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INTRODUCTION: Exposure to secondhand smoke (SHS) among women is prevalent in China which increases their risk of developing a wide range of diseases and can affect their susceptibility to adverse reproductive health effects. This study aims to examine the association between SHS exposure among women and the adoption and implementation of tobacco control measures on campus in China. AIMS AND METHODS: 7469 female college students who have never smoked were recruited from 50 universities across China using a multistage sampling technique. All participants reported their exposure to SHS and the tobacco advertising and promotion on campus. Participants from colleges with smoke-free policies reported the implementation of smoke-free policies on campus measured by: (1) no evidence of smoking and (2) the display of smoke-free signs in public places. Multivariate logistic regression models were applied using weighted survey data. RESULTS: SHS exposure among participants was 50.5% (95% CI = 44.2% to 56.9%). The adoption of a smoke-free policy was not associated with SHS exposure (OR: 1.01, 95% CI = .71, 1.42), however, the implementation of the policy was significantly negatively associated with SHS exposure (OR: 0.56, 95% CI = .47 to 0.67). In addition, tobacco advertising and promotion on campus were significantly positively associated with SHS exposure (OR: 2.33, 95% CI = 1.42, 3.82; OR: 1.52; 95% CI = 1.15, 2.02, respectively). CONCLUSIONS: Exposure to SHS is prevalent among female college students in China. Successful implementation of a smoke-free policy and banning tobacco advertising and promotion on campus could be effective measures to protect young women from the harms of SHS in China. IMPLICATIONS: Approximately half of female college students are exposed to SHS on campus in China. Failure to implement smoke-free policies and exposure to tobacco marketing on campus are associated with higher SHS exposure. To protect millions of young Chinese women from the health harms of SHS, universities need to enact and enforce smoke-free policies within campus boundaries and adopt comprehensive bans on tobacco advertising and promotion on campus.
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Estudiantes , Contaminación por Humo de Tabaco , Humanos , Contaminación por Humo de Tabaco/prevención & control , Femenino , Universidades , China/epidemiología , Estudios Transversales , Adulto Joven , Estudiantes/estadística & datos numéricos , Adulto , Política para Fumadores/legislación & jurisprudencia , Publicidad/estadística & datos numéricos , Publicidad/legislación & jurisprudencia , Publicidad/métodos , Adolescente , Control del TabacoRESUMEN
Low-dimensional Ruddlesden-Popper (LDRP) perovskites still suffer from inferior carrier transport properties. Here, we demonstrate that efficient exciton dissociation and charge transfer can be achieved in LDRP perovskite by introducing γ-aminobutyric acid (GABA) as a spacer. The hydrogen bonding links adjacent spacing sheets in (GABA)2 MA3 Pb4 I13 (MA=CH3 NH3 + ), leading to the charges localized in the van der Waals gap, thereby constructing "charged-bridge" for charge transfer through the spacing region. Additionally, the polarized GABA weakens dielectric confinement, decreasing the (GABA)2 MA3 Pb4 I13 exciton binding energy as low as ≈73â meV. Benefiting from these merits, the resultant GABA-based solar cell yields a champion power conversion efficiency (PCE) of 18.73 % with enhanced carrier transport properties. Furthermore, the unencapsulated device maintains 92.8 % of its initial PCE under continuous illumination after 1000â h and only lost 3 % of its initial PCE under 65 °C for 500â h.
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The primary aims of this study are to examine the associations between two key environmental factors-regional cigarette tobacco production and tobacco retail outlet density-and secondhand smoke (SHS) exposure in urban China and to explore the possible mechanisms that explain this association. METHODS: A cross-sectional multistage sampling design was used to collect individual information in 21 cities in China. Environmental variables were retrieved from national databases. Multilevel logistic regression analysis was conducted to examine the associations between regional cigarette tobacco production, tobacco retail outlet density and SHS exposure. Structural equation modelling was employed to determine possible mechanisms. RESULTS: SHS exposure prevalence defined as daily exposure to SHS for at least 15 min/day at the time of the survey was found to be 28.1% among non-smokers (95% CI 27.1 to 29.0) across the 21 cities. The multilevel logistic regressions showed that province-level per capital cigarette production (OR: 2.72 (95% CI 1.56 to 4.76)and per GDP cigarette production(OR:1.69(95% CI 1,42,2.01), and city-level tobacco retail outlet density (OR: 2.66 (95% CI 1.63 to 4.38)) were significantly associated with SHS exposure. Moreover, results showed that these associations may be explained by the level of tobacco advertisement, which influences social norms, including attitudes and behaviours toward SHS exposure. CONCLUSIONS: Findings shed light on the role of cigarette manufacturers and retailers in producing environmental SHS pollution. To address the health and economic burden associated with SHS in China, it will be critical for the Chinese government to enact tobacco control measures consistent with the Framework Convention for Tobacco Control. Efforts should also focus on restricting the permitted density of tobacco retail outlets, and tobacco production in China.
