Investigation of the Sleep Quality Among Hospitalized Cardiovascular Patients Using Regression Models and Qualitative Comparative Analysis.

This study aimed to explore the relationships between modifiable and non-modifiable factors that influence sleep quality in hospitalized patients with cardiovascular disease in China. This study design was cross-sectional and descriptive. This study involved a convenience sample of 242 patients hospitalized for cardiovascular issues. Hierarchical regression model and qualitative comparative analysis model were performed. Regression revealed that age and depression both had statistically significant effects on sleep quality. The combination of conditions with strongest predictive effect on sleep quality was male of younger age, high level of depression, high level of anxiety, and low level of social support. Other combinations with predictive power on sleep quality are as follows: (1) younger male patients (aged 47-63 years) with high level of anxiety, high level of social support, and low level of depression; (2) older male patients (aged 63-79 years) with high level of depression, high level of social support, and low levels of anxiety; and (3) older male patients with high level of anxiety and low level of social support. Nurses may promote primary and secondary prevention of cardiovascular health prior to hospitalization, through routine screening for depressive and anxious symptoms and assessment of the patient's social support network. It is unknown whether these findings are unique to hospitalized patients. Therefore, future work should assess the fit of the model to other more diverse groups of hospitalized patients.

The influence of subjective well-being on mental health in nursing students: the role of student cynicism.

Previous studies have reported high rates of poor mental health among nursing students, but few studies focused on the internal pathway of mental health. This cross-sectional study was conducted at a vocational medical school and investigated 384 nursing students. Symptom Check List-90, Index of Well-Being Scale and Cynical Attitudes Toward College Scale were used to test mental health, subjective well-being (SWB) and cynicism of nursing students, respectively. Academic cynicism, social cynicism and institutional cynicism were negatively related to mental health. SWB not only directly had positive effect on mental health, but had an indirect effect on mental health through academic cynicism, social cynicism and institutional cynicism.

Relationships Between Depressive Symptoms, Interpersonal Sensitivity and Social Support of Employees Before and During the COVID-19 Epidemic: A Cross-lag Study.

This study examined the correlation between depressive symptoms, interpersonal sensitivity, and social support before and during the COVID-19 pandemic and verified causal relationships among them. The study used Social Support Scale and Symptom Self-Rating Scale to investigate relevant variables. A total of 1,414 employees from company were recruited for this longitudinal study, which a follow up study was conducted on the same group of participants 1 year later. Paired sample t-test results showed that significant differences were only found in social support, not in depressive symptoms or interpersonal sensitivity. The results of correlation analysis showed that social support, depressive symptoms, and interpersonal sensitivity were significantly correlated between wave 1 and wave 2. The cross-lag autoregressive pathway showed that employees' social support level, depressive symptoms, and interpersonal sensitivity all showed moderate stability. Crossing paths showed that wave 1 social support could significantly predict wave 2 depressive symptoms (ß = -0.21, p < 0.001) and wave 2 interpersonal sensitivity (ß = -0.21, p < 0.001). Wave 1 depressive symptoms (ß = -0.10, p < 0.01) could significantly predict wave 2 social support, while wave 1 interpersonal sensitivity (ß = 0.07, p = 0.10) could not predict wave 2 social support. Social support can be considered as a protective factor against mental health problems.

Effect of family stress on life satisfaction among female workers during the COVID-19 epidemic in China: Exploring the roles of anxiety symptoms and age.

The study aimed to investigate the level of life satisfaction (LS) among Chinese female workers after resuming work during the COVID-19 epidemic, and to further explore the potential mediating and moderating roles in the association between family stress and LS. Self-reported questionnaires were completed by 10,175 participants. Results showed that the level of LS decreased. The family stress had a negative effect on LS, and the effect was mediated by anxiety symptoms. Additionally, age moderated the direct and indirect effects within this relationship. Interventions aiming to improve LS should consider these aspects and younger workers should be given special attention.

Self-Esteem as a Mediator between Life Satisfaction and Depression among Cardiovascular Disease Patients.

This study explores the association between life satisfaction and depression among patients with cardiovascular diseases and whether this association is mediated by self-esteem. A cross-sectional study was conducted in a third-grade hospital. We examined 300 patients with cardiovascular diseases with a mean age of 62.00 years (females, 133). Life satisfaction was associated with depression. Adding self-esteem to the model weakened the strength of the association between the two. Moreover, 34.2% of the effect of life satisfaction on depression could be explained by self-esteem. We found that self-esteem could totally explain the effect of life satisfaction on depression among patients with cardiovascular diseases.

