Mediating role of mental fatigue between nature exposure and mental health of prison police / 环境与职业医学

Background The mental health status of prison officers is crucial to the efficiency, security, and stability of a prison, and it is essential to pay attention to the factors that influence their mental health. Objective To understand the mental health status of prison officers, and analyze how nature exposure affects their mental health problems and a potential mediating role of mental fatigue. Methods A cross-sectional survey was carried out from May to June 2022 among 1392 prison officers from eight prisons in a province, and a total of 1284 valid questionnaires were recovered. The Nature Exposure Scale, Mental Fatigue Scale, and Depression-Anxiety-Stress Scale were used to assess nature exposure, mental fatigue, and mental health indicators among prison officers, and to explore the effect of nature exposure on mental health problems and a potential mediating role of mental fatigue. Results The recruited prison officers showed high levels of depression, anxiety, and stress. The prevalence rates of depression, anxiety, and stress were 59.11% (759/1284), 60.67% (779/1284),and 43.93% (564/1284), respectively. The results of correlation analysis revealed that nature exposure was negatively related with mental fatigue and mental health indicators (depression, anxiety, and stress) (rs=−0.242, −0.308, −0.235, −0.254, P<0.01), while mental fatigue was positively correlated with mental health indicators (depression, anxiety, and stress) (rs=0.546, 0.533, 0.536, P<0.01). The PROCESS macro results showed that the level of nature exposure among prison officers negatively associated with depression, anxiety, and stress (β=−0.180, −0.104, −0.123), and mental fatigue played a mediating role, with indirect effects of −0.200, −0.192, and −0.199, respectively. Conclusion The levels of depression, anxiety, and stress of prison officers are higher than those of other occupations. Nature exposure negatively associates with depression, anxiety, and stress, that is, it may directly alleviate the mental health problems of prison officers; and it may also alleviate mental health problems by relieving mental fatigue.

Relationship between job stress, job crafting, and job burnout among college counselors / 环境与职业医学

Background Job burnout has become an important factor affecting the mental and physical health and work efficiency of college counselors, and indirectly affects the quality and development of talent cultivation for college students. Objective To explore the relationship between job stress, job crafting, and job burnout among college counselors, and to test the mediating role of job crafting between job stress and job burnout, in order to take targeted measures to alleviate job stress and job burnout of college counselors, reduce associated health risks, and improve the effectiveness of higher education. Methods An anonymous questionnaire survey was conducted among 400 counselors from social network communication groups by convenience sampling. The Counselor Work Stress Scale, Job Crafting Scale, and Maslach Burnout Inventory-General Survey were used. Harman's single-factor method was used to evaluate common method bias in the survey data. One-way ANOVA was applied to test the difference in job stress, job crafting, and job burnout among college counselors by demographic characteristics, and chi-square test was used to analyze the difference in reporting job burnout. Partial correlation analysis was used to evaluate the correlation between selected variables. Structural equation modeling was used to analyze the relationship of job stress, job crafting, and job burnout among college counselors, and Bootstrap analysis was used to test if there was a mediating effect of job crafting on the relationship between job stress and job burnout. Results Of the 390 questionnaires recovered, there were 338 valid questionnaires (86.67%). Among the included subjects, the mean scores of job stress, job crafting, and job burnout were (2.70±0.62), (3.77±0.62), and (2.09±1.09), respectively. The positive rate of job burnout was 76.9% (260/338), with a positive rate of 72.8% in exhaustion dimension and 59.8% in cynicism dimension. There were significant differences in job crafting scores among the college counselors by different genders and professional titles (P<0.05). Female counselors had significantly higher job burnout scores and positive rates than male counselors (P<0.05). The partial correlation analysis showed that job stress, work load, school evaluation and expectation, and interpersonal relationship were positively correlated with job burnout (r=0.562, 0.442, 0.473, and 0.455, respectively, P<0.01), and negatively correlated with job crafting (r=−0.271, −0.169, −0.246, and −0.247, respectively, P<0.01); job crafting, cognitive crafting, relationship crafting, and task crafting were negatively correlated with job burnout (r=−0.447, −0.452, −0.366, and −0.340, respectively, P<0.01). The modified structural equation modeling indicated that job stress negatively affected job crafting (b=−0.348, P<0.001) and positively affected job burnout (b=0.454, P<0.001); job crafting negatively affected job burnout (b=−0.459, P<0.001), and played a partial mediating role in the relationship between job stress and job burnout, and the effect value was 0.160 (95%CI: 0.102, 0.230) that accounted for 26.10% of the total effect. Conclusion Job burnout among the college counselors is prominent. Job crafting presents an inhibitory effect on job burnout. Job stress indirectly affects the occurrence of job burnout by inhibiting the generation of job crafting.

