Medical narrative ability and humanistic care ability of Chinese clinical nurses: The mediating role of empathy ability.

AIMS: To investigate the relationship between medical narrative ability and humanistic care ability among Chinese clinical nurses, examining the potential mediating role of empathy. BACKGROUND: In the context of the bio-psychosocial medical model and humanistic nursing care, understanding the core competencies of medical narrative ability, empathy and humanistic care in nursing is crucial. This study explored the mediating role of empathy between medical narrative ability and humanistic care ability. DESIGN: A cross-sectional study. METHODS: The study employed a descriptive, cross-sectional survey design, involving 741 nurses from Wuxi People's Hospital. It assessed nurses' demographic characteristics, medical narrative ability, empathy, and humanistic care ability using an online questionnaire from December 2022 to February 2023. Pearson correlation analysis evaluated variable correlations, and PROCESS v3.3 model 4 was utilised for mediation analysis. The STROBE statement was chosen as the EQUATOR checklist. RESULTS: A positive correlation was found between nurses' medical narrative ability, humanistic care ability and empathy. Empathy partially mediated the relationship between medical narrative ability and humanistic care ability. CONCLUSION: Nurses' medical narrative ability directly and indirectly (via empathy) influences their humanistic care ability. Enhancing nurses' narrative and empathic skills can improve humanistic care, nursing quality and nurse-patient relationships. RELEVANCE TO CLINICAL PRACTICE: Managers should prioritise programmes to improve nurses' storytelling and empathy skills to enhance humanistic care, improving nursing quality and patient relationships. PUBLIC CONTRIBUTION: This study involves clinical nurses as participants and does not involve patients. This study collected data from clinical nurses using an online questionnaire platform in China. The questionnaire consisted of four sections, including demographic information and scales such as Narrative Competence Scale, Caring Ability Inventory and the Jefferson Scale of Empathy-Health Professional. Clear instructions were given to participants on how to complete each scale, and measures were taken to prevent missing or duplicate responses.

Effects of social support on vision-related quality of life in older adults with dry eye disease: the chain mediating role of illness perception and coping style.

Objective: This study explored the effects of social support, illness perception, coping style, and vision-related quality of life (VRQOL) in older patients with dry eye disease (DED) using a chain mediation model. Methods: A total of 407 patients with DED from a tertiary hospital in Wuxi, Jiangsu Province, China, between June and December 2023 were selected as participants. A demographic questionnaire, the Social Support Rating Scale, the Brief Illness Perception Questionnaire, the Medical Coping Modes Questionnaire, and the National Eye Institute Visual Functioning questionnaire-25 were all given to them to complete. IBM SPSS (version 27.0) was used for data analysis, and Model 6 of the PROCESS Macro was used to test the predicted chain mediation model. Results: The positive association between social support and VRQOL demonstrated the mediation role of illness perception and coping style. Social support affected VRQOL via three pathways: illness perception (effect = 0.190), confrontational coping style (effect = 0.103), and a combination of illness perception and confrontational coping style (effect = 0.067), accounted for 23.60%, 12.80%, and 8.32% of the total effect, respectively. Conclusion: Social support in older patients with DED can significantly and positively predict the VRQOL. In addition to the independent mediating effect of illness perception and confrontational coping style, a chain-mediating effect exists between social support and VRQOL. The study serves as a valuable strategy for healthcare professionals to prevent and intervene in VRQOL for older patients with DED in the future.

Moderated BMI accumulation modified associations between blood benzene, toluene, ethylbenzene and xylene (BTEX) and phenotypic aging: mediating roles of inflammation and oxidative stress.