Unique and cumulative effects of lifestyle-related behaviors on depressive symptoms among Chinese adolescents.

BACKGROUND: It is well known that some lifestyle-related behaviors are related to depressive symptoms, but the unique and cumulative effects of lifestyle-related behaviors on depressive symptoms among Chinese adolescents are still controversial. AIMS: The aims of this study were to examine the unique and cumulative effects of lifestyle-related behaviors on depressive symptoms among Chinese adolescents, and explored the potential influences of gender difference on these associations. METHODS: We conducted a cross-sectional study among 3967 Chinese adolescents aged 11 to 19 from Jilin, China during September and October of 2018. Students reported their lifestyle factors including sleep duration, time spent on computer, time spent on television, time spent on homework, eating breakfast, smoking, drinking, physical activity, and outdoor activity. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D). RESULTS: The prevalence of depressive symptoms was 28.2% among Chinese adolescents. Multivariate logistic regression analysis revealed that sleep duration <8 hour/day, time spent on homework ⩾3 hour/day, skipping breakfast, alcohol use, physical activity <3 days/week, and outdoor activity <2 hour/day were positively associated with depressive symptoms in both girls and boys. Time spent on computer ⩾2 hour/day was an independent risk predictor for depressive symptoms in males, while smoking only showed higher risk of depressive symptoms in females. There was an additive relationship between the lifestyle risk index scores and the risk of depressive symptoms for both genders, the relationship being strongest among females. CONCLUSION: The important role of lifestyle factors should be taking into consideration when create intervention programs to prevent and reduce depressive symptoms among adolescents. In addition, preventive interventions may need to focus on gender-informed approaches when targeting multiple lifestyle factors.

Relationship of night sleep duration with health lifestyle, depressive symptoms, internet addiction in Chinese High school Students.

This study aimed to explore effects of night sleep duration and its relationships with health lifestyle, depressive symptoms and Internet addiction among high school students. In this study, we used multistage stratified random cluster sampling method. A total of 2149 adolescents aged 14-18 years old were recruited in the study. Associations among sleep duration and demographic characteristics, health lifestyle, depressive symptoms and Internet addiction among Chinese students were analyzed by univariate analysis and binary logistic regression analysis. Then, the structural equation model (SEM) was used to study the relationships between sleep duration and other variables. The mean sleep duration was (6.56 ± 1.15) hours. Approximately 16.0% of all participants had short sleep duration, and 20.5% had long sleep duration. Binary logistic regression analysis revealed that having more high sugar drinks and fried foods were positively associated with short sleep duration. Depressive symptoms not only directly had a negatively impact on sleep duration, but also had an indirect effect on sleep duration through Internet addiction. Sleep problems are common within the population of adolescents. Depressive symptoms was an important factor in the prevention of abnormal sleep duration, and interventions that target Internet addiction is key to reduce inadequate sleep.

Association Between Perceived Stress and Post-Traumatic Stress Disorder Among Medical Staff During the COVID-19 Epidemic in Wuhan City.

Objective: The study aimed to examine the relationship between perceived stress and post-traumatic stress disorder (PTSD) among frontline medical staff during the lockdown in Wuhan city, China, due to the COVID-19 outbreak. Methods: The study was conducted in August 2020, which included 516 medical staff between 21 to 65 years. The PTSD Checklist-Civilian, Perceived Stress Scale, Insomnia Severity Index, and Compassion Fatigue Short Scale were used. Results: The results indicated that 10.5% of the medical staff experienced PTSD symptoms, and insomnia severity mediated the effect of perceived stress on PTSD. In addition, compassion fatigue moderated the association between perceived stress and PTSD. Conclusion: The study elucidated the mechanisms underlying the association between perceived stress and PTSD. Moreover, it emphasized the importance of long-term monitoring of the mental health status of frontline medical staff who supported Wuhan. The results can serve as reference for relevant medical and health departments to formulate active interventions and preventive measures against PTSD for unsung heroes who put their lives on the line during difficult times.

Does Social Support Moderate Wound Pain and Health-Related Quality of Life in Patients With Chronic Wounds? A Multicenter Descriptive Cross-sectional Study.