Smartphone addiction and life satisfaction: mediating effect of negative emotions / Adicción a teléfonos inteligentes y satisfacción con la vida: efecto mediador de las emociones negativas

Background: Smartphone users have increased worldwide, due to their multifunctionality and accessibility. Objective: To determine the mediating effect of negative emotions between life satisfaction and smartphone addiction in college students. Method: A structural equation explanatory model was proposed in which each negative emotion (depression, anxiety, and stress) has a mediating role between life satisfaction and cell phone addiction. To this end, 1109 university students from Metropolitan Lima were selected and administered the DASS 21, SABAS, SWLS. Result: A partial effect of each mediating model was found, in addition to Satisfaction with life achieved a direct effect on cell phone addiction; at the same time the mediating variables achieved a significant direct effect on addictive behavior. Conclusion: Negative emotions have a mediating role in explaining smartphone addiction.

Introducción: Los usuarios de teléfonos inteligentes se han incrementado a nivel mundial, debido a su multifuncionalidad y accesibilidad. Objetivo: Determinar el efecto mediador de las emociones negativas entre la satisfacción con la vida y la adicción a los teléfonos inteligentes en universitarios. Método: Se planteó un modelo explicativo de ecuaciones estructurales en el cual cada emoción negativa (depresión, ansiedad y estrés) tienen un rol mediador entre la satisfacción con la vida y la adicción a los celulares. Con tal fin, se seleccionaron 1109 universitarios de Lima Metropolitana a los cuales se les aplicaron el DASS 21, SABAS, SWLS. Resultados: Se encontró un efecto parcial de cada modelo mediador, además la Satisfacción con la vida logró un efecto directo sobre la adicción a los teléfonos celulares; al mismo tiempo las variables mediadoras consiguieron un efecto directo significativo sobre la conducta adictiva. Conclusión: las emociones negativas tienen un rol mediador en la explicación de la adicción a los teléfonos inteligentes.

Mediating effect of work-family conflict and work-family enrichment in the relationship between job demands and subjective well-being among nurses / 中国职业医学

Objective: To investigate the mechanisms of work-family conflict (WFC) and work-family enrichment (WFE) between job demands and subjective well-being (SWB) among nurses. Methods: A total of 1 420 nurses were selected as the study subjects from five tertiary public hospitals in Shandong Province using two-stage sampling method. Job Demands-Resources Scale, Work-Family Relationship Scale and General Well-Being Scale were used for investigating the job demands, job resources, WFC, WFE, and SWB. Results: The average score of SWB in nurses was (75.5±15.1). Job demands had a negative effect on SWB in nurses (standardized regression coefficient=-0.17, P<0.01). WFC and WFE played parallel mediating roles in the relationship between job demands and SWB, with the mediating effect values of -0.29 and -0.07, respectively (both P<0.01). The interaction of job resources and job demands positively affected WFC (standardized regression coefficient<0.01, P<0.01). Conclusion: Job demands affect SWB through the mediating roles of WFC and WFE, and the impact of job demands on WFC is moderated by job resources. The effect of job demands on WFC is relatively strong in nurses with high levels of job resources, but the difference in the effect of high and low levels of job resources is small.

The relationship between compassion fatigue and workplace psychological violence, alexithymia, and empathy among clinical nurses / 中国职业医学

Objective: To study the relationship between compassion fatigue and workplace psychological violence, alexithymia, and empathy in clinical nurses. Methods: A total of 1 159 clinical nurses from 10 cities in Henan and Fujian Provinces were enrolled using the method of grabbing random balls. Questionnaires including Workplace Psychologically Violent Behaviors Instrument, the Toronto Alexithymia Scale, Jefferson Scale of Empathy Health Professionals, Professional Quality of Life Scale were used to investigate the status of workplace psychological violence, alexithymia, empathy, and compassion fatigue in participants. Bootstrap analysis was used to analyze the relationship between workplace psychological violence, alexithymia, empathy, and compassion fatigue scores. Results: The average score for workplace psychological violence among clinical nurses was (26.2±6.5), with 405 nurses (34.9%) having experienced workplace psychological violence. The scores for alexithymia, empathy and compassion fatigue were (58.3±12.3), (104.3±18.6) and (48.5±6.7) respectively. Mild compassion fatigue was detected in 34.9% of participants, while moderate to severe compassion fatigue accounted for 48.8%. Bootstrap test result showed that workplace psychological violence had a positive impact on compassion fatigue ［standardized effect value (β)=0.40, 95% confidence interval(CI)： 0.35-0.44］. Workplace psychological violence had separate mediating effects through alexithymia (β=0.15, 95%CI： 0.10-0.19), empathy (β=0.16, 95%CI： 0.10-0.21) , and a chain mediating effect through alexithymia and empathy on compassion fatigue (β=0.06, 95%CI： 0.03-0.09). Conclusion: Compassion fatigue symptoms are relatively common among clinical nurses. Experiencing workplace psychological violence directly affects compassion fatigue and can indirectly affect it through the mediating effects of alexithymia and empathy.

