RESUMEN
This study explores the impact of life course socioeconomic status (SES) and childhood trauma on depressive symptoms in Chinese middle-aged and older adults, while also examining the role of chronic diseases and implications for social work practice. Using data from 9,942 participants, structural equation was established to investigate these relationships. Results reveals that low childhood SES positively affects depressive symptoms through low SES in mid-to-late life (std. ß = 0.168, p < .001), and domestic child abuse negatively impacts depressive symptoms through low SES in mid-to-late life (std. ß=-0.020, p < .001). Additionally, experiencing peer bullying is directly associated with depressive symptoms (std. ß = 0.145, p < .001). Exposure to domestic violence is directly related to depressive symptoms (std. ß = 0.078, p < .001) and indirectly leads to more severe depressive symptoms through chronic disease (std. ß = 0.023, p < .001). Social workers in healthcare settings can utilize these findings to better understand risk factors for depression and provide trauma-informed care and economic assistance across the life course. Additional training for social workers on the lasting impacts of childhood adversity is warranted. By intervening at both individual and policy levels, social work practitioners can help break cycles of poverty and poor health stemming from childhood.
RESUMEN
Background: Hypertension is increasingly prevalent among young and middle-aged populations in rural China, accompanied by suboptimal self-management. Given that this population forms the backbone of the labor force, enhancing their self-management capabilities is crucial for improving overall population health. Studies indicate that individuals with good health literacy are more likely to effectively manage their health. Methods: Grounded in the health literacy skills framework, a model was constructed in this study to examine the impact of health literacy on self-management among young and middle-aged hypertensive patients in rural China. Meanwhile, the mediating roles of illness perception and self-efficacy were also verified. Using a multi-stage stratified random sampling method, 338 patients were recruited to participate in the study. Structural equation modeling was utilized to establish the relationship model, and bootstrap tests were carried out to examine the mediating effects. Results: The average self-management score was 70.45 ± 11.36. Health literacy exhibited a positive correlation with self-management (standardized ß = 0.372, p < 0.001). The mediating effects through illness perception and self-efficacy were 0.040 and 0.236, constituting 6.68 and 39.31% of the total effect, respectively. Conclusion: Illness perception and self-efficacy serve as parallel mediators amid the association between health literacy and self-management. Implementing psychological counseling and health education is imperative for augmenting self-management competence and cultivating an adaptive coping mentality.