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Individuals' engagement with video games and the internet features both social and potentially pathological aspects. In this research, we draw on the social identity approach and present a novel framework to understand the linkage between these two aspects. In three samples (N study1  = 304, N study2  = 160, and N study3  = 782) of young Chinese people from two age groups (approximately 20 and 16 years old), we test the associations between relevant social identities and problematic engagement with video games and the internet. Across studies, we demonstrate that individuals' identification as 'gamers' or 'frequent internet users' predicts problematic engagement with video games and the internet through stronger perceived social support from such groups. Moreover, we demonstrate that individuals' identification as 'students' (Studies 2-3) is negatively associated with problematic engagement via social support from other students. Finally, in Study 3, we examine the articulation between social support from these three groups and subjective sense of loneliness. Findings indicate that, whereas perceived support from students is negatively associated with loneliness, the association between perceived support from gamers and internet users and loneliness is weaker and positive. Theoretical implications and directions for future research are discussed. Taken together, the studies highlight the importance of considering the social context of individuals' problematic engagement with technologies, and the role of different group memberships., (© 2020 The British Psychological Society.)

This study aimed to examine joint trajectories of loneliness, social isolation and sarcopenia and their associations with adverse outcomes. A total of 4701 participants aged ≥60 years who had a baseline and at least one follow-up assessment of loneliness, social isolation and sarcopenia across 2011, 2013 and 2015 waves in China Health and Retirement Longitudinal Study. Adverse outcomes were obtained in 2018 wave. Joint trajectories were fit using the parallel process latent class growth analysis, and their associations with adverse outcomes were evaluated using modified Poisson regression. Joint trajectory patterns for social relationship and sarcopenia did not vary by the assessment for sarcopenia, but did vary by the assessment for social relationship. Older adults exhibit distinct joint trajectories and those with persistent combination of loneliness or social isolation and sarcopenia experience greatest risk of adverse outcomes. These findings implicate integration of health care and social care for community-dwelling older adults., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The current study aimed to explore the protective factors and underlying mechanisms associated with loneliness and psychological distress among older Chinese adults within the framework of a longitudinal design. This investigation specifically focused on the mediating role of attitudes toward own aging (ATOA) in the relationship between social support and the experience of loneliness and psychological distress (comprising depression, anxiety, and stress) amidst the backdrop of the COVID-19 pandemic. A cohort of 345 elderly individuals (mean age = 83.84 years, standard deviation = 8.49 years; 55.1% females) participated in this research endeavor. The participants were required to complete self-report instruments measuring their perceived levels of social support at Time 1 (T1), attitudes towards own aging, ATOA at Time 2 (T2), and their experiences of loneliness, and psychological distress (including depression, anxiety, and stress) at T1 and Time 3 (T3). The data collection timeline encompassed baseline data collection at T1 in September 2020, a subsequent six-month follow-up at T2 in March 2021, and a one-year follow up at T3 in September 2021. The findings of this investigation unveiled a negative predictive relationship between social support at T1 and psychological distress (encompassing depression, anxiety, and stress) at T3. Furthermore, it was discerned that ATOA at T2 acted as a mediating mechanism, elucidating the longitudinal association between social support at T1 and the manifestation of loneliness and psychological distress (including depression, anxiety, and stress) at T3. The discussion section of this paper delves into an exploration of the limitations and implications inherent in these conclusions, particularly concerning their relevance to potential intervention strategies.

Background: The prevalence of loneliness among older adults is of great importance in the field of public health. Numerous studies have provided evidence supporting the effectiveness of social support as a powerful intervention for reducing loneliness in older individuals. However, the specific types of social support that yield positive results are yet to be determined. Therefore, this study aims to conduct a comprehensive review to compare and analyse the effectiveness of different support mechanisms in alleviating loneliness among community-dwelling older adults., Methods and Analysis: A thorough search will be conducted on various electronic databases, including EMBASE, PubMed, the Cochrane Library, Web of Science, PsycINFO, Scopus, Google Scholar, China National Knowledge Infrastructure Library, China Science and Technology Journal Database (Weipu), WanFang Database, and China Biology Medicine Disc. The search will include randomised controlled trials published in English or Chinese that focus on interventions for loneliness in older individuals, with loneliness as the primary measure of interest. The selection and choice of articles will be the responsibility of both reviewers. The JBI Critical Appraisal Checklist for Randomised Controlled Trials will be used to assess the methodological quality of the included trials. When sufficient data are obtained and the study is relatively homogeneous, a random-effects or fixed-effects model will be employed to conduct a meta-analysis, yielding a descriptive synthesis of the findings., Ethics and Dissemination: Ethics approval will not be sought for this systematic review as it will exclusively focus on published papers. The review findings will be showcased at a conference dedicated to this specific field and published in an appropriate journal that undergoes peer evaluation., Prospero Registration Number: CRD42020226523., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The complementarity interference (CI) model suggests that the Internet may either inhibit or facilitate interpersonal communications. This paper empirically examines the impact of Internet usage on interpersonal interactions, using a micro dataset from China to answer whether the Internet brings people closer together or further apart. The empirical results demonstrate, first, that Internet usage significantly increases both the time and frequency of people's communications with their family and friends, rather than causing them to feel more disconnected and isolated. Holding other factors constant, for each one-standard-deviation increase in Internet usage, weekly communications with family members increases by an average of 102.150 min, while there is an average increase of 54.838 min in interactions with friends. These findings as to its positive effects are robust when using other regression models and interpersonal contact measures, as well as the instrumental variable method. Second, Internet usage also contributes to decreased loneliness; it exerts this effect primarily by improving people's interactions with their family members. However, communications with friends do not significantly mediate such impacts. Third, the positive role of Internet usage on communications is more prominent for people with more frequent online socialization and self-presentation, better online skills, younger age, higher educational level, and who are living in urban areas. In addition, the beneficial effects of Internet usage are larger for communications with family members in the case of migrants. Therefore, in the context of the rapid development of information technology, the network infrastructure should be improved to make better use of the Internet to facilitate interpersonal communications and promote people's wellness. [ABSTRACT FROM AUTHOR]