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Productos de Tabaco , Contaminación por Humo de Tabaco , Humanos , Contaminación por Humo de Tabaco/análisis , Nicotiana , Estudios Transversales , China/epidemiología , Exposición a Riesgos Ambientales/análisisRESUMEN
OBJECTIVES: To examine the association of exposure to secondhand smoke (SHS) and tobacco advertising with unassisted smoking cessation among Chinese male smokers. METHODS: A questionnaire was administered to 6500 male adult smokers from six cities in China selected in a cross-sectional multistage sampling design. The survey collected self-reported demographic characteristics, smoking and cessation status, SHS exposure and tobacco advertising exposure, with 5782 valid questionnaires included in this study. Multiple logistic regression analysis was used to assess the association of unassisted smoking cessation with exposure to SHS and tobacco advertising. RESULTS: 42.1% of smokers who made unassisted quit attempts achieved abstinence (95% CI 32.5% to 51.7%). SHS (adjusted OR (aOR) 0.36; 95% CI 0.18 to 0.71; p=0.033) and tobacco advertising exposure (aOR 0.63; 95% CI 0.37 to 0.95; p=0.039) were negatively associated with unassisted smoking cessation. CONCLUSION: The vast majority of Chinese male smokers rely on unassisted methods to quit smoking. Success prevalence is high, which is very beneficial to health. This study suggests that exposure to secondhand smoking and tobacco advertising hinders the success of unassisted cessation. These findings speak to the need for environmental tobacco control measures to promote unassisted smoking cessation among Chinese adult male smokers.
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Cese del Hábito de Fumar , Contaminación por Humo de Tabaco , Adulto , China/epidemiología , Estudios Transversales , Humanos , Masculino , Fumadores , Fumar/epidemiología , Encuestas y CuestionariosRESUMEN
This prospective observational study examined changing trends in mental and behavioral responses, and their association with perceived risk, severity, self-efficacy and isolation status during the Chinese COVID-19 epidemic. There were five waves of interviews. Descriptive statistics and non-parametric test methods were used for data analysis. Participants numbered 150 for the linkable baseline survey and 102 completed all 5 survey waves and were included in the analysis. Mental stress, emotional status and lifestyle manifested a statistically significant downwards trend across the total period of this panel study. The number of reported new confirmed patients perceived high risk and perceived severity were positively associated with mental stress, emotional status and lifestyle. Self-efficacy was negatively associated with each type of mental and behavioral response. The more time people were confined to their home, the more serious the emotional and lifestyle problems. Dose-response relationships were noted between the number of reported new confirmed patients and mental stress, emotional status and lifestyle during the five observation points. This study yielded new information about mental and behavioral responses among Chinese people during the COVID-19 epidemic. Policy changes and health education are essential for minimizing the adverse health effects of these responses.
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COVID-19/psicología , Salud Mental , Adulto , Ansiedad , China/epidemiología , Estudios Transversales , Femenino , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Pandemias , Medición de Riesgo , Autoeficacia , Aislamiento Social , Estrés Psicológico , Encuestas y CuestionariosRESUMEN
Injury is a serious public health problem with significant social and economic costs. Prior studies reported an association between mental stress and unintentional injury. However, no comparable studies have examined uncertainty stress, along with other types of stress, and their relative impact upon unintentional injury. The purpose of this study was to assess the salience of uncertainty stress as a predictor. Participants were 11,954 students, who were identified through a multistage sampling process that incorporated 50 universities. Stress and unintentional injury status were obtained by self-report. Both unadjusted and adjusted methods were considered in the analyses. Based on a retrospective 12-month reporting window, 12.6% of the respondents had experienced traffic injury, 21.4% home injury, 15.2% work-related injury, and 23.1% sports injury. The multivariable logistic regression model found that uncertainty stress was associated with all categories of unintentional injury, while life stress only was related to traffic injury. These findings underscore the importance of minimizing uncertainty stress and can inform pertinent policies and reinforce the need for uncertainty stress management in China.
