Search

BackgroundWellbeing of healthcare workers is crucial for the effective functioning of primary health systems. This study aimed to examine the association between occupational stress and subclinical depression among primary healthcare workers, and to establish the foundation for future preventive strategies.MethodsA cross-sectional study was conducted in Tai’an City, Shandong Province, China. Data were collected from 832 medical staff in primary health institutions using a structured self-administered questionnaire. The participants completed the Challenge and Hindrance-Related Self-Reported Stress (C-HSS) Scale and Patient Health Questionnaire-9. Multivariable logistic regression analysis was conducted to explore the relationship between occupational stress and subclinical depression among primary healthcare workers.ResultsThe prevalence of subclinical depression among primary healthcare workers was 11.66%. Participants with subclinical depression have a significant higher level of occupational stress (including challenge-stress and hindrance-stress). Regression analysis result indicated that higher level of occupational stress was significantly associated with more severe subclinical depression, and the risk of subclinical depression remained after adjusting other covariates (OR = 4.57, 95%CI, 3.14–6.63). The association between challenge-stress and subclinical depression was not statistically significant when controlling for hindrance-stress. Subgroup analysis showed that male healthcare workers who perceived higher level of challenge stress were more likely to develop subclinical depression than female healthcare workers.ConclusionThe level of subclinical depression among Chinese primary healthcare workers was high, and occupational stress especially hindrance stress may contribute to subclinical depression. Findings were also robust in subgroup analysis after adjusting for other covariates. These findings emphasize the importance of occupational stress psychosocial interventions to decrease the risk of developing depression among the primary healthcare workers.

BackgroundSleep quality is considered to be associated with cognitive function for older adults, but little is known about whether living with others can buffer mild cognitive impairment in older adults with poor sleep quality. The objective of this study was to examine the role of living arrangements in sleep quality and cognitive function among older adults aged 65 and over.Methods2,859 older adults over 65 years old were selected by using multi-stage stratified sampling method. Cognitive function and sleep quality were measured using Mini-Mental State Examination (MMSE) and Pittsburgh Sleep Quality Index (PSQI). Binary logistic regression was performed to examine the relationship between sleep quality and mild cognitive impairment, and the interaction effects of sleep quality and living arrangements on mild cognitive impairment stratified by gender.ResultsPoor sleep quality was associated with mild cognitive impairment among men and women regardless of living arrangements. The significantly protective role of living with others in reducing the incidence of mild cognitive impairment was found in men with poor sleep quality, but not in women.ConclusionTargeted support for older adults with poor sleep quality may be effective in preventing mild cognitive impairment, and gender differences should be taken into account when promoting cohabitations.

BackgroundDepressive status of medical personnel worldwide and especially in China is an important public health and social problem. There is a strong relationship between education and depression, but no studies have studied grouping healthcare workers (HCWs) with different educational degree to discuss whether there are differences in the factors that affect depression. This study aims to examine the role of job satisfaction and sleep quality in the relationship between work stress and depression among Chinese HCWs, and teste whether the mediation models are differed by the differences of educational degree.MethodsPatient Health Questionnaire-9 (PHQ-9) scale was used to test depression. Work stress was assessed using the Challenge-blocking stress scale (CBSS). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). HCWs’ satisfaction with their current work was assessed using the Job Satisfaction Index (JSI). The representative sample of HCWs was chosen using a multi-stage stratified cluster random sampling procedure and 844 HCWs were utilized to the statistical analysis of the study.ResultsIn the overall sample, sleep quality could mediate the relationship between work stress and depression in healthcare workers (p

BackgroundLiving arrangements and social support have an impact on depression among older adults. However, the underlying mechanism between those variables remains unknown. This study aims to investigate the mediating role of social support in the relationship between living arrangements and depression among older adults.Materials and methodsMulti-stage stratified sampling method was used to select 3,859 older adults from Taian City, Shandong Province, China, for cross-sectional investigation. Living arrangements were measured by a question. Social support and depression were measured using the Multidimensional Scale of Perceived Social Support and Patient Health Questionnaire-9. Multiple linear regression models were used to assess the relationship between living arrangements and depression and the possible influence of social support on the relationship between living arrangements and depression.ResultsStatistics showed that 15.08% of older adults lived alone. After controlling for covariates, living arrangements (ß = 0.45, t = 2.87, P < 0.01) and social support (ß =−0.08, t =−16.93, P < 0.001) were significantly associated with depression. The linear regression model showed that social support mediated the relationship between living arrangements and depression, and the mediating effect accounted for 18.20% of the total effect.ConclusionThis study revealed that living arrangements played an essential role in indirectly predicting depression in older adults through social support. This provided evidence for how to reduce depression in older adults.