The associations between blood benzene, toluene, ethylbenzene, and xylenes (BTEX) and biological aging among the general adult population remain elusive. The present study comprised 5,780 participants from the National Health and Nutrition Examination Survey 1999-2010. A novel measure of biological aging, phenotypic age acceleration (PhenoAge.Accel), derived from biochemical markers was calculated. Weighted generalized linear regression and weighted quantile sum regression (WQS) were utilized to assess the associations between BTEX components and mixed exposure, and PhenoAge.Accel. The mediating roles of systemic immune-inflammation index (SII) and oxidative stress indicators (serum bilirubin and gamma-glutamyl transferase, GGT), along with the modifying effects of body mass index (BMI) were also examined. In the single-exposure model, the highest quantile of blood benzene (b = 0.89, 95%CI: 0.58 to 1.20), toluene (b = 0.87, 95%CI: 0.52 to 1.20), and ethylbenzene (b= 0.80, 95%CI: 0.46 to 1.10) was positively associated with PhenoAge.Accel compared to quantile 1. Mixed-exposure analyses revealed a consistent positive association between BTEX mixed exposure and PhenoAge.Accel(b=0.88, 95%CI: 0.56 to 1.20), primarily driven by benzene (92.78%). The association between BTEX and PhenoAge.Accel was found to be partially mediated by inflammation and oxidative stress indicators (ranging from 3.2% to 13.7%). Additionally, BMI negatively modified the association between BTEX mixed exposure and PhenoAge.Accel, with a threshold identified at 36.2 kg/mˆ2. Furthermore, BMI negatively moderated the direct effect of BTEX mixed exposure on PhenoAge.Accel in mediation models, while positively modifying the link between SII and PhenoAge.Accel in the indirect path (b interaction= 0.04, 95%CI: 0.04 to 0.06). Overall, BTEX mixed exposure was associated with PhenoAge.Accel among US adults, with benzene may have reported most contribution, and inflammation and oxidative damage processes may partially explain this underlying mechanism. The study also highlighted the potential benefits of appropriate BMI increased. Additional large-scale cohort studies and experiments were necessary to substantiate these findings.

Moral sensitivity, moral courage, and ethical behaviour among clinical nurses.

Background: Ethical behaviour in nursing practice is integral to establishing a harmonious nurse-patient relationship and improving the quality of care. A multitude of factors shapes such behaviour. Therefore, it is crucial to understand the interplay between these factors. Research objectives: This study aimed to explore the mechanisms underlying the influence of moral sensitivity on nurses' ethical behaviour and clarify the mediating role of moral courage. Research design: This cross-sectional quantitative study was conducted between July and August 2023. Participants and Research Context: The sample comprised 465 clinical nurses from three tertiary hospitals in Zhengzhou City, Henan Province, China. Data were collected using the Chinese version of the Moral Sensitivity Questionnaire-Revised Version, Nurses' Moral Courage Scale, and Ethical Behaviour Scale for Nurses. Data analysis was performed with SPSS 26.0 and AMOS 24.0, using descriptive statistics, Pearson correlation analysis, structural equation modelling, and bootstrapping methods. Ethical considerations: This study was approved by the Ethical Review Committee of Life Sciences of Zhengzhou University, China. Results: The participants were predominantly female (95.1%), with a mean age of 31.9 years. Moral courage and moral sensitivity were positively correlated with ethical behaviour. Moral sensitivity was positively associated with moral courage. Moral courage partially mediates the relationship between moral sensitivity and ethical behaviour. The indirect effect of nurses' moral sensitivity on ethical behaviour was quantified through moral courage (indirect effect = 0.290). Conclusion: Moral courage intermediates nurses' moral sensitivity and ethical behaviour. This conclusion provides nursing administrators with the insight that improving clinical nurses' moral sensitivity and courage can contribute to ensuring appropriate ethical behaviour.

Association between inflammatory bowel disease and osteoporosis in European and East Asian populations: exploring causality, mediation by nutritional status, and shared genetic architecture.

