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Aims: To explore how family functioning and family resilience mediate the relationship between disability severity and quality of home‐based care among families with disabled older adults. Methods: A cross‐sectional survey was conducted with 431 families with Uygur and Kazakh disabled older adults in Xinjiang, China, in 2020. The data were collected using the Katz Activity of Daily Living Scale; Mini‐Mental State Examination; Family Adaptation, Partnership, Growth, Affection and Resolve Index Scale; Family Resilience Assessment Scale; and Family Caregiving Consequences Inventory Scale. All mediation effects were estimated in SPSS26.0. Results: Disability severity, family functioning and family resilience were all significantly correlated with home‐based care quality. Disability severity had a 46.16% direct effect on home‐based care quality and a 53.84% indirect effect on home‐based care quality independently and in series through family functioning and family resilience. Conclusions: Disability severity directly affected home‐based care quality and had an indirect influence via family functioning and family resilience. Multidisciplinary care teams should focus on families with disabled older adults and help them improve family functioning and family resilience by implementing targeted interventions, so as to improve home‐based care quality. Summary statement: What is already known about the topic? Literature has clarified that social support and caregiver competence mediate the path relationship between disability severity and home‐based care quality from the perspective of individuals.Long‐term care for disabled older adults affects not only informal caregivers but also the whole family.The role of the family, such as family functioning and family resilience, in the whole process remains unclear. What this paper adds? Findings indicated relationships between disability severity, family functioning, family resilience and home‐based care quality.Disability severity can indirectly influence home‐based care quality not only through family functioning or family resilience but also through family functioning affecting family resilience. The implications of this paper Findings indicate that community nurses should not only pay attention to disabled older adults and their informal caregivers but also consider the impact of family functioning and family resilience when formulating interventions to improve the quality of home‐based care.When disabled older adults are transferred from hospitals to home, community rehabilitation nurses should intervene as early as possible, providing guidance on rehabilitation training and daily living skills for disabled older adults to restore and maintain function and prevent complications.Community nurses can conduct case counselling services for family members to understand and satisfy their care needs, enhancing their confidence, cohesion and problem‐solving abilities to improve the quality of home‐based care. [ABSTRACT FROM AUTHOR]

In the face of COVID-19, many schools have to educate their students using online activities. During this time, whether and how parents are involved may be of particular importance for young children—who are less able to learn independently via the Internet due to their developmental immaturity. Therefore, this study examined the cross-sectional association of maternal involvement in child online learning with child adjustment during the COVID-19 pandemic and tested maternal mindfulness as a moderator. Data were collected from 236 mothers of kindergarten-aged children (mean age = 55.91 months; 75% of them were girls) during the fourth wave of COVID-19 outbreak in Hong Kong, China. Using paper-and-pencil questionnaires, mothers rated their involvement and mindfulness and their children's pre-academic ability and internalizing and externalizing behaviors and provide demographic information. Regression models revealed that maternal involvement was associated positively with child pre-academic ability and negatively with child internalizing behaviors, but such associations were only significant for children with more mindful mothers. Maternal mindfulness did not moderate the negative association between maternal involvement and child externalizing behaviors. Findings highlighted the role of maternal mindfulness in child development, suggesting that it may be crucial to promote maternal involvement and mindfulness during the pandemic and perhaps beyond. [ABSTRACT FROM AUTHOR]

Background: Patient satisfaction has been seen as a key criterion when evaluating hospitals and is one of the main focuses of the current health‐care reform in China. This paper aimed to explore patient‐ and hospital‐level factors associated with inpatient satisfaction, which can provide policy implications for the evaluation and development of a patient‐oriented health‐care system. Methods: The paper analyses data from the 2017 China National Patient Survey which includes 20 300 inpatients from 131 tertiary hospitals across 31 provinces. Descriptive analysis and multivariable logistic regressions are conducted to identify key factors related to satisfaction. Results: Patient sociodemographic characteristics, including gender, age, income and insurance type, are found to be strongly associated with their satisfaction of inpatient experience. In terms of institutional characteristics, hospital type, size, staffing and financial performance are also significantly correlated with inpatient satisfaction. Patients are more satisfied with specialist hospitals and large hospitals measured by the number of beds and surgeries. Hospitals with higher nurse‐to‐bed ratio also receive more satisfaction. The financial performance of hospitals, however, is negatively associated with satisfaction. Conclusion: Patient satisfaction contains unique information on service quality and thus should be incorporated into the matrix of hospital evaluation. Meanwhile, differences in patient composition must be adjusted to make fair comparisons across hospitals. Moreover, future reform needs to put greater efforts in the design of comprehensive public insurance scheme, efficient hospital structure and an overall well‐functioning health‐care delivery system in order to better serve patients in China. [ABSTRACT FROM AUTHOR]

