirectly associated with help-seeking intention mediated by attitude towards the behaviour and perceived behavioural control. Of the four constructs, public stigma showed the most significant indirect relation to behavioural intention.

CONCLUSION

Healthcare workers' intention to seek psychological support is associated with multiple interacting factors, particularly subjective norm and public stigma. Targeted interventions addressing individual and systemic barriers are essential to create a supportive environment for healthcare workers to access mental health services.

IMPACT

This study identified key barriers and facilitators to healthcare workers seeking psychological support, which can assist authorities in enhancing mental health services and implementing tailored intervention strategies, thereby promoting help-seeking behaviour among healthcare workers. Moreover, our research reinforces the applicability of the theory of planned behaviour in explaining healthcare workers' intention to seek professional psychological support.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Inconsistency in psychological resilience and social support with mental health in early adolescents: A multilevel response surface analysis approach

BACKGROUND

Given the high prevalence of adolescent mental health problems, promoting understanding and implementation of protective factors is crucial for prevention and intervention efforts addressing adolescent mental health problems. This study aims to investigate whether consistency and inconsistency in protective factors are associated with adolescent mental health problems and to inform adolescent mental health interventions that target the unique needs of adolescents and promote adolescent mental health.

METHODS

We used multistage cluster sampling to conduct psychological resilience, social support, and mental health questionnaires from April to June 2023 among 10,653 Chinese adolescents (52.3 % were boys). Data were analyzed using polynomial regressions with response surface analysis.

RESULTS

The higher levels of psychological resilience and social support in adolescents were associated with fewer mental health problems (anxiety: a1 = -1.83, P < 0.001; depression: a1 = -2.44, P < 0.001; and perceived stress: a1 = -1.20, P < 0.001). When the level of psychological resilience was greater than social support, the greater the discrepancy the higher the perceived stress among adolescents (a3 = 1.19, P < 0.001). Moreover, the consistency of psychological resilience and social support had a greater impact on girls' mental health (anxiety: a1 = -1.97, P < 0.001; depression: a1 = -2.71, P < 0.001; perceived stress: a1 = -1.23, P < 0.001).

LIMITATIONS

The cross-sectional study design limited the inference of causal relationships between variables.

CONCLUSIONS

These results emphasize that adolescents need a balanced development of protective factors and targeted intervention programs for different mental health problems.

A novel prediction model for the probability of aggressive behavior in patients with mood disorders: Based on a cohort study

BACKGROUND

Accurately predicting the probability of aggressive behavior is crucial for guiding early intervention in patients with mood disorders.

METHODS

Cox stepwise regression was conducted to identify potential influencing factors. Nomogram prediction models were constructed to predict the probabilities of aggressive behavior in patients with mood disorders, and their performance was assessed using consistency index (C-index) and calibration plots.

RESULTS

Research findings on 321 patients with mood disorders indicated that being older (HR = 0.92, 95% CI: 0.86-0.98), single (HR = 0.11, 95% CI: 0.02-0.68), having children (one child, HR = 0.07, 95%CI: 0.01-0.87; more than one child, HR = 0.33, 95%CI: 0.04-2.48), living in dormitory (HR = 0.25, 95%CI: 0.08-0.77), non-student (employee, HR = 0.24, 95% CI: 0.07-0.88; non-employee, HR = 0.09, 95% CI: 0.02-0.35), and higher scores in subjective support (HR = 0.90, 95% CI: 0.82-0.99) were protective factors. On the contrary, minorities (HR = 5.26, 95% CI: 1.23-22.48), living alone (HR = 4.37, 95% CI: 1.60-11.94), having suicide history (HR = 2.51, 95% CI: 1.06-5.95), and having higher scores in EPQ-E (HR = 1.04, 95% CI: 1.00-1.08) and EPQ-P (HR = 1.03, 95% CI: 1.00-1.07) were identified as independent risk factors for aggressive behavior in patients with mood disorders. The nomogram prediction model demonstrated high discrimination and goodness-of-fit.

CONCLUSIONS

A novel nomogram prediction model for the probability of aggressive behavior in patients with mood disorders was developed, effective in identifying at-risk populations and offering valuable insights for early intervention and proactive measures.

Cross-cultural adaptation and psychometric properties of the Chinese version of the German social support questionnaire among older adults with chronic diseases

BACKGROUND

Social support is widely recognized as a protective factor against psychological distress, especially for the elderly with chronic diseases. Therefore, effective tools for measuring social support are of great significance for both research and clinical practice. This study aims to cross-culturally adapt the German Social Support Scale (F-SozU) into Chinese and assess its psychometric properties among older adults with chronic diseases.

METHODS

A cross-sectional study was conducted in a Chinese tertiary hospital. Four hundred ninety-six older adults that were approached via a convenience sampling method completed the Chinese version of the F-SozU. Content validity was evaluated using the two-round Delphi method. Psychometric properties, including item analysis, content validity, structure validity, convergent and discriminant validity and reliability were examined.

RESULT

The final version of C-F-SozU is a three-factor structure consisting of 23 items. All indicators of item analysis are acceptable. Adequate content validity was ensured by the expert panel (I-CVI = 0.80-1.00, S-CVI = 0.965) and participants. The confirmatory factor analysis model revealed that the factor structure of the C-F-SozU fitted the original scale (χ 2 /df = 2.088, CFI = 0.998, GFI = 0.943, TLI = 0.997, IFI = 0.998, RMSEA = 0.064 and SRMR = 0.043). The total Cronbach's α was 0.956, and the test-retest reliability coefficient was 0.887. The convergent validity (average variance extracted = 0.517-0.995) and discriminant validity were found to be satisfactory. No floor/ceiling effect was found.

CONCLUSION

The 23-item C-F-SozU demonstrates robust reliability and validity, rendering it a valuable instrument for evaluating social support among older adults with chronic diseases in China. The three-factor structure of the scale allows for a more detailed assessment of the social support, with the scores of each dimension and the total score being of significant reference value. More comprehensive studies may be required to confirm its effectiveness and applicability.

Emotional differences based on comments on doctor-patient disputes with varying levels of severity

BACKGROUND

The risks associated with negative doctor-patient relationships have seriously hindered the healthy development of medical and healthcare and aroused widespread concern in society. The number of public comments on doctor-patient relationship risk events reflects the degree to which the public pays attention to such events.

AIM

To explore public emotional differences, the intensity of comments, and the positions represented at different levels of doctor-patient disputes.

METHODS

Thirty incidents of doctor-patient disputes were collected from Weibo and TikTok, and 3655 related comments were extracted. The number of comment sentiment words was extracted, and the comment sentiment value was calculated. The Kruskal-Wallis H test was used to compare differences between each variable group at different levels of incidence. Spearman's correlation analysis was used to examine associations between variables. Regression analysis was used to explore factors influencing scores of comments on incidents.

RESULTS

The study results showed that public comments on media reports of doctor-patient disputes at all levels are mainly dominated by "good" and "disgust" emotional states. There was a significant difference in the comment scores and the number of partial emotion words between comments on varying levels of severity of doctor-patient disputes. The comment score was positively correlated with the number of emotion words related to positive, good, and happy) and negatively correlated with the number of emotion words related to negative, anger, disgust, fear, and sadness.

CONCLUSION

The number of emotion words related to negative, anger, disgust, fear, and sadness directly influences comment scores, and the severity of the incident level indirectly influences comment scores.