This article has been withdrawn: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/policies/article-withdrawal). This article has been withdrawn at the request of the editor and publisher. The publisher regrets that an error occurred which led to the premature publication of this paper. This error bears no reflection on the article or its authors. The publisher apologizes to the authors and the readers for this unfortunate error., Competing Interests: Conflict of interest On behalf of all authors, the corresponding author states that there is no conflict of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Aims: To explore loneliness, in association with frailty, in explaining the quality of life (QOL) of empty‐nest older adults in rural China. Design A cross‐sectional questionnaire survey was conducted. Methods: Data collection was performed from June to August 2017 in Changchun, the capital city of Jilin province, which consists of seven districts and three counties. In total, 304 older adults aged 60 years and above participated. The characteristics of older adults were evaluated in terms of frailty status, loneliness and the QOL. One‐way and two‐way analyses of covariance and the area under the receiver operating characteristic curves were used to explore the relationships of frailty, loneliness and the QOL. Results: The one‐way ANCOVA showed a significant difference among robust, prefrail and frail participants for loneliness. Moreover, an interaction effect of frailty with loneliness in determining the QOL was found. The receiver operating characteristic curves showed that loneliness and QOL could distinguish frail older adults, and the best cutoffs were 34.5 and 67.4, respectively. Conclusion: This study demonstrates a close relationship between frailty and loneliness, suggesting the need to simultaneously consider the two with regard to the QOL of empty‐nest older adults in rural China. Summary statement: What is already known about this topic? There were no studies examining the associations of frailty and loneliness with QOL or the cut‐point of the loneliness and QOL scores to reflect frailty.Few studies have revealed an association between loneliness and frailty. These studies focus mainly on older adults living in the community, and none consider the relationship between mental status and the frailty of empty nesters. What this paper adds? This study determined that frailty, loneliness and the QOL had a close relationship in empty nesters. There was a significant interaction among frailty, loneliness and the quality of life.Loneliness and the QOL could distinguish frail older adults, and the best cutoffs were 34.5 and 67.4, respectively. The implications of this paper? This study can enable governments and communities to pay attention to the psychological status of empty‐nest individuals while paying attention to their psychological problems, such as loneliness, to help them improve their quality of life. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to describe the experiences of nurses and other health care workers who were infected with coronavirus disease 2019. Methods: An empirical phenomenological approach was used. Sixteen participants were recruited in Wuhan using purposive and snowball sampling. Semistructured, in‐depth interviews were conducted by telephone in February 2020. Interviews were transcribed verbatim and analysed following Colaizzi's method. Results: Two themes emerged: (1) Intense emotional distress since becoming infected. Participants were fearful of spreading the virus to family and overwhelmed by a lack of information, experienced uncertainty and worried about treatment, felt lonely during isolation and reported moral distress about inadequate health care staffing. (2) Coping strategies were needed. They tried their best to address negative psychological reactions using their professional knowledge and gaining support from others and community resources. Conclusions: Preparedness for catastrophic events and providing timely and accurate information are major considerations in government policy development, related to pandemics and adequacy of health care personnel. Mental health resources and support, both short‐ and long‐term should be anticipated for health care providers to alleviate their fear and anxiety. Summary statement: What is already known about this topic? Health care workers, including nurses, are at the frontlines of the COVID‐19 outbreak and at high risk of infection.Experts have called for infection prevention for health care providers.Limited research has reported the experiences of health care workers infected by COVID‐19 using an empirical phenomenological approach. What this paper adds? Upon diagnosis, nurses and other health care workers experienced fear, uncertainty and distress like general patients.Health care workers reported moral distress about inadequate health care staffing issues.Health care workers could cope with their negative psychological reactions using professional knowledge and support from significant others and the community. The implications of this paper: Preparedness for large‐scale pandemics and a system that can provide openness and timely information needs consideration in policy development.Accurate information and good communication are vital to support infected health care workers and enhance their sense of safety and belonging.Long‐term support should be available when these health care workers return to work. [ABSTRACT FROM AUTHOR]

Smartphone addiction, loneliness, and depression are the norm in life, and previous studies indicate that they are closely related to each other. However, many studies have reached inconsistent conclusions and the potential mechanisms remain controversial. Therefore, based on the deficient self-regulation model, this paper aimed to examine the relationships between loneliness and smartphone addiction, including depression as a possible mediator, by testing 4274 students in China and performing a two-wave cross-lagged analysis. The results showed that: loneliness (T1) could significantly and positively predict depression and smartphone addiction (T2); depression (T1) could significantly and positively predict loneliness and smartphone addiction (T2); similarly, smartphone addiction (T1) could significantly and positively predict loneliness and depression (T2); depression (T1) mediated the relationship between loneliness (T1) and smartphone addiction (T2). The findings show the significance of promoting college students' mental health and preventing smartphone addiction. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review and meta‐analysis aimed to determine the prevalence of loneliness and social isolation among informal carers of individuals with dementia and to identify potential influencing factors. Methods: We conducted a comprehensive search across 10 electronic databases, including PubMed, Cochrane, Embase, Web of Science, PsycINFO, CINAHL, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG. Our search strategy covered the inception of the databases up to September 16, 2023, with an updated search conducted on March 8, 2024. Prevalence estimates of loneliness and social isolation, presented with 95% confidence intervals, were synthesized through meta‐analysis. Subgroup analyses and meta‐regression were employed to explore potential moderating variables and heterogeneity. Results: The study encompassed 27 research papers involving 11,134 informal carers from 17 different countries. The pooled prevalence of loneliness among informal carers of individuals with dementia was 50.8% (95% CI: 41.8%–59.8%), while the pooled prevalence of social isolation was 37.1% (95% CI: 26.7%–47.6%). Subgroup analyses and meta‐regression indicated that various factors significantly influenced the prevalence of loneliness and social isolation. These factors included the caregiving setting, study design, the intensity of loneliness, geographical location (continent), data collection time, and the choice of assessment tools. Conclusions: This study underscores the substantial prevalence of loneliness and social isolation among informal carers of individuals with dementia. It suggests that policymakers and healthcare providers should prioritize the development of targeted interventions and support systems to alleviate loneliness and social isolation within this vulnerable population. Key points: Informal carers of people with dementia contend with unique circumstances that render them susceptible to both loneliness and social isolation.There is a significant prevalence of loneliness and social isolation in informal carers of individuals with dementia.Several significant moderators influence the prevalence of loneliness and social isolation among informal carers of individuals with dementia.Moderator analysis can guide targeted interventions and support systems for at‐risk informal carers of people with dementia to alleviate loneliness and social isolation. [ABSTRACT FROM AUTHOR]

There are few studies estimating the loneliness of the Hakka elderly in China. This study aims to examine the loneliness status and related factors among the Hakka elderly in Fujian, China. The short-form UCLA Loneliness Scale (ULS-8) was used to assess the loneliness of the Hakka elderly. Factors associated with loneliness were classified as individual indicators, behavioral indicators, interpersonal indicators, and social indicators according to the health ecological model (HEM). Hierarchical linear regression models were established to identify the main factors that were most predictive of loneliness. A sample of 1,262 Hakka elderly people was included in this study. Females ( β  = 0.631, P =0.012), those with ≥2 chronic diseases ( β  = 1.340, P < 0.001), those who were currently living in rural areas ( β  = 4.863, P < 0.001) or suburban areas ( β  = 2.027, P < 0.001), those with parents both died ( β  = 0.886, P =0.001), and those with the Urban Employees Basic Medical Insurance (UEBMI; β  = 0.852, P =0.030) obtained a higher score of ULS-8. Those exercised regularly ( β  = -2.494, P < 0.001), those had leisure activities ( β  = -1.937, P < 0.001), those ate healthy ( β  = -1.270, P < 0.001), and those with better self-rated financial status and higher education level received a lower score of ULS-8. There are differences in loneliness among different Hakka elderly population subgroups, and healthy behaviors and lifestyles may reduce the loneliness of the Hakka elderly. Relevant interventions should be implemented in a targeted manner, focusing on susceptible populations. This is most evident among those who were female, living in rural areas, with parents both died, with lower education, and with multiple chronic diseases., Competing Interests: The authors declare that there are no potential conflicts of interest regarding the publication of this paper., (Copyright © 2022 Huajing Chang et al.)

