A nomogram to predict the risk of cognitive impairment in patients with depressive disorder.

This study was to describe the cognitive function status in patients with depressive disorder and to construct a nomogram model to predict the risk factors of cognitive impairment in these patients. From October 2019 to February 2021, a total of 141 patients with depressive disorder completed the survey in two hospitals. The Montreal cognitive assessment (MoCA) was used with a cutoff score of 26 to differentiate cognitive impairment. Univariable and multivariable logistic regression analyses were conducted to identify independent risk factors. A nomogram was then constructed based on the results of the multivariable logistic regression analysis. The patients had an average MoCA score of 23.99 ± 3.02. The multivariable logistic regression analysis revealed that age (OR: 1.096, 95% CI: 1.042-1.153, p < 0.001), education (OR: 0.065, 95% CI: 0.016-0.263, p < 0.001), depression severity (OR: 1.878, 95% CI: 1.021-3.456, p = 0.043), and sleep quality (OR: 2.454, 95% CI: 1.400-4.301, p = 0.002) were independent risk factors for cognitive impairment in patients with depressive disorder. The area under receiver operating characteristic (ROC) curves was 0.868 (95% CI: 0.807-0.929), indicating good discriminability of the model. The calibration curve of the model and the Hosmer-Lemeshow test (p = 0.571) demonstrated a well-fitted model with high calibration. Age, education, depression severity, and sleep quality were found to be significant predictors of cognitive function. A nomogram model was developed to predict cognitive impairment in patients with depressive disorder, providing a solid foundation for clinical interventions.

Mental health literacy of Chinese nurses from public general and psychiatric hospitals: a cross-sectional study.

Background: Mental health literacy (MHL) is crucial to address issues related to mental illness. Nurses' MHL is even more important because they are expected to deal with both the physical and psychological consequences of mental disorders. Objective: This study investigated the level, discrepancy, and characteristics of MHL among Chinese nurses from both public general and psychiatric hospitals; identified influential factors; and explored the relationship between MHL and mental health status. Methods: Using a stratified cluster sampling method to select participants, a cross-sectional survey was conducted to describe the MHL of 777 nurses from 13 general and 12 psychiatric hospitals using the Chinese version of the Mental Health Literacy Scale, Patient Health Questionnaire-2, Generalized Anxiety Disorder-2, and a demographic questionnaire. A multiple regression analysis was used to determine the factors influencing MHL among the nurses recruited. Results: The participants' total score on the Chinese version of the Mental Health Literacy Scale was 93.25 (SD = 10.52). Multiple regression analysis revealed that nurses who worked in psychiatric or higher-level hospitals, with higher professional titles or higher education had higher levels of overall MHL and core MHL, while those working in general hospitals, with shorter work duration, or who were unmarried had higher social acceptance of patients. Nurses' MHL was closely correlated with their mental health status. Conclusion: The overall and core MHL of Chinese nurses were at a moderate level, with social acceptance remaining at a relatively low level. There is an urgent need for MHL promotion programs to improve the MHL of clinical nurses. The focus must be given to overall MHL, especially core MHL, for non-psychiatric nurses to enhance their competence in mental health promotion and identification; more emphasis should be placed on the social acceptance of patients with mental illnesses for psychiatric nurses to improve their provision of professional services. Better MHL would be a formula for improving nurses' own mental health and their mental health service competence.

An online 5-week professional identity program for nursing student in clinical rotation practice during the first wave of COVID-19 pandemic: A two-arm randomized trial.