Quality of Life Among Breast Cancer Patients in Mures County, Romania: A Cross-Sectional Study

Background and aim Psychiatric pathology does not always start on its own but may be conditioned or triggered by a comorbidity with a high impact on the human psyche. When there are comorbidities, psychiatric pathology can occur due to the high diagnostic burden. Our study aims to find out if there is a correlation between the diagnosis of breast cancer and its severity, and psychiatric symptoms such as depressive mood, atypical anxiety, or even autolytic ideation that directly influence the quality of life of patients. Materials and methods The study is a prospective, cross-sectional, single-center study carried out between December 2023 and June 2024 at the Mureș County Clinical Hospital in Romania. The sample population had to be at least 18 years old and had to be diagnosed with breast cancer recently. We applied two tests, WHODAS 2 (World Health Organization's Disability Assessment Schedule 2.0) and level 1 (level 1 of cross-sectional measurements of symptoms), to be able to measure and aid assessment of mental health domains that are important across psychiatric diagnoses and also the degree of disability triggered by breast cancer. The statistical analysis included descriptive statistics and interferential statistics. Statistical tests, such as Shapiro-Wilk, Kruskal-Wallis, and Mann-Whitney U tests with Bonferroni correction tests, were used. The p-value was set to 0.05 with a confidence interval (CI) of 95%. Results The study included 120 women diagnosed with breast cancer, with a mean age of 56.64 ± 9.46 years. Regarding the severity of the diagnosis, 44 women (36.66%) had non-invasive cancer, 58 (48.33%) had invasive cancer, and 18 (15%) had metastases. There was a statistically significant difference between three of the five selected level 1 domains across cancer types. The WHODAS 2.0 disability scores showed a significant difference between groups (p < 0.001). Subjects with non-invasive cancer had the lowest WHODAS 2.0 score, followed by the invasive group, while metastases had the highest score. Conclusions Following the application of the two tests, level 1 and WHODAS 2.0, to our group of subjects, statistically significant differences were observed between the three categories of subjects. The degree of disability and the occurrence of psychological symptoms differed according to the severity of breast cancer. Adapting to the status of an oncological patient entails multiple changes from a psycho-emotional, social, occupational, and professional point of view. Although the most recent medications prolong survival, a holistic approach that considers psychological aspects can improve patients' long-term results.

Health inequality of rural-to-urban migrant workers in eastern China and its decomposition: a comparative cross-sectional study

Objectives

As a specific group with high health inequality, it is crucial to improve the health status and health inequalities of rural-to-urban migrant workers. This study aimed to evaluate the health inequality of migrant and urban workers in China and decompose it.

Methods

A cross-sectional study was carried out, using a standardized questionnaire to obtain basic information, self-rated health to evaluate health status, concentration index to measure health inequalities, and WDW decomposition to analyze the causes of health inequalities.

Results

The concentration index of health for migrants was 0.021 and 0.009 for urban workers. The main factors contributing to health inequality among rural-to-urban migrant workers included income, exercise, and age. In contrast, the main factors of health inequality among urban workers included income, the number of chronic diseases, social support, and education.

Conclusion

There were health inequalities in both rural-to-urban migrant and urban workers. The government and relevant authorities should formulate timely policies and take targeted measures to reduce income disparities among workers, thereby improving health inequality.

The physical activity and social support scale: a translation and psychometric validation study in a Chinese college student sample

Objective

This study aims to evaluate the reliability and validity of the Chinese version of the Physical Activity Social Support Scale (PASSS-C) and its measurement invariance across different gender groups in a Chinese college student sample.

Methods

A total of 1,689 Chinese college students participated in the study. We assessed the internal consistency of PASSS-C using Cronbach's alpha and McDonald's omega. A Confirmatory Factor Analysis (CFA) was conducted to test its five-factor model. Multi-group CFA was used to examine measurement equivalence between male and female groups. Convergent and criterion-related validity were assessed using Pearson correlation coefficients.

Results

The overall internal consistency of PASSS-C was good with a Cronbach's alpha of 0.952, and the subscales showed acceptable consistency. The CFA results supported the five-factor structure of PASSS-C in the college student sample, with values of CFI = 0.932, TLI = 0.917, RMSEA = 0.048, 90% CI [0.043 0.053], SRMR = 0.047. Scalar invariance was also supported across different gender groups, with ΔCFI = -0.003, ΔTLI = 0, ΔRMSEA = 0. PASSS-C demonstrated good convergent and criterion-related validity.

Conclusion

PASSS-C exhibits satisfactory psychometric properties and is a valid and reliable tool for assessing the perceived level of social support for physical activity among college students.

Research on the risk governance of fraudulent reimbursement of patient consultation fees

Background

The fundamental medical insurance fund, often referred to as the public's "life-saving fund," plays a crucial role in both individual well-being and the pursuit of social justice. Medicare fraudulent claims reduce "life-saving money" to "Tang's monk meat", undermining social justice and affecting social stability.

Methods

We utilized crawler technology to gather textual data from 215 cases involving fraudulent health insurance claims. Simultaneously, statistical data spanning 2018 to 2021 was collected from the official websites of the China Medical Insurance Bureau and Anhui Medical Insurance Bureau. The collected data underwent comprehensive analysis through Excel, SPSS 26.0 and R4.2.1. Differential Auto-Regressive Moving Average Model (ARIMA (p, d, q)) was used to fit the fund safety forecast model, and test the predictive validity of the forecast model on the fund security data from July 2021 to October 2023 (the fund security data of Anhui Province from September 2021 to October 2023).

Results

The outcomes revealed that fraudulent claims by health insurance stakeholders adversely impact the equity of health insurance funds. Furthermore, the risk management practices of Medicare fund administrators influence the publication of fraudulent claims cases. Notably, differences among Medicare stakeholders were observed in the prevalence of fraudulent claims. Additionally, effective governance of fraudulent claims risks was found to have a positive impact on the overall health of healthcare funds. Moreover, the predictive validity of the forecast model on the national and Anhui province's fund security data was 92.86% and 100% respectively.

Conclusion

We propose four recommendations for the governance of health insurance fraudulent claims risk behaviors. These recommendations include strategies such as "combatting health insurance fraudulent claims to preserve the fairness of health insurance funds", "introducing initiatives for fraud risk governance and strengthening awareness of the rule of law", "focusing on designated medical institutions and establishing a robust long-term regulatory system", and "adapting to contemporary needs while maintaining a focus on long-term regulation".

Application of free serratus anterior muscle-fascial composite tissue flap and facial lipofilling in repairing progressive hemifacial atrophy

INTRODUCTION

Progressive hemifacial atrophy (PHA) is a nonnegligible disease, and its treatment currently lacks consensus. We aim to conduct an analysis of PHA patients to summarize the postoperative effect. Moreover, we introduced the free serratus anterior muscle-fascial composite tissue flap as a safe and novelty surgical procedure for moderate-severe PHA.

METHODS

This clinical study included four patients who received a free serratus anterior muscle-fascial composite tissue flap and 19 patients who received Coleman fat transplantation. Preoperative (preoperative photograph and imageological examination) and postoperative (postoperative photograph, complications, therapeutic effect, and satisfaction) assessments were performed for all PHA patients. Body Image Concern Inventory (BICI), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) were performed preoperatively and postoperatively.

RESULTS

All the cases were cured with a good appearance with two kinds of operations. Free serratus anterior muscle-fascial composite tissue flap could correct face defects in one surgery and achieve good long time and short-time postoperative satisfaction in moderate-severe PHA. Fat transplantation could also enhance appearance in numerous operations for mild-moderate PHA. The volume of free-fat grafts decreased obviously after implantation in many cases. So, many patients (42.11%) accepted a series of operations to achieve satisfied postoperative effect. BICI, SAS, SDS score decreased a year later in all patients.

CONCLUSION

Free serratus anterior muscle-fascial composite tissue flap transplantation is an effective and safe treatment for moderate to severe PHA.

Study on the status and problems of teaching system of "medical advanced mathematics": data based on a research of 11 universities in China

BACKGROUND AND AIM

Driven by Innovation 2.0 (the information age, the innovation form of the knowledge society), the form evolved by the Internet development, giving rise to economic and social development ("Internet +"). With this background, a novel approach is presented for fostering excellence in physicians, aligning with the contemporary demands of our era.

METHODS

Self-administered questionnaire was used to facilitate the collection of data on medical advanced mathematics course offerings, distribution of teaching hours of each major and the perception of the course teaching system in 11 medical universities in China. The distribution of course offerings in each major was analyzed, and one-sample t-test was conducted on the perspectives of course offerings, content settings (theoretical & practical), educational objectives, teaching reforms, and Synthetical Sensation (SS) of the curriculum system and educational model.

