Comparison of emotional and behavioral problems of only and non only child in the kindergartens in Chengdu / 中国学校卫生

Objective@#To analyze the emotional and behavioral problems and associated factors of the only and non only child, and to provide some clues for further monitoring and intervention of psychological and behavioral development among preschool children.@*Methods@#Using a convenience sampling method, a total of 45 065 children enrolled in 153 kindergartens in 23 districts and counties of Chengdu were selected from May to June 2021 to investigate demographic characteristics and children s psycho behavioral development through online questionnaires filled out by their guardians. The Chi square tests were used to analyze whether the differences in abnormality rates of each dimension were statistically significant between the only and non only children. The emotional and behavioral problems of only children and non only children were analyzed by propensity score measurement.@*Results@#The detection rate of abnormal emotional behavior problems in children was 6.10%, including 6.34% in the only child group and 5.84 % in the non only child group. After matching, total difficulty score, and scores of emotional symptoms, conduct problems, hyperactive attention deficit, peer interaction, and social behavior differed between the only child group and the non only child group ( t =9.91, 8.97, 3.91, 15.57, -5.46, 4.08, P <0.01).@*Conclusion@#In terms of the total score of difficulties, emotional symptoms, moral problems, and hyperactivity attention defects, the non only child is better than the only child，but the opposite is true in terms of peer interaction and social behavior. Mental health conditions among the only child should be paid more attention. Whether or not the only child should be taken as an important consideration for preschool children s mental health care.

Effects of acute and chronic trauma on degree centrality of brain functional images in patients with post-traumatic stress disorder who lost their only child / 中华行为医学与脑科学杂志

Objective:To investigate the effects and significance of acute and chronic trauma on brain degree centrality (DC) in patients with post-traumatic stress disorder (PTSD) who lost their only child at resting state.Methods:Retrospectively, the study enrolled a total of 51 parents with PTSD, including 35 PTSD parents whose children was lost in emergencies (acute bereaved PTSD group) and 16 PTSD parents whose children was lost of chronic causes such as diseases (chronic bereaved PTSD group). Fifty local adults were also included as healthy controls (HC group). The clinical administered PTSD scale(CAPS) was used to evaluate the severity of the subjects' clinical symptoms.Resting-state functional magnetic resonance imaging(fMRI) data of all subjects were collected and DC values were calculated.SPSS 22.0 software was used for statistical analysis.Covariance analysis was performed among three groups, while post hoc was performed between any two groups.What's more, correlation analyses were utilized between abnormal brain regions and the scores of CAPS.Results:Significant group effects were found in multiple regions, including the right inferior temporal gyrus (MNI: x, y, z=66, -27, -21), right temporal pole (MNI: x, y, z=54, 15, -9), right orbital inferior frontal gyrus (MNI: x, y, z=42, 21, -15), bilateral medial superior frontal gyri (MNI: right x, y, z=6, 63, 12; left x, y, z=-3, 60, 18), left inferior parietal angular gyrus (MNI: x, y, z=-45, -36, 51) and left postcentral gyrus (MNI: x, y, z=-45, -33, 51). Compared with HC group, the DC of two patient groups increased in the right inferior temporal gyrus (MNI: acute x, y, z=63, -27, -21; chronic x, y, z=63, -21, -27); the DC of acute bereaved PTSD group decreased in the right temporal pole (MNI: x, y, z=45, 21, -15) and the right orbital inferior frontal gyrus (MNI: x, y, z=48, 24, -12), while the DC of chronic bereaved PTSD group decreased in the left inferior parietal angular gyrus (MNI: x, y, z=-45, -36, 51) and left postcentral gyrus (MNI: x, y, z=-45, -33, 51). Compared with chronic bereaved PTSD group, the DC of acute bereaved PTSD group increased in the left inferior parietal angular gyrus (MNI: x, y, z=-33, -39, 42) and left postcentral gyrus (MNI: x, y, z=-45, -33, 51), while decreased in the right temporal pole (MNI: x, y, z=51, 12, -9), right orbital inferior frontal gyrus (MNI: x, y, z=42, 21, -15) and bilateral medial superior frontal gyri (MNI: left x, y, z=0, 57, 15; right x, y, z=3, 57, 15). In chronic bereaved PTSD group, the DC of the left postcentral gyrus was negatively correlated with C1 (avoid trauma-related thoughts, feelings) score in CAPS ( r=-0.606, P=0.028). In acute bereaved PTSD group, the DC of the left medial superior frontal gyrus was negatively correlated with D4 (high vigilance) score ( r=-0.416, P=0.020). Conclusion:There exist functional abnormalities of multiple brain regions in acute and chronic bereaved parents with PTSD.The high arousal symptoms of the former may be related with the abnormalities of prefrontal-amygdala neural circuit, while the latter show higher avoidance which may be associated with the dysfunction of somatosensory brain regions such as postcentral gyrus.