AIM: Development and evaluation of the effectiveness of an online 5-week professional identity program among nursing students in clinical internship practice during the COVID-19 restrictions. BACKGROUND: Nurse professional identity is a strong predictor of career commitment. Clinical internship practice is a key stage when nursing students build and rebuild their professional identity. Meanwhile, the COVID-19 restrictions has strongly influenced the professional identity of nursing students as well as nursing education. A well-designed online professional identity program may contribute to nursing students who are in clinical internship practice developing positive professional identity during the COVID-19 restrictions. DESIGN: The study was a two-armed, randomised, controlled trial conducted and reported based on Consolidated Standards of Reporting Trials (CONSORT) 2010 guidelines. METHODS: A total of 111 nursing students undergoing clinical internship were randomised into an intervention group and a control group. The five-weekly session intervention was developed based on social identity theory and career self-efficacy theory. The primary outcomes were professional identity and professional self-efficacy and the second outcome was stress. Qualitative feedback was analysed by thematic analysis. Outcomes were assessed before and after the intervention and analysed using an intention-to-treat principle. RESULTS: The generalised linear model showed that group-by-time effects were significant for the total score of professional identity and three factors of professional self-image, social comparison and self-reflection and independence of career choice, with small effect sizes (Cohen's d from 0.38 to 0.48). Only one factor of the capacity of information collection and planning in professional self-efficacy was significant (Wald χ2 =0.4.82, P < 0.01) with a medium effect size (Cohen d=0.73). The group effect, time effect and group-by-time effect of stress were not significant. Three themes were: 'Gaining in professional identity, self-recognition and peer belonging'; 'Content, self-motivation and intervenor as participation facilitators'; and 'Combining offline and courses, setting group rules and building mutual trust as recommendations'. CONCLUSIONS: The online 5-week professional identity program effectively promoted the development of professional identity and the capacity for information collection and career planning but did not significantly relieve pressure during the internship.

Network analysis of somatic symptoms in Chinese patients with depressive disorder.

Introduction: Network theory conceptualizes somatic symptoms as a network of individual symptoms that are interconnected and influenced by each other. In this conceptualization, the network's central symptoms have the strongest effect on other symptoms. Clinical symptoms of patients with depressive disorders are largely determined by their sociocultural context. To our knowledge, no previous study has investigated the network structure of somatic symptoms among Chinese patients with depressive disorders. The aim of this study was to characterize the somatic symptoms network structure in patients with depressive disorders in Shanghai, China. Method: A total of 177 participants were recruited between October 2018 and June 2019. The Chinese version of the Patient Health Questionnaire-15 was used to assess somatic symptoms. In order to quantify the somatic symptom network structure, indicators of "closeness," "strength," and "betweenness" were employed as identifiers for network-central symptoms. Result: The symptoms of "feeling your heart pound or race," "shortness of breath," and "back pain" had the highest centrality values, indicating that these symptoms were central to the somatic symptom networks. Feeling tired or mentally ill had the strongest positive correlation with insomnia or other sleep problems (r = 0.419), followed by chest pain and breathlessness (r = 0.334), back pain, and limb or joint pain (r = 0.318). Discussion: Psychological and neurobiological research that offers insights into somatic symptoms may focus on these central symptoms as targets for treatment and future research.

Family resilience of patients requiring long-term care: A meta-synthesis of qualitative studies.

BACKGROUND: Long-term care of patients with chronic illnesses is an important global public health issue, compromising the well-being of family members and the family functioning. Previous studies have examined the interactive experiences and processes of various systems in the families coping with long-term care stress; however, these studies have not been systematically reviewed and integrated. AIMS: This review aimed to synthesise the existing qualitative evidence on the experiences and processes of family resilience operate in families providing long-term care for patients with chronic illnesses and to provide suggestions for the development of interventions in future studies. MATERIALS & METHODS: We searched databases including PubMed, CINAHL, EMBASE, Web of Science, ProQuest and CNKI from their inception to March 2022. We used the JBI Critical Appraisal Tool for qualitative studies to evaluate the quality of the included studies was evaluated according to. We followed The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. The results were integrated using the thematic and content analysis method. RESULTS: Fourteen studies from eight countries covering 11 diseases reported on the experiences and coping processes of long-term care families. Based on McCubbin's Resiliency Model of Family Stress, Adjustment and Adaptation (FAAR), five analytical themes were synthesised: stressors (risk factors), family belief system, internal family coping strategies, external support and resilient adaptation indicators; the relationships between themes and subthemes were illustrated. DISCUSSION: This review synthesized qualitative evidence on the experiences and processes of family resilience operate in families providing long-term care. The results of this study found that the cognition and belief of family members regarding dilemmas have a two-way effect and act on the adaptation process of family members. In family adaptation, spirituality, hope, internal and external support are extremely important. In 14 studies, caregivers were from different countries with intercultural differences, but due to less reports on this content, it is difficult to compare the differences or impact that culture or ethnicity may have. CONCLUSIONS: Family resilience plays an important role in coping with stressors associated with the long-term care of a loved one through family belief systems, internal support systems and external support systems. The development of family resilience-based interventions for long-term care families should consider the family as a whole and further construct a multidisciplinary, multilevel and multi-type social support network to enhance family resilience.