PURPOSE: We sought to explore the relationships among social support, health-related quality of life (HRQOL), and wound pain, and to examine whether social support would moderate the relationship between wound pain and HRQOL. DESIGN: A multicenter descriptive cross-sectional study. SUBJECTS AND SETTINGS: Individuals with chronic wounds attending wound clinics affiliated with 3 public hospitals in Beijing, China. METHODS: Sociodemographic and wound characteristics of 162 participants were retrieved from medical records. Participants completed questionnaires for wound-related pain intensity (Numerical Rating Scale), social support (Social Support Rating Scale), and HRQOL (Medical Outcome Study Short Form-36). The moderating effect analysis was examined using the PROCESS analytic tool developed by Hayes, based on the bias-corrected bootstrapping method. RESULTS: Results revealed that higher pain intensity was significantly related to lower HRQOL (P < .01), and higher social support was associated with better HRQOL (P < .01). However, there was no significant correlation between social support and wound pain (P = .55). Importantly, the moderating effect of social support on the relationship between wound pain and HRQOL was statistically significant (P = .008). CONCLUSIONS: We found that social support moderated the impact of wound pain on HRQOL in patients with chronic wounds. This finding suggests that support obtained from social networks may be a beneficial intervention to improve the HRQOL of patients with chronic wounds, especially those suffering from high-intensity wound pain.

Trajectories of depression and anxiety in Chinese high school freshmen: Associations with Internet addiction.

BACKGROUND: Most previous studies focused on the associations of depression and anxiety with Internet addiction (IA) have used variable-centered approaches. This study aims to explore the distinct developmental trajectories of depression and anxiety, and their association with IA based on person-centered approaches. METHODS: A total of 437 Chinese high school freshmen at the baseline were followed across one year. Latent class growth analysis (LCGA) and growth mixture modeling (GMM) were used to identify the heterogeneity of individual trajectories of depression and anxiety. RESULTS: For depression, there were three distinct trajectories identified, namely, the escalating group (n=60, 13.7%), recovery group (n=31, 7.1%), and the low-stable group (n=346, 79.2%). For anxiety, the subgroups consisted of the escalating group (n=50, 11.4%), the recovery group (n=34, 7.8%), and the low-stable group (n=353, 80.8%). The probability of IA in the depression low-stable group was significantly smaller compared to those in either the recovery group (χ2=10.794, P=0.001) or the escalating group (χ2=19.314, P<0.001). The probability of IA in the anxiety low-stable group was found to be significantly smaller than that in the recovery group (χ2=17.359, P<0.001) and the escalating group (χ2=7.752, P=0.005). LIMITATIONS: The sample was limited to students from one specific high school and had a one-year follow-up. CONCLUSIONS: The findings of the study suggest the necessity of early prevention and intervention strategies for those students with depression and anxiety, which are at elevated risk of developing IA.

Influence of Life Satisfaction on Quality of Life: Mediating Roles of Depression and Anxiety Among Cardiovascular Disease Patients.

The present study aimed to determine the mediating effects of depression and anxiety on the association between life satisfaction and quality of life. We used the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and EuroQol Five Dimensions Questionnaire (EQ-5D) to measure depression, anxiety, and quality of life, respectively. A single question was used to measure the life satisfaction of participants. Life satisfaction was significantly related with depression (r = -0.17), anxiety (r = -0.18), and quality of life (r = 0.19). Depression and anxiety were also related to quality of life. Depression and anxiety had full mediating effects (ß = -0.274; ß = -0.208) on the association between life satisfaction and quality of life. For those with poor life satisfaction, people were more likely to have high level of depression and anxiety, which in turn experienced poor quality of life.

The relationship between bullying victimization and depression in adolescents: multiple mediating effects of internet addiction and sleep quality.

Various studies have found that bullying victimization is an important factor affecting depression. However, few studies have explored the underlying mechanism of this effect.  The purpose of this study was to examine the effects of bullying victimization on depression, as well as the mediating roles of internet addiction and sleep quality. The participants were 2022 Chinese junior high school students who completed questionnaires regarding bullying victimization, internet addiction, sleep quality and depression. Correlation analysis indicated that bullying victimization, poor sleep quality, internet addiction, and depression have significant, positive correlations with each other. Hayes' PROCESS macro revealed that internet addiction and sleep quality played multiple mediation roles in the relationship between bullying victimization and depression. These results suggested that effective strategies focusing on improving problematic internet use along with sleep quality may contribute to reducing the negative effect of bullying victimization on depressive symptoms.

