Relationship between self-esteem and quality of life in middle-aged and older patients with chronic diseases: mediating effects of death anxiety.

BACKGROUND: Many studies have explored the relationship between self-esteem and quality of life. However, few studies have elucidated the mechanisms underlying the relationship between self-esteem and quality of life in middle-aged and older patients with chronic diseases. The present study aimed to explore the mediating role of death anxiety in this relationship. METHODS: Middle-old-aged patients with chronic diseases were selected as the respondents by using a multi-stage sampling method, random number table method from October 2021 to February 2022 in the Second Affiliated Hospital of Zhejiang University School of Medicine. The Cumulative Disease Rating Scale, the Self-Esteem Scale (SES), the Chinese version of the Death Anxiety Scale (CT-DAS), and the Simplified version of the Quality of Life Scale (SF-12) were used as the researching tools to conduct the survey. SPSS26.0 was used to analysis data. AMOS 23.0 software was used to construct structural equation modeling. RESULTS: 294 valid questionnaires were collected. There were significant differences in quality of life among middle-aged and elderly patients with chronic diseases who have different physical activities, socialization, and chronic pain (P < 0.01); Self-esteem was positively associated with quality of life (r = 0.330, P < 0.01), self-esteem was negatively associated with death anxiety (r = -0.222, P < 0.01), and death anxiety was negatively associated with quality of life (r = -0.263, P < 0.01); Death anxiety partially mediated the relationship between self-esteem and quality of life, with the mediating effect accounting for 18.40% of the total effect. CONCLUSION: Death anxiety partially mediates the relationship between self-esteem and quality of life. Interventions to improve self-esteem and reduce death anxiety should be used to improve the quality of life of middle-aged and senior patients with chronic diseases.

Jujuboside B alleviates acetaminophen-induced hepatotoxicity in mice by regulating Nrf2-STING signaling pathway.

BACKGROUND: Jujuboside B (JuB) is the main bioactive saponin component of Chinese anti-insomnia herbal medicine Ziziphi Spinosae Semen, which has been reported to possess varied pharmacological functions. Even though it has been traditionally used to treat inflammation- and toxicity-related diseases, the effects of JuB on acetaminophen (APAP) overdose-induced hepatotoxicity have not been determined yet. METHODS: C57BL/6 J mice were pre-treated with JuB (20 or 40 mg/kg) for seven days before APAP (400 mg/kg) injection. After 24 h of APAP treatment, serum, and liver tissues were collected to evaluate the therapeutic effects. To investigate whether the Nrf2-STING signaling pathway is involved in the protective effects of JuB against APAP-induced hepatotoxicity, the mice received the DMXAA (the specific STING agonist) or ML385 (the specific Nrf2 inhibitor) during the administration of JuB, and Hematoxylin-eosin staining, Real-time PCR, immunohistochemical, and western blot were performed. RESULTS: JuB pretreatment reversed APAP-induced CYP2E1 accumulations and alleviated APAP-induced acute liver injury. Furthermore, JuB treatment significantly inhibited oxidative stress and the pro-inflammatory cytokines, as well as alleviated hepatocyte apoptosis induced by APAP. Besides, our result also demonstrated that JuB treatment upregulated the levels of total Nrf2, facilitated its nuclear translocation, upregulated the expression of HO-1 and NQO-1, and inhibited the APAP-induced STING pathway activation. Finally, we verified that the beneficial effects of JuB were weakened by DMXAA and ML385. CONCLUSION: Our study suggested that JuB could ameliorate APAP-induced hepatic damage and verified a previously unrecognized mechanism by which JuB prevented APAP-induced hepatotoxicity through adjusting the Nrf2-STING pathway.

