Development of a Health Problem Prevention and Control Strategies Scale for Medical Rescuers Fighting Epidemics.

This study aimed to develop and validate a new scale to measure health problem prevention and control strategies employed by medical rescuers fighting epidemics. In Study I, a qualitative study, focus group discussion, and expert panel review were conducted to generate items that capture components of prevention and control strategies. In Study II, exploratory factor analysis was used to examine the scale's structure. In Study III, the scale's validity and reliability were assessed via confirmatory factor analysis, average variance extracted, composite reliability, and Cronbach's α. Data analysis was performed using Nvivo 12.0, SPSS 25.0, and Amos 23.0. The final scale was divided into three subscales (comprising 5 factors and 18 items on the Before Medical Rescue subscale, 6 factors and 28 items on the During Medical Rescue subscale, and 4 factors and 14 items on the After Medical Rescue subscale). The scale has excellent validity and reliability and can be used to measure the health problem prevention and control strategies of medical rescuers fighting epidemics.

Development and psychometric testing of physiopsychological disorders scale for medical rescuers fighting epidemics in China.

OBJECTIVE: Develop and psychometrically test the physiopsychological disorders scale for medical rescuers fighting epidemics (PDS-MRFE). METHOD: A three-phase approach was used to develop and test the physiopsychological disorders scale: (1) creating the item pool, (2) preliminarily evaluating items, and (3) refining the scale and estimating the psychometric properties. The items of the instrument were generated based on a comprehensive literature review and a qualitative study conducted with 31 medical rescuers (18 nurses and 13 doctors) fighting epidemics. A preliminary evaluation of items was conducted using content validity which was evaluated by a panel of 15 experts. Validity and reliability examinations were conducted to refine the scale and evaluate its psychometric properties. This was done using two different samples. Specifically, Sample A (360 medical rescuers) was employed for item reduction and exploratory factor analysis (EFA), and Sample B (287 medical rescuers) was employed for the confirmatory factor analysis (CFA) and determination of other psychometric properties (i.e., reliability, concurrent, convergent, and discriminant validity), which further confirmed the structure of the scale and evaluated its final psychometric properties. RESULTS: The final scale has 39 items with three subscales, including before, during, and after rescue. The exploratory factor analysis result indicated that the before-rescue scale of four items, during-rescue of 21 items, and after-rescue of 14 items explained 52.07%, 69.75%, and 52.30% of the cumulative variance, respectively. The confirmatory factor analysis result indicated that model fit indices of three subscales were acceptable and showed evidence of adequate content, convergent, discriminate, and concurrent validity. The Cronbach's α coefficients for each subscale and all dimensions ranged from 0.81 to 0.92, indicating good reliability for the PDS-MRFE. CONCLUSIONS: The physiopsychological disorders scale is a psychometrically valid and reliable instrument and can be used in both clinical practice and research to evaluate different physiopsychological disorders at different medical rescue stages among medical rescuers fighting epidemics.

Distinct dyadic quality of life profiles among patient-caregiver dyads with advanced lung cancer: a latent profile analysis.

PURPOSE: This study aimed to identify the heterogeneity of dyadic quality of life (QoL) profiles, determine whether these profiles differ in terms of demographic and medical factors, neuroticism, resilience, and family functioning, and explore the combined effect of patient and caregiver neuroticism, resilience, and family functioning on dyadic QoL profiles. METHODS: A cross-sectional study was conducted with 304 advanced lung cancer patient-caregiver dyads. Self-report questionnaires were administered to patient-caregiver dyads to assess demographic and medical characteristics, neuroticism, resilience, family functioning, and QoL. RESULTS: The latent profile analysis identified four subgroups of dyadic QoL: patient-low-caregiver-high profile (38.82%), patient-high-caregiver-high profile (22.37%), patient-high-caregiver-low profile (19.74%), and patient-low-caregiver-low profile (19.08%). Additionally, when both patients and their caregivers had a high level of neuroticism or low level of resilience and low family functioning, compared with only member having them, there was a higher risk of poorer dyadic QoL. CONCLUSIONS: Our study identified the four heterogeneities of dyadic QoL profiles among advanced lung cancer patient-caregiver dyads. Future dyadic interventions should consider the heterogeneity of dyadic QoL in this population and prioritize patient-caregiver dyads at risk of poor dyadic QoL. Furthermore, when high neuroticism, low resilience, or family functioning coexist between patients and their caregivers, both parties exhibit much lower dyadic QoL.