Influence of compassion fatigue, psychological stress and positive psychological capital on overall happiness of firefighters / 中国职业医学

Objective: To study the relationship between compassion fatigue and overall happiness among firefighters, and the mediating role of psychological stress and positive psychological capital. Methods: A total of 894 firefighters in Shandong Province were selected as the research subjects using purposive sampling method. Questionnaires including the Professional Quality of Life Scale, the Military Psychological Stress Self-Assessment Scale, the Positive Psychological Capital Scale, and the Overall Happiness Scale were used for data collection. Results: The scores of compassion fatigue, psychological stress, positive psychological capital and overall happiness among firefighters were (40.1±13.5), (13.9±3.9), (133.0±26.4) and (84.9±15.2), respectively. There were correlations between compassion fatigue, psychological stress, positive psychological capital and overall happiness (all P<0.01). Psychological stress partially mediated the relationship between compassion fatigue and overall happiness, and the mediating effect accounted for 27.0% of the total effect. Positive psychological capital moderated the front half path and the direct path between compassion fatigue and overall happiness (all P<0.01). Conclusion: Compassion fatigue can directly or indirectly affect the firefighters' overall happiness. Psychological stress plays a partial mediating role and positive psychological capital plays a moderating role between compassion fatigue and overall happiness.

Research on the driving mechanism of residents′ willingness to participate in tiered medical care based on harmonious management theory / 中华医院管理杂志

Objective:To construct and validate a theoretical model of residents′ willingness to participate in tiered medical care based on harmonious management theory, providing reference for promoting the tiered medical care system and aiding governmental decision-making.Methods:Based on the harmonious management theory and literature review, a model capturing residents′ propensity to engage in tiered medical care was formulated. Using convenience sampling method, a questionnaire survey was conducted on 2 067 residents from 24 communities in Zhejiang province from April to May 2022. Descriptive statistical analysis was conducted on the survey results, and multilevel linear regression and structural equation modeling were used to analyze the driving mechanism of residents′ willingness to participate in tiered medical care.Results:The willingness rate of residents to participate in tiered medical care was 69.7%, which was at an average level. Regression insights highlighted the positive influence of policy support perception ( β=0.170, P<0.01), awareness of management mechanisms ( β=0.093, P<0.01), cognitive attitudes ( β=0.102, P<0.01), and trust levels ( β=0.244, P<0.01) on residents′ participation willingness. In contrast, resource allocation perceptions lacked a significant effect ( β=0.065, P>0.05). The structural equation model revealed that cognitive attitudes played a mediating role in the " policy system perception → participation willingness" and " management mechanism perception → participation willingness" pathways, with effect sizes of 0.030 and 0.039, respectively. Trust levels also mediated these paths, with effect sizes of 0.039 and 0.045, and entirely mediated the " resource allocation perception → participation willingness" path, registering an effect size of 0.053. Conclusions:The harmonious management theory can be used to explain the formation mechanism of residents′ willingness to participate in tiered medical care. The government and medical institutions urgently need to further improve residents′ awareness of tiered medical care, focus on enhancing residents′ trust, and further improve policies and management measures such as financial investment, medical insurance reimbursement, and referral systems.