Nursing students' emotions, educational concerns, and the impact of study careers and professional futures during the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: COVID-19 is a challenge to education systems worldwide. The aim of the study was to explore the impact of COVID-19-pandemic-related emotions and COVID-19-related concern for education on the study careers and professional futures of nursing students. METHODS: The study was completed between March and June 2023 using a multi-stage sampling design. A total of 1126 nursing students were recruited to complete the questionnaire. The self-administered questionnaire consisted of basic characteristics of the subjects, the COVID-19-pandemic-related emotions scale, the COVID-19-related concern for education scale, and the impact of the COVID-19 on study careers and professional futures scale (SCPFI-19 S). One-way ANOVA/t-test, correlation coefficient analysis, and hierarchical linear regression analysis were used to explore factors influencing changes in study careers and professional futures, and the relationship between COVID-19-pandemic-related emotions and COVID-19-related concern for education. RESULTS: Univariate analysis of variance indicated that residence, willingness, and whether to engage in nursing after graduation were related to SCPFI-19 S (P < 0.05). COVID-19-pandemic-related emotions and COVID-19-related concern for education were significantly and positively associated with SCPFI-19 S (r = 0.566, P < 0.01; r = 0.199, P < 0.01). Stratified multiple regression analysis showed that COVID-19-pandemic-related emotions and COVID-19-related concern for education of nursing students were significant predictors of SCPFI-19 S. CONCLUSION: Overall, both COVID-19-pandemic-related emotions and COVID-19-related concern for education were significantly correlated with SCPFI-19 S. In future interventions, schools should consider structures and strategies to support students' mental health and educational trajectories during current and future epidemics or similar crises.

Psychological resilience and quality of life among middle-aged and older adults hospitalized with chronic diseases: multiple mediating effects through sleep quality and depression.

BACKGROUND: The present study is intended to examine the multiple mediating roles of sleep quality and depression in the relationship between psychological resilience and quality of life in middle-aged and older adults hospitalized with chronic diseases. METHODS: From October 2, 2021, to February 27, 2022, a questionnaire survey was conducted using a multistage stratified sampling method among 339 middle-aged and older adults (45 years and over) hospitalized with chronic diseases. These participants were recruited from a hospital in Zhejiang Province, China. The questionnaire included the Aged Cumulative Disease Rating Scale, the Psychological Resilience Scale, the Pittsburgh Sleep Quality Index Scale, the Depression Scale, and the Quality-of-Life Scale. A descriptive analysis was performed to characterize the sample. Linear regression was utilized to evaluate the relationship between psychological resilience and quality of life. Amos 24.0 was used to analyze the multiple mediated effects of sleep quality and depression. RESULTS: Psychological resilience exerted a remarkable direct effect on the quality of life in middle-aged and older adults hospitalized with chronic diseases (ß = 0.239, 95% CI = 0.125-0.354), which represented 52.98% of the total effect. Through three significantly mediated pathways indirectly affect the quality of life: (1) through the sleep quality pathway (ß = 0.115, 95% CI = 0.056-0.201), which represented 25.39% of the total effect; (2) through the depression pathway (ß = 0. 060, 95% CI = 0.023-0.114), which represented 13.24% of the total effect; and (3) through both the sleep quality and depression pathway (ß = 0. 038, 95% CI = 0.019-0.074), which represented 8.39% of the total effect. The total mediating effect was 47.02%. CONCLUSIONS: Sleep quality and depression mediate the relationship between psychological resilience and quality of life in middle-aged and older adults hospitalized with chronic diseases. Therefore, healthcare professionals and stakeholders should be concerned about the sleep status and mental health of middle-aged and older adults hospitalized with chronic diseases, strengthen their attention to psychological resilience, and provide interventions and treatment measures for hospitalized patients who have sleep problems and depressive tendencies.

Nursing students' emotional empathy, emotional intelligence and higher education-related stress: a cross-sectional study.

BACKGROUND: Nursing is one of the critically important disciplines in healthcare. Due to its complexity and specificity, nursing students often face additional higher education-related stress. However, there is less research on higher education-related stress among nursing students. Therefore, the purpose of this study was to investigate the effects of emotional empathy and emotional intelligence on the dimensions of higher education-related stress among nursing students. METHODS: This study utilized a multi-stage sampling design and was completed within the March-June 2023 period. A total of 1126 nursing students were recruited to complete the questionnaire. The self-administered questionnaire included the basic characteristics of the subjects, an emotional empathy scale, an emotional intelligence scale, and a higher education-related stress scale. One-way ANOVA/t-tests, correlation coefficients, and hierarchical linear regression analyses were used to explore the factors affecting higher education-related stress and the relationship between emotional empathy and emotional intelligence with the dimensions of higher education-related stress. RESULTS: The mean (SD) scores of challenges and dissatisfaction dimensions of higher education-related stress among nursing students were 30.052 (7.466) and 8.270 (2.205), respectively. Emotional empathy was significantly and positively related to the challenges and dissatisfaction dimensions of higher education-related stress. Emotional intelligence was negatively correlated with the challenges dimension of higher education-related stress and positively correlated with the dissatisfaction dimension. Stratified multiple regression analyses revealed that nursing students' emotional empathy and emotional intelligence were significant predictors of the dimensions of higher education-related stress. CONCLUSION: Overall, emotional empathy and emotional intelligence were significantly correlated with all dimensions of higher education-related stress. Consequently, in future interventions, the Chinese government and education sector can develop nursing students' ability to use emotional empathy and emotional intelligence rationally through emotional regulation strategies and emotional intelligence courses, to reduce the higher education-related stress they experience.

