Promotion of self-directed learning abilities among Chinese medical students through preparing for career calling and enhancing teaching competencies in medical education: a cross-sectional study.

BACKGROUND: Medical students face a heavy burden as they are tasked with acquiring a vast amount of medical knowledge within a limited time frame. Self-directed learning (SDL) has become crucial for efficient and ongoing learning among medical students. However, effective ways to foster SDL ability among Chinese medical students are lacking, and limited studies have identified factors that impact the SDL ability of medical students. This makes it challenging for educators to develop targeted strategies to improve students' SDL ability. This study aims to assess SDL ability among Chinese medical students and examine the effects of career calling and teaching competencies on SDL ability, as well as the possible mechanisms linking them. METHODS: Data were collected from 3614 respondents (effective response rate = 60.11%) using cross-sectional online questionnaires and analyzed using IBM SPSS Statistics 22.0. The questionnaire comprised a Demographic Characteristics Questionnaire, Self-directed Learning Ability Scale (Cronbach's alpha = 0.962), Teaching Competencies Scale, and Career Calling Scale. RESULTS: The average SDL ability score of Chinese medical students was 3.68 ± 0.56, indicating a moderate level of SDL ability. The six factors of the Self-directed Learning Ability Scale-self-reflection, ability to use learning methods, ability to set study plans, ability to set studying objectives, ability to adjust psychological state, and willpower in studying-accounted for 12.90%, 12.89%, 12.39%, 11.94%, 11.34%, and 8.67% of the variance, respectively. Furthermore, career calling was positively associated with SDL learning ability (ß = 0.295, p < 0.001), and SDL learning ability was positively associated with teaching competencies (ß = 0.191, p < 0.01). Simple slope analysis showed that when the level of teaching competencies was higher, the influence of career calling on SDL ability was stronger. CONCLUSIONS: Chinese medical students' SDL ability has room for improvement. Medical students could strengthen their willpower in studying by setting milestones goals with rewards, which could inspire their motivation for the next goals. Teachers should guide students to learn experience to improve students' reflective ability. Educators play a crucial role in bridging the gap between career calling education and SDL ability enhancement, highlighting the significance of optimal teaching competencies. Colleges should focus on strengthening teachers' sense of career calling and teaching competencies.

Nurse burnout: deep connections and solutions revealed by network analysis.

BACKGROUND: Burnout is very important to nurses' physical and mental health and career development. Current approaches to assessing nurse burnout tend to use a total score modeling paradigm to explore the impact of external factors on burnout. The purpose of this study is to delve into the item-level relationship between nurse burnout and its influencing factors at both the social and psychological levels using a network analysis approach. METHODS: This study was conducted in June 2023 and 1,005 nurses from 4 hospitals out of 8 tertiary care hospitals in Harbin were selected to participate in this study using whole cluster sampling method. Measurements included a general demographic questionnaire, Trait coping styles questionnaire, Organizational commitment questionnaire, Work-family conflict scale, Transformational leadership questionnaire, and Maslach Burnout Inventory-General Survey. RESULTS: Our results suggest that "C1 Time-Based work interference with family" showed the strongest centrality and bridging in the overall network. This finding underscores its centrality to burnout. Other strongest bridge symptoms included "E2 Reduced personal accomplishment" and "A1 Positive coping styles" indicating their strongest connections to other clusters. CONCLUSIONS: Nurse administrators should be encouraged to pay more attention to nurses' work situations and family distress, and to help nurses in a flexible way.

Style and influencing factors of tutors-postgraduates' interactions in Chinese medical colleges: a cross-sectional survey in Heilongjiang Province.