Aim: This research aimed to explore the level of hope and symptom burden of breast cancer women undergoing chemotherapy, and predictive factors of hope were also investigated. Background: Chemotherapy brings physical and psychological stress to breast cancer patients. As an effective coping strategy, hope gives them the courage to overcome difficulties and improve prognosis and survival. Therefore, efforts are needed to raise hope. Design/Methods: A total of 450 women who were undergoing breast cancer chemotherapy participated in this cross‐sectional study. Sociodemographic data, disease characteristics, and measures of hope and symptom burden were collected using questionnaires. Hope was assessed using the validated Herth Hope Index, and the previously validated Memorial Symptom Assessment Scale was used to assess symptom burden. This paper adhered to the STROBE guidelines. Results: Chinese breast cancer chemotherapy women hope average scores of 30.15 ± 4.82 were in the medium range of the Hearth Hope Index as specified by Herth to be 24–35. Patients with age ≤45, religious beliefs and lighter symptom burden have a higher level of hope. These variables explained a total of 22.9% of the variation in hope. Conclusions: The level of hope for women undergoing breast cancer chemotherapy still needs to be further improved. Symptom burden can negatively predict hope. Relevance to clinical practice: If nurses can decrease breast cancer chemotherapy women symptom burden, there is an impact on increasing levels of hope. [ABSTRACT FROM AUTHOR]

Background: China issued strict nationwide guidelines to combat the COVID-19 outbreak in January 2020 and gradually loosened the restrictions on movement in early March. Little is known about how these disease control measures affected the 600 million people who live in rural China. The goal of this paper is to document the quarantine measures implemented in rural China outside the epicenter of Hubei Province and to assess the socioeconomic effect of the measures on rural communities over time. Methods: We conducted three rounds of interviews with informants from 726 villages in seven provinces, accounting for over 25% of China's overall rural population. The survey collected data on rural quarantine implementation; COVID-19 infections and deaths in the survey villages; and effects of the quarantine on employment, income, education, health care, and government policies to address any negative impacts. The empirical findings of the work established that strict quarantine measures were implemented in rural villages throughout China in February. Results: There was little spread of COVID-19 in rural communities: an infection rate of 0.001% and zero deaths reported in our sample. However, there were negative social and economic outcomes, including high rates of unemployment, falling household income, rising prices, and disrupted student learning. Health care was generally accessible, but many delayed their non-COVID-19 health care due to the quarantine measures. Only 20% of villagers received any form of local government aid, and only 11% of villages received financial subsidies. There were no reports of national government aid programs that targeted rural villagers in the sample areas. Conclusions: By examining the economic and social effects of the COVID-19 restrictions in rural communities, this study will help to guide other middle- and low-income countries in their containment and restorative processes. Without consideration for economically vulnerable populations, economic hardships and poverty will likely continue to have a negative impact on the most susceptible communities. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the relationship between work engagement and inclusive leadership in Chinese hospital head nurses. Besides, it explored the effect of the mediating role of inclusive leadership in the relationship between work engagement and innovative behaviour among Chinese hospital head nurses. Background: Head nurses are essential in the group of registered nurses who are to pass the Chinese licensure examination for nurses. Their work engagement and innovative behaviour are beneficial to improve the quality, efficiency and competitiveness of nursing services. However, little is known about the mediating role of inclusive leadership in the relationship between work engagement and innovative behaviour. Methods: In April 2018, a total of 374 Chinese head nurses were surveyed with a Work Engagement Scale, an Inclusive Leadership Scale and an Innovative Behavior Scale. Because the data were normally distributed in our study, Pearson's correlation coefficient (r) was used to conduct the correlation analysis of study variables. Multiple linear regression analysis was used to explore the factors of innovative behaviour. Model 4 of Hayes's (2013) PROCESS macro and Bootstrap method was used to examine the mediating role of inclusive leadership. Result: Inclusive leadership was significantly and positively correlated to innovative behaviour and work engagement (p < 0.01). Moreover, work engagement was correlated with innovative behaviour (p < 0.01). In addition, hospital level, publishing papers, work engagement and inclusive leadership were the factors of head nurses' innovative behaviour (p < 0.01). Inclusive leadership partially mediated the relationship between work engagement and innovative behaviour, accordingly. Conclusion: Work engagement affects innovative behaviour among Chinese head nurses, and inclusive leadership is a mediator in the relationship. We should take measures to improve the leaders' level of inclusive leadership, in order to strengthen head nurses' innovative behaviour. Implications for nursing management: According to the results of the study, the leaders of head nurses should pay attention to improve head nurses' innovative behaviour, inclusive leadership, work engagement, and the quality and competitiveness of nursing. [ABSTRACT FROM AUTHOR]