RESULTS

The study included various specialties such as clinical medicine, pharmacy, public health, health management, and life sciences, all of which offered advanced mathematics course. The content of medical mathematics textbooks was designed to meet the practical needs of relevant professions, and encompass online laboratory classes and social practice. However, a noticeable misalignment was observed between the content of medical mathematics courses and the realistic requirements of professions (t = -3.614~-3.018, P < 0.05). The perceived difference in the completeness of curriculum systems was not significantly apparent. There was a difference in the perception of the effectiveness of teaching reforms (t = -4.485, P < 0.05), and there was a difference in the perception of the synthesis of the educational model in all cases (t = -5.067, P < 0.05).

CONCLUSION

There are localized differences in curricula, and the number of course hours is basically reasonable; course content needs to be updated; the implementation of course objectives is not in place; the curriculum system can meet the needs of talent training; the innovation of the education model needs to be put into practice; and there are obvious differences in the comprehensive cognition of the teaching system and the education model. Based on the analysis of the problems, we build a new STC teaching mode with smart classroom based on "professional needs, practical needs and requirements for cultivating excellent physician talents".

Acceptance Factors and Psychological Investigation of Clinical Trials in Cancer Patients

Aim

To understand the degree of oncology patients' awareness of drug clinical trials and oncology patients' willingness to participate in drug clinical trials and the factors influencing them.

Methods

The differences in the relevant variables of patients' willingness to accept clinical trials were analyzed, and a descriptive analysis was done for the measurement data (mean and standard deviation). Pearson's correlation coefficient analysis was used to examine the correlation between willingness and the demographic variables. Stepwise regression analysis was used to explore the influencing factors of patients' willingness to accept clinical trials.

Results

There were no statistical differences in age, gender, education level, marital status, place of residence, monthly income, medical payment method, and treatment time (P > 0.05). Patients' willingness to accept drug clinical trials differed in their cognitive degree of clinical drug trials (P = 0.002). Patients' willingness to accept drug clinical trials differed in their experience in clinical trials (P < 0.001). The correlation difference was statistically significant. The willingness to accept drug clinical trials was negatively correlated with treatment time (R = -0.16, P < 0.05) and positively correlated with awareness of clinical trials and whether they had been subjects (R = 0.16 and 0.43, P < 0.05). Multiple regression analysis showed that patients' willingness was directly influenced by age, treatment time, and whether they had been subjects (F = 21.315, P < 0.001).

Conclusion

Age, treatment time, and whether they had been subjects were the direct influencing factors of patients' willingness. This study pointed out that hospitals should do a good job in the publicity of clinical trials of new drugs, expand publicity channels, increase publicity efforts, improve the awareness of clinical trials of the masses, and promote the enthusiasm of the masses to participate in clinical trials of drugs.

Relationship between perceived social support and mental health among Chinese college football athletes: a moderated mediation model

Previous researches have confirmed that perceived social support has a profound effect on individuals' mental health. However, the effects and potential mechanisms of perceived social support on mental health of college athletes are still largely unknown, especially during and after the COVID-19 pandemic. Thus, the aim of this study was to explore the relationship between perceived social support and mental health in college football athletes, and to evaluate whether hopelessness and psychological pressure affected this relationship. A sample of 672 Chinese college football athletes (37.9% girls; Mage = 20.43 years; SDage = 1.68) were investigated with the Perceived Social Support Scale (PSSS), the Kessler Psychological Distress Scale (K10), the Beck Hopelessness Scale (BHS) and the Perceived Stress Scale (PSS). Surveys were voluntary and anonymous. The findings revealed that, after adjusting for demographic factors, hopelessness mediated the relationship between Chinese college football athletes' perceived social support and their mental health. Furthermore, psychological pressure moderated the negative association between perceived social support and hopelessness, and the association was stronger for them with high-level psychological pressure. These results underline the need for focused strategies in the prevention and treatment of mental health issues among Chinese college football athletes.

Adverse outcomes and health-ecological influencing factors of preoperative frailty among elderly patients with gastric cancer

PURPOSE

Frailty is defined as a state of decreased physiologic reserves arising from cumulative deficits in multiple homeostatic systems, which is important in the field of clinical oncology. We aimed to explore the relationship between preoperative frailty and adverse outcomes, and systematically analyze the factors influencing frailty based on the health ecology model among elderly gastric cancer patients.

METHODS

A observational study was conducted to select 406 elderly patients who would undergo gastric cancer surgery at a tertiary hospital. The logistic regression model was used to examine the relationship between preoperative frailty and adverse outcomes, including total complications, prolonged length of stay (PLOS), and 90-day hospital readmission. Based on the health ecology model, the factors which may influence frailty were collected from four levels. Univariate and multivariate analysis were utilized to determine the factors influencing preoperative frailty.

RESULTS

Preoperative frailty was associated with total complications (odds ratio [OR] 2.776, 95% confidence interval [CI] 1.588-4.852), PLOS (OR 2.338, 95%CI 1.342-4.073), and 90-day hospital readmission (OR 2.640, 95% CI 1.275-5.469). Besides, nutritional risk (OR 4.759, 95% CI 2.409-9.403), anemia (OR 3.160, 95% CI 1.751-5.701), number of comorbidity ≥ 2 (OR 2.318, 95% CI 1.253-4.291), low physical activity level (OR 3.069, 95% CI 1.164-8.092), apathetic attachment (OR 2.656, 95% CI 1.457-4.839), personal monthly income ≤ 1000 yuan (OR 2.033, 95% CI 1.137-3.635) and anxiety (OR 2.574, 95% CI 1.311-5.053) were independent risk factors for frailty. High physical activity level (OR 0.413, 95% CI 0.208-0.820) and improved objective support (OR 0.818, 95% CI 0.683-0.978) were independent protective factors for frailty.

CONCLUSIONS

Preoperative frailty was associated with multiple adverse outcomes and could be affected by factors of different dimensions from the health ecology perspective, including nutrition, anemia, comorbidity, physical activity, attachment style, objective support, anxiety, and income, which can guide the formation of a comprehensive prehabilitation for frailty among elderly gastric cancer patients.

How Does the Design of Consultation Pages Affect Patients' Perception of Physician Authority and Willingness to Seek Offline Treatment: A Randomized Controlled Trial

This study aimed to assess the impact of the color and font size of a dialogue box on an online physician-patient interaction page on patients' perceptions of the physician's authority and their willingness to schedule an offline appointment. A 2 × 2 between-group experiment was conducted to compare the effects of two dialogue box colors (gold vs. grey) and two font sizes (large vs. regular) on patients' perceptions. The results showed that a larger font size had a significant positive impact on patients' perceptions of the physician's authority, and the use of a gold-colored dialogue box also had a significant positive effect. A significant interaction was found between the dialogue box color and font size and patients' perceptions of the physician's authority. In addition, it was found that positive perceptions of the physician's authority significantly affected patients' willingness to schedule offline appointments and played a fully mediating role in the path of page design affecting offline appointment intentions. This study provides evidence that the design elements of a dialogue box-particularly, its color and font size-can influence patients' perceptions of a physician's authority and their willingness to schedule an offline appointment. These findings suggest that modifying the page design could improve the effectiveness of physician-patient communication.

A cross-sectional study factors associated with resilience among medical staff in radiology departments during COVID-19, Riyadh, Kingdom of Saudi Arabia

OBJECTIVES

This study aims to assess the level of resilience of medical workers in radiology departments in Riyadh, Kingdom of Saudi Arabia, during the COVID-19 outbreak and to explore associated factors.

SETTING

Medical staff, including nurses, technicians, radiology specialists and physicians, working in radiology departments at government hospitals in Riyadh, Saudi Arabia during the COVID-19 outbreak.

DESIGN

A cross-sectional study.

PARTICIPANTS

The study was conducted among 375 medical workers in radiology departments in Riyadh, Kingdom of Saudi Arabia. The data collection took place from 15 February 2022 to 31 March 2022.