OBJECTIVES: This study assesses the style of tutor-postgraduate interactions in Chinese medical colleges and explores the association between postgraduates' demographic factors and tutors' demographic characteristics. METHODS: With the stratified sampling method, a cross-sectional online survey was used. A total of 813 medical postgraduates were recruited as participants, with an effective response rate of 85.49%. The two dimensions of "Professional Ability Interaction" and "Comprehensive Cultivation Interaction" in the self-developed "Instructor-Graduate Interaction Scale for Medical Colleges" were used as dependent variables. And tutors' demographic characteristics and postgraduates' demographic characteristics were taken as independent variables. Logistic regression analysis was used to explore the influencing factors of Tutor-Postgraduates Interactions in medical colleges. RESULTS: The Tutor-Postgraduates Interaction scale consists of 14 items from the two dimensions of "Professional Ability Interaction" and "Comprehensive Cultivation Interaction". The results of the logistic regression analysis show the reasons for selecting the mentor students (industry recognition, the tutor's research direction, charm in attracting mentors, and recommendations for mentor selection); student to mentor satisfaction; student to study life satisfaction; and regular academic seminars. Indirect guidance and a high postgraduate grade high are the protective factors of interaction between tutors and postgraduates of medical colleges and universities postgraduates. Older mentors and more graduate tutors are the risk factors for Tutor-Postgraduates Interaction in medical colleges (P < 0.05). CONCLUSION: The current study proposes that managers should pay more attention to the double-track promotion of "Professional Ability Interaction" and "Comprehensive Cultivation Interaction". We should not only pay attention to the cultivation of postgraduates' professional ability but also pay more attention to the comprehensive cultivation including postgraduates' mental and psychological aspects. The interaction between tutors and postgraduates in medical colleges is generally good, but much attention should be given to the dual-track promotion mentioned above. Regular academic seminars play an important role in the process of postgraduate training. The research findings, including the influencing factors regarding tutor-postgraduate interactions, the Professional Ability Interaction and Comprehensive Cultivation Interaction, are very informative and can contribute to strategies for postgraduate management systems that enhance this relationship.

What motivates individual public service motivation and cooperation at the initial stage of the COVID-19 outbreak: A cross-sectional survey.

OBJECTIVES: This study assesses the status of public service motivation and explains it's the positive association with public cooperation during the initial stage of the COVID-19 crisis. Moreover, potential causes of Chinese citizens' public service motivation have been explored. METHODS: A cross-sectional survey of 30 provinces in China was conducted using an online questionnaire. The study was conducted in February 2020 during the initial stage of the COVID-19 pandemic. Socio-demographic factors, public service motivation, public satisfaction, public confidence, and public cooperation were assessed using questionnaires. Hierarchical multiple regression was used to identify clusters of interrelationships among public service motivation, public satisfaction, public confidence, and public cooperation among Chinese citizens. RESULTS: We found that participants' public satisfaction with COVID-19-related public services had a positive association with public confidence (B = 0.456, p < 0.001) and public service motivation (B = 0.177, p < 0.001). Moreover, public confidence regarding anti-COVID-19 measures had a positive influence on public service motivation (B = 0.308, p < 0.001) while mediating the relationship between public satisfaction and public service motivation. Public service motivation were positively associated with public cooperation with anti-COVID-19 measures during the initial stage of the COVID-19 pandemic. CONCLUSION: A considerably high level of public service motivation among Chinese citizens appeared during the initial stage of the COVID-19 pandemic, resulting in an increase in public cooperation. Moreover, the findings prove that a high degree of satisfaction with the government's initiatives regarding anti-COVID-19 measures encouraged greater personal public service motivation in respondents by increasing confidence in governmental responses and performance.

Does abusive supervision lead nurses to suffer from workplace violence? A cross-sectional study.