The relationship between self-control and obsessive-compulsive symptoms: the chain mediating effect of procrastination and anxiety / 中华行为医学与脑科学杂志

Objective:To investigate the relationship between self-control and obsessive-compulsive symptoms(OCS), and the mediating role of procrastination and anxiety in this relation.Methods:Totally 6 367 Chinese college students were recruited to complete the Chinese version of the self-control scale, the Aitken procrastination inventory, and the symptom checklist-90.Descriptive analysis and Pearson correlation were carried out using SPSS 23.0.Mplus 7.4 was used to test the model fit.The mediating effects were tested using the Bootstrap method.Results:Pearson correlation analysis showed that there were significant correlations among self-control, procrastination, anxiety, and obsessive-compulsive symptoms ( r=-0.71-0.78, P<0.01). Mediation modeling analysis showed that the total indirect effect of self-control on OCS was -0.303, accounting for 63.13% of the total effect.The mediating effect of procrastination between self-control and OCS was -0.045, accounting for 9.38% of the total effect.The mediating effect of anxiety between self-control and OCS was -0.239, accounting for 49.79% of the total effect.Moreover, the chain mediating effect of procrastination and anxiety between self-control and OCS was also significant, with an effect value of -0.019, accounting for 3.96% of the total effect. Conclusion:Self-control can negatively predict OCS, procrastination and anxiety play a chain mediating role in the effect of self-control on OCS.

Effect of stress perception on depression in medical staff: the mediating role of resilience / 中华行为医学与脑科学杂志

Objective:To explore the impact of stress perception on depression and the potential mediating role of resilience in medical staff.Methods:A total of 606 medical staff were recruited and investigated by self-designed questionnaire, the perceived stress scale (PSS-10), the 10-item Connor-Davidson resilience scale (CD-RISC-10), and the patient health questionnaire-9 (PHQ-9) from February to March, 2020.SPSS 26.0 software was used to execute Pearson or Spearman correlation analysis, common method biases test, and multicollinearity test.Model 4 in PROCESS 3.2 macro program and Bootstrap method were used for mediating effects analysis.Results:There was a positive correlation between stress perception score(16.93±6.65) and depression score (5.00(2.00, 9.00))( r=0.551, P<0.01), and a negative correlation between stress perception score and resilience score (27.08±8.68) ( r=-0.285, P<0.01) among 606 medical staff.There was a negative correlation between resilience score and depression score ( r=-0.474, P<0.01). Mesometric effect examination showed that resilience played a partial mediating role in the relationship between stress perception and depression, and the mediating effect accounted for 10.87% of the total effect. Conclusion:Stress perception can directly or indirectly influence depression scores, and resilience partially mediates the relationship between stress perception and depression.Depression can be reduced clinically by reducing stress perception or enhancing the resilience of medical personnel.

The chain mediating effect of mindfulness and perceived stress between childhood trauma and psychotic-like experiences among college freshmen / 中华行为医学与脑科学杂志

Objective:To explore the mediating effects of mindfulness and perceived stress between childhood trauma and psychotic-like experiences.Methods:In October 2021, 602 freshmen from a university in Guangdong Province were tested by childhood trauma questionnaire(CTQ), mindful attention awareness scale(MAAS), perceived stress scale(PSS), and community assessment of psychic experiences(CAPE). SPSS 21.0 and Mplus 8.3 were used for data analysis. Mann-Whitney U test was used to compare the differences between groups, and Spearman correlation analysis was used to investigate the correlation among childhood trauma, mindfulness, perceived stress and psychotic-like experiences. Bias-corrected nonparametric percentile Bootstrap method was used to examine the mediating roles of mindfulness and perceived stress between childhood trauma and psychotic-like experiences. Results:(1) In the past one month, 59.5% of the freshmen had psychotic-like experiences, and 8.5% of them experienced the distress. (2)Childhood trauma was positively correlated with perceived stress( r=0.29, P<0.01), frequency ( r=0.14, P<0.01)and distress( r=0.17, P<0.01) of psychotic-like experiences, and was negatively correlated with mindfulness( r=-0.28, P<0.01). (2)Mindfulness and perceived stress played individual mediating effects and chain mediating effect between childhood trauma and frequency of psychotic-like experiences, with effect size of 0.08, 0.04, 0.03, accounting for 53.33%, 26.67%, 20.00% of the total indirect effect(effect size=0.15), respectively. Mindfulness and perceived stress played individual mediating effects and chain mediating effect between childhood trauma and distress of psychotic-like experiences, with effect size of 0.07, 0.04, 0.03, accounting for 50.00%, 28.57%, 21.43% of the total indirect effect(effect size=0.14), respectively. Conclusion:Childhood trauma can affect psychotic-like experiences and distress through the indirect effects of mindfulness and perceived stress, or through the chain mediating effect of mindfulness-perceived stress.

