Relationships of leisure activities with physical and cognitive functions among Chinese older adults: A prospective community-based cohort study.

OBJECTIVES: Based on a prospective design, this study aimed to investigate the relationships of leisure activities with physical and cognitive functions among Chinese older adults. METHODS: The respondents aged 65 years or more were selected from the 2014-2018 of the Chinese Longitudinal Healthy Longevity Survey. Physical function measurement indicators were reflected by activities of daily living (ADL), instrumental activities of daily living (IADL), and physical performance (PP), while cognitive function was assessed by Mini-Mental State Examination. Fine-Gray competing risk regression models were used to analyze the data. RESULTS: Using the figures for 2014 as a baseline for the study, we included 6047, 6216, 5951, and 5916 respondents in the ADL, IADL, PP, and cognitive function analyses, respectively. The prospective results showed that keeping domestic animals or pets was related to a lower risk of ADL disability of respondents after adjustment (SHR: 0.619, 95% CI: 0.486, 0.788). Similarly, taking part in social activities (SHR: 0.781, 95%CI: 0.658, 0.929) and reading books or newspapers (SHR: 0.793, 95% CI: 0.656, 0.958) were associated with a lower risk of IADL disability. Playing cards or mahjong was correlated with a lower risk of cognitive impairment (SHR: 0.669, 95% CI: 0.507, 0.882), while keeping domestic animals or pets was related to a higher risk of cognitive impairment (SHR: 1.279, 95% CI: 1.047, 1.562). CONCLUSION: Participation in leisure activities moderately may decrease the risk of a decline in physical and cognitive functions among Chinese older adults.

How Do Presenteeism and Family Functioning Affect the Association Between Chinese Nurses' Job Stress and Intention to Stay?

BACKGROUND: Despite a great deal of existing research on nurses' job stress and intention to stay, it is still unclear how the association between Chinese nurses' job stress and intention to stay is affected by presenteeism and family functioning. AIMS: This study aimed to investigate the correlations of Chinese nurses' job stress, presenteeism, and family functioning with their intention to stay and clarify the mediating effect of presenteeism and the moderating effect of family functioning on the association between their job stress and intention to stay. METHOD: A cross-sectional study of 1,008 nurses was performed in a major general hospital in Qiqihar City, Heilongjiang Province, China. The participants were invited to engage in a questionnaire survey regarding job stress, presenteeism, family functioning, and intention to stay. A moderated mediation analysis was conducted through multiple linear regression analysis and the PROCESS macro. RESULTS: Job stress and presenteeism were negatively correlated with intention to stay, whereas family functioning was positively correlated with intention to stay. The effect of job stress on intention to stay was partially mediated by presenteeism (Effect = -0.147, 95% CI = [-0.305, -0.003]). In addition, family functioning moderated the direct effect of job stress on intention to stay (Index = -0.134, 95% CI = [-0.274, -0.001]). CONCLUSIONS: Presenteeism and family functioning were found to play mediating and moderating roles, respectively, in the relationship between job stress and intention to stay. Relevant interventions or family-friendly programs should be developed to enhance nurses' intention to stay.

Associations of job satisfaction and burnout with psychological distress among Chinese nurses.

Nurses' mental health is related to the quality of medical care and the outcome of treatment, and has become an important issue in nursing management. However, the role of burnout in the relationship between job satisfaction and psychological distress have not been evaluated. This study aimed to examine the prevalence of psychological distress among Chinese nurses and explore the associations of job satisfaction and burnout with psychological distress. A cross-sectional survey of 866 nurses was conducted in Qiqihar City, Heilongjiang Province of China. Job satisfaction, burnout, and psychological distress were assessed via the single-item, the Maslach Burnout Inventory-Human Services Survey, and the 12-item General Health Questionnaire respectively, followed by a mediation analysis through the multiple regression analysis and a PROCESS macro method. The prevalence of psychological distress was 35.2% among the participants. After controlling the potential confounding factors, job satisfaction and burnout were found to be still associated with psychological distress (P < 0.001). Furthermore, psychological distress was negatively correlated with both job satisfaction (r = -0.312) and personal accomplishment (r = -0.422) but positively correlated with both emotional exhaustion (r = 0.491) and depersonalization (r = 0.449). Burnout may mediate the association between job satisfaction and psychological distress (B = 0.139, ß = 0.440, P < 0.001 for emotional exhaustion; B = 0.226, ß = 0.382, P < 0.001 for depersonalization; and B = -0.105, ß = -0.368, P < 0.001 for personal accomplishment). The mental health status of Chinese nurses remains to be improved. Low job satisfaction and burnout could increase the risk of psychological distress among Chinese nurses. Moreover, job satisfaction may partially affect psychological distress among Chinese nurses through emotional exhaustion, personal accomplishment, and depersonalization. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-022-04006-w.