Background: While previous research has established an association between inflammatory bowel disease (IBD) and osteoporosis (OP), the nature of this association in different populations remains unclear. Objective: Our study used linkage disequilibrium scores(LDSC) regression analysis and Mendelian randomization(MR) to assess the genetic correlation and causal relationship between IBD and OP in European and East Asian populations. Methods: We performed separate genetic correlation and causal analyses for IBD and OP in European and East Asian populations, used the product of coefficients method to estimate the mediating effect of nutritional status on the causal relationship, and used multi-trait analysis to explore the biological mechanisms underlying the IBD-nutrition-OP causal pathway. Results: Our analysis revealed a significant genetic correlation and causal relationship between IBD and OP in the European population. Conversely, no such correlation or causal relationship was observed in the East Asian population. Mediation analysis revealed a significant mediating effect of nutritional status on the causal pathway between IBD and OP in the European population. Multi-trait analysis of the IBD-nutrition-OP causal pathway identified MFAP2, ATP13A2, SERPINA1, FTO and VCAN as deleterious variants. Conclusion: Our findings establish a genetic correlation and causal relationship between IBD and OP in the European population, with nutritional status playing a crucial mediating role.

The mediating effect of self-efficacy on social support and cancer screening behavior among Chinese women: a cross-sectional study.

BACKGROUND: Breast and cervical cancer are the most common cancers in women, and are associated with high morbidity and mortality rates. Cancer screening can facilitate early diagnosis, reduce mortality, and ease the burden of cancer. Social support and self-efficacy are strongly associated with cancer screening behavior. The present study aimed to explore the mediating effect of self-efficacy on social support and cancer screening behavior. METHODS: In this cross-sectional survey study conducted from June to October 2023, 312 women aged 35-65 years were recruited from the East Coast area of China. A general information questionnaire, cancer screening behavior questionnaire, social support scale and self-efficacy scale were used to collect data. Descriptive statistics were used to analyze the general characteristics of participants; one-way analysis of variance was used to test for differences in the measured variables; and Pearson's correlation analyses were used to describe the relationship among social support, self-efficacy, and cancer screening behavior. A mediation model was constructed and analyzed using the PROCESS macro for SPSS. RESULTS: The mean (standard deviation) screening behavior score for breast cancer and cervical cancer was 3.98 (2.79), representing an intermediate level. Self-efficacy was closely related to social support and cancer screening behavior. Social support showed a significant positive correlation with self-efficacy (r = 0.37, p < 0.01) and cancer screening behavior (r = 0.18, p < 0.01). Self-efficacy was also significantly positively correlated with cancer screening behavior (r = 0.19, p < 0.05). Self-efficacy showed a full mediating effect between social support and cancer screening behavior, with an explanatory power of 32%. CONCLUSIONS: The findings emphasize the need to increase women's level of social support and self-efficacy, which in turn can increase women's participation in breast and cervical cancer screening.

Mediating effect of menopausal symptoms between the lifestyle and depressive symptoms.

PURPOSE: This study aimed to explore relationship between lifestyle and depressive symptoms and evaluated the mediating effect of menopausal symptoms. METHODS: This was a secondary analysis of a survey in Hunan Province, China. We selected 3190 women aged 40 to 55 into final analyses. Menopausal and depressive symptoms were assessed by the Kupperman Menopausal Index and the 9-item Patient Health Questionnaire, respectively. A self-administered questionnaire was used to collect demographic and lifestyle information. RESULTS: The prevalence of depressive symptoms was 19.5%. After adjusting for demographic variables, passive smoking, drinking, and intensity of physical activity were positively associated with depressive symptoms. Frequency of exercise was a protective factor for depressive symptoms (AOR = 0.783, 95%CI: 0.446-0.991). Excess or restricted sleep duration was associated with higher probability of having depressive symptoms (AOR = 1.746, 95% CI: 1.324-2.304). Menopausal symptoms partially mediated the relationship between lifestyle and depressive symptoms. CONCLUSION: Findings highlighted the importance of menopausal symptoms in the relationship between the lifestyle and depressive symptoms, and provided a possibility that active lifestyle might improve depression symptoms among women at perimenopause through changes in sex hormones.