The relationship between patient-family caregiver congruence/incongruence in acceptance of illness and family caregivers' anticipatory grief.

OBJECTIVE: Cancer is a family affair that negatively impacts the lives of patients and their family caregivers. This study takes a dyadic perspective to investigate the effect of patient-family caregiver illness acceptance congruence/incongruence on family caregivers' anticipatory grief (AG) and examine whether caregivers' resilience moderates the abovementioned relationship. METHODS: For the study, 304 dyads of advanced lung cancer patients and their family caregivers from three tertiary hospitals in Jinan, Shandong Province, China were recruited. The data were analyzed using polynomial regressions and response surface analyses. RESULTS: Family caregivers' AG was lower when patient-family caregiver illness acceptance was congruent rather than incongruent. Lower patient-caregiver illness acceptance congruence was associated with higher AG in family caregivers compared with higher illness acceptance congruence. Family caregivers reported significantly higher AG only if their illness acceptance was lower than that of their patients. In addition, caregivers' resilience moderated the effects of patient-caregiver illness acceptance congruence/incongruence on family caregivers' AG. CONCLUSIONS: Patient-family caregiver illness acceptance congruence was beneficial to family caregivers' AG; resilience can be a protective factor for buffering the impact of illness acceptance incongruence on family caregivers' AG.

Intergenerational Transmission of Depressive Symptoms from Mothers to Adolescents: A Moderated Mediation Model.

Substantial literature investigating the intergenerational transmission of depressive symptoms has primarily focused on mothers and adolescents, whereas less is known about the potential role of fathers, especially their parenting behaviors. This study aimed to address this gap by examining the mediating role of maternal parenting, and the moderating role of paternal parenting in this intergenerational transmission pathway. A total of 528 Chinese community adolescents (Mage = 12.70 ± 1.49 years; 48.7%, girls) and their mothers participated. After adolescent sex, age, maternal educational levels, and monthly household income were controlled for, both maternal warmth and rejection mediated the association between maternal and adolescent depressive symptoms. More importantly, paternal warmth buffered the adverse effect of maternal depressive symptoms and maternal rejection on adolescent depressive symptoms. These findings highlight the buffering role of paternal parenting in blocking the intergenerational transmission risk of depressive symptoms from mothers to adolescents and emphasize the need for father-focused interventions.

Physical and mental health problems of Chinese front-line healthcare workers before, during and after the COVID-19 rescue mission: a qualitative study.

OBJECTIVE: To explore the physical and mental health problems of front-line healthcare workers fighting COVID-19 across the three phases of the epidemic rescue mission (before, during and after) in China. DESIGN: A qualitative study was adopted using face to face, in-depth semistructured interviews. Phenomenological research methods and Colaizzi's seven-step analysis method were used in the study. SETTING: The setting of the study was the offices of healthcare workers in 12 tertiary hospitals. PARTICIPANTS: Thirty-one front-line healthcare workers from 16 provinces in China, who carried out rescue missions in Hubei Province, were interviewed from October to November 2020. RESULTS: Physical and mental health problems existed before, during and after the COVID-19 rescue mission. Eleven themes emerged during the three phases. Two themes appeared before rescue mission: basic diseases, anxiety before rescue mission. Five themes appeared during rescue mission: basic physical function disorder, physical exhaustion, negative cognition, negative emotions and negative behaviour. Four themes appeared after rescue mission: physical dysfunction, negative emotions, stigmatisation and hypochondriasis. CONCLUSION: Both physical and mental health problems occurred throughout the three phases. The study results pointed that a comprehensive prevention and control system that addresses both physical and mental health problems of front-line healthcare workers throughout the three phases of epidemic rescue mission (before, during and after), and that involves themselves, their families, hospitals, the government and social organisations is needed.

Does Type A personality have a positive or negative impact on the delayed retirement intention of older workers?