The mediating effect of empathy between nursing students' personality traits and attitude towards death / 中华行为医学与脑科学杂志

Objective:To explore the mediating effect of empathy between personality traits and death attitude in nursing students.Methods:From April to May 2022, a total of 237 undergraduate nursing students were surveyed by general information questionnaire, big five inventory, Jefferson scale of empathy for nursing students, and death attitude profile-revised. Common method bias test, correlation analysis and descriptive analysis were conducted by SPSS 26.0 software.PROCESS macro program was used to test the mediating effect.Results:Agreeableness(32.78±4.92), empathy(110.03±16.83)were positively correlated with positive death attitude(57.95±12.35)( r=0.274, 0.571, both P<0.01), neuroticism(23.00±4.78)was positively correlated with negative death attitude(31.81±10.04)( r=0.199, P<0.01), empathy was negatively correlated with negative death attitude ( r=-0.226, P<0.01). Empathy partially mediated the relationship between neuroticism and negative death attitude, the mediating effect accounted for 16.08%(0.032/0.199) of the total effect, and empathy played a completely mediating role between the agreeableness and positive death attitude. Conclusion:The death attitude of undergraduate nursing students is mainly natural acceptance. Personality traits can directly affect death attitude and also indirectly affect death attitude through empathy.

Effect of basic psychological needs satisfaction on phubbing behavior among high school students: the mediating effect of fear of missing out and mobile phone addiction / 中华行为医学与脑科学杂志

Objective:To investigate the mediating roles of the fear of missing out and mobile phone addiction between the basic psychological needs satisfaction and phubbing behavior among high school students.Methods:In April 2022, a cross-sectional design survey was conducted on 14 666 high school students. All participants were evaluated by the basic psychological needs scales(BPNS), generic scale of phubbing(GSP), trait-state fear of missing out scale(T-S FOMOS) and mobile phone addiction index(MPAI). The SPSS 26.0 software was used to conduct common method deviation test, descriptive statistics, and correlation analysis.PROCESS 4.1 was used to construct the model, and the Bootstrap method was used to test for mediating effects.Results:(1)Among the 14 036 high school students, there were 1 752 (12.48%) students who were addicted to mobile phones.There were significant differences in gender in the scores including BPNS(boy: 4.43±0.79, girl: 4.36±0.79), GSP(boy: 2.72±1.01, girl: 2.76±1.03) and T-S FOMOS(boy: 1.73±0.60, girl: 1.84±0.64), ( t=5.22, -10.58, -2.78, all P<0.01). Among different grades, there were significant differences in the scores of BPNS, T-S FOMOS, MPAI, and GSP( F=25.43, 39.50, 53.45, 14.59, all P<0.01). (2)Basic psychological needs score were positively correlated with fear of missing out, mobile phone addiction and phubbing( r=-0.432--0.294, all P<0.01). Phubbing were negatively correlated with fear of missing out and mobile phone addiction( r=0.744, 0.538, both P<0.01). Fear of missing out were negatively correlated with mobile phone( r=0.646, P<0.01). (3)The basic psychological needs satisfaction had a direct effect on phubbing behavior, and the effect value was -0.188 (95% CI: -0.173--0.204). The mediating effect of fear of missing out between the basic psychological needs satisfaction and phubbing behavior was -0.035(95% CI: -0.028--0.042). The mediating effect of mobile phone between the basic psychological needs satisfaction and phubbing behavior was -0.203(95% CI: -0.191--0.214). Fear of missing out and mobile phone addiction played a chain mediating role between them, and the mediating effect value was -0.134(95% CI: -0.125--0.143), which accounted for 23.93%(-0.134/-0.560) of the total effect. Conclusion:The high level basic psychological needs satisfaction can alleviate the occurrence of phubbing behavior. It may be achieved by decreasing fear of missing out and reducing mobile phone addiction.

The mediating effect of balanced time perspective between negative evaluation fear and mobile phone addiction among vocational school students / 中华行为医学与脑科学杂志

Objective:To explore the relationship between negative evaluation fear and mobile phone addiction, and the mediating role of balanced time perspective.Methods:In April 2021, totally 1 158 secondary vocational school students were investigated by scales of fear of negative evaluation(FNE), mobile phone addiction index(MPAI)and Zimbardo time perspective inventory(ZTPI). The balanced time perspective was calculated by deviation from the balanced time perspective(DBTP). SPSS 20.0 statistical software was used for descriptive statistical analysis and correlation analysis of the data.Bootstrap method was used to test the mediating effect.Results:(1) Negative evaluation fear(37.87±7.71)was significantly positively correlated with balanced time perspective(4.50±0.75)( r= 0.379, P<0.01) and mobile phone addiction(46.11±11.92)( r=0.437, P<0.01). The balanced time perspective was significantly positively correlated with mobile phone addiction( r=0.475, P<0.01). (2) Negative evaluation fear directly and positively predicted mobile phone addiction( β=0.300, 95% CI=0.248-0.352). The balanced time perspective played a partial mediating role between negative evaluation fear and mobile phone addiction, and the mediating effect value was 0.137, accounted for 31.31%(0.137/0.437) of the total effect. Conclusion:The fear of negative evaluation can directly affect the mobile phone addiction behavior of secondary vocational students, and can also indirectly affect the mobile phone addiction by affecting the balanced time perspective.Good balanced time perspective can reduce the risk caused by the fear of negative evaluation.