Effect of early childhood psychological maltreatment on depression in non-only-child college students: the multiple mediating effects of sibling relationship and resilience / 中华行为医学与脑科学杂志

Objective:To investigate the effect of child psychological abuse on adult depression in non-only-child families, and to investigate the mediating effects of sibling relationship and resilience.Methods:The child psychological abuse scale (CPAS), the life span sibling relationship scale(LSRS), Connor-Davidson resilience scale(CD-RISC) and the center for epidemiologic studies depression scale (CES-D) were were used to evaluate 2 995 non-only-child college students from March 2020 to July 2020.Descriptive analysis and correlation analysis were performed by SPSS 21.0 software.The mediating effect was tested by AMOS 23.0 software.Results:(1) The positive rate of childhood psychological abuse was 55.29%.The positive rate of depression(16(9, 24)) was 51.62%.(2) Psychological abuse, sibling relationship, resilience and depression were significantly different in the dimensions of parental relationship ( Z=-17.986, -13.822, -13.771, -12.620, -10.650, -11.524, all P<0.01). There was a significant difference in depression variables ( Z=-2.176, P<0.05). (3) Psychological abuse was positively correlated with depression ( r=0.558, P<0.01), and negatively correlated with sibling relationship and resilience ( r=-0.379, r=-0.270, both P<0.01). Sibling relationship was positively correlated with resilience ( r=0.380, P<0.01), and negatively correlated with depression ( r=-0.366, P<0.01). There was a significant negative correlation between resilience and depression ( r=-0.431, P<0.01). (4) The indirect effect value of psychological abuse on depression was 0.138, accounting for 9.37% of the total effect.Further testing the mediating effect of psychological resilience, adult sibling relationship and child sibling relationship, the single mediating effect of resilience accounted for 3.33% of the total effect, and the chain mediating effect of adult sibling relationship and resilience accounted for 2.76%. Conclusion:The relationship between psychological abuse and depression in non-only child is very close.The relationship between psychological resilience and sibling relationship, especially adult sibling relationship, can alleviate the depression, but this effect is limited to reducing the degree of depression and can not improve the incidence of depression.

Differences in non-suicidal self-injury behaviors between only-child and non-only-child adolescents with mood disorders: a cross-sectional study / 中国当代儿科杂志