OBJECTIVES: To determine whether the effects of Type A personality were positive or negative on the intention to delay retirement when taking into account both its direct and indirect effects mediated by occupational stressors and psychological distress. METHODS: A cross-sectional survey on the intention to delay retirement, psychological distress, occupational stressors, and Type A personality among 1752 older Chinese workers was conducted, and a structural equation approach was employed to examine these effects. RESULTS: The delayed retirement intention of Chinese workers was low (i.e., individuals were unwilling to delay retirement), and the expected retirement age was significantly lower than the official retirement age (i.e., the age when individuals become eligible for government pensions). Type A personality was directly associated with significantly higher intentions to delay retirement, but its indirect effects mediated by occupational stressors and psychological distress were insignificant. CONCLUSIONS: The total effects of Type A personality on the intention to delay retirement were positive. Personalized intervention strategies based on Type A personality may be beneficial in motivating the work potential of older workers.

Do type A personality and neuroticism moderate the relationships of occupational stressors, job satisfaction and burnout among Chinese older nurses? A cross-sectional survey.

BACKGROUND: The high prevalence of burnout among nurses produces huge health service losses. Existing literature found that occupational stressors and low levels of job satisfaction were related to burnout, whilst personality traits such as type A personality and neuroticism influenced occupational stressors, job satisfaction, and burnout. The purpose of this study was to investigate the mediating effect of job satisfaction on the relationship between occupational stressors and burnout among Chinese older nurses, and explore the moderating effects of type A personality and neuroticism on the relationships among occupational stressors, job satisfaction and burnout. METHODS: A cross-sectional study was conducted in five provinces and municipalities (mainly in Shandong) in China. A total of 527 female older nurses (age≧40) were included in this study. Structural equation modelling (SEM) approach was employed to investigate the mediating effect of job satisfaction on the relationship between occupational stressors and burnout. Multi-group analysis was conducted to explore the moderating effects of type A personality and neuroticism on the relationships among occupational stressors, job satisfaction and burnout. RESULTS: Both nurses with high type A personality and high neuroticism had higher occupational stressors, higher burnout and lower job satisfaction. Occupational stressors had direct effect (ß = 0.29, P = 0.001) and indirect effect mediated by low levels of job satisfaction (ß = 0.25, P = 0.001) on burnout. Type A personality had significant moderated effect (P = 0.007) on the relationships among occupational stressors, job satisfaction and burnout, whereas the moderated effect of neuroticism was not significant. CONCLUSIONS: Low levels of job satisfaction mediated the relationship between occupational stressors and burnout among Chinese older nurses, and both the direct and indirect effect of occupational stressors on burnout were moderated by type A personality. Hospital administrators should take specific measures such as transferring older nurses to easier positions to reduce their occupational stress, thereby increasing their job satisfaction and reducing their burnout, which is especially important for the older nurses with high type A personality.

The dyadic effects of personality traits on depression in advanced lung cancer patients and caregivers: The mediating role of acceptance of illness.

OBJECTIVE: This study aimed to explore the intrapersonal and interpersonal effects of three personality traits-neuroticism, extraversion and conscientiousness-on depression and examine whether acceptance of illness mediates the actor and partner effects in advanced lung cancer patients and caregivers using the Actor-Partner Interdependence Mediation Model (APIMeM). METHODS: A total of 304 dyads of advanced lung cancer patients and caregivers were studied. Personality traits, acceptance of illness and depression were measured using 44-item Big Five Inventory, the Acceptance of Illness (AIS) scale and the Patient Health Questionnaire (PHQ-9). RESULTS: The APIMeMs suggested that there were significant actor-actor effects of the three personality traits on depression through their own acceptance of illness. Additionally, significant actor-partner effects of neuroticism and extraversion on depression were also found. Specifically, patients' neuroticism was negatively related to their own acceptance of illness, which increased caregivers' depression, and caregivers' higher extraversion was related to their own higher acceptance of illness, which reduced patients' depression. Furthermore, a significant partner-actor effect was only found in the neuroticism model. Patients' neuroticism was negatively related to caregivers' acceptance of illness, which increased caregivers' depression. CONCLUSION: The three personality traits had both interpersonal and intrapersonal effects on depression in advanced lung cancer patient-caregiver dyads, and acceptance of illness played an important mediating role in these relationships.

A preliminary study on the anxiety and depression situation and psychological intervention of the first-line medical staff in our hospital during the COVID-19 epidemic.