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Lesiones Accidentales/epidemiología , Traumatismos en Atletas/epidemiología , Traumatismos Ocupacionales/epidemiología , Estrés Psicológico/epidemiología , Incertidumbre , Accidentes Domésticos/estadística & datos numéricos , Accidentes de Tránsito/estadística & datos numéricos , Adulto , China/epidemiología , Femenino , Humanos , Modelos Logísticos , Masculino , Estudios Retrospectivos , Factores de Riesgo , Autoinforme , Estrés Psicológico/psicología , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Universidades , Adulto JovenRESUMEN
BACKGROUND: Many studies have examined childhood and adolescent obesity, but few have examined young adults and the effect of their home and current living environments on prevalence rates. The present study explores contextual factors affecting overweight and obesity among university students in China and, in particular, focuses on how the SES-obesity relationship varies across different geographical contexts. METHODS: Participants were 11,673 students, who were identified through a multistage survey sampling process conducted in 50 universities. Individual data was obtained through a self-administered questionnaire, and contextual variables were retrieved from a national database. Multilevel logistic regression models were used to examine urban and regional variations in overweight and obesity. RESULTS: Overall the prevalence of overweight and obesity in the study sample was 9.5% (95% CI 7.7, 11.3%). After controlling for individual factors, both attributes of the home location (regional GDP
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Ambiente , Sobrepeso/epidemiología , Vigilancia de la Población , Estudiantes , Universidades/tendencias , Adolescente , China/epidemiología , Bases de Datos Factuales/tendencias , Femenino , Humanos , Masculino , Obesidad/diagnóstico , Obesidad/epidemiología , Sobrepeso/diagnóstico , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Second hand smoke (SHS) exposure is a severe public health problem, especially in low and middle countries, but no studies have examined both individual and city-level variables influencing exposure. METHODS: A cross-sectional multistage sampling design was used to survey subjects from 21 cities in China. Using a standardized questionnaire individual level information was collected. City-level variables were retrieved from the National Bureau of Statistics database. Multilevel logistic regression analysis was used to assess SHS exposure variation at both the individual and city level. RESULTS: SHS exposure prevalence among non-smokers was 28.1% (95% CI 27.1-29.0). At the individual level lower educational attainment and income and higher exposure to tobacco advertising were associated with higher SHS exposure. On the other hand richer cities, and those with more anti-smoking media news coverage, had less SHS exposure. The presence of city smokefree regulations was unrelated to exposure. CONCLUSIONS: Given its human and economic costs, reducing SHS exposure should receive greater priority than it does in China. The results point to the need for the enactment of national smokefree laws in order to combat unacceptably high levels of SHS exposure.
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Exposición a Riesgos Ambientales/estadística & datos numéricos , Industria del Tabaco/estadística & datos numéricos , Contaminación por Humo de Tabaco/estadística & datos numéricos , Adulto , Publicidad/estadística & datos numéricos , Distribución de Chi-Cuadrado , China/epidemiología , Ciudades/estadística & datos numéricos , Estudios Transversales , Exposición a Riesgos Ambientales/prevención & control , Femenino , Humanos , Entrevistas como Asunto , Masculino , Análisis Multinivel , Prevalencia , Autoinforme , Distribución por Sexo , Factores Socioeconómicos , Encuestas y Cuestionarios , Industria del Tabaco/economía , Contaminación por Humo de Tabaco/prevención & control , Adulto JovenRESUMEN
BACKGROUND: In order to curb the rapid spread of COVID-19, many countries have implemented lockdown or quarantine requirements, but little is known about how this impacts suicide ideation. The purpose of this study is to examine changing trends of suicidal ideation, social trust, and social communication from the quarantine to non-quarantine period during the COVID-19 epidemic in China and the effects of quarantine on suicidal ideation. METHODS: A prospective longitudinal observation design was utilized. There were six waves of interviews from the quarantine to the non-quarantine period. Two hundred and twenty-one participants completed all observation points and were included in the study. For the continuing variables, the Mann-Kendall test was used to assess changing trends across the six observation points. For categorical variables, the Cochran-Armitage test was used to examine their changing trends. A generalized estimating equation was used to examine the association between several independent variables and suicide ideation. RESULTS: The prevalence of suicide ideation was 16.7, 14.5 %, and 14.5 %, respectively, in the quarantine period, and 13.8, 10.9 %, and 10.0 %, respectively in the non-quarantine period, which there was a significant downward trend (T: -4.06, p < 0.01) across the total observation period. Negative behavioral belief, negative social trust, and low levels of social communications were positively associated with suicide ideation, with a ß of 0.0310 (P < 0.01), 0.0541 (P < 0.01), and 0.0245 (P < 0.05) respectively. The positive attitude toward lockdown was negatively associated with suicide ideation, with a ß of -0.0137 (P < 0.01) among guaranteed classmates and it was -0.0121 (P < 0.01) among unguaranteed classmates. CONCLUSIONS: This study yielded new information and may have important policy implications to design effective intervention strategies to reduce future new infectious diseases while maintaining positive mental health and reducing suicide ideation.