ObjectiveFew are known on how and to what extent residents and healthcare providers have different preferences for family doctor contract service (FDCS). This study aimed to elicit and compare the residents' and healthcare providers' preferences for FDCS through a discrete choice experiment (DCE).MethodsResidents and healthcare providers recruited for the DCE were asked to choose repeatedly between two hypothetical service plans, which differed in six attributes: cost, service package, service delivery, type of service, accessibility of medicine, and level of healthcare team. We use mixed logit regression models to determine preferences for potential attributes.ResultsA total of 2,159 residents and 729 healthcare providers completed valid DCE questionnaires. The mixed logit model results suggested that cost, service package, service delivery, type of service, accessibility of medicine, and level of healthcare team all had a significant impact on residents' and healthcare providers' preference. The level of healthcare team was the most important characteristic of FDCS to both residents and healthcare providers, followed by types of service. They have different preferences on the cost and way of service delivery.ConclusionsThis study provides new evidence on how and to what extent residents and healthcare providers have different preferences for FDCS by determining their perception of various service attributes. These findings suggested that the optimal design and improvement of FDCS plans should consider not only residents but also healthcare providers' preferences to maximize contract service uptake.

Background: Substantial evidence indicated that absolute income is directly associated with health. Few studies have, however, examined if relative income may be equally associated with health. This study aimed to investigate the association between absolute income/relative deprivation (RD) and self-rated health (SRH). We also investigated whether the urban-rural difference was existing in these associations.Methods: Using cross-sectional data of 7,070 participants in the Shandong Family Health Service Survey of older people, this study applied binary logistic model and semi-parametric model to estimate the effect of absolute income and relative deprivation on SRH of older people. The Kakwani Index was used as a measure of relative deprivation at the individual level.Results: Absolute income has a significant positive effect on the SRH among both urban and rural older people. When considered RD as a variable, both absolute income and RD have negative significant effects on SRH among all older people. In addition, the negative effect of RD on rural elderly is more pronounced than that of urban older populations. Semi-parametric regression results show that there was a complex non-linear relationship between income and SRH. Psychological distress substantially attenuated the association between relative deprivation and SRH.Conclusions: Relative deprivation is negatively associated with self-rated health in both urban and rural older people after controlling the absolute income. RD may partly explain the association between income inequality and worse health status. Compared with the urban elderly, the effect of income-based relative deprivation on SRH was more pronounced among the rural elderly, and more care should be given to the lower income and rural older populations.

Background: The psychology of university and college students is immature, they are thus more likely to suffer from depression due to the COVID-19 pandemic. The present study aims to investigate the self-reported depression status of Chinese university and college students and explore its influencing factors.Methods: We conducted a network-based online survey, and a total of 17,876 participants completed the questionnaire. Depression was measured by the Self-Rating Depression Scale (SDS). Univariate analysis and multivariate logistic analysis were performed to explore the influencing factors of self-reported depression symptoms.Results: The proportion of self-reported depression symptoms, mild self-reported depression symptoms, and moderate to severe (M/S) self-reported depression symptoms was 65.2, 53.7, and 11.5%, respectively. The mean score of self-reported depression was 54.8 ± 9.0. Female, personality type of partial introversion, junior college educational level, “moderate” or “high” self-perceived risk of infection, “moderately” or “highly” impacted by the outbreak, and being eager to go back to school were risk factors for M/S self-reported depression symptoms (p < 0.05). While, “moderate” or “high” concern about the outbreak, “moderate” or “high” satisfaction with pandemic prevention and control measures, and having health literacy on communicable diseases were protective factors for M/S self-reported depression symptoms (p < 0.05).Conclusion: The status of self-reported depression symptoms among university and college students was severer than expected, and the influencing factors were multifaceted. Government and school administrators should strengthen the dissemination of knowledge on disease prevention and control. Moreover, much attention should be paid to female and junior college students.