OBJECTIVES@#To investigate the differences in non-suicidal self-injury (NSSI) behaviors between only-child and non-only-child adolescents with mood disorders.@*METHODS@#A three-stage sampling method was used to perform a cross-sectional survey of 529 adolescents, aged 12-18 years, who had mood disorders and NSSI behaviors. These adolescents were sampled from the outpatient service of 20 mental hospitals in 9 provinces of China from August to November 2020. A self-made questionnaire was used to collect general demographic data. The Functional Assessment of Self-Mutilation, Beck Scale for Suicide Ideation, Kessler Psychological Distress Scale, Stress Mindset Measure-General, Multidimensional Scale of Perceived Social Support, Multidimensional Students' Life Satisfaction Scales, and Rosenberg Self-Esteem Scale were used to collect the information on self-injury behaviors and psychological factors in these adolescents.@*RESULTS@#A total of 529 adolescents with mood disorders and NSSI behaviors were surveyed, among whom 375 were only-child adolescents and 154 were non-only-child adolescents. Compared with the non-only-child group, the only-child group had a significantly higher total score of Functional Assessment of Self-Mutilation (P<0.05) .The type and frequency of self-injury in the only-child group were significantly higher than those in the non-only-child group (P<0.05). Psychological analysis showed that compared with the non-only-child group, the only-child group had a significantly lower score of self-esteem (P<0.05) and significantly higher scores of psychological distress and depressive symptoms (P<0.05). The multiple linear regression analysis showed that the score of suicidal ideation was positively correlated with the frequency of NSSI behaviors in both only-child and non-only-child adolescents with mood disorders (P<0.05); in the only-child adolescents, the level of self-esteem was negatively correlated with the frequency of NSSI behaviors (P<0.05), and the score of stress perception was positively correlated with the frequency of NSSI behaviors (P<0.05); in the non-only-child adolescents, the score of anxious emotion was positively correlated with the frequency of NSSI behaviors (P<0.05).@*CONCLUSIONS@#Among the adolescents with mood disorders and NSSI behaviors, the only-child adolescents tend to have a higher frequency of self-injury and poorer mental health, and therefore, the only-child adolescents with mood disorders and NSSI behaviors need more attention.

Resilience / 中南大学学报(医学版)

OBJECTIVES@#There are almost one million families who lost their only child in China, and 65.6% of them had severe and long lasting depression and needed timely psycho-intervention. This study aims to explore the relationship among resilience and its influential factors, and to compare their effect on depression.@*METHODS@#A total of 212 only-child loss person in 9 administrative regions in Changsha were assessed by using Connor-Davidson Resilience Scale, Zung Self-rating Depression Scale, Simplified Coping Style Questionnaire, Simplified Eysenck Personality Questionnaire, Social Support Rating Scale, and General Self-efficacy Scale. A hypothetical model was tested based on Kumpfer resilience framework and stress-coping theory.@*RESULTS@#The influential factors of resilience were: positive coping (the total effect value was 0.480), support utilization (the total effect value was 0.359), neuroticism (the total effect value was -0.326), negative coping (the total effect value was 0.279), extraversion (the total effect value was 0.219), and objective support (the total effect value was 0.077). The process of individual-environment interaction showed a greater impact on resilience, which had a direct effect on depression (the total effect value was -0.344, 67.1%), and also indirect effect through self-efficacy (the total effect value was -0.169). The total effect of resilience accounted for 20.1% of the total effect of all variables.@*CONCLUSIONS@#Resilience mainly impacts depression directly, and can negatively predict depression in only-child loss parents. Resilience, located before self-efficacy, is a significant stress mediating variables. Personality traits and support utilization indirectly impact resilience via negative and positive coping. The key to promote the reorganization of resilience is the process of individual-environmental interaction, involving support utilization, positive coping, and some sorts of negative coping strategies, which plays an important role in developing a resilience intervention program and can improve the depression of the only-child loss person.

A comparison of aggressive behavior and influencing factors of family environment between firstborn and only children in primary school / 中国学校卫生

Objective@#To understand aggressive behavior and associated family determinants of firstborn and only children in primary school, so as to provide the basis for child aggressive behavior prevention.@*Methods@#Using stratified cluster sampling method, 922 pupils from grade 2 to grade 6 were selected from three primary schools in Bengbu. The questionnaire survey included general information, family background and child aggressive behaviors.@*Results@#Among boys, the 7 year old only child scored [26.0(22.0,34.5)] higher than firstborn children [20.0(17.5,26.5)] in overall aggression, and the 9-year-old firstborn child [ 27.5 (23.0,34.3)] scored higher than the only child [23.0(18.5,28.5)]. The scores of 8-year-old firstborn child in the dimension of physical aggression [7.0(4.0,11.0)] were higher than that of only child [5.0(3.0,8.0)] ( Z=1.97, 2.39, 2.11, P < 0.05 ). Among girls, 8-year-old only child scored higher [5.0(3.0,7.0)] in the dimension of physical aggression than that of the firstborn child [ 3.0 (3.0,4.0)], and the 12-year-old firstborn child scored [7.0(6.0,8.0)] higher in the dimension of hostility than that of the only child [4.5(3.3,9.0)] ( Z=2.48, 1.98, P <0.05). Multiple linear regression analysis found that boys of firstborn children scored higher in all dimensions of aggressive behavior than those of girls except hostility, and paternal education was negatively associated with physical aggression and hostility ( P <0.05). Age was positively associated with verbal aggression among the only children ( P <0.05). Family economic status was negatively associated with physical aggression ( P <0.05). Paternal education was negatively associated with hostility among students with anger and hostility of family members higher than that of parents ( P < 0.05 ).@*Conclusion@#Higher family economic status, high quality of parent company and appropriate parenting style can reduce the occurrence of children s aggressive behavior and promote healthy physical and psychological development.