AIM: This study aimed to (1) assess the current status of Chinese nurses' exposure to workplace violence; (2) identify the cluster of interrelationships between abusive supervision, anxiety and depression symptoms, work ability, and workplace violence in nursing settings; and (3) clarify the functional mechanism among these variables. METHODS: A cross-sectional survey was conducted online from September to October 2020 in China. A total of 1,221 valid questionnaires were collected across 100 cities in 31 provinces. RESULTS: Approximately 67.57% of participants experienced workplace violence in the past one year, in the types of verbal violence (59.71%), made difficulties (43.16%), mobbing behaviour (26.70%), smear reputation (22.52%), physical violence (11.30%), intimidating behaviour (10.16%) and sexual harassment (4.10%), respectively. Moreover, nurses' exposure to workplace violence was significantly and positively influenced by the perceptions of abusive supervision (ß = 0.209, p < .01) and the symptoms of anxiety and depression (ß = 0.328, p < .01). Anxious and depressive symptoms partly mediated the association between abusive supervision and workplace violence, which were significantly moderated by work ability (ß = -0.021, p < .05). CONCLUSIONS: Our study assesses the prevalence of the seven types of workplace violence against Chinese nurses. Majority of nurses have experienced different types of workplace violence. Nurses who are abused by their supervisor are more likely to develop poor psychological health than those who are not. Moreover, nurses' positive association of abusive supervision with workplace violence is more notable among nurses with lower work ability. IMPLICATIONS OF NURSING MANAGEMENT: 'No abusive supervision, no workplace violence'. A harmonious nursing environment needs to be provided to minimize exposure to workplace violence and mental health threats towards nursing staff, which is a key point for hospital administrators and health policymakers. Essential work ability should be developed to reduce the damage of the abusive supervision and workplace violence against nurses.

A cross-sectional study of job burnout, psychological attachment, and the career calling of Chinese doctors.

BACKGROUND: The main objectives of this study were as follows: (1) evaluate the prevalence of burnout syndrome among doctors, (2) establish associations with demographic factors in China, and (3) examine the mediating role of psychological attachment in the relationship between job burnout and career calling. METHODS: This cross-sectional survey was conducted by administering an online questionnaire in May 2016. The survey was performed across Thirty provinces. In total, A total of 3016 Chinese doctors were selected as participants, of which 2617 completed valid questionnaires (effective response rate: 86.77%). RESULTS: The overall prevalence of burnout symptoms among Chinese doctors was 85.79%. Little variance was reported for burnout symptoms according to age (Waldχ2 = 6.843, P < 0.05, OR < 1), professional title (Waldχ2 = 13.110, P < 0.05, OR > 1), and daily working hours (Waldχ2 = 7.226, P < 0.05, OR > 1). However, the burnout of Chinese doctors was found to be associated with psychological attachment (B = - 0.6433, P < 0.0001) and career calling (B = 0.3653, P < 0.0001); furthermore, psychological attachment (B = 0.2350, P < 0.001) mediated the relationship between job burnout and career calling. CONCLUSION: Burnout symptoms among Chinese doctors were prevalent and associated with age, professional title, and long working hours. Chinese doctors aged 20-30 experienced a much higher level of burnout symptoms. The longer hours doctors worked, the more likely they were at risk of burnout symptoms, especially among attending physicians. Doctors who endured high-level burnout tended to exhibit decreasing psychological attachment, which threatened their sense of career calling. Finally, this paper proposed related explanations for the function mechanisms based on both theoretical and practical perspectives.

Constructing a general competency model for Chinese public health physicians: a qualitative and quantitative study.

BACKGROUND: The purpose of the study was to construct a general model of the competencies required by Chinese public health physicians. This study is intended to lay the foundation for promoting reform of public health education in China, and may help perfect the testing and grading system of public health courses. METHODS: The behavioral event interviews were used to collect data on knowledge, skills and performance characteristics of public health physicians for coping with public health events. A random stratified sampling survey was used to select public health professionals and workers from different public health institutions in 14 provinces (municipalities or autonomous regions) of China. We then purposively selected 150 senior public health professionals from various agencies and 85 senior public health educators at colleges and universities to take part in the checklist survey. Finally, three times expert consultations were performed to determine the dimensions and elements of the general competency model for Chinese public health physicians. RESULTS: The age range of the 3245 participants was 18-65 years old. When comparing public health professionals and public health education specialists, we found significant differences in the perceived importance of the core competencies between these groups. The model was revised several times and finalized through the expert consultations, and comprised seven competency dimensions. CONCLUSION: The final public health practitioner competency model comprised seven competency dimensions: basic knowledge of medicine, public health knowledge, health management and health promotion, specialized skills, research and development, comprehensive abilities and professionalism.