Depressive symptom mediates the association between the number of chronic diseases and cognitive impairment: a multi-center cross-sectional study based on community older adults.

Objective: The purpose of this study was to understand the relationship between the multiple chronic conditions (MCC), mental health and cognitive function of older adults in the community, and to propose a hypothesis that depressive symptom mediate the number of chronic diseases and cognitive impairment in older adults. Method: Participants aged 65 years and older from 35 communities in 14 cities in Guangxi, China were recruited. The residents' depressive symptom (PHQ-9) and cognitive status (AD-8) were evaluated, Chi-square test was used to explore the effects of different socio-demographic characteristics on depressive symptom and cognitive impairment. Pearson correlation analysis and the process model 4 were used to explore the relationship between the number of chronic diseases, depressive symptom and cognitive impairment. Result: A total of 11,582 older adults were included in our analysis. The rate of MCC reaching 26.53%. Hypertension combined with diabetes accounts for the highest proportion of two chronic diseases (13.2%). Among the combination of three chronic diseases, the highest incidence of coexisting hypertension combined with cervical/lumbar spondylosis, and rheumatoid arthritis (7.1%). In this study, depression symptoms accounted for 12.9% of older adults aged 65 and above, and cognitive impairment accounted for 27.4%. Female, older age, reside in urban areas, lower educational levels, no spouse, live alone, and MCC were risk factors for depressive symptom and cognitive impairment in older adults (P<0.05). Depressive symptom had a mediating effect in the number of chronic diseases and cognitive impairment, and the mediating effect (1.109) accounted for 44.13% of the total effect (0.247). Conclusion: The mental health of the older adult needs to be taken seriously, and improving depressive symptom can reduce the occurrence of cognitive impairment in older patients with MCC to a certain extent.

The mediating effects of school bullying victimization in the relationship between childhood trauma and NSSI among adolescents with mood disorders.

BACKGROUND: Nonsuicidal self-injury (NSSI) is a serious problem in the adolescent population worldwide. Childhood trauma and bullying have been identified as risk factors for NSSI. We explored the relationships among Childhood trauma, Bullying victimization and the severity of NSSI behaviours, and test the effect of Bullying victimization in mediating the association between Childhood trauma and the NSSI behaviours. METHODS: A total of 123 adolescents were recruited. They were diagnosed with depression or depressive episodes of bipolar disorder and had experienced NSSI in the last year. They were assessed using the Chinese version of the Childhood Trauma Questionnaire (CTQ-C), the Revised Olweus Bullying Victimization Questionnaire (OBVQ-R), and the Adolescent Self-Harm Questionnaire (ASHQ). RESULTS: Females presented a significantly greater prevalence of sexual abuse and relationship bullying than boys. Individuals in the younger age group (10-14 years) presented a greater incidence of emotional neglect, verbal bullying, relationship bullying, and total bullying, and their NSSI score was also higher than that of those in the older age group (15-19 years). Only children show a greater prevalence of sexual abuse than nononly children. Single-parent families scored higher on emotional abuse, emotional neglect, physical neglect and physical bullying than two-parent families. There was a significant positive correlation between each dimension of childhood trauma and all the dimensions of bullying, between childhood trauma and NSSI, and between bullying and NSSI. Childhood trauma can not only directly affect the severity of NSSI but also indirectly aggravate the severity of NSSI through bullying victimization. The mediating effects of bullying victimization on emotional abuse, physical abuse, emotional neglect and physical neglect were 14%, 21%, 20%, 13% and 20%, respectively. CONCLUSION: There was a significant positive correlation between childhood trauma and bullying, between childhood trauma and NSSI, and between bullying and NSSI. Childhood trauma can not only directly affect the severity of NSSI but also indirectly aggravate the severity of NSSI through bullying victimization. Bullying victimization played the partial mediating effects between Childhood trauma and NSSI.

Relationship Between Father-Child Attachment and Adolescents' Anxiety: The Bidirectional Chain Mediating Roles of Neuroticism and Peer Attachment.