The dyadic care experiences of elderly individuals with disabilities and caregivers in the home setting from the perspective of family resilience: A qualitative study.

Background: China is one of the most rapidly aging countries in Asia, and nearly 90% of elderly individuals with disabilities choose to receive traditional, family-based, long-term care. A majority of family caregivers have insufficient care capacity and experience physical and emotional distress, which in turn affects the elderly. Objective: To describe the dyadic care experiences of elderly individuals with disabilities and their caregivers from the perspective of family resilience. Methods: A phenomenological research method was used. Semi-structured, in-depth, face-to-face interviews with 9 dyads of elderly people with disabilities and their families were conducted from August 2020 to February 2021. The Colaizzi method was used to analyze, summarize, and refine the interview data. Results: The dyadic care experiences of elderly individuals with disabilities and their caregivers can be summarized in terms of two themes. Theme 1 is dyadic pressure, which includes the following subthemes: (1) substantial objective burden; (2) dual negative experiences, i.e., the perceived low value of elderly individuals and low positive gains by caregivers; and (3) dyadic emotional transmission. Theme 2 is dyadic cooperative coping, which includes the following subthemes: (1) adjustment of family beliefs, including by giving meaning to stress, maintaining a positive outlook toward the future and ensuring spiritual sustentation; (2) changes in family patterns, including flexible adjustment of family patterns and multichannel utilization of social resources; and (3) improvement of family communication, including effective information transmission, rational emotional expression and emotional connection, and cooperation to solve and prevent problems. Conclusion: Elderly individuals with disabilities and their family caregivers face multiple physical, psychological, and social difficulties and demands during daily care, in which context negative experiences exert influence on this dyad. They collaborate to exhibit family resilience via the adaptation and improvement of family beliefs, family patterns and family communication. The family as a unit expends a great deal of effort to adapt to conditions of stress in the context of caring and shows family resilience, which is closely related to the family's cultural background and community situation. Dyadic resilience-based interventions can be developed based on core elements found by this study.

Experiences and coping strategies of somatic symptoms in patients with depressive disorder: A qualitative study.

BACKGROUND: Depressive disorder is the most prevalent mental illness and is characterised by the presence of mental and somatic symptoms, with the latter affecting 65.0% to 98.2% of patients with their general function and quality of life. PURPOSE: The purpose of this study aimed to explore the experiences and coping strategies of somatic symptoms in Chinese patients with depressive disorder, and to gain new insight into the illness and the health care provided to patients. METHODS: Semi-structured, in-depth interviews were conducted with 15 patients diagnosed with depressive disorder according to international classification of diseases 10th revision. The interviews were transcribed verbatim and the thematic analysis was adapted to the data. MAXQDA10 software was used to organise, encode, classify, induce, and extract themes. RESULTS: Four major themes were extracted from the interviews: (1) descriptions of symptoms; (2) perceptions of the symptoms; (3) symptom disturbance; and (4) coping strategies of symptoms. Within the first theme, patients identified the following sub-themes: complex experiences of somatic symptoms, which were mainly in the neuromuscular system, circulatory respiratory system, gastrointestinal system and some symptoms without obvious systemic classification; difficulty in locating symptoms accurately; and being not consistent with examination results. The second theme included patient's inadequate understanding of somatic symptoms; and denial of the link between physical discomfort and depression. Disturbance of somatic symptoms embraced three sub-themes: (1) Uncertainty about somatic symptoms; (2) Struggling with daily life; (3) Impact on social activities; (4) feeling a decrease in family support. Lastly, coping strategies taken by patients in the face of various symptoms mainly included relying on drug treatment, avoiding stressors, diverting attention, and compromise or acceptance. CONCLUSIONS: Patients with depressive disorder experience a variety of somatic symptoms that have a negative impact on social function and reduce their quality of life. Patients did not have an adequate understanding of their physical discomfort and lacked effective coping strategies for these somatic symptoms. Professional staff should pay more attention to patients' somatic symptoms and focus on targeted symptom management to facilitate patient recovery.

Characteristics of somatic symptoms among Chinese patients diagnosed with major depressive episode.