Transformation of the education of health professionals in China: progress and challenges.

In this Review we examine the progress and challenges of China's ambitious 1998 reform of the world's largest health professional educational system. The reforms merged training institutions into universities and greatly expanded enrolment of health professionals. Positive achievements include an increase in the number of graduates to address human resources shortages, acceleration of production of diploma nurses to correct skill-mix imbalance, and priority for general practitioner training, especially of rural primary care workers. These developments have been accompanied by concerns: rapid expansion of the number of students without commensurate faculty strengthening, worries about dilution effect on quality, outdated curricular content, and ethical professionalism challenged by narrow technical training and growing admissions of students who did not express medicine as their first career choice. In this Review we underscore the importance of rebalance of the roles of health sciences institutions and government in educational policies and implementation. The imperative for reform is shown by a looming crisis of violence against health workers hypothesised as a result of many factors including deficient educational preparation and harmful profit-driven clinical practices.

The association among thriving in life, quality of life, and suicidal ideation in Chinese urban older adults: the moderating effects of attitude toward own aging.

BACKGROUND: As the global trend of population aging intensifies, the health and well-being of the older population has gradually become a focus of attention for the global community. This study assessed the status of thriving in life among Chinese urban older adults and identified its relationship with attitude toward own aging and quality of life (QoL). It also tested whether attitude toward own aging moderates the association between thriving in life and Qol or between thriving in life and suicidal ideation. METHODS: Primary data were collected through a cross-sectional survey among urban older adults from three provinces in China. They were invited to complete an anonymous survey using face-to-face interviews from December 2019 to January 2020. Data from 764 older adults were analyzed. RESULTS: Approximately 44.39% of participants reported positive responses toward the four domains of thriving in life. Thriving in life and attitude toward own aging had a significant association with QoL. Thriving in life was a protective factor for suicidal ideation for older adults. Moreover, attitude toward own aging moderated the association between thriving in life and QoL and that between thriving in life and suicidal ideation. CONCLUSIONS: Chinese urban older adults were reportedly thriving in life, which contributed to increased QoL and reduced suicidal ideation. Notably, the study revealed that more positive attitudes towards own aging were associated with higher levels of thriving in life, better QoL, and reduced suicidal ideation. Targeted interventions for older adults should be devised to promote thriving in life and prevent negative attitudes of older people towards their own aging, further raising QoL and reducing suicidal ideation.

Moderating role of family functioning and resource support in the relationship between career calling and academic burnout among Chinese medical students during the controlled COVID-19 pandemic: a cross-sectional study.

PURPOSE: This cross-sectional study aims to assess the level of academic burnout among Chinese medical students during the controlled COVID-19 pandemic and identify the potential demographic factors affecting academic burnout. It also explored the relationship between career calling, family functioning, resource support, and academic burnout, as well as investigated whether family functioning and resource support could moderate the relationship between career calling and academic burnout among Chinese medical students. METHODS: The study was conducted in five Chinese cities in 2021. A total of 3614 valid questionnaires were collected to assess the relationship between academic burnout, career calling, family functioning, and resource support, and determine whether demographic factors contribute to academic burnout. Hierarchical multiple regression analysis was used to explore factors correlated with academic burnout and test the moderating effect of family functioning and resource support on the relationship between career calling and academic burnout. RESULTS: The mean academic burnout score was 3.29 ± 1.17. Sex, major, academic performance ranking, monthly living expenses, physical health, and sleep quality significantly affected academic burnout (p < 0.05). Academic burnout was negatively correlated with career calling, resource support, and family functioning. Family functioning and resource support moderated the relationship between career calling and academic burnout. Simple slope analysis revealed that high family functioning and resource support strengthened the impact of career calling on academic burnout. CONCLUSIONS: Most medical students in China experienced relatively high levels of academic burnout during the controlled COVID-19 pandemic. Furthermore, specific demographic factors contribute to academic burnout. Family functioning and resource support moderate the relationship between career calling and academic burnout. These findings emphasize the importance of implementing career-calling education, supplementing family functioning in the form of school support, and providing sufficient smart learning resources among medical students in the post-pandemic era.