Mental health for older people has become a major social concern. Literature has shown that older people, especially when they become empty nesters—when a parent lives alone or lives with his/her spouse after the youngest child leaves home—may start to develop various mental health problems due to reduced contacts with their children. Using fixed-effects, multivariate regression with a difference-in-differences approach and propensity score matching, this paper examines the relationship between being an empty nester and mental health among older people in China, and the moderating effects of social contact and contact with one's children in terms of mental health. Our data come from the China Health and Retirement Longitudinal Study of 2011, 2013, 2015 and 2018. We found that, in the short term, the mental health of older people may not be affected after they became empty nesters. But in the longer term, if they did not have regular contact with their children, their mental health would deteriorate with time. Social contact, especially cognitive activities, was beneficial to the mental health of the older empty nesters. We also found that for older empty nesters with disabilities, frequent social contact and contact with their children were more important. We urge the government to promote community-based social activities for older people, especially for those with functional limitations. [ABSTRACT FROM AUTHOR]

Purpose: Given its detrimental implications for employees' well-being and work performance, this paper seeks to understand how workplace loneliness occurs by focusing on a job-related antecedent, job autonomy. Drawing on role identity theory and situational strength theory, the purpose of this paper is to propose that job autonomy relates to workplace loneliness via perceived insider status, a process moderated by perceived clan culture. Design/methodology/approach: A two-wave survey served to collect data from 430 knowledge workers in 17 enterprises from several major cities in Eastern China. Findings: Job autonomy relates to workplace loneliness via the mediation of perceived insider status. Specifically, job autonomy impacts positively on perceived insider status, which further reduces workplace loneliness. Besides, the relationship between perceived insider status and workplace loneliness is conditional on perceived clan culture – perceived insider status decreases workplace loneliness more effectively in the case of higher perceived clan culture. Furthermore, perceived clan culture moderates the mediating effect of perceived insider status. Originality/value: This paper is among the few attempts to offer a comprehensive framework in which job and organizational characteristics combine to explain workplace loneliness. Moreover, the findings illustrate that perceived insider status and perceived clan culture complement each other in alleviating workplace loneliness. [ABSTRACT FROM AUTHOR]

At present, the dual pressure of rural labor outflow and population aging in China makes the problems of the rural elderly population increasingly prominent, and its health problem is particularly prominent. Based on the 2014 China elderly population health survey data (CLHLS), this paper finds that the physical health status of the rural elderly has a significant positive impact on their loneliness; that is, the rural elderly with poor health status are more likely to feel lonely. At the same time, the age of the elderly has a significant positive impact on their loneliness. On the contrary, gender, personality, family income and intergenerational support of the elderly have a negative impact on their loneliness. Chronic diseases such as hypertension and diabetes have no significant effect on the loneliness of the elderly in rural areas, but there is a "severe disease effect"; that is, when chronic diseases develop into serious diseases or acute serious diseases, it can negatively impact the elderly psychologically and produce or deepen their sense of loneliness. Based on the above conclusions, this paper further puts forward relevant policy suggestions from three aspects: constructing a disease prevention and control system for the rural elderly, improving the care and service system for the rural elderly, reshaping rural filial piety culture, and creating a good atmosphere of "respecting, loving and respecting parents" in rural areas.

Based on activity theory, this paper employed data from the 2013, 2015, and 2018 waves of the China Health and Retirement Longitudinal Survey, and adopted Hierarchical Linear Modeling and longitudinal mediation analysis to explore the temporal variation characteristics of loneliness and the influence of social participation on loneliness in Chinese Older Adults, as well as the mechanism of them. The study found that loneliness among older adults overall was at a moderate level from 2013 to 2018 and increased over time, which may be related to decreasing social participation from year to year. Decreased social participation was associated with increased loneliness over time (β = -0.060, p < 0.001) and lower social support (β = 0.109, p < 0.001), which was associated with more loneliness (β = -0.098, p < 0.001). In addition, social support played a significant mediating role in the realization of social participation in alleviating loneliness. Social participation can not only directly reduce loneliness, but also reduce loneliness by increasing social support.

Internet addiction among older adults is a new problem in many countries. However, previous studies on excessive Internet use have focused more on young people, and only few studies have focused on Internet addiction in older adults. There is a need to continue to expand research on Internet addiction in older adults. This paper aimed to fill the gap in exiting literature. We adopted a self-reported questionnaire to assess the elderly's interaction with children, loneliness, life satisfaction and Internet addiction among old adults. A total of 241 old people were obtained from data collection in China via online survey with the help of a professional research company. We used OLS regression analysis and bootstrap method to test the hypothesis. The results of the empirical analysis indicated that (1) interaction with children was significantly negatively associated with the Internet addiction of old people; (2) loneliness mediated the relationship between interaction with children and old adults' Internet addiction; and (3) life satisfaction moderated the effect of interaction with children, and the indirect effect between interaction with children and old adults' addiction via loneliness was stronger for those with low life satisfaction. Finally, we discussed the theoretical significance, practical implications, limitation of this research. Interventions to improve family function systems especially for older people with low life satisfaction can help prevent the development of Internet addiction. [ABSTRACT FROM AUTHOR]

With the latest, rapid developments of the Internet, young people have become the main group in the online world. Congruently, Internet problem behaviors have shown a significant growth trend among adolescents. The present paper explores the factors affecting adolescents' problem network behavior from the perspective of their shyness, gender, and loneliness, and provides suggestions for guiding these young people toward using the network rationally. The study surveyed 5,130 teenagers from Shandong province in China to investigate the moderating effect of gender on the relationship between shyness and problem network behavior, and the mediating effect of loneliness on the moderating effect. The results indicated that the level of shyness among girls was significantly higher than that among boys, whereas the prevalence of cyberbullying, pathological Internet use, and Internet gaming disorder was significantly lower for girls than for boys. The relationship among shyness, cyberbullying, and Internet gaming disorder was found to be moderated by gender, and the problems of cyberbullying and Internet gaming disorder faced by shy boys were greater than those faced by shy girls. In addition, the moderating effect of gender on cyberbullying and Internet gaming disorder was found to occur through the mediating factor of loneliness. The paper concludes with a discussion of the theoretical significance and generalizability of our research results. [ABSTRACT FROM AUTHOR]

Objectives: This paper reports on the first study in China that used nationally representative data to compare mental health and depressive feeling between empty-nest and non-empty-nest elderly people (over 60 years old), and examine whether the health disparities (if any) can be explained by differences in family, emotional, housework, and economic support. Methods: We used the 2010 China General Social Survey and multivariate regression models to examine mental health and depressive feeling of 556 non-empty-nest and 210 empty-nest elderly people in China. Results: After controlling for various socio-demographic characteristics, although the empty-nest elderly were significantly more likely to report depressive feeling and poor mental health than non-empty-nest elderly, the difference was only statistically significant for depressive feeling. Importantly, the disparity in both depressive feeling and mental health can be mediated by differences in family economic support and household economic pressure. Conclusions: Our results highlight the risks of depressive feeling arising from the empty-nest living arrangement of elderly people and suggest that a poorer economic situation may result from decreased mental health. Drawing upon these results, future public policies aimed at improving mental health of empty-nest elderly may need to be more targeted to improve their economic conditions such as ameliorating pension and social welfare system shortcomings.

INTRODUCTION Significant changes occurred in the way people socialize and interact with each other since China reported its first COVID-19 cases. However, little is known about how smoking behaviors may have changed due to the COVID-19 pandemic in China. The aim of this study was to assess changes in smoking behavior and intention to quit during the early stage of the COVID-19 pandemic in China and to investigate the associated factors. METHODS An online cross-sectional survey was conducted among Chinese adult smokers. Participants were recruited through snowball sampling from 19 March to 2 April 2020. RESULTS A total of 1388 smokers participated in this study. Of those, 1014 (73.0%) reported not changing their cigarette consumption, 104 (7.5%) reported smoking more and 268 (19.3%) reported smoking less due to the pandemic. Average daily cigarette consumption among all participants decreased from 15.0 (IQR: 10.0--20.0) to 13.0 (IQR: 8.0-20.0) (W=6.919, p<0.001). For intention to quit, 270 (19.5%) respondents reported becoming more willing to quit, and 91 (6.6%) reported becoming less willing to quit. Multivariate analyses showed that tobacco addiction, overall knowledge about the relationship between smoking and COVID-19, level of attention devoted to COVID-19, anxiety, living alone, and number of smokers in the family were significantly correlated with cigarette consumption and intention to quit, and living alone was the strongest factor associated with increased cigarette consumption (AOR=5.29; 95% CI: 1.51-18.56). CONCLUSIONS The COVID-19 pandemic led to a slight decrease in cigarette consumption and an increase in quitting intention among Chinese smokers. During the early stages of the pandemic, it was important to focus on the anxiety of smokers, dispel smokers' misunderstandings of smoking and COVID-19 and create a supporting environment in the family to help smokers quit. [ABSTRACT FROM AUTHOR]

The article discusses the concept of ageing in place (AIP), a policy tool used to encourage older adults to continue living independently in their home or neighbourhood. Topics include the various comorbidities that older adults living alone may experience, the different models used to manage comorbidities, and the current predicament of AIP programs in terms of different stakeholder demands.