Background: Adolescent anxiety is closely associated with the quality of parent-child attachment. However, previous studies have predominantly focused on the impact of mother-child attachment. Little is known about the direct and indirect associations of father-child attachment on adolescent anxiety. Purpose: This study aims to investigate the association and underlying mechanisms that link father-child attachment and adolescent anxiety. A bidirectional chain mediating model was constructed to test whether neuroticism and peer attachment play bidirectional mediating roles in father-child attachment and adolescent anxiety. Methods: The proposed model was examined among 763 adolescents aged 11-16 years (male 53.1%) from four middle schools in Central China. Students completed questionnaires on father-child attachment, anxiety, neuroticism and peer attachment. The correlation and bidirectional chain mediating effect analyses were conducted using SPSS Process. Results: (1) Father-child attachment negatively correlated with adolescent anxiety and neuroticism, and positively correlated with peer attachment; (2) Father-child attachment had an indirect association on adolescent anxiety through three pathways: a partial mediating effect on neuroticism, a partial mediating effect on peer attachment, and a bidirectional chain mediating effect involving both neuroticism and peer attachment. Conclusion: This study revealed father-child attachment has an indirect association with adolescent anxiety through the bidirectional chain mediation of neuroticism and peer attachment. These empirical findings shed light on the intricate dynamic between father-child attachment and anxiety among Chinese adolescents, highlighting the crucial role of fathers in the prevention and reduction of adolescent anxiety from the perspectives of father-child dynamics, personal traits, and interpersonal relationships.

The impact of social capital on rural residents ' income and its mechanism analysis -Based on the intermediary effect test of non-agricultural employment.

Agricultural, rural, and farmer-related issues are of pivotal importance, significantly influencing the evolution of our party, nation, and state. Central to these multifaceted issues, the farmer's plight is three-fold: low earnings, the hardship of income augmentation, and a pronounced socioeconomic divide between rural and urban areas. The crux of resolving these agricultural, rural, and farmer-related issues lies in elevating the income levels of farmers. Utilizing data from the China Family Panel Studies (CFPS) 2018, this study probes the influence of social capital on the earnings of rural dwellers and delves into the intermediary role of non-agricultural employment. The findings indicate a substantial and positive correlation between social capital and rural income. The conclusions remain robust even after applying instrumental variable methods to counteract endogeneity. Mediation analysis reveals that social capital significantly boosts opportunities for non-agricultural employment, which, in turn, enhances the income of rural residents. Therefore, the roles of social capital and non-agricultural employment in income augmentation warrant careful consideration.

The relationship between sleep quality and occupational fatigue in endoscopy nurses: mediating role of positive coping style.

Background: Nursing occupational fatigue has emerged as a critical issue affecting the safety and health of nurses. This phenomenon not only impairs nurses' performance and mental well-being but also poses risks to patient safety and the quality of care provided. This study focuses on endoscopic nurses to explore the mediating role of positive coping styles between sleep quality and occupational fatigue, aiming to identify effective strategies to alleviate fatigue, thereby improving the work environment and enhancing healthcare quality. Methods: From July to August 2023, a cross-sectional design was used to select 258 endoscopy nurses from 25 top-three hospitals in 14 cities across 5 provinces in China. Data was collected through general information questionnaires, Fatigue assessment instrument, Pittsburgh sleep quality index, and Simple Coping Style Questionnaire. A structural equation model of sleep quality - positive coping style - occupational fatigue was constructed using Amos 26.0, and Bootstrap was employed to test the mediating effect. Results: The results showed that the mean scores of sleep quality, occupational fatigue, and positive coping style for endoscopy nurses were 8.89 ± 4.13, 17.73 ± 5.64, and 18.32 ± 10.46, respectively. Positive coping style were negatively correlated with sleep quality and occupational fatigue (p < 0.001). Positive coping style partially mediated the relationship between sleep quality and occupational fatigue, with a mediating effect value of 0.253, accounting for 42.10% of the total effect. Conclusion: Sleep quality can indirectly affect the level of occupational fatigue through positive coping style. Nursing managers should enhance nurses' positive coping skills, improve nurses' sleep quality, and reduce occupational fatigue among nurses.