RESULTS

The total resilience score was 29.37±6.760 and the scores of each dimension showed that the higher mean score was observed in the domain of 'flexibility', while the lowest was observed in 'maintaining attention under stress'. Pearson's correlation analysis showed that there was a significant negative correlation between resilience and perceived stress (r=-0.498, p<0.001). Finally, based on multiple linear regression analysis, factors affecting resilience among participants are the availability of psychological hotline (available, B=2.604, p<0.050), knowledge of COVID-19 protective measures (part of understanding, B=-5.283, p<0.001), availability of adequate protective materials (partial shortage, B=-2.237, p<0.050), stress (B=-0.837, p<0.001) and education (postgraduate, B=-1.812, p<0.050).

CONCLUSIONS

This study sheds light on the level of resilience and the factors that contribute to resilience in radiology medical staff. Moderate levels of resilience call for health administrators to focus on developing strategies that can effectively help cope with workplace adversities.

The Role of Subjective Wellbeing in Mediating Social Trust to the Mental Health of Health Workers

Mental health problems of health workers are attracting increasing concerns in China and the world. A trustful relationship between health workers and patients is the foundation of quality patient care, which is currently under serious threat. This study aimed to determine the associations of social trust on subjective wellbeing and mental health of health workers. Using the survey data of 262 health workers extracted from the 2018 Chinese Family Panel Studies, a structural equation model with partial least square approach was established. The results showed that social trust was linked to both subjective wellbeing (β = 0.251, p < 0.01) and mental health (β = -0.210, p < 0.01). The effect of social trust on mental health was partially mediated by subjective wellbeing (51.87%). The association between social trust and subjective wellbeing was moderated by socioeconomic status: social trust has a stronger effect on subjective wellbeing in those with higher socioeconomic status. Erosion of social trust may present a serious risk to mental health and subjective wellbeing of health workers. High socioeconomic status can amplify the effect of social trust.

An Empirical Study on Physical Subhealth Risk Perception: A Physical Examination Data of Tertiary Grade-A Hospitals in Anhui Province, China

Background

Physical subhealth directly correlates to people's work effectiveness and quality of life, so subhealth prevention has become an urgent medical problem.

Methods

A random sampling method was used to conduct a questionnaire survey of physical examinees from June to September, 2019. In total, 770 people participated in our study. The Pearson correlation and multiple stepwise regression analysis were used to explore the relationship among demographic variables, physical subhealth, and risk perception. Also, this study used a two-way interaction moderated multiple regression approach to examine the moderating effects of demographic variables on physical subhealth and risk perception.

Results

The risk perception level was negatively associated with physical health. Age, education level, and subhealth proportion in the work unit all significantly and positively influence physical health, whereas living place, subhealth duration, and marital status negatively influence physical health. Living place, average annual household income, number of employees in the work unit, and subhealth proportion in the work unit significantly and positively influence the risk perception, and only age negatively influences the risk perception. The number of children had a moderating effect on physical subhealth and risk perception (Interaction coefficient α = -0.3, P < 0.05).

Conclusions

To achieve the overall improvement of public health, relevant management departments can provide targeted interventions for the public with different levels of risk perception. Also, the physical subhealth of the public can be addressed by encouraging the public to attach importance to education, improving the public living environment to build a livable city, strengthening psychological guidance and intervention for couples heading toward divorce to reduce the divorce rate, focusing on the health of work unit employees and regularly organizing employees to attend medical checkups, and actively responding to the national policy of family planning.

Association between social supports and negative emotions among pediatric residents in China: The chain-mediating role of psychological resilience and burnout

Background

Chinese pediatricians are facing challenges, and there is a need to examine the issue of negative emotions, namely, stress, anxiety and depression, among front-line pediatric residents in clinical settings. Understanding the current situation and influencing factors of negative emotions among pediatric residents in China and exploring the formation mechanism can lay a foundation for psychological interventions.

Methods

A total of 138 pediatric residents in the Children's Hospital, Zhejiang University School of Medicine, China, were surveyed using the Depression Anxiety Stress Scale-21 (DASS-21), Social Support Rating Scale (SSRS), Connor-Davidson Resilience Scale (CD-RISC), and Maslach Burnout Inventory-General Survey (MBI-GS).

Results

(1) The incidence of abnormal stress, anxiety, and depression among pediatric residents was 18.8%, 47.8%, and 47.8% respectively. (2) Negative emotions were significantly negatively correlated with social supports and psychological resilience, and positively correlated with burnout. (3) The chain-mediating effect of resilience and burnout between social supports and negative emotions was significant.

Conclusion

Psychological resilience and burnout played a chain-mediating role between social supports and negative emotions. Measures should be taken to improve the mental health of Chinese pediatric residents.

The risk assessment of relapse among newly enrolled participants in methadone maintenance treatment: A group-LASSO based Bayesian network study

Background

Relapse is a great barrier to improving the effectiveness of methadone maintenance treatment (MMT). Participants with different treatment durations could vary in their compliance with MMT, which may lead to different levels of relapse risk. This study aims to identify the risk factors for relapse and assess the relapse risk of MMT participants of different treatment durations.

Method

This retrospective study used data collected from seven MMT clinics in Guangdong Province, China, from January 2010 to April 2017. Newly enrolled participants who received 6 (n = 903) and 12 (n = 710) months of consecutive treatment with complete data were included. We selected significant risk factors for relapse through the group lasso regression and then incorporated them into Bayesian networks to reveal relationships between factors and predict the relapse risk.

Results

The results showed that participants who received 6-month treatment had a lower relapse rate (32.0%) than those of 12-month treatment (39.0%, P < 0.05). Factors including personal living status and daily methadone dose were only influential to those who received the 6-month treatment. However, age, age at the initial drug use, HIV infection status, sexual behaviors, and continuous treatment days were common factors of both durations. The highest relapse risk for those after the 6-month treatment was inferred as 66.7% while that of the 12-month treatment was 83.3%. Farmers and those who have high accessibility to MMT services may require additional attention.

Conclusion

It is necessary to implement targeted interventions and education based on the treatment durations of participants to decrease the relapse rate. Meanwhile, those about HIV/sexually transmitted infection prevention and anti-narcotics should be held in the whole process.

Association between social support and depressive symptoms among Chinese nurses with formal employment versus contract-based employment

BACKGROUND

Inequalities may exist in social and health status among nurses with different employment types. Few studies have investigated the relationship between social support and depressive symptoms among formally employed nurses compared with those in contract-based employment. This study aimed to examine the associations between social support and depressive symptoms among Chinese nurses with different forms of employment.

METHODS

The present cross-sectional study was performed with 1,892 nurses from 12 tertiary hospitals in Shandong Province, China. The Social Support Rating Scale and the 10-item Center for Epidemiologic Studies Depression Scale were used to measure social support and depressive symptoms, respectively. The association between social support and depressive symptoms among participants was explored using multiple linear regression analysis.

RESULTS

The prevalence of depressive symptoms was 45.7%. The mean score for total social support was 40.16 (SD = 7.47), which was lower than the norms in the general Chinese population. Formally employed participants' total social support scores were statistically significantly higher than those of contract-based employees (p ≤ 0.05). After controlling for confounding factors, the multiple linear regression analysis showed that subjective support and support utilization scores were inversely associated with depressive symptoms. Objective support scores were negatively associated with depressive symptoms only among contract-employment nurses.

CONCLUSION

Chinese nurses have a higher prevalence of depressive symptoms and lower social support than the Chinese general population. Compared with contract-employment nurses, formally employed nurses had higher social support. Inverse associations exist between social support and depressive symptoms among nurses with different types of employment. It is suggested that improving Chinese nurses' social support levels and reducing their depressive symptoms, especially for nurses employed through contracts, are critical.

ANALYSIS OF THE RESULTS OF A MEDICAL AND SOCIOLOGICAL SURVEY OF HEALTHCARE PROVIDERS ON MOTIVATIONAL COMPONENT OF ENSURING THE HEALTHCARE QUALITY

OBJECTIVE

The aim: To identify the main motivational components of improving the healthcare quality in health care providers in Sumy.