Post-traumatic stress disorder and psychological distress in Chinese youths following the COVID-19 emergency.

This study aims to explore the relationship between psychological distress and post-traumatic stress disorder among Chinese participants as the result of COVID-19 outbreak. This study was conducted within 1 month after COVID-19 appeared in China, it included 570 participants age from 14 to 35. The results indicated that 12.8% of all participants with the symptoms of post-traumatic stress disorder and the effects of psychological distress on post-traumatic stress disorder was mediated by negative coping style. Gender moderated the direct effect between psychological distress and post-traumatic stress disorder, which is a significant discovery for relevant departments to take further measures.

Clustering of lifestyle factors and the relationship with depressive symptoms among adolescents in Northeastern China.

BACKGROUND: Previous studies have showed the independent associations between screen time, physical activity (PA), sleep duration, and depressive symptoms, but little is known about the influence of lifestyles on depressive symptoms. This study aimed to identify clustering patterns of health-related behavior in Chinese adolescents and their association with depressive symptoms. METHODS: The sample consisted of 4178 adolescent students. Screen time, physical activity, and sleep time were self-reported. The level of depressive symptoms was measured using the Center for Epidemiologic Studies Depression Scale. A two-step cluster analysis was conducted to identify lifestyle patterns. Univariate and multivariate logistic regression were used to examine the associations between clusters and depressive symptoms. RESULTS: About 28.1% of participants reported depressive symptoms. Four lifestyle clusters were identified: (1) active pattern (n = 865 [20.7%]); (2) high sleep duration pattern (n = 1263 [30.2%]); (3) high screen time pattern (n = 665 [15.9%]); and (4) low physical activity-low sleep duration pattern (n = 1385[33.1%]). Cluster 1 and 2 were relatively healthy groups. Cluster 3 and 4 were at a higher risk of developing depressive symptoms than cluster 1. LIMITATIONS: This was a cross-sectional study, and causal relations could not be identified. Self-reported questionnaire instruments were used to collect data, which might have led to some recall bias. CONCLUSIONS: Clusters of lifestyle behaviors were identified, and differences in depressive symptoms were found among clusters. Public mental illness prevention strategies should expand their capacity to focus on lifestyle patterns.

Relationships among economic stress, social support, age and quality of life in patients with chronic wounds: A moderated mediation model.

AIMS: The aims of this study were as follows: (a) to determine if social support mediates the relationship between economic stress and quality of life; and (b) to explore whether participants' ages would moderate the indirect relationship between economic stress and quality of life through social support. DESIGN: A questionnaire-based, cross-sectional study. METHODS: From January 2015-June 2016, a total of 300 patients with chronic wounds were recruited from three hospitals. Data regarding economic stress, social support and quality of life were collected through survey questionnaires. The moderated mediation analysis was examined using the Hayes' PROCESS macro modelling tool, based on the bias-corrected bootstrapping method. RESULTS: Economic stress was negatively correlated with quality of life and social support. The indirect effect of economic stress on quality of life through social support was negative. Furthermore, age moderated the relationship between economic stress and quality of life, as well as the relationship between economic stress and social support. CONCLUSION: Reducing economic stress and improving social support are important strategies for improving quality of life in patients with chronic wounds, especially for younger patients. IMPACT: Patients with chronic wounds experience considerable economic stress and severely impaired quality of life; however, little is known about the inner mechanisms of this relationship. This study emphasized the importance of providing social support in coping with the damage that economic stress causes to health. Clinical nurses should strengthen the comprehensive assessment of the socioeconomic status of patients and adjust nursing plans timely, to reduce the economic burden of patients based on the rational use of wound care materials. Moreover, when nursing for patients with chronic wounds, especially the elders, caregivers should strengthen the evaluation of social support and develop interventions to improve social support.

The Effect of COVID-19 on Youth Mental Health.