Meaning in life has been posited to improve psychological well-being. People facing adversities can reduce psychological distress through pursuing a sense of purpose in life. However, the effectiveness of meaning in life in promoting psychological well-being has been found varied, and what factors may affect the function of meaning in life remain unclear. In this paper, the authors suggest that resilience, the positive adaptation during or following significant adversity, can strengthen the protective effects of meaning in life on psychological well-being. To test this hypothesis, we analyzed data from a sample of 518 vulnerable children of parents living with HIV about their meaning in life, resilience, depression, and loneliness. Results showed that resilience moderated the relationship between meaning in life and depression, and between meaning in life and loneliness. Meaning in life was associated with lower levels of depression and loneliness among children high in resilience, in comparison to children low in resilience. Future interventions targeting meaning in life and well-being should consider children's resilience, which can allow for better individualization of the treatment. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic emphasized the importance of public spaces. Accessing public spaces during the pandemic improves physical health, reduces feelings of loneliness, and lessens depression. However, not all public spaces can provide an effective response during the pandemic. The public spaces' ability to respond to the pandemic varies depending on their resilience level, which refers to the capability of those spaces to adapt to the challenges posed by the COVID-19 pandemic and maintain functionality to meet users' needs during this crisis. By investigating the response of existing public spaces to the COVID-19 pandemic and identifying and examining the criteria of pandemic resilience, this study aims to explore and improve public spaces' capability to respond effectively during the pandemic. One hundred and sixty nine public spaces in three regions in Chongqing City in China are studied. Four main criteria involving 9 sub-criteria of pandemic resilience that can be integrated into public spaces' planning and design are studied. Three questionnaire surveys are used in this study to examine how public spaces adapt to the pandemic and evaluate the pandemic resilience criteria. The questionnaire data is analyzed using the Statistical Package for Social Sciences (SPSS) software. The pandemic resilience criteria are assessed and analyzed using a Geographic Information System (GIS). The study utilized the analytic hierarchy process (AHP) to assign weights to the criteria of pandemic resilience. Weighted overlay analysis (WOA) is applied to assess the pandemic resilience level in public spaces. Results indicate various possibilities for pandemic resilience depending on the characteristics of the area. However, these resilience levels are inadequate to respond effectively to the pandemic, resulting in diminished utilization of public spaces during the COVID-19 pandemic across all studied regions compared to the periods preceding the pandemic and after the complete reopening. This study presents a remarkable source for strengthening the resilience of cities against pandemic emergencies. [ABSTRACT FROM AUTHOR]

In the context of the epidemic, the daily routines of China's elderly populace underwent substantial transformations. The implementation of home-based pandemic containment strategies led to heightened levels of social isolation and loneliness, exerting a discernible influence on the subjective well-being of this demographic. Consequently, residing in retirement apartments has emerged as a more advantageous alternative for elderly individuals capable of self-care. To meet their life and emotional needs and improve their sense of well-being, we used the KANO model to design a health management app for the self-care of older persons. We summarised the functional requirements for the self-care of elderly people, distributed questionnaires to generate a list of requirements, and conducted data analysis. We optimised the low-fidelity prototype based on the usability test results combined with relevant interface design elements to implement emotional interaction design practices for older persons' self-care. Furthermore, we completed a design evaluation and program optimisation of the design practice to guide the final visual design. The research findings identify the core principles of interactive design for elderly users to enable visual design specifications for improving the lives of the elderly population. This research highlights the need to design more appropriate products that meet demographic characteristics. This work contributes to strengthening the connection between elderly people and society while bridging the 'digital divide' based on this population's cautious approach to technologies and declining abilities to learn. [ABSTRACT FROM AUTHOR]

Background: Loneliness is a negative emotional state that can lead to physical and mental health problems. This study's objective was to acquire an in-depth understanding of the heterogeneity and the predictors of loneliness among older adults in rural China and provide valuable references for practical interventions. Methods: Older rural adults in China (N = 680) were recruited between January and April 2023. Latent profile analysis (LPA) was employed to identify subgroups of loneliness among participants. Single-factor and multinomial logistic regression analyses were conducted to investigate predictors of loneliness. Results: The loneliness of rural older adults could be divided into three subgroups: low interaction loneliness group (55.0%), moderate emotional loneliness group (31.8%), and high loneliness group (13.2%). The subgroup predictors included age, gender, religious beliefs, marital status, living alone, number of chronic diseases, and smartphone use (P < 0.05). Conclusion: This study identified a classification pattern for loneliness among older adults in rural areas of China, revealed the characteristics of different demographic variables in loneliness categories, and highlighted the heterogeneity of loneliness in this population. It serves as a theoretical reference for formulating intervention plans aimed at addressing various loneliness categories for local rural older adults. Clinical trial registration: ChiCTR2300071591. [ABSTRACT FROM AUTHOR]

Background: This study examined the relationship between loneliness and bedtime procrastination among Chinese university students, the mediating effects of COVID-19 risk perception and self-regulatory fatigue, and connectedness to nature's protective role, post pandemic. Methods: We recruited 855 students to complete the Loneliness, Perceived Risk of COVID-19 Pandemic, Self-Regulatory Fatigue, Bedtime Procrastination, and Connectedness to Nature Scales. Data for descriptive statistics, correlation analysis, and moderated chain mediation effects were analyzed using SPSS 24.0 and process 3.5 macros. Results: Loneliness positively correlated with bedtime procrastination, COVID-19 risk perception mediated the impact of loneliness on bedtime procrastination, self-regulatory fatigue mediated the effect of loneliness on bedtime procrastination, and COVID-19 risk perception and self-regulatory fatigue mediated the effect between loneliness and bedtime procrastination. Furthermore, connectedness to nature mediated the impact of COVID-19 risk perception on self-regulatory fatigue. Conclusions: The results indicate the effects and potential mechanisms of loneliness on bedtime procrastination after the relaxation of the pandemic prevention and control policy in China from the perspective of self-regulatory resources and provide insights into improving university students' sleep routine and mental health post pandemic. [ABSTRACT FROM AUTHOR]

Background: Uncomplicated urinary tract infections (uUTIs) are one of the most common community-acquired infections, particularly among women. Common symptoms of UTI include dysuria, urinary urgency and increased frequency, and lower abdominal pain. With appropriate treatment, symptoms may resolve in a few days. However, there is a lack of research on the emotional impact of this disease. We conducted a qualitative, interview-based study to gain a greater understanding of the emotional impact of uUTIs in women in China and Japan. Methods: A qualitative, exploratory, in-depth, interview-based study was conducted between 19 November 2020 and 25 February 2021. Women aged ≥ 18 years who experienced ≥ 1 uUTI and received antibiotic treatment in the past year were eligible for inclusion. Participants must have experienced ≥ 1 of the following symptoms during a uUTI episode: urinary urgency, frequency, dysuria, or lower abdominal/suprapubic pain. Participants who reported back pain or fever (indicative of complicated UTI) were excluded. Participants with recurrent or sporadic UTIs were included, with specific screening criteria used to ensure capture of both groups. Following a screening call, a structured, in-depth telephone interview (~ 30 min in duration) was conducted by three female external moderators trained in qualitative interviewing, assisted by an interview guide. Interviews were analysed individually and thematically, with the results presented within the identified themes. Results: A total of 65 women with uUTI completed the in-depth telephone interview: 40 (62%) from China and 25 (38%) from Japan. Participants reported that the symptoms of uUTI affected multiple aspects of their lives, and described feelings of embarrassment, frustration, guilt, dread, and loneliness associated with symptoms that interfered with relationships, work and daily activities, and sleep. Participants reported seeking healthcare from several different points of contact, from local pharmacies to hospitals. Conclusions: Our analysis highlights the profound emotional impact of uUTIs in women in China and Japan, and the journey these participants take before their initial interaction with a healthcare professional. These insights emphasise the need to better understand the full impact of uUTI, and the role of healthcare professionals in improved patient education and support. [ABSTRACT FROM AUTHOR]