The Mediating Role of Extra-family Social Relationship Between Personality and Depressive Symptoms Among Chinese Adults.

Objectives: This study aims to explore the associations of personality traits and extra-family social relationship with depressive symptoms among Chinese adults. Methods: A nationally representative sample of 29,810 adults aged 16 and above were selected from 2018 CFPS. Personality and depressive symptoms were measured using CBF-PI-15 and the CES-D8 scale. Extra-family social relationship was assessed through the self-rated evaluation. The multiple regression analysis and the PROCESS macro were used for the mediation analysis. Results: Extraversion (OR = 0.807, 95% CI = 0.773, 0.842), agreeableness (OR = 0.795, 95% CI = 0.756, 0.835) and extra-family social relationship (OR = 0.927, 95% CI = 0.913, 0.941) had negative associations with depressive symptoms. Extra-family social relationship could mediate between extraversion and depressive symptoms (Indirect effect = -0.049,95% CI = -0.060, -0.039) as well as agreeableness (Indirect effect = -0.056, 95% CI = -0.068, -0.046) and depressive symptoms. Comparing to females, the indirect effect accounts for a higher proportion of total effect in males. Conclusion: Extra-family social relationship might mediate the association between extraversion and depressive symptoms as well as agreeableness and depressive symptoms.

Gender and age differences in the associations between personality traits and depressive symptoms among Chinese adults: Based on China Family Panel Study.

This study aims to explore the associations between personality traits and depressive symptoms among Chinese adults and analyse the gender and age differences in the associations. A national representative sample of 28,628 adults aged 18 and above were selected from the 2018 China Family Panel Studies (CFPS) data. The short version of the Big Five Inventory (CBF-PI-15) and the Center for Epidemiologic Studies Depression (CES-D 8) were used to measure personality traits and depressive symptoms respectively. Binary logistic regression models were employed to analyse the associations between personality traits and depressive symptoms in the whole participants, different age groups and genders respectively. After adjustment, higher levels of conscientiousness, extraversion and agreeableness were related to lower level of depressive symptoms, while higher levels of openness and neuroticism were related to higher level of depressive symptoms (p < 0.05). A significant interaction between gender and conscientiousness on depressive symptoms was found (interaction p = 0.005), and the association between conscientiousness and depressive symptoms was stronger in males than females (p < 0.001). Significant interactions between age and conscientiousness (interaction p = 0.007), agreeableness (interaction p = 0.001) on depressive symptoms were found respectively. Moreover, the associations of conscientiousness and agreeableness with depressive symptoms were strongest among old group, followed by middle-aged group, and then young group (p < 0.05). In conclusion, conscientiousness, extraversion and agreeableness had negative associations with depressive symptoms, while openness and neuroticism had positive associations with depressive symptoms. The negative association between conscientiousness and depressive symptoms was stronger among males than females, and the negative associations of conscientiousness and agreeableness with depressive symptoms were strongest among old group, followed by middle-aged group, and then young group.

Factors Associated with Subjective Well-Being of Chinese Adolescents Aged 10-15: Based on China Family Panel Studies.