Chain mediating effect of experience avoidance and emotional eating between intolerable uncertainty and life satisfaction in college students / 中华行为医学与脑科学杂志

Objective:To explore the mediating effect of experiential avoidance and emotional eating between intolerable uncertainty and life satisfaction of college students.Methods:From October to December 2021, a total of 890 college students in the Beijing-Tianjin-Hebei region were tested by the intolerable uncertainty scale (simplified version), the acceptance action scale second edition, the Dutch eating behavior questionnaire and the life satisfaction scale. All data processing and analysis were preformed by SPSS 22.0 software, and the mediating effect was tested by Pearson correlation analysis and Bootstrap analysis.Results:The intolerable uncertainty score was (26.43±7.64), the experiential avoidance score was (22.63±9.67), the emotional eating score was (26.43 ±11.83), and the life satisfaction score was (16.74±6.03). Intolerable uncertainty was significantly and negatively correlated with life satisfaction( r=-0.76, P<0.01), and was significantly and positively correlated with experience avoidance and emotional eating( r=0.66, 0.78, both P<0.01). Experience avoidance was significantly and positively correlated with emotional eating( r=0.70, P<0.01), and was significantly and negatively correlated with life satisfaction( r=-0.62, P<0.01). Emotional eating was significantly and negatively correlated with life satisfaction( r=-0.68, P<0.01). Intolerable uncertainty affects life satisfaction through four paths.The direct effect value of intolerable uncertainty on life satisfaction was -0.53, accounting for 70.23% of the total effect. The separate mediating effect value of experience avoidance was -0.11, accounting for 50.00% of the total indirect effect.The separate mediating effect value of emotional eating was -0.08, accounting for 36.36% of the total indirect effect, and the chain mediating effect value of experience avoidance and emotional eating was -0.03, accounting for 13.64% of the total indirect effect. Conclusion:Intolerable uncertainty can directly affect life satisfaction of college students and indirectly through experiencing avoidance and emotional eating.

Mediating effects of self-perceptions of aging between frailty and cognitive function in community-dwelling older adults / 中华行为医学与脑科学杂志

Objective:To explore the mediating role of self-perceptions of aging between frailty and cognitive function in community-dwelling older adults.Methods:From February to July 2021, a total of 528 elderly people in Xinxiang community were investigated with the frailty phenotype, the brief self-perceptions ageing questionnaire and the Mini-mental state examination(MMSE) scale.According to the MMSE total score and education level, the subjects were divided into cognitive impairment group (illiteracy≤17, primary school≤20, junior high school and above≤24, n=74) and cognitive normal group( n=454). SPSS 25.0 software was used for common method deviation test, descriptive statistics and correlation analysis, while AMOS 24.0 software was used to build structural equation model and Bootstrap method was used for intermediary effect test. Results:(1)The prevalence of cognitive impairment among the elderly in the community was 14.1%. The differences between the cognitively normal group and cognitively impaired group were statistically significant in terms of age, education, number of chronic diseases suffered and depression ( χ2=59.21, 6.53, 9.84, 25.47, all P<0.05). The differences were statistically significant in terms of frailty( χ2=75.65, P<0.001) and self-perceptions of aging ( t=77.67, P<0.001). (2)Self-perceptions of aging in the cognitively impaired group (47.39±8.66) was higher than that in the cognitively normal group (38.22±8.24) ( t=77.67, P<0.001) .Frailty score in cognitively impaired group (2.00 (1.00, 3.00)) was higher than that in the cognitively normal group (0.00 (0.00, 1.00))( Z=-8.63, P<0.001) . (3)Frailty was negatively correlated with cognitive function ( r=-0.492, P<0.01), and positively correlated with self-perceptions of aging ( r=0.540, P<0.01). Self-perceptions of aging was negatively correlated with cognitive function ( r=-0.541, P<0.01) . After controlling the influencing factors such as age, education level, chronic diseases and depression, the correlation was still significant (all P<0.01) . (4) Self-perceptions of aging played a partially mediating role in the relationship between frailty and cognitive function, the mediating effect accounted for 58.5% of the total effect. Conclusion:Frailty and self-perceptions of aging have a significant impact on the cognitive function of the elderly in the community, and self-perceptions of aging plays a partial intermediary role between the frailty and cognitive function of the elderly in the community.