To assess the anxiety and depression situation and psychological intervention effect of the first-line medical staff in our hospital during the COVID-19 epidemic. A total of 384 front-line medical staff in our hospital from January 25 to March 8, 2020 were selected as subjects, which were divided into group A and group B respectively. PHQ-9 depression scale and GAD-7 self-rating anxiety scale questionnaire were used to investigate their anxiety and depression. After 1 month, all subjects were re-self-assessed for anxiety and depression, which were named as A1 and B1 group respectively. The GAD-7 anxiety scale had mild, moderate, and severe anxiety scores before group A, which were significantly higher than those in group B (P < 0.05); after psychological intervention, group A1 had significantly reduced anxiety scores (P < 0.05). And there were no markedly difference of PHQ-9 scale scores before and after psychological intervention between groups A and B, A and A1, and B and B1 (P > 0.05). The first-line medical staff in our hospital have different degree of anxiety and depression during COVID-19. Early positive psychological intervention has an effect on ameliorating the anxiety.

Dyadic effects of family-functioning and resilience on quality of life in advanced lung cancer patients and caregivers: An actor-partner interdependence mediation model.

PURPOSE: Lung cancer as a stressful event profoundly impacts the entire family, especially patients and their family caregivers. This study uses a dyadic analysis approach to explore the dyadic effects of family functioning on the quality of life (QoL), and whether resilience acts as a mediator in advanced lung cancer patient-caregiver dyads. METHODS: This was a cross-sectional study, and 287 dyads of advanced lung cancer patients and their caregivers were enrolled. Family-functioning, resilience, and QoL were assessed by the General Functioning subscale of the Family Assessment Device (FAD), the 10-item Connor-Davidson Resilience Scale, and the Short Form-8 (SF-8) Health Survey, respectively. Data were analyzed using the actor-partner interdependence mediation model. RESULTS: This study found that, for patients and caregivers, resilience mediates the actor effects of family-functioning on QoL. That is, family-functioning was positively related to their resilience, which improved QoL. Another important finding is that caregivers' family-functioning had significant indirect effects on patients' QoL through their resilience. CONCLUSIONS: Positive family functioning perceived by patients and caregivers can improve their QoL by developing their own resilience. Furthermore, family-functioning perceived by caregivers can also improve patients' QoL through their resilience. Medical staff should identify vulnerable patients and caregivers with poorer family-functioning and resilience, and make focused intervention to improve the QoL of both lung cancer patients and their family caregivers.

Perfectionism and Psychological Distress among Chinese Judges: Do Age and Gender Make a Difference?

BACKGROUND: Judges may experience mental health problems, which reduces their performance in juridical cases, and constitutes a great threat to both the authority of law and social justice. This study aimed to assess the prevalence of psychological distress among judges and examine the effect of perfectionism on psychological distress with age and gender as the moderators. METHODS: This survey was carried out in person with 565 Chinese judges in 2016, using the Almost Perfect Scale-Revised and the Kessler Psychological Distress Scale. The effects of perfectionism on psychological distress was explored by Structural Equation Model (SEM), and the moderating effects of age and gender were tested by Multi-group analysis. RESULTS: Psychological distress was reported by 89.20% of the judges surveyed. Discrepancy had a significant positive effect on psychological distress, but order had a significant negative effect on psychological distress, with high standards exerting no significant effect. Age had a significant moderating effect, whereas the moderating effect of gender was not significant. CONCLUSION: The three dimensions of perfectionism exerted different effects on psychological distress of Chinese judges, and the relationships were moderated by age.

Mediating role of occupational stress and job satisfaction on the relationship between neuroticism and quality of life among Chinese civil servants: a structural equation model.