The results revealed that career calling was strongly and negatively correlated with academic burnout during the controlled COVID-19 pandemic.High family functioning and resource support strengthened the impact of career calling on academic burnout during the controlled COVID-19 pandemic.

Moderating Role of Peer Pressure and Positive Learning Environment Between Career Calling and Academic Procrastination in Chinese Medical Students During Controlled COVID-19 Pandemic: A Cross-Sectional Study.

Purpose: The COVID-19 pandemic sets specific circumstances that may accelerate academic procrastination behavior of medical students. Career calling is a protective factor that fights against academic procrastination and may further improve medical students' mental health and academic achievement. This study aims to determine the status of Chinese medical students' academic procrastination during controlled COVID-19 pandemic. Moreover, the study investigates the relationships and mechanisms among career calling, peer pressure, a positive learning environment, and academic procrastination. Patients and Methods: Data were collected from several Chinese medical universities through an anonymous cross-sectional survey of 3614 respondents (effective response rate = 60.0%). Using online questionnaires to collect the data and IBM SPSS Statistics 22.0 for statistical analysis. Results: The average score of academic procrastination of Chinese medical students was 2.62±0.86. This study proved the usage of peer pressure and positive learning environment as moderating roles of relationship between career calling and academic procrastination. Career calling was negatively correlated with academic procrastination (r = -0.232, p < 0.01), while it was positively correlated with peer pressure (r = 0.390, p < 0.01) and a positive learning environment (r = 0.339, p < 0.01). Moreover, academic procrastination was negatively correlated with peer pressure (r = -0.279, p < 0.01) and a positive learning environment (r = -0.242, p < 0.01). Peer pressure was positively correlated with a positive learning environment (r = 0.637, p < 0.01). Conclusion: The findings emphasize the importance of constructive peer pressure and a positive learning environment that discourages academic procrastination. Educators should highlight medical career calling education by offering related courses to fight against academic procrastination.

Proactive personality and critical thinking in Chinese medical students: The moderating effects of psychological safety and academic self-efficacy.

Objectives: This study aimed to identify the relationship among proactive personality, psychological safety, academic self-efficacy and critical thinking, and to further explore whether psychological safety and academic self-efficacy could be a moderator in the association between proactive personality and critical thinking among Chinese medical students. Materials and methods: The cross-sectional study was carried out from October to December 2020 in China. Totally, 5,920 valid responses were collected at four Chinese medical universities. Critical thinking, proactive personality, psychological safety, academic self-efficacy and demographic factors were assessed through questionnaires. Hierarchical multiple regression was used to identify interrelationship clusters among variables. Simple slope analyses were performed to explore the moderating effects of psychological safety and academic self-efficacy. Results: The mean score of critical thinking among medical students was 3.85 ± 0.61. Proactive personality, psychological safety, and academic self-efficacy were shown to be important factors for critical thinking. Psychological safety and academic self-efficacy moderated the association between proactive personality and critical thinking. A simple slope analysis showed that high psychological safety and academic self-efficacy weakened the impact of proactive personality on critical thinking. Conclusion: Most medical students surveyed in China might have relatively high levels of critical thinking. Psychological safety and academic self-efficacy moderated the association between proactive personality and critical thinking. More interventions related to psychological safety and academic self-efficacy will be helpful to improve critical thinking among Chinese medical students.

Relationship between psychological capital and depression in Chinese physicians: The mediating role of organizational commitment and coping style.