Relationship between self-perceptions of aging and cognitive function in community elderly: the mediating and moderating effects of loneliness / 中华行为医学与脑科学杂志

Objective:To explore the relationship between self-perceptions of aging and cognitive function, and the mediating and moderating effect of loneliness among them.Methods:A multi-stage stratified sampling was conducted in Jinzhou from September to November 2021, and 318 community-based elderly were included.General data questionnaire, the brief ageing perceptions questionnaire (BAPQ), UCLA loneliness scale(UCLA-LS) and mini-mental state examination (MMSE) were applied to all subjects.IBM SPSS 25.0 software was used to conduct independent sample t-test, analysis of variance and Pearson correlation analysis, and Bootstrap program of AMOS 22.0 was used to analyze the mediation effect.The model in SPSSAU on-line analysis program was used to test the moderating effect. Results:The average scores of self-perceptions of aging, loneliness and cognitive function were (44.85±12.48), (41.70±8.73) and (24.87±3.40) respectively.And 65 of 318 subjects had cognitive impairment, and the detection rate was 20.44%(65/318). Self-perceptions of aging, loneliness and cognitive function scores were significantly correlated between each other(all P<0.05). Self-perceptions of aging had a negative effect on cognitive function ( β=-0.467, P<0.01). Self-perceptions of aging had a positive effect on loneliness ( β=0.585, P<0.01). Loneliness had a negative effect on cognitive function ( β=-0.234, P<0.01). The indirect standardization effect of loneliness between self-perceptions of aging and cognitive function was -0.137, and the mediating effect accounted for 22.68% of the total effect.Loneliness played a moderating role between self-perceptions of aging and cognitive function ( β=-0.114, t=-2.26, P=0.025). Conclusion:Self-perceptions of aging and loneliness can predict the cognitive function in the elderly, and loneliness plays a mediating role between self-perceptions of aging and cognitive function.Early detection of negative senility emotion and loneliness of the elderly will play a positive role in preventing the occurrence of cognitive impairment.

Relationship between self-esteem and mental health of medical students: mediating effect of psychological flexibility / 中华医学教育探索杂志

Objective:To explore the relation among self-esteem, psychological flexibility and mental health in medical students, and to provide scientific reference for mental health education for medical students.Methods:A total of 788 medical students selected from a medical university in Chongqing City were investigated with the symptom checklist 90 (SCL-90), self-esteem scale (SES), acceptance and action questionnaire-Ⅱ (AAQ-Ⅱ), and cognitive fusion questionnaire-fusion (CFQ-F). SPSS 22.0 software was used for statistical analysis. T test, ANOVA, correlation analysis and tests for mediation effects were conducted. Results:There were significant differences in self-esteem and mental health level among medical students in gender and different grades ( t=-2.55, P<0.05; F=6.53, P<0.05). Mental health, self-esteem and psychological flexibility of medical students were correlated in pairs ( r=-0.528-0.694, P<0.01). Psychological flexibility played a partial mediation role between self-esteem and mental health of medical students, and the mediating effect accounted for 60.03% of the total effect. Conclusion:Self-esteem can directly predict the mental health of medical students, and can also indirectly affect mental health through psychological flexibility. Medical universities should carry out psychological education and promotion work with pertinence.

Mediating effect of psychological capital on rumination and learning burnout among undergraduate nursing students / 中华医学教育探索杂志

Objective:To investigate the effect of rumination on learning burnout of nursing undergraduate students and the mediating role of psychological capital between rumination and learning burnout of nursing undergraduate students.Methods:A total of 296 undergraduate nursing students from three medical colleges were assessed by using ruminative responses scale, learning burnout questionnaire and psychological capital scale. SPSS 20.0 was used for t-test. Pearson correlation was to analyze the relationship among psychological capital, learning burnout and ruminative thinking. AMOS 20.0 was used to construct and analyze the mediating model of psychological capital and its mediating effect was tested by Bootstrap method. Results:The average score of rumination of nursing undergraduate students was 46.60±11.40, learning burnout score was 56.18±11.25, and psychological capital scale score was 99.93±15.27. There was a significant difference among the rumination, psychological capital, and learning burnout scores in whether there was curriculum failure ( P < 0.05). The total score of rumination was positively related to the total score of learning burnout ( r = 0.39, P < 0.01), and was negatively related to the total score of psychological capital ( r = -0.53, P < 0.01). The total score of rumination was negatively related to the total score of psychological capital ( r = -0.46, P < 0.01). The psychological capital played a partial mediating role between rumination and learning burnout. The mediating effect value was 0.216, accounting for 61.521% of the total variation. Conclusion:The rumination can both directly affect the learning burnout of nursing undergraduate students and indirectly affect the learning burnout through psychological capital. Psychological capital plays a bridge role in improving rumination related to learning burnout.