Comparison of emotional and behavioral problems between preschool firstborn children across the transition to siblinghood and the only children / 中国学校卫生

Objective@#To compare the emotional and behavioral characteristics of preschool firstborn children across the transition to siblinghood with the only children in a district of Chongqing.@*Methods@#Data were derived from a cohort study on firstborn children transition to siblinghood. Totally 882 firstborn children (3.58±1.25) years old and 329 only children (3.98±1.02) years old were recruited from two hospitals and 19 kindergartens in a district of Chongqing, respectively. Their mothers filled out the parental version of Child Behavior Checklist (CBCL) and self designed questionnaire.@*Results@#The overall scores of emotional and behavioral problems of firstborn children and only children were (25.17±18.82) and (31.75±18.64). The results of rank sum test showed that the scores of the firstborn children in all dimensions, internalizing and externalizing behavior problems and overall emotional and behavioral problems were lower than those of the only children ( P <0.05). Chi square test results showed that the detection rates of internalizing, externalizing and overall emotional behavior problems in only children(12.77%, 13.07%, 14.59%) were higher than those in firstborn children(8.28%, 8.28%,8.16%) ( χ 2=5.62, 6.36, 11.09, P <0.05). Multiple linear regression showed that after adjusting for age, gender, family economic pressure, temperament type of children, family atmosphere and family type, the scores of internalizing problems, externalizing problems and overall problems of the only children were still higher than those of the firstborn children ( B =1.54, 2.32, 6.81, P <0.05).@*Conclusion@#The firstborn children across the transition to siblinghood show less emotional and behavioral problems than the only children, and the scores and detection rates of all types of emotional and behavioral problems of the firstborn children are lower than those of the only children.

A comparative study of sociality between firstborn children and only children of young age / 中国学校卫生

Objective@#To understand the current situation of the social development between only children and firstborn of young age, so as to provide a reference for the promotion of the social development of young children.@*Methods@#Stratified cluster sampling method was used to select 734 only children and firstborn children aged 3-9 in two kindergartens and two primary schools from grade 1 to grade 3 for questionnaire survey in Bengbu City. The content included the general information of children and their parents and the social assessment of children.@*Results@#The rate of emotional symptoms in firstborn children(27.8%) was higher than those of only children (17.6%)( χ 2=9.45, P <0.01). The results of univariate analysis showed that the rate of hyperactivity and inattention in social development of both only children and firstborns decreased with the increase of family socioeconomic status ( P < 0.05 ). Multivariate Logistic regression analysis of only children showed that only children with high economic status had a lower risk of hyperactivity and inattention and had a higher risk of peer interaction( P <0.05). The prosocial behavior of girls was better than that of boys in the aspect of social development of only children and firstborn children( OR =1.70, 2.85, P <0.05). For only children, the occurrence risk of being difficult was lower when the primary caregiver was parents than grandparents( OR =1.63, P < 0.05 ). For firstborn children, the risk of being difficult in nuclear families was lower than that in third generation families( OR = 2.14 , P <0.05). Multivariate analysis of the only child showed that boys had higher risk of hyperactive attention and less prosocial behavior than girls ( OR =2.24, 1.70, P <0.05), and a lower risk of developing mood disorders than girls( OR =0.57, P <0.05). The social development of only children varied among different grades, and the risk of abnormal prosocial behavior was lower with the increase of grades ( P <0.05).@*Conclusion@#Higer family social status is positively associated with children s social development level. But parents with high economic status should also avoid too much material and spiritual doting. Parents should strengthen their own learning to enhance the level of socialized education, raising siblings equally, improve the quality of parent child relationship, and promote the all round development of children s socialization level.