The relationship between organizational justice and bullying behaviors among nurses: the role of nurse managers' caring behaviors.

BACKGROUND: Organizational justice is pivotal in fostering a fair and supportive workplace culture, which strengthens the connections between managers and nurses, among nurses themselves, and ultimately, between nurses and their patients. Assessing the perceived levels of organizational justice and managerial behaviors can identify key areas for improving nurses' commitment and loyalty, while simultaneously reducing incidents of workplace bullying. PURPOSE: This study aims to investigate how bedside nurses perceive organizational justice, nurse managers' caring behaviors, and their exposure to workplace bullying. Additionally, it seeks to explore the relationship between organizational justice, nurse managers' caring behaviors, and nurses' perceived exposure to workplace bullying. METHODS: A descriptive-correlational study was conducted in the inpatient care unit of a Saudi hospital. A convenience sample of 256 nurses participated, completing the Organizational Justice Questionnaire (OJQ), the Caring Factor Survey: Caring of the Manager (CFS-CM), and the Negative Acts Questionnaire-Revised (NAQ-R). The collected data were analyzed using descriptive statistics and regression analysis. RESULTS: Descriptive statistics revealed moderate levels of perceived organizational justice and managerial caring behaviors among nurses, alongside low reported exposure to workplace bullying. Significant correlations were found among the studied variables, indicating that higher perceived organizational justice was associated with higher managerial caring and lower workplace bullying (p < 0.05). Mediation analysis demonstrated a significant indirect effect of organizational justice on workplace bullying through the mediating role of nurse managers' caring behaviors (a×b = -0.0652, p < 0.001). Furthermore, the direct effect of organizational justice on workplace bullying remained significant even when accounting for the mediator (c = -0.5509, p < 0.001). CONCLUSION: This study highlights the vital role of organizational justice and managerial caring in cultivating a positive work environment and mitigating workplace bullying. Implementing clear policies and procedures while promoting fairness and equality in resource allocation, decision-making processes, and interactions are essential strategies for fostering positive attitudes and work behaviors among nurses.

The mediating effect of depression on the association between lung disease and cardiovascular health.

Introduction: In this study, we investigated the effect of depression on the interaction between lung disease and cardiovascular health (CVH). Methods: Utilising data from the National Health and Nutrition Examination Survey (2013-2018), we employed multivariate regression and bootstrap mediation analysis to explore the relationships among lung diseases, depression, and CVH scores. Results: Complex and significant associations were identified among lung diseases, depression, and CVH scores, with depression mediating 9.42% of the effect on CVH, especially for chronic bronchitis patients. Conclusions: Depression significantly mediated the relationship between lung disease and reduced CVH scores, highlighting the importance of mental health management in lung disease patients.

Anxiety and sleep quality in patients receiving maintenance hemodialysis: multiple mediating roles of hope and family function.

The objective of this cross-sectional study was to examine the extent of sleep quality among individuals undergoing maintenance hemodialysis (MHD) and to scrutinize whether hope and family function serve as mediators in the association between anxiety and sleep quality in this cohort. A convenience sampling method was used to recruit 227 patients receiving maintenance hemodialysis from two tertiary hospitals in Wuhan. Participants completed several self-report questionnaires, including the Sociodemographic questionnaire, Hospital Anxiety and Depression Scale, Athens Insomnia Scale, Herth Hope Index, and Family APGAR Index. As per the findings of the chain mediation analysis, it was observed that the sleep quality scores were directly predicted by anxiety. Moreover, anxiety positively predicted sleep quality scores through hope and family function as mediators. The observed types of mediation were partial mediation. The total indirect effect value was 0.354, indicating the mediating effect of hope and family function, while the total effect value was 0.481, representing the overall effect of anxiety on sleep quality. The total effect size was 73.60% (0.354/0.481), indicating that the mediation accounted for a significant portion of the relationship. This study established the chain mediating effect of hope and family function between anxiety and sleep quality in patients receiving maintenance hemodialysis. The findings highlight the importance of addressing anxiety and promoting hope and family function to improve sleep quality in this population. The findings suggest that healthcare professionals should be attentive to the anxiety levels of these patients and implement targeted interventions to help alleviate anxiety, enhance hope, and improve family functioning, with the ultimate goal of improving sleep quality in this population.