PURPOSE: This study aimed to describe the clinical features of somatic symptoms among Chinese patients diagnosed with major depressive episode (MDE). METHODS: A total of 213 inpatients with MDE from two mental health hospitals were recruited and investigated using the Somatic Symptom Inventory (SSI), Hamilton rating scale for depression, Hamilton rating scale for anxiety, and a demographic questionnaire. RESULTS: The participants included 142 patients with unipolar depression and 71 patients with bipolar depression. The mean SSI score of all participants was 49.30 (SD = 14.80). "Feeling fatigued, weak, or tired all over" was found to be the most common somatic symptom (61.0% reported moderate levels or above), followed by "feeling of being not in as good physical health as most of your friends" (56.3%), and "feeling weak in parts of the body" (49.3%). "Headache" and "soreness in muscles" were common painful symptoms. Both patients with unipolar and bipolar depression had similar somatic symptoms, including painful and non-painful ones. The somatic symptoms of all participants were closely correlated with the severity of depression and anxiety (P < 0.01). Patients with anxiety, older age, low education, and negative life events in the last year had more somatic symptoms. CONCLUSIONS: Inpatients with MDE of somatic symptoms are common, which were significantly correlated with the severity of depression and anxiety. Further efforts should focus on early recognition and integrated care model management of patients based on their characteristics to improve their quality of life and treatment outcomes.

Validation and Psychometric Testing of the Chinese Version of the Mental Health Literacy Scale Among Nurses.

The Mental Health Literacy Scale (MHLS) is the most widely used and strong theory-based measurement tool to gain an understanding of mental health knowledge and ability. This study aimed to test the psychometric properties of the Chinese version of the Mental Health Literacy Scale (MHLS-C) and to document the norm and its influential factors of mental health literacy among nurses. The MHLS was translated following Brislin's translation model and tested with a sample of 872 clinical registered nurses. The Jefferson Scale of Empathy-Health Professionals (JSE-HP), Patient Health Questionnaire-2 (PHQ-2), and Generalized Anxiety Disorder-2 (GAD-2) were administered to assess convergent validity. The minimum average partial test, parallel analysis and confirmatory factor analysis supported 4 first-order 2 second-order structure. The 4 factors were named "knowledge of mental disorder," "ability to seek information and help," "recognition of mental disorder," and "acceptance of patients with mental illness," with factor 1-3 were summarized into MHLS-Core (Core literacy subscale) and factor 4 as MHLS-SA (Social acceptance subscale). The MHLS-C was moderately negatively correlated with the PHQ-2 and GAD-2 (-0.111, -0.081) and highly positively correlated with JSE-HP (0.492). The Cronbach's α was 0.85 for the overall scale and 0.89 and 0.93 for two subscales. The test-retest reliability was good, with intraclass correlation coefficients (ICCs) of 0.80 for the whole scale, and 0.79 and 0.94 for two subscales. As an approximately normal distribution, the 50 th percentile for the MHLS-C was 99, with 50 th percentiles of 74 and 20 for MHLS-Core and MHLS-SA. Higher position, higher professional credentials, higher hospital hierarchy, other specialist hospital, psychiatric hospital and unmarried status were positive predictors. The 29-item MHLS-C, with two subscales of MHLS-Core and MHLE-SA, is a stable and validated tool to measure mental health literacy. MHLS-Core could be used independently to measure the core content of mental health literacy. It may be applicable for Chinese health professionals, but need further validation among the general public. MHL curriculum and a targeted culturally appropriate program for acceptance for health professionals, especially for those in general hospitals and with less working tenure, may be recommended.

Effectiveness of the three-line relaxation-based group intervention on mental stress management among nursing students / 中国学校卫生

Objective@#To investigate the feasibility and efficiency of three-line relaxation-based group intervention on mental stress management among nursing students.@*Methods@#A total of 224 nursing students were randomly divided into the intervention group in which three-line relaxation training for 12 weeks were delivered together with psychological health education (PHE), and the control group which only delivered PHE. The SelfRating Anxiety Scale (SAS) and the Self Rating Depression Scale (SDS) were used before and after intervention. T-test was used to compare inter-group difference.@*Results@#After 4-week intervention, there’s no significant difference in the score of SAS and SDS between the two groups(P>0.05). After 12-week intervention, average SAS and SDS score of intervention group was significantly decreased compared with before intervention (both P<0.01). After 12-week intervention, no significant changes were observed in the score of SAS and SDS in the control group (both P>0.05). After 4-and 12-week intervention, average score in SAS and SDS of intervention group was significantly lower than that of the control group(P<0.05).@*Conclusion@#Three-line relaxation is effective in relieving mental stress of nursing students.