PATIENTS AND METHODS

Materials and methods: The study involved data obtained from 187 doctors working in primary health care institutions, inpatient and outpatient departments of health care institutions in Sumy, during September-November 2020. The study used systematic, bibliosemantic approaches, comparative and statistical analysis, and logical generalization. The obtained data were processed and statistically analyzed with Google Forms and Microsoft Excel 2010 Windows.

RESULTS

Results: The analysis of data received from the surveyed group of respondents showed that 83 doctors (44.39%) have 11-15 years' work experience, 51 people (27.27%) - 6-10 years, 40 people (21.39%) have up to 5 years of work experience and 13 people (6.95%) - more than 15 years. Most doctors (114 people (60.96%)) work for one position, 39 people (20.86%) work for less than one, while 34 people (18.18%) work for more than one position. The number of doctors who indicated that they were mostly overworked during the working day was 123 (65.77%), another 46 (24.60%) indicated that they were overworked during the working day correspondingly to their workload at occupied position, and 18 respondents (9.63%) answered that they were not fully loaded. At the same time, 91.98% of people indicated that the actual amount of their salary does not correspond to the workload, and there is no financial stimulation system for medical care quality increasing (87.70% of responses).

CONCLUSION

Conclusions: The study showed that the healthcare facilities where the respondents work do not have an effective system of staff motivation for work quality (79.14% of responses). It was found that doctors are ready to work harder and better for additional pay, despite the high level of workload (88.24% of responses), and consider it necessary to introduce an effective stimulation system to improve the quality of medical services (96.79% of responses).

Questionnaire development on measuring parents’ anxiety about their children’s education: Empirical evidence of parental perceived anxiety data for primary and secondary school students in China

Background

With the implementation of the “double reduction” policy in China, parents of primary and secondary school students are experiencing a growing trend of educational anxiety that needs to be alleviated.

Objective

To manage the education anxiety risk of parents of primary and secondary school students, a measurement questionnaire of parents’ anxiety about their children’s education (MQPAE) was developed and its reliability and validity were evaluated.

Methods

A self-administered MQPAE was developed. An online crowdsourcing questionnaire platform was used to collect data on parents’ anxiety about their children’s education (PAE), and parents of primary and secondary school students in Hefei, China, were selected as the study population. The randomly extracted 5,747 questionnaires were gradually screened by discrete trend method, t-test, and Pearson’s correlation coefficient method for the initial screening of PAE items, based on which exploratory factor analysis (EFA) was conducted for the final screening of questionnaire items and the reliability of the questionnaire. The reliability of the questionnaire was assessed by internal consistency and Pearson’s correlation coefficient analysis. Confirmatory factor analysis (CFA) was conducted using 639 pre-selected data to investigate the validity of the questionnaire. Structural equation modeling was used to investigate the structural validity of the questionnaire, and average variance extracted (AVE), combined reliability (CR), and maximum of shared squared variance (MSV) were used to test for convergent and discriminant validity.

Results

Exploratory factor analysis extracted five factors with a cumulative variance contribution of 65.66%. The CFA showed that χ²/df = 4.306, CFI = 0.920, NFI = 0.898, RMSEA = 0.072<0.08, AGFI = 0.839>0.80, PNFI = 0.793 and PGFI = 0.708. The overall Cronbach’s α coefficient of the questionnaire was 0.956, and the factors’ Cronbach’s α coefficients were 0.926, 0.857, 0.913, 0.901, and 0.768, respectively. Repeated measurements of Pearson’s correlation coefficients were 0.908, 0.911, 0.873, 0.891, 0.907 and 0.885 (all p < 0.001). The AVE was greater than 0.5 and the CR was greater than 0.7, and the value of the MSV was less than the corresponding AVE.

Conclusion

The MQPAE has good reliability and validity and can be used in studies related to PAE of primary and secondary school students.

Relationship between social support, anxiety, and depression among frontline healthcare workers in China during COVID-19 pandemic

Background

Social support is an important factor affecting individual mental health. However, the relationship between social support and mental health in frontline healthcare workers (FHW) during the coronavirus disease 2019 (COVID-19) pandemic has garnered less attention. In this study, we aimed to investigate the level of social support and the prevalence of depression and anxiety in FHW during the COVID-19 pandemic and determine the factors affecting the relationship between social support, depression, and anxiety.

Methods

A cross-sectional study using an online survey was conducted to collect data from FHW between 15 February and 31 March 2020 in China. The data included demographic factors, Self-rated Depression Scale (SDS), Self-rated Anxiety Scale (SAS), and Social Support Rate Scale (SSRS). Spearman correlation test was performed to determine the correlation among SAS, SDS, and SSRS scores. Multiple linear regression analysis was performed to determine the relationship among demographic factors, social support, depression, and anxiety in FHW.

Results

Of all 201 participants, 44 (21.9%) had depressive symptoms and 32 (15.9%) had anxiety symptoms. The average total SSRS scores among FHW were lower than that of the norms of the Chinese general population (37.17 ± 7.54 versus 44.38 ± 8.38, P < 0.001). Marital status positively affected the SSRS score (β = 7.395, P < 0.01). Age over 40 years old negatively affected the SSRS score (β = -5.349, P = 0.017). The total SSRS score, subjective social support score, objective social support score, and support utilization score among FHW negatively correlated with the SAS score and SDS score (P < 0.05). A lower support utilization score was significantly associated with high anxiety and depressive symptoms (β = -0.869, P = 0.024; β = -1.088, P = 0.035, respectively).

Conclusion

During the COVID-19 pandemic, FHW experienced depression, anxiety, and inadequate social support. The marital status and age had a major impact on social support. Social support was inversely associated with depression and anxiety. Improving the mental health of FHW by strengthening social support is crucial. Future studies are needed to investigate how to improve the level of social support and mental health condition of FHW facing public health emergencies in the future.

Prevalence and risk factors for vascular calcification based on the ankle-brachial index in the general population: a cross-sectional study

Background

To investigate the prevalence of vascular calcification based on the ankle‐brachial index (ABI) value and analyse the risk factors for vascular calcification in the general population.

Methods

A cross-sectional study was conducted to collect clinical, laboratory, and lifestyle data in individuals aged 30–70 recruited from the physical examination centre. The automatic arteriosclerosis detector was used to measure the ABI. Difference tests, correlation analyses, and multivariate logistic regression analyses were performed to identify risk factors for vascular calcification.

Results

The overall prevalence of vascular calcification was 24.39% in 1033 subjects. The prevalence of vascular calcification in males was much higher than that in females (27.80% vs. 17.49%, P < 0.001). The differences in age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), hypertension, and fatty liver disease were statistically significant in males (P < 0.05). The differences between serum uric acid (UA), total cholesterol (TC), TG, low-density lipoprotein cholesterol (LDL-C), estimated glomerular filtration rate (eGFR), alcohol consumption, exercise, and postmenopausal status were statistically significant in females (P < 0.05). Increased age (odds ratio (OR) = 1.028, 95% confidence interval (CI) 1.008–1.049, P = 0.007), increased BMI (OR = 1.238, 95% CI 1.147–1.337, P < 0.001) and elevated DBP (OR = 2.563, 95% CI 1.262–5.205, P = 0.009) were independent risk factors for vascular calcification in males after adjusting for confounding factors. Increased BMI (OR = 1.159, 95% CI 1.029–1.304, P = 0.015), elevated UA (OR = 1.545, 95% CI 1.077–2.216, P = 0.018), elevated LDL-C (OR = 1.044, 95% CI 1.060–1.027, P < 0.001), and a lack of exercise (OR = 2.402, 95% CI 1.073–5.373, P = 0.033) were independent risk factors for vascular calcification in females.

Conclusions

The prevalence of vascular calcification based on the ABI value is also high in the general population of our centre. Increased age, BMI, and elevated DBP are independent risk factors for vascular calcification in males. Increased BMI, UA, LDL-C, and a lack of exercise are independent risk factors for vascular calcification in females. Attention should be given to strengthening the prevention and control of vascular calcification in the general population.