Relationship between kinesiophobia and somnipathy among inpatients with lumbar degenerative disease after surgery and its impact pathway / 中国实用护理杂志

Objective:To explore the relationship between kinesiophobia and somnipathy among inpatients with lumbar degenerative disease after surgery, and analyze the mediating effects of post-traumatic stress disorder and family care.Methods:A cross-sectional survey method was adopted, from July 2020 to July 2022, a total of 130 lumbar degenerative disease patients from Wuhan Dongxihu District People′s Hospital were enrolled as research object by convenience sampling method. General information questionnaire, Tampa Scale for Kinesiophobia, Pittsburgh Sleep Quality Index, Posttraumatic Stress Checklist-civilian version and Family APGAR index were used for investigation. A structural equation model was established to evaluate the mediating effect of post-traumatic stress disorder, family care on kinesiophobia and somnipathy.Results:The scores of kinesiophobia, somnipathy, post-traumatic stress disorder and family care were (39.95 ± 3.90), (7.63 ± 0.46), (25.99 ± 4.99), (5.67 ± 1.76) points, respectively. There were significant differences in the scores of somnipathy in terms of age, monthly income, course of disease and pain degree ( F values were 3.21 to 10.12, all P<0.05). The dimensions and total scores of somnipathy were positively correlated with kinesiophobia ( r values were 0.347 to 0.800, all P<0.05) and post-traumatic stress disorder ( r values were 0.385 to 0.825, all P<0.05), negatively correlated with the scores of family care ( r values were - 0.653 to - 0.282, all P<0.05); the scores of family care was negatively correlated with kinesiophobia and post-traumatic stress disorder ( r = - 0.695, - 0.637, both P<0.05); the scores of kinesiophobia was positively correlated with post-traumatic stress disorder ( r = 0.773, P<0.05). The indirect effect of kinesiophobia on somnipathy was identified, and the total indirect effect value was 0.44; the indirect effect value of family care and post-traumatic stress disorder was 0.09, which accounted for 12.0% of the total effect. Conclusions:Post-traumatic stress disorder and family care play a multiple mediating role on the relationship between kinesiophobia and somnipathy in patients with lumbar degenerative disease after surgery.

Mediating effects of disease perception on disease uncertainty and health behaviors among thrombolysis therapy in patients with acute ischemic stroke / 中国实用护理杂志

Objective:To explore the mediating effects of disease perception on disease uncertainty and health behaviors among thrombolysis therapy in patients with acute ischemic stroke, to provide a theoretical basis for improving patient health behavior.Methods:By cross-sectional survey methods, from June 2021 to June 2022, a total of 123 thrombolysis therapy in patients with acute ischemic stroke were investigated by general information, Mishel Uncertainty in Illness Scale, Health Behavior Scale for Stroke Patients and Revised Illness Perception Questionnaire by convenience sampling method. The mediating effect of disease perception between disease uncertainty and health behavior was verified by structural equation model.Results:The scores of disease uncertainty, health behaviors and disease perception were (52.21 ± 7.67), (63.77 ± 9.40), (127.70 ± 26.19) points in patients with acute ischemic stroke. Health behaviors and each dimension including exercise, medication, instruction, nutrition, responsibility, tobacco and alcohol were negatively correlation between disease uncertainty ( r values were -0.762 to -0.411, all P<0.01), and positively correlation between disease perception ( r values were 0.689 to 0.912, all P<0.01). Disease uncertainty was a significantly negative predictor for health behaviors ( β= -0.71, P<0.01); disease perception was also a significantly negative predictor for disease perception ( β = -0.85, P<0.01). Disease uncertainty had a significantly indirect effect on the health behaviors for thrombolysis therapy in patients with acute ischemic stroke through disease perception, which showed the mediating effect of health behaviors accounts for 15.2% of total effect. Conclusions:Disease perception play a mediating role in the relationship between disease uncertainty and health behaviors among thrombolysis therapy in patients with acute ischemic stroke.