Perceived Empowerment, Social Support, and Quality of Life Among Chinese Older Residents in Long-Term Care Facilities.

OBJECTIVE: This study examines how older residents' social support and perceived empowerment are associated with their quality of life (QOL) in long-term care (LTC) facilities in Shanghai, China, controlling for their health-related conditions, facility type, and other socio-demographic characteristics. METHOD: Using a convenient sampling approach, we selected nine LTC facilities in Shanghai, China. We surveyed 515 older residents from these facilities. RESULTS: Older participants in this study rate their QOL, social support, and perceived empowerment as moderate, and these variables are positively associated with their QOL. Older residents who live in government-owned and private-run LTC facilities are more likely to have a higher level of perceived QOL compared with those living in government-run facilities. DISCUSSION: There is an urgent need to increase staff awareness and capacity to empower older residents, and to engage them in their care plan and delivery. LTC facilities could provide more opportunities for older residents' social networking within and outside LTC facilities. Improvement of older residents' QOL is critical in the future development of resident-centered care models in LTC facilities.

Management of non-adherence to fluid intake restrictions in hemodialysis patients in a tertiary hospital: a best practice implementation project.

BACKGROUND: Non-adherence to fluid-intake restrictions is one of the most common problems for hemodialysis (HD) patients. A combined approach that involves patients, healthcare professionals and caregiver inputs based on best practice is important for enhancing adherence within a busy health system. OBJECTIVES: The aim of this project was to promote evidence-based practice in the management of fluid-intake restrictions among HD patients in a HD center. METHODS: Six evidence-based criteria developed by the Joanna Briggs Institute were used as a basis for audits undertaken in the Hemodialysis Center of Huashan Hospital, Shanghai, mainly focusing on nurse education, fluid-intake management by patients and the role of caregivers in assisting with fluid-intake management by patients. The project included three phases and was conducted over 5 months. The Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice audit tools for promoting change in health practice were used to examine compliance with the criteria before and after the implementation of best practice. RESULTS: Results from pre- and post implementation audits indicated that the compliance rates of four criteria reached 100% after the implementation of various strategies. One criterion (patients' self-monitoring) resulted in a compliance rate of 73.33%. One other criterion (patients' medical documentation) was maintained at 100% compliance. Patients' adherence to fluid intake, knowledge and attitude to self-management also improved significantly in the post implementation audit. CONCLUSION: This project achieved a significant improvement in evidence-based practice for the management of non-adherence to fluid-intake restrictions in HD patients. An increase in the number of HD patients found to be adherent to fluid-intake restrictions was reported during this process.

Family Risk Factors Associated With Aggressive Behavior in Chinese Preschool Children.

PURPOSE: The study explored family predictors of aggressive behavior in preschool children in China. DESIGN AND METHODS: Using a stratified cluster sampling method, 1382 preschool children were recruited from ten kindergarten schools in Shanghai, China. Their parents completed the Child Behavior Checklist (CBCL)-aggression subscale, the Parent Behavior Inventory, the Family Environment Scale, and a demographic questionnaire. RESULTS: The mean age of the 1382 children was 4.97years (SD=.88), with 55.1% (762) boys, and 44.9% (620) girls. According to the CBCL, the prevalence of aggressive behavior in preschool children was 12.4%. Multivariate logistic regression analysis showed that family conflicts (OR = 1.231, 95% CI: 1.115-1.360), hostile/coercive parenting (OR = 1.083, 95% CI: 1.051-1.116), inconsistent parenting between grandparents and parents (OR = 1.658, 95% CI: 1.175-2.341), and more time spent watching TV (OR = 1.999, 95% CI: 1.568-2.550) significantly predicted aggressive behavior of children. CONCLUSIONS: Children with more family conflicts who experience hostile/coercive parenting were more likely to engage in aggressive behavior. Moreover, inconsistent parenting attitudes between grandparents and parents, and excessive TV exposure also contributed to childhood aggression. Given that the results of this study show a high prevalence of aggressive behavior in preschool children, future research must pay greater attention to this aspect. PRACTICE IMPLICATIONS: Family risk factors identified as relevant to children's aggression in this study provide avenues to develop family-focused strategies for curbing aggression in preschool children.

