What is the impact of integrated care on the job satisfaction of primary healthcare providers: a systematic review.

BACKGROUND AND OBJECTIVES: The integration of care influenced the job satisfaction of healthcare professionals, especially affecting primary healthcare providers (PCPs). This study aimed to perform a systematic review to explore the impact of integrated care on the job satisfaction of PCPs on the basis of Herzberg's two-factor theory. METHODS: This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched 6 electronic databases, including CNKI, WANFANG, PubMed, Web of Science, Cochrane Library, and Embase. Data were retrieved from inception to 19 March 2023. The Mixed Methods Appraisal Tool (MMAT) version 2018 was used to assess the methodological quality of studies for inclusion in the review. RESULTS: A total of 805 articles were retrieved from databases, of which 29 were included in this review. 2 categories, 9 themes, and 14 sub-themes were derived from the data. 2 categories were identified as intrinsic and extrinsic factors. Intrinsic factors included 4 themes: responsibilities, promotion opportunities, recognition, and a sense of personal achievements and growth. Extrinsic factors included 5 themes: salaries and benefits, organizational policy and administration, interpersonal relationships, working conditions, and work status. To specify some key information under certain themes, we also identify sub-themes, such as the sub-theme "workload", "work stress", and "burnout" under the theme "work status". CONCLUSIONS: Findings suggested that the integration of care had both negative and positive effects on the job satisfaction of PCPs and the effects were different depending on the types of integration. Since PCPs played a vital role in the successful integration of care, their job satisfaction was an important issue that should be carefully considered when implementing the integration of care.

Association between Oral Health and Depressive Symptoms in Chinese Older Adults: The Mediating Role of Dietary Diversity.

Diet is a modifiable factor in healthy population aging. Additionally, oral health and diet are important factors affecting depressive symptoms. To assess the mediating role of dietary diversity (DD) in oral health and depressive symptoms in older adults, we selected 8442 participants aged ≥ 65 years from the 2018 Chinese Longitudinal Health Longevity Survey (CLHLS) for a cross-sectional study. Depressive symptoms were determined based on scores on the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Dietary diversity scores (DDS) were established based on the frequency of intake of food groups. Oral health was measured by denture use and toothbrushing frequency. Stepwise multiple linear regression and PROCESS macros were used for mediated effects analysis and testing. The sample had a positive detection rate of 44.1% for depressive symptoms, 40.8% for denture use, and 41.9% for once-a-day toothbrushing. Denture use (ρ = -0.077, p < 0.01) and toothbrushing frequency (ρ = -0.115, p < 0.01) were negative predictors of depressive symptoms in older adults. DD significantly mediated the association between denture use (indirect effect -0.047; 95%CI: -0.068-0.028; p < 0.001), toothbrushing frequency (indirect effect -0.041; 95%CI: -0.054-0.030; p < 0.001), and depressive symptoms. Denture use and toothbrushing frequency not only directly reduce the risk of depressive symptoms in older adults, but also indirectly affect depressive symptoms through DD.

Longitudinal association of chronic diseases with depressive symptoms in middle-aged and older adults in China: Mediation by functional limitations, social interaction, and life satisfaction.

Background: Several previous studies have shown that the development of depression is often accompanied by chronic diseases; although closely related, the mechanism between them is not clear. Here we investigate the potential role of functional limitations, social interaction, and life satisfaction in the relationship between chronic diseases and depressive symptoms in middle-aged and older adults in China. Methods: We selected 2407 respondents aged ≥45 from the China Health and Retirement Longitudinal Study conducted in 2013, 2015, and 2018. We established panel data to estimate the longitudinal impact of chronic diseases on depressive symptoms and the mediating role of functional limitations, social interaction, and life satisfaction. Results: Chronic diseases were associated with more depressive symptoms. All of the mediating pathways examined passed functional limitations, and approximately 43.4% of the association between chronic diseases and depressive symptoms was explained by these three mediating variables. Conclusions: The impact of chronic diseases on depressive symptoms was primarily mediated by functional limitations, and the mediating role of social interaction and life satisfaction was also confirmed. Therefore, attention should be paid to reducing the level of functional limitation in middle-aged and older adults with chronic diseases and improving life satisfaction by increasing social opportunities to alleviate depressive symptoms in middle-aged and older adults.