Introduction: In recent years, fear of disease progression (FoP) has become one of the most common psychological problems in cancer patients. However, there are fewer studies on the FoP in patients with gastrointestinal tumors. We aimed to assess the level of FoP in patients with gastrointestinal tumors and analyze the factors related to FoP. We also aimed to examine the relationship among loneliness, hope and FoP in patients with gastrointestinal cancer. Methods: A cross-sectional survey was conducted on three Grade A hospitals in southwestern China from November 2021 to July 2022. The demographic and clinical characteristics questionnaire, Fear of Disease Progression Scale (FoP-QSF), Cancer Loneliness Scale (CLS), and Herth Hope Index (HHI) were included in this study. Data analysis included descriptive statistics, independent samples t-tests, one-way analysis of variance, and multiple linear regression analysis. Results: In total, 245 gastrointestinal cancer patients participated in this study. The average (standard deviation) FoP score in patients was 32.94 ± 10.64. In total, 245 gastrointestinal cancer patients participated in this study. The average (standard deviation) FoP score in patients was 32.94 ± 10.64. The average score of CLS was 17.65 ± 6.71, and that for the HHI was 31.27 ± 7.73. Pearson correlation analysis showed that FoP was negatively significant correlated with hope level (r = -0.522) and FoP was positively significant correlated with loneliness (r = 0.545). Linear regression analysis showed that educational level, age, living condition, hope, and loneliness were the significant predictors of FoP and explained 53.10% of the variability in FoP (F = 16.372). Conclusion: Findings highlight the need to strengthen attention to FoP in gastrointestinal cancer patients. Our study showed that gastrointestinal cancer patients who have a high school education, are age 45 to 59, live alone, high level of loneliness, and low level of hope have higher FoP. Medical staff should enhance clinical screening of FoP and consider the formulation of relevant interventions for high-risk groups to reduce loneliness among patients, raise their hope level, and reduce their FoP. [ABSTRACT FROM AUTHOR]

In 2022, COVID-19 continued to spread across the globe, and to stop the spread of the virus and protect people's health, universities across China continued to remain in a lockdown state. Loneliness is an important topic among college students, and the coronavirus pandemic has exacerbated loneliness. This prolonged school lockdown was unprecedented and it caused severe social isolation and emotional loneliness for students. Few people know how nursing students experience loneliness and find a way through their experience. This qualitative phenomenological study was conducted to reveal the lived experiences of nursing students who indicated COVID-19 lockdown-related loneliness in a previous quantitative survey. We performed 20 semi-structured interviews with nursing students aged 19–23 yrs during their lockdown (April 2022 to June 2022). Our research applied Colaizzi's seven-step data analysis processes to reveal shared patterns in terms of how nursing students experienced lockdown and found the following four themes: emotional challenges associated with loneliness; causes of loneliness; positive and negative motivation to learn; and accepting solitude and reconstructing real life. [ABSTRACT FROM AUTHOR]

Researchers have increasingly concentrated on loneliness in the workplace as a crucial factor influencing the mental health of employees and the viability of telework. In contrast, the current understanding of the strategies mitigating workplace loneliness and how leaders utilize their behaviors to impact followers' loneliness remains limited. Since servant leadership values the emotional needs of followers and displays a high level of empathy, this study investigated the direct and indirect effects of servant leadership on workplace loneliness. In this study, 267 employees (mean age = 31.5 years) from 28 provinces in China were recruited to participate in this survey. We proposed that servant leaders motivate their own empathic communication and other followers' empathic communication to reduce lonely followers' workplace loneliness. This research further examined the relationship between the leader's and colleagues' empathic communication, and the two jointly mediate the connection between servant leadership and followers' workplace loneliness. We constructed a serial mediation model to examine the relationships between servant leadership, leader's empathic communication, colleagues' empathic communication, and workplace loneliness. The results indicate that servant leadership creates a cycle of empathy and provides insights into building a culture of empathy to improve employee well-being. [ABSTRACT FROM AUTHOR]

Loneliness is a serious problem for older people, which can be alleviated by social support. The dramatic population ageing together with social and economic change in China increases the likelihood of loneliness and the availability of different sources of social support of older people. The aim of this review was to identify the prevalence of loneliness and its related factors and sources of social support of older people in China. Electronic literature searches were conducted in September 2011 using Web of Science, PsycINFO, MEDLINE, PubMed, CINAHL, China Academic Journal and VIP Database for Chinese Technical Periodicals. Twenty-six papers were identified and reviewed. The prevalence of loneliness varied across the studies, reflecting the different measurements and samples. Marital status, gender, age, educational level, economic level, living arrangements, health status and social support were significant factors related to loneliness. The family was the most important source of social support followed by friends. The receipt of family support improved subjective well-being and mental health, but the effects of support from friends were inconsistent. Chinese older people received relatively little support from neighbours, governmental or other social organisations. Further well-designed studies are needed to identify additional factors related to loneliness and to understand the support from friends, neighbours, formal organisations and other sources., (© 2013 John Wiley & Sons Ltd.)

Background: Several studies show the relationship between self-esteem and stigma perception and also between self-esteem and social alienation, but none sufficiently analyze the relationship between stigma perception and social alienation of people with disability., Objective/hypothesis: The primary aim of this paper is to investigate the mediator and moderator effects of self-esteem on the relationship between stigma perception and social alienation of people with disability., Methods: The participants were 129 adults with disability (80 males and 49 females) from eight communities in China. Data was collected by using the stigma perception scale, self-esteem scale, social avoidance scale, social anxiety subscale of the self-consciousness scale, and loneliness scale. Each item is rated on a 5-point scale (1 = "strongly disagree" to 5 = "strongly agree")., Results: Stigma perception was positively correlated with social avoidance (p < 0.001), social anxiety (p < 0.001), and loneliness (p < 0.001). Self-esteem was inversely correlated with social avoidance (p < 0.001), social anxiety (p < 0.001), loneliness (p < 0.001), and stigma perception (p < 0.001)., Conclusions: Self-esteem partially mediated the relationship between stigma perception and social avoidance, social anxiety and loneliness. Moreover, self-esteem moderated the relationship between stigma perception and social avoidance, but not on social anxiety and loneliness., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Teachers are considered to be one of the most important influences in the lives of students. Teachers' assessments of students may be a primary source of information on children's mental and behavioral health; however, this topic has received little attention in research. We examined this issue through linking teachers' ratings of students and mental and behavioral outcomes of children affected by HIV. The hypothesis is that teacher ratings will be predictive of specific child mental and behavioral health outcomes. A quantitative cross-sectional design with self-administered paper-and-pencil instruments was used. The sample included 1221 children (aged 6–18, grades 1–11) affected by HIV including 755 orphans who lost one or both parents to AIDS and 466 vulnerable children living with HIV-infected parents in a central province of China. The corresponding teacher sample included 185 participants. Each child completed an assessment inventory of demographic information and mental and behavioral health measures. Teachers completed a questionnaire about children's school performance. SEM analyses revealed a good model fit according to all fit indices: comparative fit index = 0.93, root mean square error of approximation = 0.07, and standardized root mean square residual = 0.04. Structural equation modeling revealed that problem ratings by teachers were positively associated with child loneliness and behavioral problems, social competence ratings by teachers were negatively related to child depression, and personal growth and social interaction ratings by teachers were negatively related to child loneliness, depression, and trauma. The current study represents a unique contribution to the field in that it recognizes that teachers can be a valuable source of information on children's psychological health. Results from this study have implications for health prevention and intervention for children and families suffering from HIV/AIDS. [ABSTRACT FROM AUTHOR]