Associations of mental well-being with higher education-related stress and orientation of the academic goals among nursing students: A cross-sectional study.

To investigate the association between the mental health of nursing students, the stress of higher education, and academic goal orientation. At a medical college, 1170 nursing students volunteered for this cross-sectional survey. The Warwick-Edinburgh Well-being Scale, the Higher Education Stress Scale, and the Academic Goal Orientation Questionnaire were utilised to collect data. Descriptive statistics, ANOVA, and Pearson correlation analysis were all performed to evaluate the data. The significance level for all statistical tests was p < 0.05. A total of 1126 valid samples, with a 96.23% effective recovery rate. The Higher Education Stress Scale score for nursing students was (38.31 ± 8.29), the Academic Goal Orientation Questionnaire result was (49.32 ± 9.62), and the Mental Health Scale value was (31.24 ± 14.00). Overall, there was a strong relationship between the stress associated with higher education, academic goal orientation, and the mental health of nursing students. Therefore, in future interventions, the Chinese government and its relevant educational authorities can enhance nursing students' ability to reasonably regulate stress related to higher education and set clear academic goals by adjusting the strategies for regulating nursing students' academic stress and increasing the number of academic goal-oriented courses to improve their mental health.

The relationship between stigma and quality of life in hospitalized middle-aged and elderly patients with chronic diseases: the mediating role of depression and the moderating role of psychological resilience.

Objective: Patients with chronic diseases may have some psychological problems due to their own or surrounding environmental factors, which can adversely affect the patient's illness and life. Given that the number of chronically ill patients in China is currently increasing every year, more research is needed to determine the best ways to manage changes in psychological status and psychological stress responses in chronically ill patients. The researchers constructed a mediated moderation model to explore the impact of stigma on the quality of life of chronically ill patients, as well as the mediating role of depression and the moderating role of psychological resilience. Methods: A stratified sampling method was used to select 363 middle-aged and old-aged patients with chronic diseases aged 45 years and older from the Affiliated Hospital of Zhejiang University for the study. Data were collected from patients with chronic diseases such as cardiac, respiratory, renal, and other chronic diseases using the Cumulative Illness Rating Scale for Geriatrics (CIRS-G), the Stigma Scale for Patients with Chronic Diseases (SSCI), the Patient Health Questionaire-9 (PHQ-9), the Quality of Life Inventory (SF-12), and the Conner-Davidson Resilience Scale (CD-RISC) were collected from patients with cardiac, respiratory, renal, and other chronic diseases. A descriptive analysis was used to describe the sample. Linear regression was used to evaluate the relationship between the variables. Mediation and moderation analyses were used to explore the mediating role of depression and the moderating role of psychological resilience. Results: There was a moderate negative correlation between stigma and quality of life (r = -0.378, P < 0.01). There was a moderate negative correlation between depression and quality of life (r = -0.497, P < 0.01). There was a moderately positive correlation between psychological resilience and quality of life (r = 0.382, P < 0.01). There was a moderate negative correlation between psychological resilience and depression (r = -0.348, P < 0.01). There was a weak negative correlation between psychological resilience and stigma (r = -0.166, P < 0.01). There was a strong positive correlation between stigma and depression (r = 0.607, P < 0.01) The mediation study showed that stigma was a significant predictor of quality of life and that stigma and quality of life were mediated to some extent by depression, with the mediating effect accounting for 67.55% of the total effect. The direct path from stigma to depression is moderated by psychological resilience (ß = -0.0018, P < 0.01). Conclusions: Depression mediates the relationship between stigma and quality of life, while psychological elasticity plays a moderating role between stigma and depression, and when the level of psychological elasticity increases, the more significant the role of stigma on depression. As a physiologically and psychologically vulnerable group, patients with chronic diseases' overall quality of life and mental health should be taken more seriously, and clinical workers should pay timely attention to the psychological and mental conditions of patients with chronic diseases and provide timely and appropriate interventions and therapeutic measures. The relevant results of this study also provide a new perspective for clinical work on psychological intervention for patients with chronic diseases.