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Purpose: This study aimed to investigate death anxiety (DA) in caregivers of patients with advanced cancer and identify associated factors in the context of Chinese culture., Methods: Caregivers (N = 588) of advanced cancer patients in a tertiary cancer hospital completed anonymous questionnaire surveys. Measures included the Chinese version of the Templer Death Anxiety Scale (C-T-DAS), the Quality-of-Life Scale, the State-Trait Anxiety Scale, and the Social Support Rating Scale. Data were analyzed in SPSS (IBM Corp, Armonk, NY, USA) using descriptive statistics, Pearson's correlation test, and linear regression., Results: Respondents returned 588 (93.03%) of the 632 questionnaires. The total C-T-DAS score was 7.92 ± 2.68 points. The top-scoring dimension was "Stress and pain" (3.19 ± 1.29 points), followed by "Emotion" (2.28 ± 1.31 points) and "Cognition" (1.40 ± 0.94 points). In contrast, the lowest-scoring dimension was "Time" (1.06 ± 0.77 points). Factors associated with DA (R 2  = 0.274, F = 13.348, p < 0.001) included quality of life (QoL), trait anxious personality, social support, caregiver length of care, caregiver gender, and patients' level of activities of daily living (ADL)., Conclusions: Our results demonstrated high levels of DA in caregivers of patients with advanced cancer. Generally, female caregivers and those with low social support had high DA. Caregivers caring for patients with low ADL levels or with a low QoL and trait anxious personality reported high DA. Certain associated factors help to reduce caregivers DA. Social interventions are recommended to improve the end-of-life transition and trait anxious personality as well as quality of life for caregivers., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Aim: Being front-line healthcare professionals is associated with possible severe information anxiety during the COVID-19 pandemic. Investigating signs of information anxiety is the first and key step of its targeted medical intervention. This study aims to explore the signs of front-line healthcare professionals' information anxiety during the COVID-19 pandemic., Design: This study is qualitative research. Grounded theory was used to classify information anxiety signs of front-line healthcare professionals., Methods: Twenty-four front-line healthcare professionals from a general hospital with over 5000 beds in Wuhan were recruited to participate in semi-structured interviews. According to the frequency and frequency variation of signs appearing in interviews, the trends of signs during the virus encounter, lockdown, flattening and second wave were compared. Based on the interviews, those signs that were conceptually related to each other were extracted to construct a conceptual model., Results: Psychological signs (emotion, worry, doubt, caution, hope), physical signs (insomnia, inattention, memory loss, appetite decreased) and behavioural signs (panic buying of goods, be at a loss, pay attention to relevant information, change habits) could be generalized from 13 subcategories of information anxiety signs. Psychological signs were the most in every period of the pandemic. Furthermore, psychological signs decreased significantly during lockdown, while behavioural and physical signs increased. Finally, severe psychological and behavioural signs were associated with physical signs., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

This paper investigated a research area worthy of greater attention: foreign language classroom anxiety (hereafter FLCA) and enjoyment (hereafter FLE) of older adults learning English as a foreign language in Chinese Universities of the Third Age. Understanding the largely overlooked emotional involvement of older language learners contributes to sustaining their motivation in lifelong learning for more remarkable personal growth and successes. Based on the survey of 587 Chinese older learners of English between the age of 50 and 80, paired sample t-test showed that more FLE was reported than FLCA. The results of Welch's ANOVA suggested that those who were better educated had less FLCA and those who believed themselves healthier had more FLE. The language performance evaluation (i.e. relative standing in class and English mastery) affects both FLE and FLCA. Further interviews with 34 older participants revealed three major sources of FLE, including the language use in life situations, the favorable attitude toward FL learning in the cognitive, aesthetic cultural and pragmatic aspects and the social interactions in the U3As. FLCA occurs when the language performance is perceived as dissatisfying and when aspects of mental health (e.g. worsening memory) impede effective learning. Although FLCA and FLE had only a very weak correlation, Chinese older adult learners commented on a shared belief that anxiety usually precedes and subsequently enhances enjoyment in learning, indicating a sign of emotional resilience later in life. This paper demonstrates a need for understanding the emotions in language learning across life stages and socio-cultural contexts.

