ABSTRACT
Objective@#To investigate the mediating role of activities of daily living (ADL) and self-rated health in chronic disease-caused depressive symptoms among the elderly, so as to provide insights into depression control among the elderly. @*Methods@#Basic features, depressive symptoms, number of chronic diseases, ADL and self-rated health of the elderly at ages of 60 years and older were collected from the China Health and Retirement Longitudinal Study 2018. Multiple linear regression model was created using the Process program to examine the mediating role of ADL and self-rated health in number of chronic disease-caused depressive symptoms, and the significance of the mediating role was tested using the Bootstrap test. @*Results@#A total of 5 892 elderly participants were enrolled, with a mean age of (68.42±6.23) years and including 2 744 men (46.57%). The participants had a median depressive symptom score of 8 (interquartile range, 10) points, a median number of chronic diseases of 1 (interquartile range, 1), a median ADL score of 12 (interquartile range, 3) points, and a median self-rated health score of 3 (interquartile range, 1) points. Mediation analysis showed that number of chronic diseases affected depressive symptoms via the independent mediating role of ADL (β=0.163, 95%CI: 0.120-0.206) and self-rated health (β=0.303, 95%CI: 0.259-0.351), and affected depressive symptoms via the chain mediating role of ADL and self-rated health (β=0.057, 95%CI: 0.043-0.074) among the elderly, and the gross mediating role consisted of 58.44% of total effects. @*Conclusions@#The number of chronic diseases may incease the risk of depressive symptoms through aggravating the impairment of ADL and decreasing self-rated health levels among the elderly.
ABSTRACT
Objective@#To investigate the needs for license skill training among grassroots public health personnel in Hohhot City, so as to provide the advice for improvements in training among grassroots public health personnel in Hohhot City. @*Methods@#A total of 1 802 staff were sampled from 108 grassroots healthcare institutions in four districts, four counties and one banner of Hohhot City using a multi-stage stratified random sampling method. Participants' demographics and five dimensions of training needs, including professional knowledge, professional skills, basic public health service guidelines, epidemiological survey and development of interventions, were collected through questionnaire surveys, and factors affecting the training demands were identified using a generalized linear mixed-effect model.@*Results@#The respondents included 789 men (43.78%) and 958 individuals at ages of 31 to 50 years (53.16%). There were 1 379 respondents (76.53%) that wished to receive training on professional knowledge, 1 312 respondents (72.81%) that wished to receive training on professional skills, 1 012 respondents (56.16%) that wished to receive training on basic public health service guidelines, 333 respondents (18.48%) that wished to receive training on epidemiological survey and 206 respondents (11.43%) that wished to receive training on development of interventions. Participants at ages of 41 to 50 years and 61 years and older, participants with a specialty in nursing, and participants that worked on construction of resident archives and health management of patients with tuberculosis had higher demands for training on professional knowledge; participants that worked on construction of resident archives, children healthcare management and health management of patients with chronic diseases had higher demands for training on professional skills; participants with a specialty in general practice, preventive medicine and public health, participants that worked on construction of resident archives, health management of pregnant and lying-in women, health management of elderly people and health management of patients with severe mental disorders, report and response of infectious diseases and emergency public health events had higher demands for training on basic public health service guidelines; participants that worked on vaccination, report and response of infectious diseases and emergency public health events and assisted management of health and family planning supervision had higher demands for training on epidemiological surveys; participants that worked on health management of patients with chronic diseases, assisted management of health and family planning supervision, and participants with experiences of clinical practices had higher demands for training on development of interventions (all P<0.05). @*Conclusions@#The grassroots public health personnel have a high demand for license skill training in Hohhot City, and age-, specialty- and job-specific training is required.