BACKGROUND: Knowledge on the quality of life (QOL) of civil servants is limited. Therefore, the aims of this study were to investigate the QOL of civil servants, and examine whether occupational stress and job satisfaction mediated the association between neuroticism and QOL in civil servants from Shandong, China. METHODS: The cross-sectional study included 559 civil servants aged 27 to 60 years from Shandong province in China. Participants completed questionnaires assessing neuroticism, occupational stress, job satisfaction, and QOL. Structural equation modeling (SEM) was conducted to examine the hypothetical model. RESULTS: Among the civil servants, the average score for QOL was 75.49 ± 14.73. The SEM analysis showed a good fit of the data to the hypothesized model. Neuroticism, occupational stress, and job satisfaction explained 38% of the variance of QOL. Neuroticism was positively correlated with occupational stress and negatively correlated with job satisfaction and QOL. A strong direct effect (- 0.386, P < 0.01) and moderate indirect effect (- 0.133, P < 0.01) of neuroticism on QOL mediated by occupational stress and job satisfaction were observed. In addition, a direct effect (- 0.197, P < 0.01) and an indirect effect (- 0.044, P < 0.01) of occupational stress on QOL mediated by job satisfaction were also observed. CONCLUSIONS: Occupational stress and job satisfaction partly mediated the relationship between neuroticism and QOL among Chinese civil servants. Thus, selecting individuals with a low level of neuroticism as civil servants, reducing occupational stress, and increasing job satisfaction may be important measures to improve their QOL.

The mediating role of perceived prejudice in the relationship between self-esteem and psychological distress among Chinese male nursing students.

Male nursing students may experience social prejudice, which may lead to psychological distress. However, few quantitative studies have focused on their mental health. This study aimed to explore the relationship among self-esteem, perceived prejudice, and psychological distress in male nursing students, and compare differences in self-esteem, perceived prejudice, and psychological distress, as well as the relationships among these variables between male nursing students who selected nursing as their first choice for a major and those who did not. A survey based on a cross-sectional design was used. Self-esteem, perceived prejudice, and psychological distress of 460 male nursing students in China were measured using the Rosenberg Self-esteem Scale, a self-developed questionnaire, and the Kessler 10, respectively. Structural equation modeling was adopted to test the theoretical model regarding the relationships among self-esteem, perceived prejudice, and psychological distress. The results indicated that 82.2% of the participants reported psychological distress. The participants who did not select nursing as their first choice for a major reported a significantly higher perceived prejudice, higher prevalence of psychological distress, and lower self-esteem. Therefore, when selecting male students, nursing schools must prioritize those who selected nursing as their first choice for a major.

Prevalence of psychological distress and the effects of resilience and perceived social support among Chinese college students: Does gender make a difference?

This study aimed to examine the gender differences in the prevalence of psychological distress, and in the effects of resilience and perceived social support on psychological distress among Chinese college students. A cross-sectional survey was conducted in current study. The psychological distress, resilience, and perceived social support of 1400 university students of China were measured using the Kessler Psychological Distress Scale, the 10-item Connor-Davidson Resilience Scale, and the 12-item Multidimensional Scale of Perceived Social Support, respectively. Multiple group analyses were conducted using structural equation modeling to examine the moderating role of gender in the effects of resilience and perceived social support on psychological distress. The prevalence of psychological distress was 90.86%. Female college students reported a higher prevalence of psychological distress (94.07%) than males (89.11%). Among male college students, the resilience was more strongly associated with psychological distress than perceived social support (-0.18 vs.-0.16). In contrast, among female college students, resilience was not significantly related, but perceived social support was closely related with psychological distress (0.01 vs. -0.31). In conclusion, Chinese female college students are more vulnerable to psychological distress than males. Gender moderates the relationships among resilience, perceived social support, and psychological distress.

The protective role of self-esteem, perceived social support and job satisfaction against psychological distress among Chinese nurses.

AIM: To determine the prevalence of psychological distress, and to explore the combined protective roles of self-esteem, perceived social support and job satisfaction against psychological distress. BACKGROUND: Few studies have explored the combined protective effect of self-esteem, perceived social support and job satisfaction on nurses' mental health in the same theoretical framework. METHODS: The Rosenberg Self-Esteem Scale, the Multidimensional Scale of Perceived Social Support, a self-developed Job Satisfaction Questionnaire and the Kessler Psychological Distress Scale were used to survey 581 nurses. The hypothesized model of the relationships among self-esteem, perceived social support, job satisfaction and psychological distress was tested with structural equation modelling. RESULTS: The prevalence of psychological distress was 92.3%. Job satisfaction exerted the strongest direct protective effect against psychological distress, with perceived social support and self-esteem exerting the second and third strongest direct protective effects, respectively. Additionally, self-esteem had an indirect protective effect. CONCLUSIONS: Chinese nurses showed a surprisingly high prevalence of psychological distress. Job satisfaction, self-esteem and perceived social support were identified, in this order of importance, as protective factors against psychological distress. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse administrators should take measures to improve nurses' job satisfaction and social support, and hire individuals with high self-esteem as nurses.