Effects of fruits and vegetables intake and physical activities on the relationship between one-child and low height level classification / 中国学校卫生

Objective@#To explore the relationship between one-child and low height level classification among children and adolescents, and the effects of fruits, vegetables and physical activities on this association, and to provide as cientific reference for probing into and improving the differences of their height level between one child and child with siblings.@*Methods@#Using stratified cluster sampling method, 93 primary and secondary schools in 7 provinces and cities in China were selected for physical examination and questionnaire surveys. A total of 40 978 primary and middle school students aged 7-17 were selected. A multilevel Logistic regression model was used to analyze.@*Results@#Univariate analysis found that being one-child was less likely to be classified as low height level(OR=0.63, 95%CI=0.58-0.67); the multilevel model also found that the probability that one-child being at low height level was still lower(OR=0.78, 95%CI=0.73-0.85), and daily vigorous-intensity physical activities ≥1 h (OR=0.92, 95%CI=0.85-0.99) and daily vegetables and fruits intake ≥5 servings (OR=0.83, 95%CI=0.75-0.92) could also reduce the probability of being at low height level. Hierarchical analysis found that when vegetables and fruits intake and physical activities time were sufficient, there was no longer a significant difference in the height level classification between one-child and child with siblings(P>0.05).@*Conclusion@#Being one-child could be a protective factor for the height level classification of children and adolescents. Adequate intake of vegetables and fruits and time of vigorous-intensity physical activities could fill the gap of height level classification between of being one-child and child with siblings. Effective behavioral intervention measures should be taken to protect the healthy growth of height among children and adolescences.

Influencing factors of happiness for the elderly who lost their only child in a community of Shanghai / 上海预防医学

Objective To investigate the general well-being of the elderly who lost their only child in the community and explore its influencing factors in this regard, providing reference for the formulation and implementation of targeted interventions. Methods A total of 84 elderly people who lost their only child in Longhua street community were selected by sampling for questionnaire survey with generally well-being schedule (GWB of Chinese version). Results The total score of GWB of the 84 elderly who lost their only child was 62.82±5.52, satisfaction and interest in life being 3.60±1.17, worries about health 7.96±1.76, energy 13.45±2.09, melancholy or happy mood 13.00±1.5, control of emotion and behavior 9.35±1.59, relaxation and tension 15.46±2.35.Among the factors influencing the overall happiness of the elderly who lost their only child, education level accounted for the proportion (P < 0.01), medical expenses (P < 0.01), age of death of the child (P=0.04), and participation in social activities (P=0.03). Conclusion The score of GWB is lower for the elderly who lost their only child, it is imperative to take personalized and comprehensive intervention to help those elderly get out of the psychological shadow and encourage them to face life positively.

Intervention provided by family doctors improves loneliness status for people who lost their only child / 中华全科医师杂志

Objective To investigate the intervention of family doctor management system on the loneliness in people who lost their only child.Methods Sixty two residents who lost their only child in Shanghai Xujiahui district were enrolled in the study from December 2015 to June 2016.The participants were randomly divided into study group and control group with 31 cases in each group;the participants in study group were signed by family doctors and the psychological intervention was provided,those in control group had no intervention,the participants were followed up for 6 months,the psychological status was evaluated with UCLA loneliness scale in two groups.Results There were no significant differences in UCLA scores (63.26 ±7.17 vs.60.03 ±7.59,t =1.709,P ＞0.05) and in the severity of loneliness (mild 0/30 vs.1/31,moderate 9/30 vs.11/31,severe 21/30 vs.19/31,x2 =1.284,P ＞ 0.05) between study and control groups before the intervention.There were significant differences in UCLA scores (63.26 ±7.17 vs.40.13 ± 5.61,t =15.631,P ＜ 0.05) and in the severity of loneliness (mild 0/30 vs.17/30,moderate 9/30 vs.13/30,severe 21/30 vs.0/30,x2 =38.727,P ＜ 0.05) before and after 6 months of intervention in study group;while there were no significant changes in UCLA score (60.03 ± 7.59 vs.59.64 ± 6.90,t =0.650,P ＞ 0.05) and in the severity of loneliness (mild 1/31 vs.0/31,moderate 11/31 vs.14/31,severe 19/31 vs.17/30,x2 =1.471,P ＞ 0.05) in control group after 6-month follow-up.The UCLA scores (40.13 ±5.61 vs.59.64 ±6.90,t =12.086,P＜0.05) and the severity of loneliness (mild 17/30 vs.0/31,moderate 13/30 vs.14/31,severe 0/30 vs.17/31,x2 =34.030,P ＜ 0.05) in study group were significantly lower than those in control group after intervention.Conclusion The family doctor management system can improve the loneliness and mental health status of people who lost the only child,to reduce the risk of mental illness and the family and social burden.