After the implementation of "double reduction" policy, parental education anxiety becomes a hit subject in the society. Aimed to figure out formation logic and countermeasures of it, this paper adopts literature survey method, through numerous researches, discovers that on the one hand, the policy has comprehensively standardized cram schooling market, optimized the homework design and relieved students' burden, which renders the overall educational ecology sustainable. But on the other hand, affected by multiple factors, such as the weakening function of family education, the imbalance between the supply and demand of educational resources, single selection criterion and unpredictable educational deviation, parents' educational anxiety keeps swelling, bearing several features like the heterogeneity of anxiety, classification of anxious crowds, different stages of anxiety and intergenerational mobility. Therefore, only by synchronous implementation of multiple measures, reconstructing education ecological system, standardizing the policy and continuing to strengthen faculty force, can we relieve parental education anxiety and give a push to the genuine implementation of "double reduction" policy.

The genesis and spread of COVID-19 around the world since 2020 have caused severe impacts in every aspect of people's lives, from work life to recreation, social activities to physical health. Higher education has not been excluded. Universities have altered curriculum, changed delivery methods, provided more counseling, purchased new technology, and altered attendance policy for classroom, athletic, social and artistic events (Hamlin, 2021). To assess the impacts of these changes on college students, the authors created a questionnaire to ask students about their perceptions of these COVID-related impacts on their own personal lives. The survey had 56 questions about how the virus affected their academic, social, financial, physical and emotional lives. Over 800 students responded with objective input and subjective comments. Due to the volume of data, the authors have split the study into two parts. The survey results for the first part, academic and social aspects of the survey, were published in "Understanding the Impact of Covid-19 on College Student Academic and Social Lives," Research in Higher Education Journal Volume 41 (see http://www.aabri.com/manuscripts/213347.pdf). It will sometimes be referred to herein to provide clarity to the reader. The actual survey itself can also be found at that site. This paper focuses on the impact of the coronavirus on student financial and physical well-being, which have become major stressors to this age group and have contributed to higher levels of anxiety and depression. It also examines how the virus has affected their social and emotional well-being. Lastly, recommendations are made to help educators understand the severity of the problem, and to take action to provide assistance for those students who have been adversely affected.

This article mainly focuses on comparing motivation and anxiety levels in native versus non-native English teacher classes based on survey results from Chinese university students majoring in English. Using a 5-point Likert Scale, the participants responded to 48 close-ended survey items regarding English language learning motivation and anxiety. The overall results indicated that they tended to have high motivation level and low anxiety level in their English classrooms, but several survey items suggested that they were significantly more motivated and less anxious in native teacher classes than non-native teacher classes, which led to higher achievement levels in native teacher classes. Although the result seems to suggest that students prefer native English teachers, this does not imply that non-native teachers are not as qualified as their counterparts, as some survey items indicate that both teachers are equally prepared for classes and accessible for assistance. Based on the survey results, this paper makes some suggestions on how English teachers can better help their students' English learning.

This paper reports on the trajectory of college students' emotions as they engaged in online learning during a pandemic and how their emotions related to their learning. Through a qualitative analysis of 11 college students' reflections and interview data collected over one semester in a university in China, the case study shows the complexity of students' emotions in the aforementioned context. The students' emotions demonstrated a dynamic transition from anxiety and curiosity to emotional stability, and then back to anxiety, a phenomenon that interacted with the changing sources in the research context. The students also felt that their emotions while engaging in online learning interacted with their learning. Implications of the study include caring about and promoting students' social-emotional well-being and encouraging students to regulate their emotions while learning online during a pandemic as well as in normal times.