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COVID-19 , Cuarentena , Ideación Suicida , Confianza , Humanos , COVID-19/psicología , COVID-19/epidemiología , COVID-19/prevención & control , Cuarentena/psicología , Masculino , Femenino , China/epidemiología , Confianza/psicología , Adulto , Estudios Prospectivos , Estudios Longitudinales , SARS-CoV-2 , Persona de Mediana Edad , Comunicación , Adulto Joven , PrevalenciaRESUMEN
The primary aims of this study are to examine associations between obesity-related eating behaviors (OEB) and chronic and infectious diseases, and mental disorders. A representative nationwide survey was used to collect information among 11,659 medical students from 31 universities in China. Multiple variable logistic regression analysis was conducted to examine the associations between OEB and the diseases. The multiple variable logistic regression model found that OEB was significantly associated with chronic disease (OR (Odds Ratio): 1.74 < 95 % C.I (Confidence Interval): 1.45, 2.65 > ), infectious disease (OR: 3.37 < 95 % C.I: 1.04, 1.81 > ), and mental disorder (OR: 1.87(<95 % C.I: 1.55, 2.25 > ). These findings underscore the importance of addressing OEB in programs and policies to promote health and prevent disease among university students.
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An epidemic of a highly lethal disease can overwhelm people emotionally and physically. Little is known about how public mental and preventive patterns changed during the transition from the COVID-19 epidemic to sporadic infection. This study examined changing trends of metal response and behavioral variables, and their impact from uncertainty stress in this process in China. A prospective longitudinal observation design was utilized. There were 7 waves of surveys from COVID-19 epidemic status to the sporadic infection period. Sixty-two participants completed all observation points and were included in the study. The Mann-Kendall Test was used to assess changing trends across the seven observation points. The nonparametric linear mixed effects model was used to examine the association between uncertainty stress and mental and behavioral responses. The mean uncertainty stress did not change significantly over the observation period (Z: -0.911, p > 0.05). This trend was also true for perceived risk, perceived severity, self-efficacy for prevention, and prevention behavior. There was a statistically significant downward trend in irrational beliefs about prevention (Z: -4.993, p < 0.01), sleep (Z: -2.499, p < 0.05), emotions (Z: -5.650, p < 0.01), and lifestyle (Z: -5.978, p < 0.01). The results showed that uncertainty stress was positively associated with irrational beliefs (ß: 0.16298, p < 0.01), their sleep (ß: 0.02070, p < 0.05), emotions (ß: 0.03462, p < 0.01), and lifestyle (ß: 0.02056, p < 0.05). High levels of uncertainty stress were negatively associated with self-efficacy for prevention and prevention behavior, ß was -1.33210 (p < 0.01) and -0.82742 (p < 0.01). These results may have important policy and disease prevention in post-epidemic times.
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BACKGROUND: Numerous studies have identified factors associated with deliberate self-harm (DSH), but environmental influences have largely been neglected. This study explored regional and university contextual factors that impact DSH among undergraduate students in China. METHODS: Subjects in this observational cross-sectional study totaled 5016 undergraduate students, who were identified through multistage survey sampling in 22 Chinese universities. Individual-level data were obtained through a self-administered questionnaire, and environmental variables were extracted from the National Bureau of Statistics database. Multilevel logistic regression models were used to examine regional correlates of DSH. RESULTS: The overall prevalence of self-reported DSH in the study sample was 7.5 % (95 % CI: 4.1 %, 10.9 %). The full multilevel logistic model showed university rank and city size were inversely associated with DSH prevalence (Adjusted Odds Ratio (AOR): 0.24 and 0.55). Regional unemployment rates were positively associated with DSH prevalence (AOR: 1.98, 95 % CI: 1.48, 2.65). DISCUSSION: Contextual disparities appear to contribute to DSH among Chinese undergraduates. Preventive initiatives must focus on redressing imbalances in the allocation of social and economic resources across universities and regions.