Background: It is well known that the medical profession is a high-risk practice, with intense work and complex situations. The physicians are prone to suffer from depression due to occupational stress under high workloads for long periods of time. Depression not only impairs physicians' mental health, but also affects the quality of health services, so it is important to explore the factors and mechanisms affecting depression among physicians. Methods: In this cross-sectional study, 1,139 physicians from Heilongjiang Province were surveyed by cluster sampling procedures. The questionnaires included Psychological Capital Questionnaire, Chinese Employee Organizational Commitment Questionnaire, Trait Coping Style Questionnaire and Self-rating Depression Scale. Pearson correlation analysis and Bootstrap were used for statistical analysis. Results: This study found that 41.6% of physicians suffering from depression. Among them, 17.0% of physicians showed moderate depression, and 2.6% of physicians exhibited severe depression. The serial-multiple mediation of organizational commitment and positive coping styles in the relationship between psychological capital and depression was significant. Conclusion: The results showed that the psychological capital was sequentially associated with increased organizational commitment, and then increased positive coping styles, which resulted in reduced depression among physicians.

A Cross-Sectional Study of Individual Learning Passion in Medical Education: Understanding Self-Development in Positive Psychology.

Background: Boosting the individual learning passion of medical students is a novel approach to improve their academic performance. It facilitates the medical education reform, motivating both policymakers and educators to focus on the function of positive psychology in the career development of medical students. Therefore, this study aimed (1) to assess the status of two types of learning passion; (2) to clarify the relationship between self-esteem and two types of learning passion among Chinese medical students; (3) to examine the mediating role of psychological capital (PsyCap) in the relationship between self-esteem and two types of learning passion, respectively; and (4) to identify the moderating role of professional identity in the relationship between PsyCap and two types of learning passion, respectively. Methods: A cross-sectional online survey was conducted from April to June 2016 in China. A total of 1,218 valid questionnaires (effective completion rate: 67.93%) were collected from four medical schools. Results: Self-esteem significantly and positively influenced medical students' PsyCap (ß = 0.637, P < 0.01) and two types of learning passion, including harmonious learning passion (ß = 0.589, P < 0.01) and obsessive learning passion (ß = 0.436, P < 0.01). PsyCap fully mediated the relationship (ß = 0.578, P < 0.01) between self-esteem and harmonious learning passion positively, whereas it suppressed the relationship (ß = 0.490, P < 0.01) between self-esteem and obsessive learning passion. Further, professional identity significantly moderated the correlation between PsyCap and harmonious learning passion (ß = -0.554, P < 0.05), rather than obsessive learning passion (P > 0.05). Conclusion: Two types of learning passion of medical students are positively influenced by self-esteem and PsyCap. Medical students with high-level self-esteem should possess strong PsyCap, which augments their harmonious as well as obsessive learning passion. Moreover, the positive effect of medical students' PsyCap on harmonious learning passion is more notable among those with a lower professional identity. Finally, this study argues that strengths-based interventions of self-esteem and PsyCap are a beneficial approach for future enhancing learning passion in the domain of medical education.

Factors Influencing Post-traumatic Stress Symptoms in Chinese Adolescents During the COVID-19 Pandemic.

To investigate the prevalence of post-traumatic stress symptoms (PTSSs) and analyze the influencing factors of PTSS among adolescents in a large sample study during the COVID-19 pandemic, we did a cross-sectional study by collecting demographic data and mental health measurements from a large group of 175,318 adolescents in 32 Chinese provinces and autonomous regions, using the Impact of Event Scale-Revised (IES-R) that was used to measure the PTSS of the participants. The results showed that the prevalence of PTSS was 35.7% in Chinese adolescents during the COVID-19 pandemic. Binary logistic regression analysis showed that, for the personal risk factors, the older age, female gender, the personality domains of extroversion, the irregular sleep schedule, the lack of aerobic exercise, and the lack of peer support were associated with the higher levels of PTSS. The family subjective and objective factors were associated with higher levels of PTSS. Our findings suggested that family factors are the most important factors that affect Chinese adolescents' PTSS due to the longtime home quarantine.

Association Between Self-Perceived Stigma and Quality of Life Among Urban Chinese Older Adults: The Moderating Role of Attitude Toward Own Aging and Traditionality.