Objective. Obesity prevalence is unequally distributed across gender and ethnic group in Malaysia. In this paper, we examine the role of socioeconomic inequality in explaining these disparities. Design. The body mass index (BMI) distributions of Malays and Chinese, the two largest ethnic groups in Malaysia, are estimated through the use of quantile regression. The differences in the BMI distributions are then decomposed into two parts: attributable to differences in socioeconomic endowments and attributable to differences in responses to endowments. Results. For both males and females, the BMI distribution of Malays is shifted toward the right of the distribution of Chinese, i.e., Malays exhibit higher obesity rates. In the lower 75% of the distribution, differences in socioeconomic endowments explain none of this difference. At the 90th percentile, differences in socioeconomic endowments account for no more than 30% of the difference in BMI between ethnic groups. Conclusions. Our results demonstrate that the higher levels of income and education that accrue with economic development will likely not eliminate obesity inequality. This leads us to conclude that reduction of obesity inequality, as well the overall level of obesity, requires increased efforts to alter the lifestyle behaviors of Malaysians. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to evaluate the health‐related quality of life of nursing workers and influential factors. Background: Nursing workers are under great occupational stress. However, few population‐level studies of nursing workers' health conditions have been reported from China. Design This was a cross‐sectional study conducted in 12 medical institutions in east China between January and March 2015. Methods: Social‐demographic information, nursing workers' work‐related information and health‐related quality of life using the Chinese (mainland) version of the Short Form 36 health survey were collected by a self‐administrated questionnaire. Results: Nursing workers reported significantly lower scores of the vitality, mental health dimensions, and mental component summary of the Short Form 36 survey compared with general population reference values. They scored significantly higher for five other dimensions and comparably for the physical role dimension. Pre‐job training, families' positive attitudes to their job, and good relationships with clients were positively related with nursing workers' mental well‐being. Conclusion: To promote nursing workers' mental health, compulsory work‐related training, voluntary psychological counselling, and targeted legislation are needed. SUMMARY STATEMENT: What is already known about this topic? Shortages of professional medical staff in medical institution at all levels will not be quickly met, and nursing workers are thought to be an important supplement in China.Population‐level study on nursing workers' point of view of their work and health condition has been little reported in China. What this paper adds? Nursing workers were mentally vulnerable regarding their vitality and mental health scores.Job training, families' positive attitudes to their job, and good relationships with clients were all protective factors for nursing workers' mental well‐being. The implications of this paper: Compulsory work‐related training for nursing workers provided by intermediary companies can help promote nursing workers' well‐being.Voluntary psychological counselling provided by hospitals can also be helpful to build a supportive work environment for nursing workers.Governments need to regulate this market and protect nursing workers' rights and benefits by legislation. [ABSTRACT FROM AUTHOR]

• Parental investment and skill mediate caregiver mental health and child development. • Caregiver depression are more harmful to parenting practices and child development. • The variety of play material has significant mediation effect on child development. • Coercive parenting mediate caregiver mental health and child development. Parenting practices are associated with early childhood development (ECD), and some evidences suggest that mental health might affect parenting practices. However, the interrelationships of mental health, parenting practices, and ECD outcomes have not yet been well documented in developing contexts like rural China. This paper aims to investigate the interrelationships between the caregiver's mental health, parenting practices, and the child's ECD outcomes in rural China. A total of 1787 sample households in an undeveloped rural area of western China are enrolled in the study. A socioeconomic questionnaire, the Depression, Anxiety and Stress Scale, the Family Care Indicators, the Parent and Family Adjustment Scales, and the Bayley Scales of Infant Development version III were used to measure the socioeconomic characteristics of sample households, the caregiver's mental health, parental investments and parenting skills, and the child's development outcomes, respectively. Mediation model was then applied to estimate the interrelationships. The results showed that parental practices significantly mediated between the caregiver's mental health and the child's cognition, language, motor, and social–emotion development. Through parental investments, one standard deviation increases in the caregiver's mental health test score was associated with the decline in the child's four development scores by 0.6% standard deviation, respectively. Through parenting skills, one standard deviation increases in the caregiver's mental health test score was associated with the decline in the child's language and social-emotional score by 2% and 5% standard deviation, respectively. Different dimensions of caregiver mental health, parental investments and skills played heterogeneous roles in the interrelationships. Early interventions aimed at improving the caregiver's mental health, parental investments and skills are important and might be effective to improve early childhood development in rural China. [ABSTRACT FROM AUTHOR]

• Adopted Chinese youth scored more favorably on BASC-3 than non-adopted Chinese youth. • Adopted Chinese youth scored more favorably on BASC-3 than non-adopted US youth. • High adoptive family SES benefited adopted youth adjustment. • Testing measurement invariance is important for cross-cultural comparison. In this paper, we examined if high SES families had an effect on youth's adjustment by comparing 226 internationally adopted female Chinese youth who experienced pre-adoption institutionalization with 1059 non-adopted Chinese peers living in China, as well as 209 non-adopted American peers. On average, the adopted youth's families had a higher SES status than the two comparison groups. Survey data on behavioral problems and prosocial adjustment were collected with the third edition of the Behavioral Assessment for Children (BASC-3). We found the adopted Chinese youth outperformed their Chinese counterparts in all comparisons and their US counterparts in most comparisons. These results offer some evidence that a high family SES may compensate for the adoption-related risks such as earlier institutionalization. Possible mechanisms underlying the benefit of high SES were discussed. [ABSTRACT FROM AUTHOR]