Does the digital economy improve comprehensive total factor productivity in China?

Total factor productivity is an important symbol of high-quality economic development. At present, the question of whether the digital economy can infuse fresh impetus into enhancing total factor productivity has emerged as a prominent concern in China. This paper constructs a new undesirable output to measure comprehensive total factor productivity (CTFP) with the slack-based measure (SBM) undesirable Malmquist-Luenberger index by using 2011-2020 Chinese provincial panel data. Then, this paper explores the impact of the digital economy (DIG) on CTFP with a fixed effects (FE) panel model and a mediating effect model. The results show that CTFP increases by an average of 3.9%, technical efficiency contributes -1.1%, and the contribution rate of technological progress is 5.0%. Technological progress is the main source of CTFP growth. The empirical findings show that the DIG has a positive and significant impact on CTFP. This paper conducts various robustness tests, and the results remain consistent with the previous conclusion. Moreover, mechanism tests suggest that the promoting effect of the DIG on CTFP can be attributed to three main effects: technological innovation, the factor endowment structure and the educational level. Furthermore, the results of heterogeneity analysis demonstrate that the promoting effect of the DIG on CTFP exists in China's eastern, central and western regions. The findings of this research can serve as a valuable reference for informing decision-making processes related to environmental governance and high-quality economic development in China.

Association between frailty and meaning in life of older adults in nursing home: the mediating effect of psychological resilience.

Background: Meaning in life is a crucial aspect of psychological well-being, often overlooked despite its clinical significance. This warrants further investigation, especially regarding its relationship with frailty and psychological resilience. Objective: This study aims to assess the status and relevance of frailty, psychological resilience, and meaning in life among older adults in Chinese nursing homes. Additionally, it explores the mediating role of psychological resilience between frailty and meaning in life, providing insights to improve the meaning in life for older adults in nursing homes. Methods: Between August 2022 and November 2022, 302 older adults in Chinese nursing homes were selected using convenience sampling. The study utilized the Socio-demographic Characteristics Questionnaire, Tilburg Frailty Indicator, Connor-Davidson Resilience Scale, and the Source of Meaning Scale for Older Adults. A face-to-face questionnaire survey was conducted, and SPSS 27.0 was employed for analyzing correlations between frailty, psychological resilience, and meaning in life. The mediating effect of psychological resilience was assessed using Model 4 in the Process plug-in. Results: Older adults in nursing homes exhibited a frailty total score of 4.00 (2.00, 5.00), with a prevalence of 28.5%. Psychological resilience scored 66.00 (51.75, 76.00), and meaning in life scored 149.00 (132.00, 158.25). Frailty showed a negative correlation with both meaning in life and psychological resilience, while meaning in life demonstrated a positive correlation with psychological resilience. Psychological resilience exhibited a partial mediating effect, accounting for 51.04% of the total effect between frailty and meaning in life. Conclusion: Frailty incidence is high among older adults in nursing homes, with psychological resilience at a general level and meaning in life in the upper middle level. Psychological resilience plays a crucial role as a partial mediator between frailty and meaning in life. Timely assessment of frailty, targeted interventions, and improvements in psychological resilience are essential for enhancing the meaning in life and promoting successful aging.

Coping Tendency as a Mediator in the Relationship Between Psychological Resilience and Health Problems Among College Students.