(1) Background: This study aimed to explore the factors associated with the subjective well-being (SWB) of Chinese adolescents from a more comprehensive perspective and to analyze the importance of its influencing factors. (2) Methods: Obtained from the China Family Panel Studies (CFPS) 2018, the research data involved 2316 adolescents aged 10-15. By using the Chi-square test, t-test and binary logistic regression, we investigated the associations of individual-, family- and community-level factors with SWB in Chinese adolescents. To explore the rank of the influencing factors of SWB, the random forest model was set up. (3) Results: In individual-level factors, girls, who were adolescents with higher academic performance and school satisfaction, with the habit of midday napping and reading books, and with higher self-esteem, had a higher SWB. In family-level factors, mothers living at home resulted in a higher SWB, while quarrelling with their parents led to low SWB. In community-level factors, adolescents with better social relationships, social trust and who were better at telling their troubles to others had a higher SWB. Based on the random forest model, the importance degree was ranked, and the top five were decided, including self-esteem (89.949), social relations (43.457), academic performance (31.971), school satisfaction (27.651) and quarrelling with parents (19.026). (4) Conclusions: Self-esteem, social relations, academic performance, school satisfaction and quarrelling with parents are all important variables that are related to the SWB of Chinese adolescents.

Associations of parent-adolescent relationship and self-esteem with emotional and behavioral problems among Chinese adolescents.

BACKGROUND: This study aimed at exploring the associations of parent-adolescent relationship and self-esteem with emotional and behavioral problems (EBPs) among Chinese adolescents using a large-scale nationally questionnaire survey data from China. METHODS: Obtained from China Family Panel Studies (CFPS) 2018, the research data involved 2400 adolescents aged 10-15. Multiple linear regression analysis and the PROCESS macro were used for examining the mediating effect of self-esteem on the associations of parent-adolescent relationship with EBPs. RESULTS: After controlling the potential confounding factors, parent-adolescent relationship and self-esteem were significantly associated with EBPs (P < 0.01). Correlation analysis results showed that parent-adolescent relationship (r = -0.116, P < 0.01) and self-esteem (r = -0.209, P < 0.01) were negatively correlated with EBPs. Self-esteem partially mediated the associations of parent-adolescent relationship with EBPs among Chinese adolescents. LIMITATIONS: The cross-sectional design limited the ability to make causal inferences. CONCLUSIONS: Positive parent-adolescent relationship and high self-esteem contributed to fewer EBPs of adolescents. Parent-adolescent relationship predicted EBPs partially mediated by self-esteem. Establishing positive parent-adolescent relationship and improving individual self-esteem may thus be promising targets for intervention in adolescents with EBPs.

Association between perceived life stress and subjective well-being among Chinese perimenopausal women: a moderated mediation analysis.

BACKGROUND: The impact of perceived life stress on subjective well-being has been well-established; while few studies have explored the mediating and moderating mechanisms of the association between perceived life stress and subjective well-being among perimenopausal women. This study is aimed at exploring the mediating effect of depressive symptoms and the role of interests/hobbies as a moderator in the association between perceived life stress and subjective well-being among perimenopausal women. METHODS: The participants were 1,104 perimenopausal women at the age of 40 to 60, who were asked to complete a paper-based questionnaire. A single item was used to measure self-perceived life stress and interests/hobbies. The Zung Self-rating Depression Scale (SDS) and Subjective Well-being Scale for Chinese Citizens (SWBS-CC) were applied to assess both depressive symptoms and subjective well-being. Multiple linear regression analysis and the PROCESS macro were adopted to analyse not only the mediating effect of depressive symptoms but also the moderating role of interests/hobbies. RESULTS: Perceived life stress was negatively associated with subjective well-being (B =  - 1.424, ß =  - 0.101, P < 0.001). The impact of perceived life stress on subjective well-being was partially mediated by depressive symptoms (mediation effect = -0.760, 95% confidence intervals (CI) [-1.129, -0.415]). In addition, the interaction term between depressive symptoms and interests/hobbies was significantly related to subjective well-being (ß =  - 0.060, P < 0.05), indicating moderating effect. Moderated mediation had a significant index (Index = -0.220, SE = 0.099, 95% CI [-0.460, -0.060]). CONCLUSIONS: Perceived life stress was negatively related to subjective well-being. The impact of perceived life stress on subjective well-being was mediated by depressive symptoms. Besides, interests/hobbies moderated the indirect effect of depressive symptoms on the relationship between perceived life stress and subjective well-being.