Prevalence and correlates of psychological distress and coronavirus anxiety among hospital essential services workers in Singapore

INTRODUCTION

The COVID-19 pandemic has affected almost all populations, with frontline workers experiencing a higher risk of mental health effects compared to other groups. Although there are several research studies focusing on the mental health effects of the pandemic on healthcare workers, there is little research about its impact on workers in outsourced hospital essential services. This study aims to examine the prevalence and correlates of psychological distress and coronavirus anxiety among staff working in 3 outsourced hospital essential services-housekeeping, porter service and maintenance services.

METHODS

A cross-sectional study was conducted among outsourced hospital essential services workers in a tertiary hospital. Data on demographics, medical history, lifestyle factors, psychosocial factors and mental well-being were collected using self-administered questionnaires. Robust logistic regression was used to determine risk factors associated with psychological distress and dysfunctional anxiety related to COVID-19.

RESULTS

A total of 246 hospital essential services workers participated in the study. The prevalence of psychological distress was 24.7%, and dysfunctional anxiety related to COVID-19 was 13.4%. Social support and workplace support were found to be independently associated with a lower risk of psychological distress, and social connectivity was associated with a lower risk of dysfunctional anxiety related to COVID-19.

CONCLUSION

These findings highlight the crucial roles of communities and workplaces in combating the mental health consequences of the pandemic. Public health programmes that aim to tackle the emerging mental health crisis in hospital essential services workers should incorporate strategies to address psychosocial factors, in addition to traditional self-care approaches.

The Relationship between Emotional Stability, Psychological Well-Being and Life Satisfaction of Romanian Medical Doctors during COVID-19 Period: A Cross-Sectional Study

Due to the COVID-19 pandemic, as well as the fast progression of modern society, occupational stress has recently reached alarming levels with consequences for doctors’ psychological well-being. The aim of this study was to analyze the relationship among emotional stability, psychological well-being, and life satisfaction of medical doctors. We conducted a cross-sectional study on 280 medical doctors from Romania between February 2021 and September 2021, in the period between the third and fourth pandemic waves, who were evaluated by the DECAS, ASSET, and Satisfaction with Life scales. Our results showed that emotional stability is negatively correlated with psychological well-being (r = −0.526, p < 0.000) and positively correlated with life satisfaction (r = 0.319, p < 0.0001). Between psychological well-being and life satisfaction, we found a negative correlation (r = −0.046, p < 0.001). This study shows that there is a correlation among emotional stability, psychological well-being, and life satisfaction, which is why it can be considered that Romanian doctors have generated coping mechanisms during the COVID-19 pandemic.

Subhealth Risk Perception Scale: Development and Validation of a New Measure

Background

To develop an individual's physical subhealth risk perception scale and evaluate its reliability and validity, so as to provide a measurement tool for individual physical health risk.

Methods

A questionnaire on the perception risk of physical subhealth was developed. Using a random sampling method, 785 people in the Anhui provincial physical examination centre were selected as the research participants. Of the questionnaires returned, 770 were valid, giving an effective rate of 98%. Firstly, the Pearson correlation coefficient method was used to study the correlation of 35 items in the initial scale, and then, polychoric factor structure analysis was carried out by using the Pratt D matrix to optimize the item structure. The Cronbach'α coefficient method was used to test the internal consistency reliability, and a structural equation model was used to explore the construct validity of the scale. The discriminant validity of the scale was obtained by factor analysis. A general linear model was used to analyse the relationship between the clinical manifestations of physical subhealth and the level of risk perception, and the convergent validity of the scale was evaluated.

Results

All the data of 35 items were significantly correlated at the 0.01 level. The correlation coefficients between a1 and a2, a3 and a4, b1 and b2, b2 and b3, c4 and c5, c5 and c6, c6 and c7, c8 and c9, d1 and d2, d2 and d3, e5 and e6, g1 and g2, g2 and g3, and g2 and g4 were greater than 0.6. The items with correlation coefficients greater than 0.6 were reduced by a Pratt D matrix. The resulting physical subhealth risk perception scale covers five factors with a total of 18 items. The Cronbach'α coefficient of the scale was 0.889, and the Cronbach'α coefficients of the five factors F1-F5 were 0.780, 0.825, 0.801, 0.736, and 0.704, respectively. Structural equation model analysis showed that χ²/df = 3.43, p < 0.001, RMSEA = 0.08, GFI = 0.88, NFI = 0.84, AGFI = 0.84, and CFI = 0.88. Factor analysis showed that factors F1–F5 had significant correlations (p < 0.01), and the correlation coefficients were less than the corresponding square root value of AVE. Based on the subhealth clinical manifestations of the participants, the general linear model was used to explore the convergent validity of the scale, and the results indicated that the scale passed the convergent validity test.

Conclusions

We propose a physical subhealth risk perception scale amounting to 18 items, which includes five dimensions: health knowledge (2 items), risk perception (5 items), trust selection (4 items), information channel (4 items), and social groups (3 items). The reliability and validity of the physical subhealth risk perception scale are acceptable. Applying the scale into practice has potential to improve the overall public health level.

Mental Health and Resilience among Nurses in the COVID-19 Pandemic: A Web-Based Cross-Sectional Study

Objective: Nurses exposed to COVID-19 could be psychologically stressed. The present study investigated the mental health and the resilience level in the nurses' population. Method: This cross-sectional study was performed on 432 nurses in 27 hospitals working in Guilan province, north of Iran, between April 29, to May 14, 2020. Mental health and resilience were measured using the 12-item General Health Questionnaire-12 (GHQ-12) and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Hierarchical multiple linear regression model was used to identify factors associated with mental health. Results: The mean GHQ-12 and CD-RISC-10 scores were 15.72 (SD, 5.67) and 25.97 (SD, 6.88), respectively. Probable psychological distress (GHQ-12 score ≥ 15) was present in 57.2% of nurses. Among demographic and COVID-19-related variables, only educational level was significantly and negatively correlated with mental health. After controlling the variables, hierarchical regression analyses results showed that lower resilience was associated with poor mental health (β = -0.49; P < 0.001). Conclusion: Regarding the nurses' mental health, appropriate psychological/psychiatric intervention is necessary, and resilience can play a role as a mental health promoter.

Prevalence of common mental health issues among migrant workers: A systematic review and meta-analysis

Previous literature has shown that migrant workers manifested higher common mental issues (especially depressive symptom) compared to local workers due to stressors such as financial constraint and lack of access to healthcare. The aim of this systematic review and meta-analysis is to summarize the current body of evidence for the prevalence of depression and anxiety among migrant workers as well as exploring the risk factors and the availability of social support for migrant workers. Seven electronic databases, grey literature and Google Scholar were searched for studies from 2015 to 2021 related to mental health, social support and migrant workers. Study quality was assessed using the Newcastle Ottawa Scale and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Study heterogeneity was evaluated using I2 statistics. Random effects meta-analysis results were presented given heterogeneity among studies. The search returned 27 articles and only seven studies were included in meta-analysis, involving 44 365 migrant workers in 17 different countries. The overall prevalence of depression and anxiety among migrant workers was 38.99% (95% CI = 0.27, 0.51) and 27.31% (95% CI = 0.06, 0.58), respectively. Factors such as age, biological (health issue, family history of psychiatric disorder), individual (poor coping skills), occupational (workplace psychosocial stressors, poor working condition, salary and benefits issue, abuse), environmental (limited access towards healthcare, duration of residence, living condition) and social factor (limited social support) were associated with a mental health outcome in migrant workers. The availability of social support for migrant workers was mainly concentrated in emotional type of support. A high prevalence of depression and anxiety was found among migrant workers across the globe. This finding warrants a collective effort by different parties in providing assistance for migrant workers to promote their mental well-being.