BACKGROUND: Ageism is a global challenge, which leads to a range of adverse outcomes for elderly people worldwide, which maybe more severe among urban older adults in a competitive society. However, how self-perceived ageism influences the quality of life in a sample of urban older adults remains inconclusive. OBJECTIVES: The current study aims to assess the status of self-perceived stigma among urban Chinese older adults, identify its relationship with quality of life, and further explore whether both attitude toward own aging and traditionality moderate this relationship. MATERIALS AND METHODS: Primary data were collected through cross-sectional surveys among urban older adults in three provinces of China from October 2019 to December 2020. A total of 764 urban older adults were valid participants (effective response rate = 81.28%) and completed questionnaires via anonymous face-to-face interviews. Socio-demographic factors, self-perceived stigma, attitude toward own aging, traditionality, and quality of life were assessed using questionnaires that included the Self-perceived Stigma, Attitude Toward Own Aging, Traditionality, and SF-8 Scales. RESULTS: For urban Chinese older adults, the average score of self-perceived stigma was 2.041 ± 0.726. Self-perceived stigma (ß = -0.391, p < 0.05) and attitude toward own aging (ß = -0.211, p < 0.05) both influenced quality of life. Additionally, attitude toward own aging (ß = -0.530, p < 0.05) and traditionality (ß = -0.525, p < 0.05) moderated the association between self-perceived stigma and quality of life. Simple slope analysis revealed that when the level of negative attitude toward own aging and traditionality was higher, the strength of the influence of self-perceived stigma on quality of life was stronger. CONCLUSION: Urban Chinese older adults were aware of the self-perceived stigma, which contributes to decreased quality of life. Attitude toward own aging and traditionality could moderate the association between self-perceived stigma and quality of life. When negative attitudes toward own aging and traditionality are higher, self-perceived stigma has a greater effect on the quality of life. More interventions related to relieving self-perceived stigma, traditionality, and negative attitude toward own aging should be considered to build a new modern society that emphasizes health, friendliness, well-being, and dignity for all ages.

The Impact of Transformational Leadership on Physicians' Performance in China: A Cross-Level Mediation Model.

Transformational leadership has been becoming increasingly vital to the provision of high-quality health care, particularly during major public health emergencies. The present study aims to investigate the impact of transformational leadership on physicians' performance and explore the cross-level underlying mechanisms with achievement motivations and coping styles among Chinese physicians. During 2017-2019, 1,527 physicians of 101 departments were recruited from six hospitals in China with a cluster random sampling method. Participants completed several questionnaires regarding their job performance, achievement motivations, coping styles, and transformational leadership. Multilevel mediation effects were tested using cross-level path analysis. The result of this study indicated that transformational leadership was applied well in Chinese medical settings with a score of 101.56 ± 6.42. The hierarchical linear model showed that transformational leadership had a cross-level direct positive effect on physicians' performance (ß = 1.524, p < 0.05). Furthermore, results of cross-level path analyses revealed that transformational leadership contributed to physicians' performance by sequentially influencing achievement motivations first and then coping styles. In addition, the path "transformational leadership → positive coping (PC) style → physicians' performance" showed the strongest cross-level indirect effect. In summary, public health leaders should enhance physicians' performance by promoting individual development, especially achievement motivation and PC style.

The Relationship between Achievement Motivation and Job Performance among Chinese Physicians: A Conditional Process Analysis.

BACKGROUND: To explore the relationship between achievement motivation and job performance among physicians, this study investigated the impacts of different personality traits on job performance among the physicians. METHODS: This cross-sectional study was conducted in 2017 and 1,523 physicians from eight tertiary grade A hospitals in Harbin, China. The type of data collected included the achievement motivation of the physicians, job performance, organizational commitment, personality traits, and other demographic variables. To assess and compare the demographic data, independent t-test and ANOVA were applied. Further, Pearson correlation coefficients were used to evaluate the correlation among the variables. Moderated mediation analysis was performed to test the correlation among the job performance, achievement motivation, organizational commitment, neuroticism, extraversion, openness, agreeableness, and conscientiousness. RESULTS: Achievement motivation directly influences job performance and organizational commitment partially mediates the direct effects of achievement motivation on job performance. Additionally, our findings demonstrated that agreeableness and conscientiousness moderate the strength of the relationships between achievement motivation and job performance mediated by organizational commitment. CONCLUSION: We propose that hospital managers should pay attention to the personal growth of the physicians and improve their organizational commitment via creating a positive working climate and training for career planning and education. Moreover, managers should identify conscientiousness and agreeableness individuals and increase their responsibilities geared towards improving the performance of the organization.