Associations of sleep quality, anxiety symptoms and social support with subjective well-being among Chinese perimenopausal women.

BACKGROUND: Few studies have explored the internal pathway of the association between sleep quality and subjective well-being among perimenopausal women. METHODS: A survey was performed of 1063 perimenopausal women aged 40 to 60 years who participated in a regular health examination conducted at the First Hospital of Jilin University, China. Participants were asked to complete a study questionnaire. The Pittsburgh Sleep Quality Index, Zung Self-rating Anxiety Scale, Perceived Social Support Scale and Subjective Well-being Scale for Chinese Citizens were used to assess sleep quality, anxiety symptoms, social support and subjective well-being, respectively. The data were analyzed using t-tests, analysis of variance, Pearson correlation analysis, multiple linear regression analysis and the PROCESS macro. RESULTS: The mean total subjective well-being score was 90.14 ± 12.80. The correlation analyzes showed that sleep quality (r = -0.341, P < 0.001) and anxiety symptoms (r = -0.490, P < 0.001) were negatively correlated with subjective well-being. Social support was positively correlated with subjective well-being (r = 0.480, P < 0.001). The effect of sleep quality on subjective well-being was partially mediated by anxiety symptoms (Effect = -0.462, 95% CI = [-0.577, -0.363]). In addition, social support moderated the association between anxiety symptoms and subjective well-being (Index = -0.006, 95% CI = [-0.012, -0.001]). LIMITATIONS: This was a cross-sectional study. CONCLUSIONS: The effect of sleep quality on subjective well-being was partially mediated by anxiety symptoms, and social support moderated the association between anxiety symptoms and subjective well-being among perimenopausal women.

Association between pregnant specific stress and depressive symptoms in the late pregnancy of Chinese women: the moderate role of family relationship and leisure hobbies.

Background: Little research has been conducted on the association between pregnant specific stress and depressive symptoms, and whether family relationship and leisure hobbies moderate the association. Methods: A cross-sectional survey of 647 pregnant women was conducted in Shenyang City, Liaoning Province of China. Pregnancy Pressure Scale (PPS), Edinburgh Postnatal Depression Scale (EPDS) and two single items were used to assess stress, perinatal depressive symptoms, family relationship and leisure hobbies, respectively. The analysis included χ2-test, Fisher's exact test, and binary logistic regression. Results: The prevalence of perinatal depressive symptoms was 22.9% among the participants. After adjustment, four dimensions of pregnancy stress were found to increase the risk of depressive symptoms, and odds ratios (ORs) were 4.175 (95% confidence interval (CI) = 2.240, 7.779), 5.947 (95% CI = 2.624, 13.478), 3.907 (95% CI = 2.375, 6.425), and 8.534 (95% CI = 4.588, 15.873) for factors 1, 2, 3, and 4 (recognition of the role of parents, worrying about maternal and child health and safety, the changes in body shape and physical activity level, as well as child care and marriage), respectively. In addition, significant interactions were found between factor 2, factor 4 and family relationship, leisure hobbies with depressive symptoms, respectively (interaction P < 0.10). Conclusion: Tailored stress-overcoming programs, as well as health services, are needed to relieve women's pregnancy stress and prevent them from depressive symptoms. Clinical practice should conduct family relationship-oriented interventions and women themselves can cultivate extensive leisure hobbies in the period of pregnancy preparation.

Associations of body mass index, waist circumference and waist-to-height ratio with cognitive impairment among Chinese older adults: Based on the CLHLS.