Development of a Questionnaire to Assess Nursing Competencies for the Care of People with Psychiatric Disabilities in a Hospital Environment.

The recovery of people with psychiatric disabilities requires high-quality nursing care. However, the existing research on the nursing competencies needed for caring for people with psychiatric disabilities have been based on a narrow competency framework. By adopting a broader competency framework, this study aimed to find the competencies needed for the nursing care of people with psychiatric disabilities in a hospital environment. Accordingly, a questionnaire will be developed to measure these competences. First, a literature review and interviews with psychiatrists, psychiatric nurses, and people with psychiatric disabilities were conducted to develop the pool of competency items. Second, a pilot study was conducted to review the initial pool of items. Finally, a survey of 581 psychiatric nurses was used to conduct a series of principal component analyses to explore the structure of the questionnaire. The 17-item questionnaire included 5 factors, which accounted for 68.60% of the total variance: sense of responsibility, vocational identification, agreeableness, cooperation capacity, and carefulness; the Cronbach's alpha coefficients were 0.85, 0.85, 0.74, 0.80, and 0.77, respectively. Most of the competencies belonged to attitudes, values, and traits, which were overlooked in previous studies. The questionnaire has satisfactory internal reliability and structural validity, and could contribute some to the selection of the psychiatric workforce.

Job satisfaction mediates subjective social status and turnover intention among Chinese nurses.

Nurse turnover is one of the reasons for the global nurse shortage. Although previous studies have examined the determinants of turnover intention in detail, there is limited knowledge on the effect of subjective social status on nurse turnover intention. Therefore, in this study, we examined this relationship, including job satisfaction as a mediator, among Chinese nurses. This cross-sectional study employed questionnaires to assess subjective social status, job satisfaction, and turnover intention in 581 nurses who were randomly recruited from 10 hospitals in Jinan, China. The results partially supported our model. Although subjective social status exerted no significant direct effect on turnover intention, it exerted a significant indirect effect through job satisfaction. These results provide a new insight into why nurses leave their jobs, and possible new solutions to the nurse turnover problem. Efforts should be made to improve nurses' subjective social status.

The influence of perceived prejudice on willingness to be a nurse via the mediating effect of satisfaction with major: A cross-sectional study among chinese male nursing students.

BACKGROUND: The gender-based stereotype of nursing as a female profession has been a large obstacle to men entering the nursing profession. However, there is little quantitative research on the influence of prejudice induced by this stereotype on male nursing students' willingness to be nurses. OBJECTIVES: To examine the effect of perceived prejudice on willingness to be a nurse via the mediating effect of satisfaction with major among Chinese male nursing students. DESIGN: A cross-sectional survey was used. METHODS: Four hundred and sixty male nursing students who were enrolled either in bachelor's programs in universities or advanced diploma programs in colleges in Jinan, China, were surveyed using questionnaires measuring perceived prejudice, satisfaction with major, and willingness to be a nurse. Structural equation modeling with bias-corrected bootstrapping was employed to determine the influence of perceived prejudice on willingness to be a nurse with major satisfaction as a mediator. RESULTS: Male students who were in an advanced diploma nursing program and those for whom nursing was the first-choice major reported significantly less perceived prejudice, greater satisfaction with major, and greater willingness to be nurses than did those in a bachelor's nursing program and those for whom nursing was not the first-choice major, respectively. Moreover, although perceived prejudice had no significant direct effect on willingness to be a nurse (ß=0.07, p>0.05), it did have a strong indirect effect (full mediation) via satisfaction with major (ß=-0.59, p<0.001). CONCLUSIONS: Perceived prejudice strongly influenced male nursing students' willingness to be nurses via the full mediating effect of satisfaction with major. Because this obsolete stereotype of nursing as a female occupation gives birth to prejudice against male nursing students, effective measures should be taken to change this stereotype to recruit more men as nursing staff.