Despite increasing awareness of mental health problems among older adults, limited mental health services are available to meet their needs. The proposed study aimed to evaluate the need for mental health services among older adults in Shanghai, China, and identify gaps in the existing service system to inform policy making. Based on 80 face-to-face interviews amongst several groups of older adults and community officers, doctors and government stakeholders, the study found that (a) the mental health needs of older adults living with family members mainly present as needs for social interaction, sense of belonging, and self-realization; (b) special groups, such as older adults living alone, mainly desire support to address loneliness, older adults with physical disabilities desire social respect, and those with mental disabilities seek social acceptance; and (c) community cadres and other stakeholders have paid little attention to demands related to mental well-being among older people. It is necessary to deliver mental health education to community stakeholders and the public, popularize mental health knowledge, and publicize professional psychological counseling and treatment services. Meanwhile, policy makers should allocate resources to train professional mental health services personnel to meet these growing mental health needs and increase financial support for mental health services for older adults. [ABSTRACT FROM AUTHOR]

It has become a significant issue that an increasing number of adolescents are addicted to mobile phones. From the perspective of social comparison theory, this study aims to explore the relationship between benign envy/malicious envy and mobile phone addiction, as well as the role of loneliness and self-control in it. A total of 1951 valid samples were collected from primary and middle schools in China. The research showed that benign envy (malicious envy) could negatively (positively) predict mobile phone addiction. Meanwhile, self-control played as a mediator between benign envy/malicious envy and mobile phone addiction, while loneliness had no significant mediating effect. In addition, benign envy/malicious envy influenced mobile phone addiction by the chain mediation of "loneliness → self-control." For the first time, this study reveals the effects of benign envy and malicious envy on mobile phone addiction and the internal mechanisms from the perspective of social comparison theory, offering illuminations for the prevention of mobile phone addiction. [ABSTRACT FROM AUTHOR]

There is little empirical data on the heightened risk of loneliness among individuals residing in the COVID-19 epicenter or those who have recently left. This study compared the risk of loneliness in individuals residing in Wuhan, the COVID-19 epicenter in China, and those who had recently left during the initial outbreak period to those living in non-epicenter regions. During the COVID-19 outbreak in China in 2020, three samples were obtained using snowball sampling. The samples included 2882 epicenter residents, 1028 left residents, and 2963 non-epicenter residents. Loneliness was assessed using the six-item De Jong Gierveld Loneliness Scale, with a score of two or more indicating the presence of loneliness. 53.5% and 55.2% of epicenter and recently left residents, respectively, experienced loneliness, which was significantly higher than the 43.9% observed in non-epicenter residents. After adjusting for covariates, the risk of loneliness remained statistically significant for both epicenter and left residents (OR = 1.35, P < 0.001 and OR = 1.20, P = 0.017, respectively), when compared to non-epicenter residents. Individuals residing in the COVID-19 epicenter, as well as those who have recently left, are at a heightened risk of loneliness during the outbreak. These individuals need psychosocial support to mitigate their risk of loneliness and promote their psychological wellbeing. [ABSTRACT FROM AUTHOR]

Background: Following China's strategy of developing applied and compound social talents, vocational undergraduates are surging rapidly, and it is essential to understand the causes of their depression to effectively prevent and intervene in schools. Objective: We aimed to investigate the relationship between negative life events (NLEs) and depression among vocational undergraduates in China, along with the mediating role of loneliness and the moderating role of socioeconomic status (SES). Methods: A convenience sample survey was conducted at a vocational education university (N = 1487), and analyzed using partial least squares structural equation modeling. Results: Findings showed that NLEs directly predicted depression (β = 0.399, 95% CI [0.339, 0.452], p < 0.001) among vocational undergraduates. Furthermore, this relationship was partially mediated by loneliness (β = 0.182, 95% CI [0.145, 221], p < 0.001); SES moderated the link between NLEs and depression (β = 0.051, 95% CI [0.004, 092], p < 0.05), but not between NLEs and loneliness (p > 0.05). Conclusions: The current study highlights the impact of NLEs on depression among vocational undergraduates, indicating the importance of addressing NLEs and consequent feelings of loneliness to promote mental health. In addition, the moderating role of SES underscores the necessity of targeted interventions to mitigate the impact of NLEs on depression. The present study contributes to our understanding of the unique characteristics of depression in vocational undergraduates and has practical implications for psychological support services. Moreover, it probably has broader implications for addressing mental health challenges in global education settings for vocational undergraduates. [ABSTRACT FROM AUTHOR]

Compared with the many studies in western countries, research on the prevalence of and risk factors for loneliness amongst older people in China is sparse. This paper reviews the current cross-national literature on loneliness and, using data from two national surveys undertaken in 1992 and 2000, assesses the prevalence of loneliness amongst older people in China and explores the factors that raise their vulnerability to the negative feeling. The reported prevalence of loneliness was 15.6 per cent in 1992 and 29.6 per cent in 2000. We suggest that part of the differential is accounted for by the differences in the methodologies of the two surveys and in the questions used to assess loneliness. The evidence from both surveys suggests that loneliness was relatively prevalent among those aged 65 or more years, females and those living in rural areas, and that these variations had greater amplitude in 2000. As in western countries, increased age, being widowed or divorced, and poor self-rated health were significantly associated with old-age loneliness in China at the two dates. Two factors positively related to loneliness were found that are specific to the Chinese context, however: living in a rural (as opposed to urban) area, and thinking that one's children are not filial. To develop our understanding of loneliness among older people in China and other non-western countries, it will be necessary to construct more rigorous and comparable measurements of loneliness and to undertake longitudinal studies of social relationships. [ABSTRACT FROM AUTHOR]

Smoking is a major public health problem in most countries and usually occurs in marginalized groups. Analyzing the smoking behavior of migrant workers, a marginalized group in China, is of practical significance. Using panel data from the China Health and Retirement Longitudinal Study (CHARLS) database from 2013 to 2018, this study examined influence factors of smoking behavior (whether to smoke and smoking frequency) among migrant workers in China through the Heckman two-stage model. The results showed that the smoking rates of migrant workers were positively associated with social activity and a sense of loneliness, while smoking frequency was negatively associated with work stress and life satisfaction. Meanwhile, smoking behavior was associated with the demographic variables such as gender, age, and education level. Gender differences in smoking behavior were particularly notable among Chinese migrant workers. Furthermore, there was regional heterogeneity in smoking behavior among migrant workers. Smoking behavior in the eastern region was mainly influenced by psychological factors of wellbeing, such as social activity and life satisfaction, while it was affected by material conditions such as income in the central-western region. Effective strategies to control tobacco use among migrant workers are proposed in order to promote social integration between urban and rural residents, increase vocational education and training, and strengthen anti-smoking propaganda among migrant workers. [ABSTRACT FROM AUTHOR]