Childhood Emotional Neglect Is Associated With Low Social Support in Chinese Patients With Major Depressive Disorder

Background: Previous studies have shown that childhood maltreatment (CM) is closely associated with social support in the general population. However, little is known about the associations of different types of CM with social support in Chinese patients with major depressive disorder (MDD), which was the goal of the current study. Methods: One hundred and sixty-six patients with moderate-to-severe MDD were enrolled. Participants were assessed by the Childhood Trauma Questionnaire-28 item Short Form, Social Support Rating Scale (SSRS), the 24-item Hamilton rating scale for depression, and the 14-item Hamilton Anxiety Rating Scale. Correlation analysis and Hierarchical multiple linear regression analysis were adopted to investigate associations of types of CM with social support. Results: (1) Physical neglect (PN) and emotional neglect (EN) were the most commonly reported types of CM in patients with MDD. (2) EN was the only type of CM significant in the regression models of the SSRS total score, the score of subjective support, and the score of utilization of support. Limitations: The data of CM was collected retrospectively and recall bias may be introduced. Assessment of CM and social support were self-reported and could be influenced by the depression status. Conclusion: In Chinese patients with MDD, PN and EN are the most prevalent types of CM. EN is the only type of CM associated with low social support in regression models, calling for special attention in the assessment and intervention of EN.

The mediating role of social support in the relationship between physician burnout and professionalism behaviors

OBJECTIVE

Burnout poses as an understudied challenge to professionalism, and social support may explain their relationship. We sought to investigate the role of social support (moderating or mediating) in the association between physician burnout and professionalism (with four behavioral domains: respect, integrity, excellence, responsibility).

METHODS

We invited 4100 physicians from nine tertiary hospitals in Liaoning province, China, during February 2017, to participate in a cross-sectional survey. Professionalism, burnout, and social support were respectively assessed using three standardized tools. Descriptive statistics, multivariable linear regression, and ordinal logistic regression were used to analyze the data.

RESULTS

3506 physicians (85.5%) effectively completed the survey. After controlling for potential confounding factors, burnout was associated with lower professionalism (β = -0.65, SE = 0.07), particularly in respect (OR = 0.51, 95%CI: 0.41-0.64) and responsibility (OR=0.72, 95%CI: 0.57-0.90). However, there was no statistically significant association between burnout and integrity or excellence. Social support was associated with higher professionalism ((β = 0.24, SE = 0.02) and all of its behavioral domains and played a partial mediating effect on the association between burnout and professionalism.

CONCLUSION

Social support partially mediates the relationship between physician burnout and behavior-based professionalism.

PRACTICE IMPLICATIONS

Addressing burnout and promoting social support could be integral in fostering physician professionalism in the healthcare setting.

Depressive symptoms among primary healthcare workers during the novel SARS-CoV-2 coronavirus pandemic in the Muscat governorate

BACKGROUND

With the unprecedented spread of the novel SARS-CoV-2 coronavirus, primary healthcare workers (PHCWs) are having to shoulder the increasing weight of this ongoing pandemic.

AIMS

This study explored the rate and covariates of depressive symptoms among PHCWs in the Muscat governorate.

METHODS

A cross-sectional online survey was conducted from 10 May to 10 June 2020 among PHCWs working in all primary healthcares across the Muscat governorate. Data on sociodemographic and risk factors of having at least one underlying physical health condition, a psychiatric history, family history of psychiatric disorders, and direct involvement with COVID-19 positive patients were sought. The Patient Health Questionnaire (PHQ-9) was then used to solicit the presence of depressive symptoms. Those with a cutoff point ≥10 were considered as showing depressive symptoms. Logistic regression was used to determine risk factors associated with depressive symptoms in PHCWs after adjusting for all sociodemographic factors.

FINDINGS

A total of 432 (72%) out of 600 PHCWs with an average age of 39.2 years (SD = 7.8 years) ranging between 25.0 and 75.0 years responded to the survey. There were more females (n = 281, 65.3%) than males, and more than 45% (n = 195) of them were physicians. Additionally, more than 78% (n = 338) had been in contact with COVID-19 patients. There was a significant association between different age groups and profession (P < .001), having at least one underlying physical health condition (P = 0.001) and depressive symptom status (P = 0.038). A total of 78 out of the 423 subjects (18.1%) were considered to have depressive symptoms. After adjusting for all factors, the logistic regression model showed that an age of 34 years or below (OR = 2.079, P = 0.021) and having at least one underlying physical health condition (OR = 2.216, P = 0.007) were factors contributing significantly to depressive symptoms among the PHCWs.

Depression and its associated factors: perceived stress, social support, substance use and related sociodemographic risk factors in medical school residents in Nairobi, Kenya

BACKGROUND

Little data exists regarding depression and its associated factors in medical residents and doctors in Sub-Saharan Africa. Residents are at high risk of developing depression owing to the stressful nature of their medical practice and academic training. Depression in medical residents leads to decreased clinical efficiency, and poor academic performance; it can also lead to substance abuse and suicide. Our primary aim was to measure depression prevalence among medical residents in Kenya's largest national teaching and referral hospital. Secondary aims were to describe how depression was associated with perceived stress, perceived social support, substance use, and educational environment.

METHODS

We sampled 338 residents belonging to 8 different specialties using self administered questionnaires in this cross-sectional survey between October 2019 and February 2020. Questionnaires included: sociodemographics, the Centres for Epidemiology Depression Scale - Revised, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, Alcohol, Smoking and Substance Involvement Screening Test, and Postgraduate Hospital Educational Environment Measure. Bivariate and multivariate linear regression were used to assess for risk factors for depression.

RESULTS

Mean participant age was 31.8 years and 53.4% were males. Most residents (70.4%) reported no to mild depressive symptoms, 12.7% had moderate, and 16.9% had severe depressive symptoms. Most residents had high social support (71.8%) and moderate stress (61.6%). The educational environment was rated as more positive than negative by 46.3% of residents. Bivariate analyses revealed significant correlations between depressive symptoms, perceived stress, substance use, perceived social support, and educational environment. Multivariate analysis showed that depression was strongly associated with: fewer hours of sleep (β = - 0.683, p = 0.002), high perceived stress (β = 0.709, p < 0.001) and low perceived social support (β = - 2.19, p < 0.001).

CONCLUSIONS

Only 30% of medical residents in our study had moderate and severe depressive symptoms. Most residents in our study reported high levels of social support, and moderate levels of stress. Though their overall appraisal of medical residency experience was positive, mental health support and self-care skills in the training of medical professionals needs prioritization.

Readiness for Hospital Discharge and Its Correlates Among People Living With HIV in Hunan, China: A Cross-sectional Study

ABSTRACT

We aimed to (a) describe the readiness for hospital discharge in people living with HIV and (b) explore factors associated with readiness for hospital discharge. A cross-sectional survey was conducted at two infectious disease hospitals in Hunan, China, from May to November 2017. The readiness for hospital discharge scale (RHDS) was used to assess discharge readiness. The average item mean for the RHDS ranges from 0 to 10, and higher scores represent a higher level of readiness for hospital discharge. The mean score of the RHDS was 7.78 (95% confidence interval 7.586-7.968), and 27.6% of participants (n = 56/203) felt unready for discharge (RHDS <7). We found that older age, lack of medical insurance, lower self-rated health status, poorer quality of discharge teaching, and more severe depressive symptoms were significantly associated with a lower level of readiness for hospital discharge. Interventions are needed to improve readiness of people living with HIV for hospital discharge in Hunan, China, especially for those of advanced age, without medical insurance, with worse self-rated health status, and those with higher levels of depressive symptoms.

Economic burden and health related quality of life of ultra-rare Gaucher disease in China

Background

The diagnosis and health care of patients with rare diseases present a tremendous challenge worldwide. This study described the health care service utilization through participants’ perspective and estimated the cost of illness (COI), and patients with Gaucher disease (GD)’s/caregivers’ health-related quality of life in China.

Method

An online retrospective survey of patients with GD and their caregivers was conducted during May–June 2018. Socio-demographic, health service utilization, disease-related expenses, social support, sleep quality (Pittsburgh Sleep Quality Index [PSQI]), and the Short Form Health Survey (SF-36) were investigated. Using self-reported information, we estimated the annual COI, including direct healthcare, direct non-healthcare, and indirect costs.