Older Residents' Perspectives of Long-Term Care Facilities in China.

China's formal long-term care (LTC) system is in its developmental stage due to lack of standardized health assessments for resident admission, limited government funding, an acute shortage of qualified staff at all levels, and regional disparities in quality of care. Relocation to LTC facilities changes the lives of older adults because they have to leave behind their homes and previous social networks. The current study aimed to provide an in-depth exploration of 25 older adult residents' lives in four LTC facilities in China. A conventional content analysis approach was used to interpret participant interviews. Residents experienced losses and gains from residential life. Three themes emerged: (a) influences of cultural beliefs, (b) basic care needs fulfilled in LTC facilities, and (c) lack of quality care in LTC facilities. Findings show that residents' basic needs were met in Chinese LTC facilities, but there is room for improvement in delivering quality care. [Journal of Gerontological Nursing, 42(8), 34-43.].

Relationship between parenting and proactive versus reactive aggression among Chinese preschool children.

This study examines the relationship between parenting and proactive versus reactive aggression among preschool children in China. Children (1164) from 10 kindergartens in Shanghai were rated by their parents and teachers using the Parent Behavior Inventory (PBI) and the Aggressive Behavior-Teacher's Checklist. Children had higher levels of reactive than proactive aggression, and older children and boys had higher levels of both proactive and reactive aggression. Hostile/coercive parenting style and low father education were significantly linked to aggression in children. These findings suggest that parenting style and type of aggression should be addressed when considering prevention and intervention.

[Relations between aggressive behavior and family factors among preschool children in Shanghai].

OBJECTIVE: To describe the prevalence of aggressive behavior among preschool children and its related family factors. METHODS: 1234 preschool children in ten kindergartens were rated on their aggressive behavior by their parents, using Child Behavior Checklist (CBCI), Parent Behavior Inventory (PBI) and a general questionnaire. RESULTS: The overall prevalence of aggressive behavior among preschool children was 12.9% (95%CI: 11.0 - 15.0) according to the CBCL assessment, with the rate being slight higher (13.7%, 93/680) in boys than in girls (11.9%, 66/554). Data from logistic regression analysis showed that parents' hostile/coercive parenting style (OR = 2.396, 95%CI: 1.636 - 3.510) and inconsistent parenting attitude between parents and grandparents (OR = 1.867, 95%CI: 1.287 - 2.710) would lead to more aggressive behaviors in preschool children. Compared with children without difficulty in falling asleep, those who often (OR = 3.415, 95%CI: 1.901 - 6.135) or sometimes (OR = 2.147, 95%CI: 1.256 - 3.671) had problem falling asleep at night had more aggressive behaviors. On the other hand, factors as: watching TV less than 1 hour each day (OR = 0.252, 95%CI: 0.136 - 0.467), father in older age (OR = 0.703, 95%CI: 0.503 - 0.983) and participating in regular outdoor activities (OR = 0.617, 95%CI: 0.399 - 0.955) were protective factors to the aggressive behaviors of the children. CONCLUSION: The prevalence of aggressive behavior in preschool children was high which called for more attention. Intervention programs targeting the family should consider the influencing factors as ways of parenting, consistent attitude on parenting in the family etc. to reduce the occurrence of aggressive behavior among preschool children.

Subjective health-related quality of life of Chinese older persons with depression in Shanghai and Hong Kong: relationship to clinical factors, level of functioning and social support.

AIM: This study aimed to measure and compare the perceptions of HRQoL amongst Chinese older people with depression between Hong Kong and Shanghai and to explore the association of HRQoL with clinical factors, level of functioning and social support in the two sites. METHODS AND RESULTS: A cross-sectional study was conducted with a convenience sample of 80 older people from Hong Kong and 71 from Shanghai with a diagnosis of depression. The results showed that both the Hong Kong and Shanghai groups had a poor perception of their HRQoL when compared with Caucasian populations. The Shanghai group had a significantly higher HRQoL perception than did the Hong Kong group. Physical health problems that affected functional abilities also influenced older people's satisfaction with life. The severity of depression, number of medical conditions, functional abilities and satisfaction towards social support were predictors of HRQoL. CONCLUSION: The high rate of depression in Hong Kong and Shanghai deserves attention. Older people with depression have both psychological and physical health care needs. This study provides insights for healthcare professionals to plan innovative and co-ordinated services that meet the various health care needs of older people with depression.