Background: Since the end of 2019, the coronavirus disease (COVID-19) outbreak rapidly became a pandemic. The psychological state of people during the COVID-19 pandemic has gained interest. Our aim was to study the prevalence of anxiety, depression, and stress in college students during the COVID-19 pandemic. Methods: A systematic search of Medline, Embase, Web of Science, and the Cochrane Library was conducted up to September 20, 2020. Reviewers independently assessed full-text articles according to predefined criteria. Stata14/SE was used to calculate the prevalence and 95% confidence intervals (CIs) of anxiety, depression, and stress among college students from different countries. A random effects model was adopted. The Egger test was used to determine publication bias. Results: A total of 280 references were retrieved, and 28 papers met our inclusion criteria, for a total of 436,799 college students. Thirteen studies involved non-Chinese college students, and 15 studies involved Chinese college students. The prevalence of anxiety, depression, and stress was 29% (95% CI, 19-25%), 37% (95% CI, 32-42%), and 23% (95% CI, 8-39%), respectively. Conclusion: The COVID-19 pandemic has had a negative psychological effect on college students, and the prevalence of anxiety, depression, and stress among Chinese college students is lower than among non-Chinese college students.

There are many studies on variables related to burnout among preschool teachers, but the results of these studies are inconsistent. This study explored the variables most associated with preschool teachers' burnout through meta-analysis. The researchers conducted an extensive search of the China Knowledge Network (CNKI), Vip journal, and Wanfang databases. A total of 59 papers were included through strict inclusion criteria, and a total of 14 variables were analyzed. The results indicate that the variables that have large effect sizes with burnout are turnover intention (r = 0.7124), job stress (r = 0.4744), teacher efficacy (r = -0.4331), and job satisfaction (r = -0.4229). This study provides a data reference for the prevention and improvement of burnout among preschool teachers in China, and will also provide directions for further research to follow.

This paper presents a compilation of personal reflections from 66 contributors on the impact of, and responses to, COVID-19 in accounting education in 45 different countries around the world. It reveals a commonality of issues, and a variability in responses, many positive outcomes, including the creation of opportunities to realign learning and teaching strategies away from the comfort of traditional formats, but many more that are negative, primarily relating to the impact on faculty and student health and well-being, and the accompanying stress. It identifies issues that need to be addressed in the recovery and redesign stages of the management of this crisis, and it sets a new research agenda for studies in accounting education.

This paper addresses the student support systems available in Chinese schools, with reference to those available in Canadian schools, in order to understand the most effective foundations for academic success and student motivation. The focus of educational support within Chinese and Ontario schools is rooted around times of high-stress exams, such as the Senior High School Entrance Exam ("Zhongkao," [characters omitted) and the National Higher Education Entrance Exam ("Gaokao," [characters omitted]) in China, and the Education Quality and Accountability Office (EQAO) Literacy Exam and the Canadian Achievement Tests (CAT) in Ontario. I explore the available means through which schools provide guidance and additional support for students throughout the grades leading up to major examinations. This inquiry involves observation of various Chinese classrooms, research of literature examining stress levels and academic success, and observations of school programs and guidance facilities within the schools and communities.

This paper explores existing evidence on indicators of risk to the mental health status of Chinese students studying in Australian universities prior to the COVID-19 pandemic. Studies published from January 1999 to January 2020 were considered. Findings indicated that Chinese students routinely report increased levels of fear, stress, anxiety, depression and social problems, as well as decreased levels of general well-being, while studying in Australia. Numerous factors may exacerbate the issues confronted by Chinese university students studying in Australia, including language barriers; social, academic and financial difficulties; challenges associated with the different education systems of the two countries; and their own underuse of available mental health services. Recommendations for further practice and research are presented based on these findings.

With the ubiquitous usage of wireless, portable, and handheld devices gaining popularity in 21st century, the revolutionary mobile technology introduces digital new media to educational settings, which has changed the way of traditional teaching and learning. WeChat is one of the most popular social networking applications in China featured by its interactivity and real-time communication that has attracted attention of educators to its pedagogical value. This study evaluates the utilization of WeChat in mobile learning and, in particular, its potential for improving English pronunciation among English learners in China. It probes into the perennial problems of Chinese students in English pronunciation acquisition and oral practice, discusses WeChat's support functions in mobile learning, demonstrates the relevant empirical studies of WeChat in teaching and learning, and analyses the potential value of using WeChat in improving English pronunciation. Examinations in this paper enable one to reflect on the strengths of mobile learning by WeChat and to explore how this social media tool is likely to solve the pronunciation difficulties of Chinese English learners. It is found that applying WeChat to English pronunciation teaching and practicing helps create better self-directed learning environment, enhance learning flexibility and improve oral learning effectiveness. It is hopefully that insights gained from examining how WeChat helps improve English pronunciation learning will shed light on further innovations of teaching designs in this area.