BACKGROUND: Few studies have been conducted on the associations of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with cognitive impairment among Chinese older adults through a prospective design. OBJECTIVE: This study was aimed to evaluate the associations of BMI, WC, and WHtR with cognitive impairment. METHODS: We included participants aged 65 years and older in 2014 at baseline and 2018 follow-up surveys of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). BMI, WC, and WHtR were calculated from measured weight, height, and waist circumference. Mini-Mental State Examination was utilized to assess cognitive impairment. Modified Poisson regression was used for calculating prevalence ratios, risk ratios, and 95% confidence intervals. RESULTS: A total of 5156 participants were included in 2014 at baseline. The prevalence of cognitive impairment was 42.5%, 26.7%, and 21.2% in underweight, normal-weight, and overweight/obesity participants defined by BMI categories, respectively, and 24.1% and 26.8% in central obesity participants defined by WC and WHtR cutoffs, respectively. Prospectively, participants with underweight were more likely to suffer from cognitive impairment (RR = 1.258, 95% CI: [1.016, 1.559]), but no risk was found among participants with overweight/obesity after adjustment. Regardless of whether covariates were adjusted or not, no effect on cognitive impairment was found in participants with WC and WHtR groups in the follow-up survey. CONCLUSIONS: Underweight may be a significant risk factor for the cognitive impairment of Chinese older adults. Weight management programs targeting older adults should attach importance to achieving and maintaining optimal body weight and improving cognitive function.

Associations of negative life events and coping styles with sleep quality among Chinese adolescents: a cross-sectional study.

BACKGROUND: Limited published research has examined the relationships of negative life events and coping styles with sleep quality in Chinese junior high school students. We aimed to investigate the prevalence of poor sleep quality and to clarify the role of coping styles between negative life events and sleep quality. METHODS: A cross-sectional study of 3081 students was conducted in Ganzhou City, Jiangxi Province, Southeastern China. Adolescent Self-Rating Life Events Checklist, Simplified Coping Style Questionnaire, and Pittsburg Sleep Quality Index were applied to assess negative life events, coping styles, and sleep quality, respectively. Descriptive analyses, independent-samples t tests, one-way analyses of variance, Pearson correlation analyses, and structural equation modeling (SEM) were applied to analyze the data. RESULTS: The prevalence of poor sleep quality was 26.7%. Negative life events (B = 0.038, P < 0.001) and negative coping style (B = 0.049, P < 0.001) demonstrated a positive association with poor sleep quality, while positive coping style indicated a negative association with poor sleep quality (B = -0.029, P < 0.001). Interactions of negative life events and coping styles with sleep quality were not found (all P > 0.05). The association between negative life events and sleep quality was mediated by negative coping styles. CONCLUSIONS: Our results indicated that poor sleep quality was common in these Chinese adolescents. Negative life events and negative coping style were associated with an increased prevalence of poor sleep quality, while the positive coping style was related to a decreased prevalence of poor sleep quality. A negative coping style mediated the association between negative life events and sleep quality.

The prevalence of depressive symptoms and associated factors in middle-aged and elderly Chinese people.

BACKGROUND: This study aimed to evaluate the prevalence of depressive symptoms and associated factors in middle-aged and elderly people in China. METHODS: Data were obtained from the China Family Panel Studies (CFPS) 2018. We selected 16,767 respondents over the age of 45 as samples for research and analysis. A short version of the Center for Epidemiological Research Depression Scale (CES-D) was used to assess depressive symptoms. Chi-square test and multiple logistic regression analysis were used to explore the related factors of depressive symptoms. Back Propagation neural network model was established to examine the ranking of influencing factors of depressive symptoms. RESULTS: There was 24.1% prevalence of depressive symptoms among the respondents. The 14 important variables affecting depressive symptoms were screened out with the multivariable logistic regression. Based on the BP neural network to rank the degree of importance, the top five important variables were determined, which were subjective well-being (100.0%), self-reported health (92.0%), life satisfaction (83.4%), ADL disability (74.0%), and marital status (69.7%). LIMITATIONS: This study was a cross-sectional study, and causality cannot be determined. CONCLUSIONS: The prevalence of depressive symptoms in middle-aged and elderly Chinese people was high. Subjective quality of life evaluation, health condition and marital status were important factors that have an impact on depressive symptoms.

Relationships of organisational justice, psychological capital and professional identity with job burnout among Chinese nurses: A cross-sectional study.