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Conducta Autodestructiva , Estudiantes , Humanos , Universidades , Encuestas y Cuestionarios , Autoinforme , Conducta Autodestructiva/epidemiología , Factores de RiesgoRESUMEN
BACKGROUND: The public's hesitant attitude is a major subjective barrier in promoting vaccination against COVID-19 to build herd immunity. The current study aimed to address how individual factors such as health literacy and perceived stress affect people's vaccine hesitancy of COVID-19 vaccine, and to provide insights for tailoring vaccine-promotion strategies. METHODS: With structured questionnaires, an online survey was conducted to address the relationship between the health literacy, perceived stress, and COVID-19 vaccine hesitancy among community population in mainland, China. Moderated analysis was conducted to test the effect of health literacy on vaccine hesitancy among people with different levels of perceived stress. RESULTS: 560 responses were collected in total. 39.8% of the participants reported vaccine hesitancy, and this rate was higher among younger people and female. Moreover, people with higher level of health literacy showed reduced vaccine hesitancy, while this effect was only significant among those with low or moderate level of stress. For people with high level of stress, no significant effect of health literacy was found. CONCLUSIONS: The findings suggest that increasing people's health literacy could lead to reduced vaccine hesitancy in community sample. However, this effect disappeared when the stress level was high, suggesting other promotion services may need to be developed to increase the acceptance of COVID-19 vaccine. In conclusion, vaccine promotion strategies should be tailored for different populations, with taking account of individual's health literacy and perceived stress.
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COVID-19 , Alfabetización en Salud , Vacunas , COVID-19/prevención & control , Vacunas contra la COVID-19 , China/epidemiología , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Padres , Aceptación de la Atención de Salud , Vacunación , Vacilación a la VacunaciónRESUMEN
Objectives: We examined changing trends of uncertainty stress, and its impact on disease fear and prevention behaviors during the Chinese COVID-19 epidemic, using a prospective observational study. Methods: We employed a longitudinal design. We recruited participants for an online panel survey from chat groups on social media platforms. There were 5 waves of interviews. Information on uncertainty stress and related variables were collected via the online survey. Descriptive statistics and the GIM program were used for data analysis. Results: Participants numbered 150 for the linkable baseline survey and 102 (68%) for the final survey. Uncertainty stress (ß = -.047, SE = .118, p > .05) did not show a statistically significant temporal change trend over the observation period. Disease fear manifested a statistically significant downwards trend (ß = -.342, SE = .157, p < .05), and prevention behaviors indicated an upwards trend (ß = .048, SE = .021, p < .05) during the observation period. Uncertainty stress was positively associated with disease fear (ß = .45046, SE = .05964, p < .001), and negatively associated with self-efficacy (ß = -.6698, SE = .01035, p < .001), and prevention behaviors (ß = -.02029, SE = .00876, p =.021). Conclusion: This study yielded new information about uncertainty stress among Chinese people during the COVID-19 epidemic. Policy changes and public education are essential for minimizing the negative effects of uncertainty stress in disease prevention.
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COVID-19/prevención & control , COVID-19/psicología , Miedo , Estrés Psicológico , Incertidumbre , Adulto , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Investigación Cualitativa , SARS-CoV-2 , Encuestas y CuestionariosRESUMEN
Respective associations between uncertainty stress and three dimensions of social capital with suicidal ideation were assessed among 4446 undergraduates from 22 Chinese universities in a cross-sectional study. Multiple logistic regression model and structural equation modeling were used to examine these relationships. Uncertainty stress was more strongly and uniquely associated with suicidal ideation than with life stress. Social capital, especially social networks, shared a dual role as a correlate of suicidal ideation and means to reduce the impact of uncertainty stress. School-based gender- and age-specific suicidal ideation interventions should emphasize social capital enhancement and uncertainty stress coping.
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Capital Social , Estudiantes de Medicina , China/epidemiología , Estudios Transversales , Humanos , Ideación Suicida , Incertidumbre , UniversidadesRESUMEN
INTRODUCTION: Social deprivation is a known determinant of health and related behaviors. Many studies have linked socioeconomic factors to secondhand smoke (SHS) exposure. However, no studies have examined the relationship between social deprivation and SHS exposure. This study examined whether contextual social deprivation - variously based on living in a house without a car, that was overcrowded, or had an unemployed member (s) - had an independent association with SHS exposure at both individual and regional levels among Chinese residents. METHODS: A cross-sectional multistage sampling design was utilized to interview subjects from 6 selected cities in China. A standardized questionnaire selected sociodemographic characteristics, contextual social deprivation and SHS exposure. Multilevel logistic regression models were used to assess the association between social deprivation and SHS exposure. RESULTS: A total of 5782 valid questionnaires were collected in this study. Among 2930 non-smokers, the SHS exposure prevalence was 21.9% (95% CI: 19.5- 24.30). Multilevel logistic regression showed a negative association between household income, regional GDP, and SHS exposure, respectively, and positive associations between contextual social deprivation and SHS exposure. CONCLUSIONS: Findings support the central proposition that contextual social deprivation must be factored into SHS exposure messages. Our research underscores the importance of reducing health inequality in controlling SHS exposure.