Impact of a Chaxu Atmosphere on Nurses' Organizational Responsibility behavior-The Mediating Roles of Envy and Silence.

BACKGROUND: Chaxu atmosphere refers to the degree of differences, like the ripple effects in water, of the association between group members and the leader of the group resource. Unlike Western culture, China's nurses have been working in Chaxu atmosphere, which may boost their negative emotion and influence their workplace behavior. PURPOSE: This study aimed to clarify the chain-mediating role of envy and silence in the association between Chaxu atmosphere and organizational responsibility behavior. METHODS: A cross-sectional online survey was conducted, and a multistage stratified sampling method was employed to collect data. The study was conducted from September to October 2020 in China. Totally, 1740 nurses were recruited, and 1221 valid responses were collected. Socio-demographic factors, Chaxu atmosphere, employee envy, employee silence, and organizational responsibility behavior were assessed using questionnaires that included the Chaxu Atmosphere Scale, Employee Envy Scale, Employee Silence Scale, and Organizational Responsibility Behavior Scale. Hierarchical multiple regression was used to identify clusters of interrelationships among Chaxu atmosphere, envy, silence, and organizational responsibility behavior in nursing settings. RESULTS: Though the Chaxu atmosphere did not directly influence the organizational responsibility behavior of Chinese nurses, its effect is mediated by a chain of envy and silence. First, Chaxu atmosphere evoked envy in the nurses (ß=-0.040, P<0.001), thereby leading to decreased organizational responsibility behavior. Second, the Chaxu atmosphere promoted silence toward organizational issues (ß=-0.057, P<0.001), resulting in decreased organizational responsibility behavior. Third, the Chaxu atmosphere evoked envy in the nurses, which contributed to the formation of silence (ß=-0.025, P<0.001), resulting in a further decrease in organizational responsibility behavior. CONCLUSION: Nurses working in a high-level Chaxu atmosphere are prone to remaining silent on critical organizational issues due to increased envy, which subsequently reduces their organizational responsibility behavior. A better understanding of the association between the Chaxu atmosphere and workplace behavior will help nursing managers to foster harmonious relationships between nurses and their teams and to improve each individual's organizational responsibility behavior.

Contribution of Character Strengths to Psychology Stress, Sleep Quality, and Subjective Health Status in a Sample of Chinese Nurses.

Objectives: The main objectives of this study were to describe the current state of character strengths (CSs) of nurses; explain how they affect stress, sleep quality, and subjective health status; and reveal the mediating role of stress for the subject matter on the association between CSs, sleep quality, and subjective health status. Methods: A cross-sectional online survey was conducted from September to October 2020 in China. A multistage stratified sampling method was used, and 1,221 valid questionnaires across 100 cities in 31 provinces were collected. Results: For the participants in this survey, the three dimensions of CSs ranging from high to low were caring (4.20 ± 0.640), self-control (3.53 ± 0.763), and inquisitiveness (3.37 ± 0.787). There was difference in CSs scores across age (F = 8.171, P < 0.01), professional categories (F = 5.545, P < 0.01), and job tenure (F = 9.470, P < 0.01). The results showed that CSs significantly affected the psychological stress (ß = -0.365, P< 0.01), sleep quality (ß = 0.312, P< 0.01), and subjective health (ß = 0.398, P< 0.01) of nurses. Moreover, psychological stress partially mediated the association between CSs and both types of health outcomes. Conclusion: In China, the CSs of nurses are at high levels. We find that nurses with high-level CSs are likely to experience less psychological stress and exhibit healthy psycho-physiological responses, which contribute to positive health outcomes. Finally, our study argues that strength-based interventions of positive psychology in hospitals should be provided to minimize threats to the physical and psychological health of health professionals, which is a beneficial choice for future hospital reforms in the domain of occupational health management.