This study examines the effects of own and spousal health on transitions in loneliness over time among married middle-aged and older adults in China, and explores the possible gender differences in these effects using data from the three waves of the China Health and Retirement Longitudinal Study (2011–2015). The sample includes 6,422 men and 6,391 women who were married and aged 45 and older at the baseline survey. Middle-aged and older adults with poorer physical and emotional health statuses are more likely to transition into and less likely to transition out of loneliness in a two-year period. Spouse's emotional health also affects both types of transition in loneliness and spouse's functional limitation affects transition into loneliness through spouse's emotional health. In addition, for married men, their own functional limitation is significantly associated with their transitions into and out of loneliness. For married women, their spouse's functional limitation is significantly associated with their transition into loneliness and this is mainly through its association with spouse's emotional health. Also, for married women, their spouse's emotional health is significantly associated with their transition out of loneliness. Social interventions to reduce feelings of loneliness need to take a couple approach and consider both spouses' health problems and how they may affect their daily activities and their interactions with each other and with others. [ABSTRACT FROM AUTHOR]

Objectives: The present study examined the moderating effects of family social capital on the relationship between community social capital and loneliness among older adults in urban Chinese communities during the COVID-19 outbreak period between January and March 2020.Method: We used quota sampling to recruit 472 community-dwelling older adults aged 60 years or older. A multiple-group analysis was applied to examine the proposed hypotheses.Results: Community-based cognitive social capital was significantly associated with both social and emotional loneliness among older adults with relatively low levels of family social capital. However, these associations were statistically nonsignificant among those with high family social capital levels. Community-based structural social capital was not associated with loneliness in either family social capital group.Conclusion: The findings highlight the role of cognitive social capital in reducing loneliness and support community social capital replacement theory in explaining the mechanism linking social capital to loneliness in later life in the context of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Objective: Non-suicidal self-injury (NSSI) behaviors are prevalent in adolescents and have adverse effects on physical and mental health. However, little is known about the relationship between NSSI and alexithymia, or the underlying mechanisms that could explain this relationship. This study aimed to elucidate the current status of NSSI in adolescent depression, and analyze the relationship between alexithymia, loneliness, resilience, and adolescent depression with NSSI, so as to provide a theoretical basis for psychotherapeutic interventions. Method: The study sample involved inpatients and outpatients from 12 hospitals across China and adolescents with depression who met the DSM-5 diagnostic criteria for depression episode. The following scales were used: The Functional Assessment of Self-Mutilation, Toronto Alexithymia Scale, UCLA Loneliness Scale, and Connor Davidson Resilience Scale. Results: The detection rate of NSSI in adolescents with depression from 2021.01.01-2022.01.01 was 76.06% (1782/2343). Spearman's correlation analysis revealed a significant correlation between alexithymia, loneliness, resilience and NSSI in depressed adolescents, and the results of the non-parametric test showed that the differences between the two groups for each factor were statistically significant. Binary logistic regression results showed that alexithymia (B = 0.023, p = 0.003, OR = 1.023, 95% CI: 1.008–1.038) and depression (B = 0.045, p < 0.001, OR = 1.046, 95% CI: 1.026–1.066) are risk factors for NSSI, resilience (B = − 0.052, p < 0.001, OR = 0.949, 95% CI: 0.935 − 0.964) is a protective factor for NSSI. Alexithymia directly predicted NSSI and also indirectly influenced NSSI through the mediated effect of resilience. Loneliness moderates the first half of the path of this mediated model. Conclusion: The present study confirms a moderated mediation effect: Alexithymia can have an impact on NSSI behaviors in depressed adolescents through the mediating role of resilience. Loneliness, as a moderating variable, moderated the first half of the pathway of the mediating model. We discuss perspectives for future research and interventions based on the findings of the study. [ABSTRACT FROM AUTHOR]

Background: Alexithymia is common and causes serious harm to people living with HIV/AIDS. Therefore, this study aimed to examine its prevalence and associated factors among people living with HIV/AIDS in China. Methods: A cross-sectional study was conducted in two designated AIDS medical institutions in Harbin, China between January and December 2019. In total, 767 participants completed the 20-item Toronto Alexithymia Scale, the University of California Los Angeles Loneliness short-form, the Patient Health Questionnaire-9, the HIV Treatment Regimen Fatigue Scale, and the Alcohol Use Disorders Identification Test‐Consumption. The participants responded to several questions regarding their demographic characteristics, life satisfaction, disease-related economic burden, and their antiretroviral therapy (ART) side effects. Multivariate logistic regression assessed the relationship between alexithymia and associated factors. Odds ratios (OR) and 95% confidence intervals (CI) for OR were calculated. Results: Approximately 36.1% of the participants were classified as having alexithymia. After adjusted age and education, the logistic regression model indicated that disease-related economic burden (OR = 1.477, 95% CI = 1.155–1.888), ART side effects (OR = 1.249, 95% CI = 1.001–1.559), loneliness (OR = 1.166, 95% CI = 1.101–1.236), and HIV treatment regimen fatigue (OR = 1.028, 95% CI = 1.017–1.039) were positively associated with alexithymia. Conclusions: The mental health problems of people living with HIV/AIDS are essential to understand and deserve attention. Disease-related economic burdens are major associated factors. Multiple actors should provide better services and guarantees for patients. [ABSTRACT FROM AUTHOR]

Background: This study aimed to explore whether and how self-rated health, depression and functional ability interactively associated with loneliness using a sample group of older adults residing in China rural communities. Methods: Data on socio-demographic information, self-rated health, depressive symptoms, functional ability and loneliness (quantified via a single question) were collected from 1009 participants. Cross-tabulations with chi-square test, bivariate correlations, and Classification and Regression Tree (CART) models were employed for analysis. Results: We found that 45.1% of the participants were classified as lonely. Our results gain insight into the hierarchical order of predictors for the presence of loneliness, suggesting that there was a significant interaction between functional ability and depressive symptoms while self-rated health was not a significant factor. The probability of loneliness increased with the combination of limited functional ability and depression, and varied with different interaction of functional ability, depressive symptoms, and marital status, respectively. Notably, while there were some differences, similar associations were observed among older male and female respondents. Conclusion: To delay or reduce loneliness, early detection which focuses on older people who report limitations in functional ability, depression, and being female, offers opportunities to start early interventions. Our findings might be helpful not only in designing and implementing loneliness prevention programs but also in improving healthcare for older rural community-dwelling people. [ABSTRACT FROM AUTHOR]

Aims and objective: To synthesise current international empirical evidence on loneliness and social isolation in Chinese late‐life immigrants. Background: Loneliness causes adverse health consequences in Chinese late‐life immigrants leading to increased utilisation of often increasingly limited healthcare resources. However, little is known about how Chinese late‐life immigrants perceive and experience loneliness and social isolation in their host countries. Design: An integrative review methodology. Methods: Using a systematic search strategy, Google scholar and databases, such as Scopus, Web of Science, PubMed, CHNAHL, Medline and open access Theses were searched. No limitation was placed on publication date. Peer‐reviewed studies published from the database inception to May 6, 2021 in the English language were included. The review process is reported according to PRISMA. Results: Eight articles met the criteria and were included in this review. Two themes resulting from the data synthesis process were identified. Firstly, 'disrupted social relations after late‐life immigration' and secondly 'moving away from filial expectations'. Conclusion: Loneliness and social isolation are commonly experienced by Chinese late‐life immigrants when residing in host countries. Understanding and identification of the sources of loneliness and social isolation among late‐life immigrants are essential prompts for healthcare professionals, particularly nurses, to engage sensitively with Chinese late‐life immigrants. Nurses culturally relevant care delivery in a variety of settings may best serve recipients' social and health related needs. Relevance to clinical practice: This integrated review informs the planning of health and social services for addressing Chinese late‐life immigrants' experiences of loneliness and social isolation. Focused attention on cultural responsiveness is an important component of providing quality and safe nursing care. This review of the recent evidence on socially‐rooted health concerns affected by both immigration and ageing will help advance nursing practice in providing culturally responsive care interventions. [ABSTRACT FROM AUTHOR]