Moral ethic prevails in the science and education of chemistry. These issues are unique to chemistry and arise from between the theoretical and the practical behavior in laboratory. The study reported in the paper investigated the impact of personal moral philosophies on the safety practices of students in chemistry and related majors. The results showed that lab anxiety, safety attitude, safety knowledge, and idealism were significant predictors of safety practice, with the last item being the strongest predictor. According to Forsyth's four distinct personal moral philosophies, among Chinese students, situationism was the most common, followed by exceptionism and then absolutism, with subjectivism as the least common. All lowest scores are from exceptionism. Idealism was more common among males than females, more among higher grade students than lower, and more among students from eastern as compare to western regions of China. All the results showed that the content of idealism should be incorporated into safety training to improve safety practices. Attention to idealistic education in all aspects of university education can help to improve safety behavior.

Anxiety experienced in the course of learning a foreign language is specific and unique (Horwitz et al., 1986; MacIntyre & Gardner, 1989). This paper reports a study on anxiety in Chinese undergraduate non-English majors at three different proficiency levels in a three-week immersion summer camp. By way of survey, interviews, reflective journals and observations, this research seeks to investigate the relationship between anxiety and native-speaking teacher's teaching and extracurricular activities in an immersion summer camp. Specifically, it tries to explore that (1) whether a considerable number of students at each level felt anxious when speaking to native-speaking teachers and volunteers in and out of classroom in the summer camp setting, (2) whether the more proficient students tend to be less anxious in the summer camp setting, (3) whether the students felt less anxious when they learn English and western cultures not for any examination. Based on the findings, some suggestions for future teaching and research are proposed.

Abundant health knowledge resources are available on social media to facilitate technology-enhanced knowledge learning among older adults. The objective of this study is to investigate the predictors and the underlying formation mechanism of older adults' intention to learn health knowledge on social media. We propose a novel model to examine how older adults' emotional state (i.e., health anxiety) and cognitive state (i.e., e-health literacy) during knowledge acquisition influence threat appraisal (i.e. perceived severity and perceived susceptibility) and coping appraisal (i.e. self-efficacy and perceived benefits), thereby shaping older adults' intention to learn health knowledge. Survey data from 337 Chinese older adult users of social media was collected to test the research model. Results reveal that perceived susceptibility, self-efficacy and perceived benefits exert positive effects on older adults' health knowledge learning intention, while the impact of perceived severity on health knowledge learning intention is not statistically significant; health anxiety is positively correlated with perceived severity and perceived susceptibility, and e-health literacy is a powerful predictor of self-efficacy and perceived benefits. This paper enriches the literature related to technology-enhanced knowledge learning and online health behavior among older adults. Effective strategies are proposed based on the findings for practitioners dedicated to promoting health knowledge via social media and older adults who apply health knowledge to address health-related needs.

This paper reports on the result of a study on Chinese university EFL learners' foreign language writing anxiety in terms of general pattern, effect and causes. 1174 first-year students answered the 26-item Foreign Language Writing Anxiety Scale (FLWAS) (Young, 1999) and took an English writing test, 18 of whom were invited for semi-structured interviews. The results showed that 1) FLWAS had three principal components--low confidence in English writing (FLWAS1), dislike of English writing (FLWAS2) and English writing apprehension evaluation (FLWAS3), 2) the whole sample, as well as male and female students, were generally confident in and liked English writing, and were not apprehensive of having their English writing evaluated, 3) significant differences existed between male and females students, and among different proficiency groups in all the FLWAS scales, 4) foreign language writing anxiety significantly negatively affected students' performance in the English writing test, and 5) a number of factors contributed to the students' foreign language writing anxiety.