Correlation of suicidal ideation with social support and quality of life among only-child loss people / 中华行为医学与脑科学杂志

Objective To investigate the correlation of suicidal ideation with social support and quality of life among only-child loss people.Methods Totally 320 only-child loss people were collected by using stratified cluster random sampling method.Social support rating scale(SSRS) and general quality of life inventory(GQOLI) were used to investigate the suicidal ideation status.The association of suicidal ideation with social support and quality of life was analyzed by Pearson correlation analysis.Results The suicidal risk rate of only-child loss people was 45.0％.Compared with control group((4.87±2.32),(35.50±9.33),(139.46±37.80)),only-child loss group had lower scores in suicidal ideation,SSRS,GQOLI ((8.94±3.99),(29.97±9.15),(29.97±9.15) respectively,t=1.997-15.009,P＜0.05 or P＜0.01).The suicidal ideation total score was negatively correlated with scores of SSRS and all its 4 items,GQOLI,physical function,psychological function(r=-0.121--0.270,P＜0.05 or P＜0.01).The score of suicidal ideation in the past year was positively correlated with scores of material function (r=0.135,P＜ 0.05).Regression analysis showed that age,marriage,objective support,subjective support and GQOLI were the influencing factors(t=-3.251-3.160,P＜ 0.01 or P＜0.05).Conclusion Only-child loss people have higher suicidal risks,which is negatively correlated with lower social support and quality of life,and influenced by age,marriage,SSRS and GQOLI factors.

Health-related quality of life and influencing factors among community people after losing the only-child / 现代临床护理

Objective To explore the health-related quality of life and the influencing factors among community people after losing the only-child. Method A total of 300 people who came from 30 communities in 5 main urban districts of Kunming involved in the investigation using the medical outcomes study 36-item short form health survey (SF-36)by multistage stratified sampling during September and November 2016. Results The scores of physical component summary,mental component summary and 8 dimensions were significantly lower than those of the norm(all P<0.05).The physical component summary(64.72±18.38),which was higher than that of the mental component summary (51.86±22.95)(P<0.01).Multiple linear stepwise regression analysis showed that the higher the personal average monthly income in the recent year was and the longer after losing the only-child, the better the quality of life. Conclusions The health-related quality of life among community people after losing the only-child is lower,the personal average monthly income and the length after losing the only-child are the influencing factors.The community nurses should establish a community nursing service system for them and carry out individualized nursing interventions to improve their health-related quality of life.

Characteristics and influencing factors analysis of depressive symptoms among only-child-lost-persons / 重庆医学

Objective To explore the characteristics and influencing factors of depressive symptoms among the only-child-lost persons.Methods A total of 841 only-child-lost persons and 674 controls conforming to entering group condition were selected.The difference of SDS score between the two groups and the demographic characteristics distribution differences of depression severity in only-child-lost persons were compared and the influencing factors were analyzed.Results The SDS score had statistical difference between the only-child-lost persons group and control group(P＜0.05),and was correlated to the only-child-lost years and no physical disease;the proportion of mild to moderate depression in the only-child-lost persons of the low cultural level,somatic diseases and middle income level groups was significantly higher than that in the other groups;the only-child-lost persons with low income level,age≤60 years old and high educational level had a higher proportion of severe depression;the Logistic regression analysis showed that the educational level had a significant influence on the depression onset among the only-child-lost persons,the difference was statistically significant(P＜0.05).Conclusion The characteristics of depressive symptoms among the only-child-lost persons are related to their demographic characteristics.