Background: Insomnia has become an important issue in recent years. Insomnia is affected by many factors. Previous research has shown that during the COVID-19 pandemic, there would be a long-term negative effect on the mental health of medical college students. The state of medical college students' insomnia directly determines the results of medical education and the career development prospects of the medical students themselves. Therefore, it is very important to understand the insomnia situation of medical students in the post-epidemic era. Methods: This study was conducted 2 years after the global COVID-19 pandemic (April 1-April 23, 2022). The study used an online questionnaire, administered through a web-based survey platform. The Athens Insomnia Scale (AIS), Fear of COVID‐19 Scale (FCV-19S), GAD-2, PHQ-2, and socio-demographic information were surveyed by the Questionnaire Star platform. Results: The prevalence of insomnia was 27.80% (636/2289). Grade(P < 0.05), age(P < 0.001), loneliness(P < 0.001), depression(P < 0.001), anxiety(P < 0.001), fear of COVID-19 was highly correlated with insomnia (P < 0.001). Adapting to online class(P < 0.001) was a protective factor of smartphone addiction. Conclusions: This survey shows that Insomnia was highly prevalent among the Chinese medical college students during the COVID-19 pandemic. Governments and schools should through psychological interventions to address the current situation of insomnia among medical students, and formulate targeted programs and strategies to reduce their psychological problems. [ABSTRACT FROM AUTHOR]

This study aimed to examine the mediating role of social capital in the association between perceived physical neighborhood environment and loneliness among older adults in urban China. Data were derived from face-to-face interviews with people (n = 472) aged 60 or older in urban communities of Shanghai, China, in 2020. Loneliness was measured by the 6-item De Jong Gierveld Scale. A multiple mediator model was adopted to examine the research hypotheses. Cognitive social capital played a full mediation role in the association between perceived community health care (β = −.061, p <.05), safety (β = −.168, p <.001), recreational services (β = −.058, p <.05), and loneliness. Structural social capital was associated with loneliness (β = −.102, p <.05), whereas its mediator effect was not significant. Perceived transportation convenience had neither a direct nor an indirect effect on loneliness among older adults. Findings indicate that older adults' perceptions of healthcare services, safety, and recreational resources could help alleviate their loneliness via fostering cognitive social capital. Interventions improving older adults' perceptions of community health care, safety, and recreation, and their social capital level could help reduce the prevalence of loneliness. [ABSTRACT FROM AUTHOR]

This study used a cross-sectional study design to investigate whether the mindfulness trait was a protective factor against problematic smartphone use (PSPU) of early adolescents, and whether negative affectivity and fear of missing out (FoMO) mediated this relationship. The study selected a sample of middle school students (N = 517, 46.03% males, Mage = 13.81, SD = 1.40) in China. The results of the structural equation modelling indicated that (a) mindfulness significantly and negatively predicted PSPU, (b) FoMO played a mediating role between mindfulness and PSPU, (c) negative affectivity (including depression and anxiety) played a mediating role between mindfulness and PSPU, but loneliness did not, and (d) negative affectivity and FoMO played a chain-mediated role, and depression, anxiety, and loneliness played a chain-mediated role with FoMO between mindfulness and PSPU. We discuss the possibility that high levels of mindfulness in early adolescents may reduce the short-term effects of problematic smartphone use by reducing negative emotions and FoMO and relate our results to an emphasis on the role of enhanced mindfulness in long-term internal self-regulation and well-being. Findings have implications for individuals and schools for PSPU prevention and intervention. [ABSTRACT FROM AUTHOR]

This study aims to examine whether adverse childhood experiences (ACEs) are associated with oral health conditions (denture use, difficulty in chewing, and edentulism) among middle-aged and older adults in China and if gender and adulthood education moderate the associations. Data were obtained from the 2014 and 2018 surveys from the China Health and Retirement Longitudinal Study (N = 17,091) and logistic regressions were carried out. Results show that childhood hunger (OR = 1.12), loneliness (OR = 1.10) and family relations (OR = 1.07) were significantly associated with higher odds of denture use and there were significant associations between hunger (OR = 1.16) and difficulty in chewing. For the female subsample, education significantly moderated the adverse effect of childhood hunger on denture use and difficulty in chewing. Findings suggest that ACEs have long-lasting impacts on oral health conditions in later life and adulthood education might offer critical resources for females, helping them buffer the detrimental health impacts of ACEs. [ABSTRACT FROM AUTHOR]

Objective: To map the current research status and understand existing findings regarding end-of-life care needs in Mainland China. Method: First-hand, empirical studies on the needs of dying patients and/or their families in Mainland China were searched in Web of Science, Scopus, Proquest, Taylor & Francis Online and CNKI in December 2019. Findings were synthesized. Results: A total of 33 (10 qualitative) studies were involved. Chinese dying patients and their families had physical, psychological, social, and spiritual needs and needs for knowledge and information. Prevalent needs of dying patients were mainly symptom control and decent look, being treated kindly by professional caregivers, family accompany, dignity, and comfortable environment. Families mainly need healthcare professionals to take good care of patients and wishes for information, knowledge, and facilities to help themselves become better caregivers. Conclusions: Findings lay the foundation for effective and tailored services for Chinese clients and provided insights for future investigations. [ABSTRACT FROM AUTHOR]

Background The coronavirus disease 2019 (COVID-19) pandemic has presented numerous challenges to public health, including the emergence of subjective dry eye symptoms among individuals. However, there is currently a dearth of comprehensive knowledge regarding the associated factors with subjective dry eye symptoms in the general population. Methods A nationwide survey in China was carried out from 20 June to 31 August 2022, involving 21 916 participants. Subjective dry eye symptoms were assessed using the Ocular Surface Disease Index-6. We employed random forest classification to select potential associated factors based on the socioecological model. We also conducted univariate and multivariable logistic regression analyses to explore the factors associated with subjective dry eye symptoms. Network analyses were employed to explore the network structure of subjective dry eye symptoms and associated factors. Results The item "watching TV (or similar task)" displayed the highest node strength and exhibited the highest predictability within the network. The results of the multivariate logistic regression analysis demonstrated significant associations between subjective dry eye symptoms and several factors, including loneliness (odds ratio (OR) = 1.29; 95% confidence interval (CI) = 1.26 to 1.32), problematic Internet use (OR = 1.08; 95% CI = 1.08 to 1.09), family communication (OR = 1.01; 95% CI = 1.00 to 1.01), the presence of depression (OR = 1.53; 95% CI = 1.39 to 1.68) and anxiety (OR = 1.31; 95% CI = 1.17 to 1.47) symptoms, older age (OR = 1.01; 95% CI = 1.01 to 1.01), self-rated health status (OR = 0.99; 95% CI = 0.98 to 0.99), family health (OR = 0.97; 95% CI = 0.96 to 0.97), health literacy (OR = 0.98; 95% CI = 0.97 to 0.99) and the agreeableness personality trait (OR = 0.97; 95% CI = 0.95 to 0.99). Conclusions These findings have important implications for public health interventions targeting the prevention and management of subjective dry eye symptoms in the general population. Strategies addressing individual risk factors and supporting psychological well-being may prove beneficial in mitigating the burden associated with subjective dry eye symptoms. [ABSTRACT FROM AUTHOR]