Aims: This review aims to assess the effect of comprehensive nursing care on liver cancer patients undergoing interventional therapy in China. Methods: In accordance with PRISMA guidelines, we reviewed randomized controlled trials and observational studies assessing the effect of comprehensive nursing care against standard care on liver cancer patients undergoing specific interventional therapies in China, including PubMed, Embase, CENTRAL and CINAHL till June 2023. Data synthesis was conducted using a random‐effects model and reported as pooled odds ratio (OR) or mean difference (MD) or standardized mean differences (SMD). Results: Ten Chinese studies with 1682 participants were evaluated. Comprehensive nursing care significantly enhanced patient outcomes in liver cancer treatment. Quality of life improved markedly (OR: 0.16, 95% CI: 0.06–0.41). Notable reductions were observed in anxiety (MD: −8.96, 95% CI: −11.52 to −6.40) and depression (MD: −9.47, 95% CI: −11.79 to −7.14). Patients also experienced increased physical (SMD: 1.70, 95% CI: 1.15–2.25), social (SMD: 1.65, 95% CI: 1.14–2.16) and activity scores (SMD: 1.94, 95% CI: 1.49–2.39), alongside a decrease in post‐treatment complications (OR: 0.28, 95% CI: 0.21–0.37), demonstrating the multifaceted benefits of comprehensive care. Conclusion: Comprehensive nursing care may improve patient outcomes in liver cancer treatment, offering potential benefits in reducing the side effects of interventional therapy. Summary statement: What is already known about this topic? Liver cancer patients undergoing interventional therapy often experience significant physical and psychological challenges.Comprehensive nursing care has been hypothesized to offer potential benefits in addressing these challenges.There is limited evidence on the exact impacts of comprehensive nursing care on these patients, leading to knowledge gaps in its applicability and efficacy. What this paper adds? This review demonstrates that comprehensive nursing care can lead to significant improvements in the quality of life for liver cancer patients in China.This review provides evidence that comprehensive care reduces levels of anxiety and depression in these patients.This review shows that this approach boosts physical, social function and activity scores while also reducing post‐treatment complications. The implications of this paper: This paper suggests integrating comprehensive nursing care as a standard practice, given its potential to significantly improve patient outcomes and quality of life.This research emphasizes the importance of equipping oncology nurses with comprehensive care skills and expanding their roles to ensure optimal patient outcomes.Despite promising results, there is a need for further high‐quality, randomized controlled trials to confirm these findings and delve deeper into other potential benefits and best practices of comprehensive nursing care for liver cancer patients. [ABSTRACT FROM AUTHOR]

This paper focuses on George Du Maurier's 'chinamania' cartoons that were published in the popular British satirical magazine Punch. Depictions of languid men and selfish women obsessed with blue and white china (the porcelain), a familiar symbol of China (the country), visualised anxieties over degeneration at a time when China was viewed as a regressive civilisation. By exploring late nineteenth century notions of decline, this paper argues that Du Maurier's series of cartoons simultaneously mocked English societal foibles while positioning China to serve as a visual warning of wider issues concerning the degeneration of society and by extension, the British nation and its standing in the international arena. [ABSTRACT FROM AUTHOR]

The Flourishing Scale (FS) is a brief eight-item inventory used to measure psychological well-being. This study evaluated the psychometric properties of the FS in a sample of 766 Chinese adolescents. The paper-and-pencil method was adopted. Confirmatory factor analysis was conducted to examine the factor structure of the FS items. Expanded Satisfaction With Life Scale and Hospital Anxiety and Depression Scale were used to examine the criterion-related and incremental validities. Results showed good internal consistency reliability, one-factor structure, strong convergent validity, and incremental validity of the FS in the current sample. We can conclude that the FS is suitable for use in the Chinese adolescent context.

Recently, there has been a rapidly growing trend in non-English-speaking countries for English to be adopted as the medium of instruction in higher education. Consequently, it has become necessary to conduct research that will guide lecturers in effectively adopting (EMI) on campus. This paper presents a blended learning strategy that integrates a cloud learning environment (CLE) to give students the opportunity to experience online learning activities. A two-group experiment shows that the use of this CLE-integrated learning strategy can greatly improve students' learning results, strengthen their professional skills, and increase their motivation. These findings may be attributable to the reduced anxiety among students, increased access to learning resources and sufficient support available under the CLE-integrated learning strategy. Thus, this study confirms the positive effect of CLEs on courses that use EMI.