The purposes of this study was to assess the youth mental health after the coronavirus disease 19 (COVID-19) occurred in China two weeks later, and to investigate factors of mental health among youth groups. A cross-sectional study was conducted two weeks after the occurrence of COVID-19 in China. A total of 584 youth enrolled in this study and completed the question about cognitive status of COVID-19, the General Health Questionnaire(GHQ-12), the PTSD Checklist-Civilian Version (PCL-C) and the Negative coping styles scale. Univariate analysis and univariate logistic regression were used to evaluate the effect of COVID-19 on youth mental health. The results of this cross-sectional study suggest that nearly 40.4% the sampled youth were found to be prone to psychological problems and 14.4% the sampled youth with Post-traumatic stress disorder (PTSD) symptoms. Univariate logistic regression revealed that youth mental health was significantly related to being less educated (OR = 8.71, 95%CI:1.97-38.43), being the enterprise employee (OR = 2.36, 95%CI:1.09-5.09), suffering from the PTSD symptom (OR = 1.05, 95%CI:1.03-1.07) and using negative coping styles (OR = 1.03, 95%CI:1.00-1.07). Results of this study suggest that nearly 40.4% of the youth group had a tendency to have psychological problems. Thus, this was a remarkable evidence that infectious diseases, such as COVID-19, may have an immense influence on youth mental health. Therefor, local governments should develop effective psychological interventions for youth groups, moreover, it is important to consider the educational level and occupation of the youth during the interventions.

When adolescents face both Internet addiction and mood symptoms: A cross-sectional study of comorbidity and its predictors.

This study aimed to determine the prevalence of comorbid Internet addiction (IA) and mood symptoms and to identify common and unique risk profiles for individual and comorbid mental health problems among adolescents. A total of 2272 high school students in Changchun, China, were included in a cross-sectional study. Participants were asked to complete paper-based questionnaires on sociodemographic characteristics, lifestyle factors, Internet use, parent-child relationships, IA, and mood symptoms. Multivariate logistic regressions were used to compare the risk profiles for IA, mood symptoms, and their comorbidity. The Bonferroni correction was used for multiple tests. Students who were girls, were current smokers, had more than 1.5 h sleep deprivation per day on weekdays, used the Internet for more than 30 and 240 min per day on weekdays and weekends, respectively, used social networking sites more than 6 times per day, were Internet gamers, and/or reported poor parent-child relationships reported higher rates of comorbid IA and mood symptoms. Adolescents exposed to more of these correlates would have a higher risk of IA, mood symptoms, and their comorbidity. Public strategies for the prevention of mental illnesses should expand their capacity to identify and limit the co-occurrence of IA and mood symptoms.

The role of school connectedness and maladaptive cognitions in the association between stress and Internet addiction: A serial mediation model.

PURPOSE: To explore the mediating effect of school interest and maladaptive cognitions in the relationship between stress and Internet addiction. DESIGN AND METHODS: A total of 2271 high school students were recruited from a Chinese high school. Serial mediation model was used. RESULTS: School interest and maladaptive cognitions had 0.03 and 0.13 indirect effects in the association between stress and Internet addiction, and accounting for 7.9% and 34.2% of the total effect, respectively. The serial indirect effect of school interest and maladaptive cognition was 0.05, accounting for 13.2% of the total effect. PRACTICE IMPLICATIONS: The present study highlights the need of reducing stress and increasing school interest among high school students to prevent and intervene the occurrence of Internet addiction.

Relations between Stress and Quality of Life among Women in Late Pregnancy: The Parallel Mediating Role of Depressive Symptoms and Sleep Quality.

OBJECTIVE: This study aims to examine the parallel multiple mediators of depressive symptoms and sleep quality in the relations between stress and physical health-related quality of life (PHQOL)/mental health-related quality of life (MHQOL) among the women in late pregnancy. METHODS: Of 1120 pregnant women participated in the cross-sectional study which consisted of Perceived Stress Scale, Edinburgh Postnatal Depression Scale, Pittsburgh Sleep Quality Index and MOS 12-item Short Form Health Survey. Parallel multiple mediator models were used to analyze the relations between stress, depressive symptoms, sleep quality and PHQOL/MHQOL. RESULTS: The effect of perceived stress on PHQOL was partially through the indirect path of sleep quality (ß=-0.061). But in the model for MHQOL, depressive symptoms and sleep quality played parallel mediators, and the indirect path effect of depressive symptoms (ß=-0.179) was higher than sleep quality (ß=-0.029). CONCLUSION: The findings contributed to the understanding about the influential mechanism of stress on PHQOL/MHQOL. And it reminded the importance of sleep quality and depressive symptoms for improving QOL in late pregnancy.