A comparative study on positive mentalities between the only-child medical interns and the non-only-child medical interns in a Chongqing hospital / 中华医学教育探索杂志

Objective To investigate the group characteristics of positive mentalities between the only-child medical interns and the non-only-child medical interns in different birth order.Methods By cluster sampling method,Positive Mentalities Scale for university students was applied to test 194 medical interns who enrolled in a Chongqing hospital in 2015 to obtain the score of positive psychological quality of medical students.Descriptive statistics and variance analysis were conducted using SAS 8.2.Results The total scores of the only-child interns' positive mentalities were significantly higher than those of the firstborn interns[(97.26 ± 11.04) vs.(92.30 ± 12.84),P=0.010].The scores of the study-loving factor from high to low were listed as follows:the only-child interns,interns born in other birth order,interns who were the youngest children in the family,and the firstborn interns.Meanwhile,statistical difference was found in those (P＜0.05).The team-spirit factor scores of the interns who were the youngest children in the family were significandy lower than those of others (P＜0.05).All the scores concerning self-discipline factor were relatively low.All the scores of self-discipline factor,modesty factor and thanks-giving factor had no statistical difference (P＞0.05) between the only-child interns and the non-only-child interns.Conclusion The positive mental development of the only-child interns are superior to that of the firstborn interns.The training of positive mentalities of the firstborns and the youngest children in family should be paid attention to and the training of self-discipline should be strengthened among all medical interns.

Mediation role of self-efficacy between social support and depression of only-child-lost people / 中南大学学报(医学版)

Objective:To investigate the relationship between social support and depression of only-child-lost (OCL) people,and the mediation role of self-efficacy in this relationship.Methods:By stratified cluster sampling,214 OCL people were enrolled,with 80 males and 134 females,ages from 49 to 83 years old.They were assessed by General Self-Efficacy Scale,Social Support Rating Scale,and Self-rating Depression Scale.Results:Univariate analysis showed that there were significant differences in age groups (t=2.85,P＜0.05),with or without spouse (t=5.62,P＜0.05),family location (t=3.95,P＜0.05),per capita monthly income (F=3.48,P＜0.05) among the social support scores.There was significant difference between the per capita monthly income and self-efficacy scores in QCL people (F=5.46,P＜0.05).Correlation analysis showed self-efficacy and social support were positively correlated (r=0.26,P＜0.01).Self-efficacy (r=-0.59,P＜0.01) and social support (r=-0.59,P＜0.01) negatively correlated with depression in OCL people.Self-efficacy partially mediated the relationship between social support and depression.Conclusion:The person who is ＜60 years old,with spouse and the high per capita monthly income,and lives the rural area,would have high social support levels among QCL people.The person who has high per capita monthly income would have high self-efficacy.Self-efficacy is one of the direct prediction for depression,and plays an indirect role between social support and depression.Intervention of depression among OCL people could be applied to change their cognition,and to enhance their self-efficacy.

Exploration on the Ethical Problems in the Implementation of the Two-Child Policy in China / 中国医学伦理学

The implementation of two-child policy has great significance.It can rationalize the population structure,diversify the family model,easethe pension problem significantly,and rationalize parent-child relationships.At the same time,there exist ethical problems in some aspects of society,such as the attribution of female reproductive fights,the anxiety the only child suffered from the second child,the continuing imbalance of gender,the occupational predicament of female reproduction,the effects on women health and family economy.Therefore,the country and society should respect and maintain women's reproductive rights,guarantee women's occupational stability,pay attention to the education of family ethics,promote the traditional values of respecting the old and cherishing the young,and develop the social old-age security system,thus to ensure the effective implementation of the two-child policy and build a harmonious family and society.