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Background: Studies exploring the relationship between air pollution levels and mental stress have rarely been done, and no studies have been done comparing university student mental stress levels based on regional air pollution levels. Objectives: The objective of this study was to evaluate the association between air pollution and mental stress among university students. Methods: Participants were 11,942 students, who were identified through a multistage survey sampling process conducted in 50 universities. Regional air pollution levels were retrieved from a national database, and mental stress was measured using a perceived stress scale. Both unadjusted and adjusted methods were utilized in the data analyses. Results: Mental stress prevalence was 36.9% (95% Confidence Interval: 24.4-49.5%). The final model indicated that regional air pollution levels were positively associated with students' mental stress. Conclusions: This study provided new and direct evidence of the health hazards of air pollution. The findings underscore the need to develop and implement stringent environmental protection policies, while simultaneously raising public awareness of environmental protection.
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Contaminación del Aire , Universidades , Contaminación del Aire/efectos adversos , China/epidemiología , Humanos , Estrés Psicológico/epidemiología , EstudiantesRESUMEN
OBJECTIVES: We examined associations between excessive WeChat use and mental disorders at the individual and contextual level. METHODS: We conducted a representative nationwide survey sampling process of 11,283 medical students from 30 universities in China. Mental health status was measured by the Chinese Health Questionnaire. Both unadjusted and adjusted methods were considered in the analyses. RESULTS: High frequency and long-time use prevalence was 19.1% and 31.2% respectively among WeChat users. The multilevel logistic regression model found that individual-level high frequency (OR = 1.26) and long-time use (OR = 1.24) were significantly associated with mental health disorders. University-level excessive WeChat use also was associated with the mental disorders (OR = 1.33 [high frequency use]; OR = 1.17 [long-time use]). Structural equation analysis showed that individual- and university-level high frequency and individual-level and university-level long-time WeChat use have a direct influence on poor mental health. The above variables, except individual-level long-time use, have an indirect influence on poor mental health through mental stress. CONCLUSIONS: This study provides new evidence that excessive WeChat use is associated with mental disorders. These findings underscore the importance of alerting people to the possible health risks of excessive social media use.
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Trastornos Mentales , Estrés Psicológico , China/epidemiología , Humanos , Trastornos Mentales/epidemiología , Estrés Psicológico/epidemiología , Encuestas y Cuestionarios , UniversidadesRESUMEN
Objectives: This study aimed to examine the relationships between the types of stress and students' mental health, to distinguish the effects of stressors on mental health problems, and to explore the important role of uncertainty stress on the development of mental disorders in a nationally representative sample of Chinese college students. Methods: A cross-sectional multistage study was conducted. Participants were 11,954 students, who were recruited from 50 Chinese universities located in 43 cities covering 23 provinces, autonomous regions, and municipalities across China. The Student Daily Stress Questionnaire (SDSQ) was applied to measure the different types of stress, and mental health status was measured using the 12-item Chinese Health Questionnaire (CHQ). Both unadjusted and adjusted logistic regression models were utilized in the statistical analyses. Multilevel analyses were performed to examine the variation of mental disorder at both the individual and university levels. Results: The prevalence of mental disorders was 22.8% (95% CI: 22.0-23.5%). The unadjusted models showed that age, gender, grade, major, and university location and type were the correlates of mental disorders among students. The unadjusted models developed in this research found that study stress, life stress, and uncertainty stress were positively associated with mental disorder. The multilevel logistic regression models showed that uncertainty stress was far more likely to result in students' mental disorders than study or life stress after controlling for university level. The greater the perceived uncertainty stress, the higher the prevalence of mental disorders. Conclusion: This study provides robust evidence of the impact of uncertainty stress on mental disorders among college students. Compared with life and study stress, more attention should be given to uncertainty stress. The information from this study should be helpful when considering effective mental health policies and interventions among college students in China.