Results

Forty patients and their 49 caregivers were surveyed. The patients’ onset age of GD was 9.3 ± 10.9; their disease course was 3.5 ± 3.1 years. 21 (42.9%) patients had ≥ 2 caregivers, but 35 (71.4%) caregivers reported have no experience as a caregiver. 79.6% caregivers have stopped working, and 87.8% changed weekly working schedule. Before final diagnosis, patients visited 3.9 ± 3.1 (max = 20) hospitals and took 1.2 ± 1.7 (max = 6.6) years for confirmed diagnosis. On average, 5.0 ± 9.6 misdiagnoses occurred, and the per-patient diagnoses cost was USD ($) 7576. After GD confirmation, 8 (16.3%) patients received no treatment, 40 (81.6%) received pharmacotherapy, 10 (20.4%) received surgery, 38 (77.6%) received outpatient service (8.8 ± 9.1 times/annually), and 37 (77.5%) received inpatient service (4.0 ± 3.5 times/annually). Annual per-patient COI was USD ($) 49,925 (95% confidence interval: 29,178, 70,672). Average direct healthcare cost was $41,816, including pharmaceutical ($29,908), inpatient ($7,451), and outpatient ($1,838). Productivity loss per-caregiver was $1,980, and their Zarit Burden Inventory score was moderate-severe (48.6 ± 19.6). Both patients/caregivers reported lower social support (32.4 ± 7.4, 34.9 ± 7.6), two times higher PSQI (7.9 ± 2.9, 8.7 ± 3.6), and half lower SF-36 (41.3 ± 18.6, 46.5 ± 19.3) than those reported for healthy Chinese individuals.

Conclusions

The high misdiagnosis rate, together with delayed diagnosis, substantial costs, and deteriorated health-related quality of life of GD patients as well as their heavy care burden, calls for extreme attention from policymakers in China. Further efforts of government and society are urgently demanded, including pharmaceutical reimbursement, screening newborns, developing precise diagnostic tools, and training doctors.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13023-021-01963-6.

The association between core job components, physical activity, and mental health in African academics in a post-COVID-19 context

This study examined the association between core job components (i.e. teaching, research, and student assessment), physical activity (PA), and mental health in a post-COVID-19 context. An online questionnaire administered via Google Forms was used to gather data from 1064 African academics in four countries. A sensitivity analysis was applied to adjust for covariates. Data were analyzed with the hierarchical linear regression analysis. The average age of participants was 44 years. The study found that PA was positively associated with research but negatively associated with student assessment. Mental health was positively associated with onsite teaching but negatively associated with online teaching and research. PA did not predict mental health and mediate the relationship between the job components and mental health. It is concluded that PA may not increase mental health in African academics in a post-COVID-19 situation that required the resumption of work while observing social distancing protocols.

The Association Between Social Support, COVID-19 Exposure, and Medical Students' Mental Health

Background: The coronavirus disease-2019 (COVID-19) pandemic has halted in-person medical education worldwide. Limited studies have reported on the mental health status of medical students during this public health emergency. This study aimed to explore the association of personal virus exposure, regional epidemic condition, and social support with medical students' depressive and anxiety symptoms during the COVID-19 outbreak in China. Methods: In February 2020, 5,982 medical students (60.0% females, Meanage = 21.7 years, Medianage = 22 years) completed an online survey consisting of demographics, personal virus exposure, the Patient Health Questionnaire, the Generalized Anxiety Disorder Scale, and the Social Support Rating Scale. Results: The prevalence rates of mild to severe depressive symptoms and anxiety symptoms were 35.2 and 22.8%, respectively. Multivariate linear regression showed that students with low- or medium-level social support had a higher risk of experiencing depressive or anxiety symptoms than those with high-level social support. COVID-19 exposure was positively associated with mild to severe depressive or anxiety symptoms. Respondents living in provinces with 500-1,000 confirmed COVID-19 cases had an increased risk of experiencing mild to severe depressive symptoms compared with those living in provinces with <100 cases. Other related factors were gender and years of training. Conclusions: Some medical students suffered from a poor psychological status during the COVID-19 outbreak. Low social support was a stronger factor related to poor mental status compared with COVID-19 exposure or the provincial epidemic condition. Thus, we suggest that colleges or universities provide social support and mental health screening.

Disrupted rhythms of life, work and entertainment and their associations with psychological impacts under the stress of the COVID-19 pandemic: A survey in 5854 Chinese people with different sociodemographic backgrounds

BACKGROUND & AIM

The coronavirus disease 2019 (COVID-19) pandemic has affected the life and work of people worldwide. The present study aimed to evaluate the rhythm disruptions of life, work, and entertainment, and their associations with the psychological impacts during the initial phase of the COVID-19 pandemic.

METHOD

A cross-sectional study was conducted from the 10th to 17th March 2020 in China. A structured e-questionnaire containing general information, the Chinese version of Brief Social Rhythm Scale, and Zung's self-rating scales of depression and anxiety (SDS and SAS) was posted and collected online through a public media (i.e. EQxiu online questionnaire platform). Scores in sleeping, getting up, and socializing (SGS) rhythm and eating, physical practice, and entertainment (EPE) rhythm were compared among and between participants with different sociodemographic backgrounds including gender, age, education, current occupation, annual income, health status, and chronic disease status. Correlations of SDS and SAS with SGS-scale and EPE-scale were also analyzed.

RESULTS

Overall, 5854 participants were included. There were significant differences in the scores of SGS-scale and EPE-scale among people with different sociodemographic backgrounds. The scores were significantly higher in the groups with female gender, low education level, lower or higher than average income, poor health status, ages of 26-30 years or older than 61 years, nurses and subjects with divorce or widow status. There were also significant differences in SAS and SDS scores among people with different sociodemographic backgrounds (all P< 0.05). The overall prevalence of depression and anxiety was 24.3% and 12.6%, respectively, with nurses having the highest rates of depression (32.94%) and anxiety (18.98%) among the different occupational groups. SGS-scale was moderately correlated with SDS and SAS, and disruption of SGS rhythm was an independent risk factor for depression and anxiety.

CONCLUSION

Social rhythm disruption was independently associated with depression and anxiety. Interventions should be applied to people vulnerable to the rhythm disruption during the COVID-19 pandemic.

Competitive Anxiety, and Guilt and Shame Proneness From Perspective Type D and Non-type D Football Players

The precompetitive, competitive, and postcompetitive mental states of athletes are currently not sufficiently researched. Long-term exposure to stressors contributes to the formation of mental blocks and leads to various health problems. One of the factors that can explain the variability of athletes' reactions to stress is their personality. This study is the first to examine competitive anxiety, and guilt and shame proneness in the context of the reaction of football players to distress in sports. The study consists of 112 male football players aged 16–24 (21.00 ± 1.90) who were divided into type D and non-type D football players according to scoring on the Denollet Scale (DS14). Football players also filled out the Sport Anxiety Scale (SAS-2) and the Guilt and Shame Proneness Scale (GASP). The taxonomic approach was conducted to test and to examine differences in stressor intensity as a function of type D personality. A correlation, multivariate analysis of variance, and regression analysis were performed in the study. We found that type D football players were more afraid of failures in sports (worry), felt more often autonomous excitement concentrated in the stomach and muscles (somatic anxiety), and showed more frequent concentration disruption than did non-type D football players. We also found that although type D football players were more likely to rate their behavior as negative and inappropriate, they showed a much greater effort to correct it than did non-type D football players. Negative affectivity and social inhibition of type D football players were positively correlated with competitive anxiety. In addition, we noted lower levels of somatic anxiety and lower concentration disruption for football players who used escape strategies to manage stress. The shame proneness subscale monitoring negative self-evaluation was also closely related to the concentration disruption of football players. We found that the examination of athletes by type D personality is necessary due to the fact that negative affectivity and social inhibition are significant predictors of competitive anxiety of football players, which explains their worries at 24.0%, somatic anxiety at 8.2%, and concentration disruption at 10.6%.