AIMS AND OBJECTIVES: The present study was aimed at describing the status of job burnout and exploring the mediating roles of psychological capital and professional identity on the association between organisational justice and job burnout. BACKGROUND: With the shortage of nurses all over the world, nurses' job burnout has become the focus of studies in recent years. However, limited published research has examined the mediating roles of psychological capital and professional identity on the association between organisational justice and job burnout within hospital contexts in China. DESIGN: A cross-sectional design. METHODS: A total of 1,009 nurses were enrolled from a major general hospital located in Qiqihar City in the northeast of China from March-July 2018, and asked to complete questionnaires regarding organisational justice, psychological capital, professional identity and job burnout. The STROBE checklist was adhered to in this study. RESULTS: It was observed that the overall proportion of nurses with job burnout was 58.8%. All the correlations among organisational justice, psychological capital, professional identity and job burnout were statistically significant, with coefficients ranging between -0.487-0.863. Psychological capital and professional identity had indirect effects equal to -0.072 and -0.142, respectively, on the association between organisational justice and job burnout, taking up 13.7% and 26.9% of the total effect, respectively. The serial indirect effect of psychological capital and professional identity was -0.129, accounting for 24.5% of the total effect. CONCLUSIONS: This study showed the necessity of addressing the status of job burnout among Chinese nurses. Psychological capital and professional identity may mediate the linkage between organisational justice and job burnout independently and accumulatively. RELEVANCE TO CLINICAL PRACTICE: Nursing managers should strengthen organisational justice and improve the psychological capital and professional identity of nurses through effective strategies to prevent the job burnout of nurses.

Establishment and associated factors of health records among young Chinese migrants.

BACKGROUND: Most Chinese migrants have been faced with obstacles to getting access to local public health services. Young migrants among internal migrants make a major contribution to the economy. However, the establishment of their health records has been ignored. This research was aimed at exploring the status and associated factors of the establishment of health records among young Chinese migrants. METHODS: Data were obtained from the 2017 China Migrants Dynamic Survey (CMDS). Chi-square test and binary logistic regression were performed to investigate the associated factors of the establishment of health records among young Chinese migrants. RESULTS: Approximately 30.2% of young migrants had their health records established in inflow communities. Urban residence, medical insurance (insured), and lower average monthly household income were attributed to the establishment of more health records. Young migrants who were in northeast China and across provinces and immigrated for working or engaging in trade were less likely to have health records established. Young migrants who participated in social activities and public affairs activities and took type of people in touch as natives in the inflow area showed a higher possibility of establishing health records. Meanwhile, receiving health education and hearing about national basic public health services (BPHSs) were beneficial for establishing the health records of more young migrants. CONCLUSION: This study showed that the health records of young migrants had a relatively low establishment rate. Sociodemographic and migration characteristics, health status, public health services, and social integration factors were all related to the health record establishment of young Chinese migrants.

Relationships of professional identity and psychological reward satisfaction with subjective well-being among Chinese nurses.

AIM: This study aimed at exploring the impact of professional identity and psychological reward satisfaction on subjective well-being and clarifying the effect of psychological reward satisfaction on this relationship. BACKGROUND: People know little about the effect of psychological reward satisfaction on the relationship between professional identity and subjective well-being. METHODS: A cross-sectional survey was carried out on 1,009 nurses from Qiqihar City, Heilongjiang Province of China. Professional Identity Scale, Psychological Reward Satisfaction Scale and General Well-Being Schedule were used to assess professional identity, psychological reward satisfaction and subjective well-being, respectively. Associations were explored by using structural equation modelling. RESULTS: The subjective well-being of 436 (43.2%) nurses was at low and moderate levels. After the adjustment of potential confounding factors, professional identity was still associated with subjective well-being (B = 3.035, ß = 0.215, p < .001). Professional identity (r = .308) and psychological reward satisfaction (r = .309) were positively correlated with subjective well-being. Psychological reward satisfaction mediated the association between professional identity and subjective well-being (effect = 0.114, p < .001). CONCLUSION: This study suggested that the subjective well-being of nurses should be improved by paying special attention to them and taking targeted support measures. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers can help enhance the professional identity of nurses by organising nursing education activities, and pay more attention to psychological reward satisfaction to improve the subjective well-being of nurses.