Reliability and validity study of the Chinese Version of Coping-adaptation Processing Scale:Short Form- 15 items applied in people after losing the only- child / 中国实用护理杂志

Objective To introduce and translate the Coping-adaptation Processing Scale:Short Form-15 items (CAPS:SF) and evaluate the reliability and validity among people after losing the only-child. Methods CAPS:SF was translated into Chinese (CV-CAPS:SF) according to Brislin. A sample of 77 people after losing the only-child were recruited to complete the scale to evaluate the reliability and validity of scale. Results The scale-content validity index of the CV-CAPS:SF was 0.94;the Cronbachαwas 0.85 and split-half coefficient was 0.84. The score of coping was (38.60 ± 5.30) points. The take strength from spirituality or the successes of courageous people was the highest (3.44±0.50) points;the use humor in handling the situation was the lowest (2.05±0.58) points. Different age, education degree, marital status, occupation, average monthly income of latest year, the length after losing the only-child in the face of the difference was statistically significant (t/F=7.636-85.130, all P<0.05). Conclusions The CV-CAPS:SF is reliable and valid. It could be used to help the nursing staff understand coping among people after losing the only-child .

Social support and subject well-being of only-child-lost people：the mediating role of self-efficacy / 中华行为医学与脑科学杂志

Objective To investigate the relationship between social support and subjective well-be-ing in only-child-lost ( OCL ) people, and the mediating effect of self-efficacy in this relationship. Methods By stratified cluster sampling,206 only-child loss people were investigated with Social Support Rating Scale ( SSRS) ,General Self-Efficacy Scale ( GSES) and Index of Well-Being ( IWB) ,and data were analyzed with SPSS19.0 software and Amos17.0 software. Results ①Scores of SSRS,GSES and IWB in only-child-lost people were(31.78±8.18),(24.12±0.67) and (8.38±3.05). ②Correlation analysis showed that scores of GSES,SSRS and 3 dimensions of SSRS were positively correlated with scores of IWB ( r=0. 542,0.332,0.214,0.332,0.216;P<0.05) . ③Self-efficacy partially mediates the relationship between social support and subjective well-being through mediating effect test(χ2/ df=1.986,GFI=0.985,AGFI=0.942, RMSEA=0.069),mediating effect accounted for 16.08%.Conclusion Social support is an important factor which plays a direct or indirect role in subject well-being. Self-efficacy is the intermediate link between social support and subject well-being.

Situações familiares na obesidade exógena infantil do filho único / Family situations in the childhood obesity of the only child

Este é um trabalho qualitativo cujo objetivo foi aprofundar a compreensão da dinâmica familiar de filhos únicos obesos na infância. Crianças de oito famílias participaram do estudo: quatro meninos e quatro meninas, entre 7 e 10 anos, de grupo socioeducacional alto e baixo com avaliação nutricional para obesidade: IMC acima do percentil 97. Foram aplicados no domicílio os seguintes instrumentos: entrevista semiestruturada, teste projetivo Scenotest e avaliação nutricional. A análise apoiou-se na teoria das configurações vinculares (Berenstein e Puget). Os resultados apontaram dinâmicas familiares envolvendo contextos de natureza social, cultural e histórica da sociedade que parecem favorecer ambas as condições: a da obesidade infantil e a de filho unigênito. Elementos sociais enfatizando o individualismo se refletem em nível familiar e íntimo. Assim, a criança pode vir a encontrar, logo ao nascer, condições propiciadoras para que a vinculação básica com a figura materna não se processe de modo pleno, ocasionando deslocamento de parte do que não recebe para a satisfação no alimento. Além disso, a cultura do consumo interfere no modo e tipo de alimentação oferecida, na ludicidade e da sociabilidade infantil, assim como o estreitamento das possibilidades vinculares: intrapessoais, interpessoais, transpessoais, acrescentando-se o fato de não ter irmãos. Esse estudo mostrou que, embora nem todo filho único seja obeso e nem todo obeso seja filho único, uma condição pode ser facilitadora da outra na medida em que a situação sociocultural-histórica da sociedade de consumo hipermoderna parece direcionar a família a ambas as condições.