Purpose: The study aimed to explore the status of four common health problems (ie, smoking, internet addiction, physical inactivity, psychological disorder) among college students and analyze the relationship between psychological resilience, coping tendency and health problems. Participants and Methods: The convenience sampling method was used to recruit 500 college students from four universities. The General Information Questionnaire, Adolescent Psychological Resilience Scale, Simplified Coping Style Questionnaire and Health Risk Behavior Questionnaire were used for survey. Results: Among the students, there were 71 smokers (15.4%) and 61 internet addicts (13.2%). Over a third of the students reported physical inactivity (35.9%) and a minority had psychological disorder (6.3%). The psychological resilience score differed between students who smoked, had internet addiction, physical inactivity, psychological disorder and those without these health-risk behaviors. Logistic regression analysis showed that negative coping tendency was the common contributing factor of physical inactivity, internet addiction and psychological disorder. Coping tendency played a partial mediating effect in the relationship between psychological resilience and health problems, with a mediating effect of 37.93%. Conclusion: Psychological resilience can not only affect health problems directly but also influence health problems indirectly through coping tendency. Educators and administrators in universities can apply effective measures to improve psychological resilience and positive coping to prevent or reduce health problems among undergraduates.

The Association Between Social Support and the Quality of Life of Older Adults in China: The Mediating Effect of Loneliness.

BACKGROUND: Quality of life, social support, and loneliness are common problems among older adults in China , but the relationships among these issues have not been clearly identified. OBJECTIVES: The present study aimed to determine the relationships among Quality of life, social support, and loneliness. METHODS: A total of 560 older adults were randomly selected , the social support rating scale (SSRS), University of California at Los Angeles (UCLA) loneliness scale, and Short-Form 12 (SF-12) were employed to measure their degree of social support, level of loneliness, and quality of life. RESULTS: The average physical component summary (PCS) score was 49.97±16.33, and the average mental component summary (MCS) score was 47.26±11.49. Loneliness plays a partial mediating role between social support and quality of life. CONCLUSION: Loneliness and a lack of social support will affect the quality of life of the older adults. Thus, we need to urgently strengthen the care and support for the older adults and alleviate the loneliness of the older adults in the community.

A prospective cohort study of multimetal exposure and risk of gestational diabetes mellitus.

The relationship between co-exposure to multiple metals and gestational diabetes mellitus (GDM) and the mechanisms involved are poorly understood. In this nested case-control study, 228 GDM cases and 456 matched controls were recruited, and biological samples were collected at 12-14 gestational weeks. The urinary concentrations of 10 metals and 8-hydroxydeoxyguanosine (8-OHdG) as well as the serum levels of malondialdehyde (MDA) and advanced glycation end products (AGEs) were determined to assess the association of metals with GDM risk and the mediating effects of oxidative stress. Urinary Ti concentration was significantly and positively associated with the risk of GDM (odds ratio [OR]:1.45, 95 % confidence interval [CI]: 1.12, 1.88), while Mn and Fe were negatively associated with GDM risk (OR: 0.67, 95 % CI: 0.50, 0.91 or OR: 0.61, 95 % CI: 0.47, 0.80, respectively). A significant negative association was observed between Mo and GDM risk, specifically in overweight and obese pregnant women. Bayesian kernel machine regression showed a significant negative joint effect of the mixture of 10 metals on GDM risk. The adjusted restricted cubic spline showed a protective role of Mn and Fe in GDM risk (P < 0.05). A significant negative association was observed between essential metals and GDM risk in quantile g-computation analysis (P < 0.05). Mediation analyses showed a mediating effect of MDA on the association between Ti and GDM risk, with a proportion of 8.7 % (P < 0.05), and significant direct and total effects on Ti, Mn, and Fe. This study identified Ti as a potential risk factor and Mn, Fe, and Mo as potential protective factors against GDM, as well as the mediating effect of lipid oxidation.