Background: Appropriate physical activity (PA) and good sleep are beneficial to maternal and fetal health. This paper sought to explore the associations of PA and sleep quality among healthy women at the first and second trimesters of pregnancy on mental health and pregnancy outcomes., Methods: Totally 268 healthy pregnant women were retrospectively analyzed as study subjects, 134 each in the first trimester (FT) and second trimester (ST). Their baseline clinical data were obtained respectively at two stages of pregnancy. The PA/sleep quality of subjects were assessed through the Pregnancy Physical Activity Questionnaire-Chinese version (PPAQ-C)/Pittsburgh Sleep Quality Index (PSQI) scale. The mental health was assessed via the Hospital Anxiety and Depression Scale (HADS). The correlations of PA and sleep quality with mental health were analyzed using Spearman correlation analysis. Pregnancy outcomes of all subjects, associations of moderate intensity (MI) PA and sleep quality with adverse pregnancy outcomes, and independent influencing factors for adverse outcomes were analyzed., Results: Pregnant women in the ST group exhibited higher levels of MI, worse sleep quality, and lower levels of anxiety and depression than those in the FT group. Anxiety and depression were negatively correlated with MI but positively linked with PSQI scores at the first and second trimesters. MI ≥ 7.5 MET-h/week and good sleep quality were associated with a reduced incidence of adverse pregnancy outcomes., Conclusion: MI ≥ 7.5 MET-h/week and good sleep quality at the first and second trimesters of pregnancy benefit mental health and markedly reduce the occurrence of adverse pregnancy outcomes., (© 2024. The Author(s).)

Mathematics anxiety (MA) is a widespread phenomenon that affects an individual's learning of mathematics. MA between different genders has been of great interest to researchers. Meta-analysis was used to examine the relationship between MA and gender in Chinese children, along with the influencing factors. After literature search and screening, 83 papers and 91 independent samples met the inclusion criteria. The results of the main effect test of the random effect model revealed a correlation of significant levels between MA and gender, r = -0.131, 95%CI [-0.158, -0.105], Z = -9.508, and p < 0.001. Girls had higher MA than boys. The outcomes of the moderating effect test indicated that the moderating effect of age, economic region and measurement instrument in the relationship between MA and gender was significant. But the moderating effect of period was not significant. Specifically, gender differences in MA were greater at the middle school compared to the elementary school. And the greatest correlation between children's MA and gender was in the western region. The gender difference of MA measured by different instruments varied., 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 The Authors. Published by Elsevier B.V. All rights reserved.)

Purpose: To determine the prevalence of anxiety and depression in patients with nasopharyngeal carcinoma (NPC) and to identify central symptoms and bridge symptoms among psychiatric disorders., Methods: This cross-sectional study recruited patients with NPC in Guangzhou, China from May 2022, to October 2022. The General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used for screening anxiety and depression, respectively. Network analysis was conducted to evaluate the centrality and connectivity of the symptoms of anxiety, depression, quality of life (QoL) and insomnia., Results: A total of 2806 respondents with complete GAD-7 and PHQ-9 scores out of 3828 were enrolled. The incidence of anxiety in the whole population was 26.5% (depression, 28.5%; either anxiety or depression, 34.8%). Anxiety was highest at caner diagnosis (34.2%), while depression reached a peak at late-stage radiotherapy (48.5%). Both moderate and severe anxiety and depression were exacerbated during radiotherapy. Coexisting anxiety and depression occurred in 58.3% of those with either anxiety or depression. The generated network showed that anxiety and depression symptoms were closely connected; insomnia was strongly connected with QoL. "Sad mood", "Lack of energy", and "Trouble relaxing" were the most important items in the network. Insomnia was the most significant bridge item that connected symptom groups., Conclusion: Patients with NPC are facing alarming disturbances of psychiatric disorders; tailored strategies should be implemented for high-risk patients. Besides, central symptoms (sad mood, lack of energy, and trouble relaxing) and bridge symptoms (insomnia) may be potential interventional targets in future clinical practice., 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 The Author(s). Published by Elsevier B.V. All rights reserved.)

Social anxiety is a common comorbid factor of problematic mobile phone use, but the relationship between them from the inside structure has been underexplored. This two-wave longitudinal study aims to identify the central symptoms of problematic mobile phone use and social anxiety, respectively, as well as the bridge symptoms between the two disorders. Furthermore, this study examined the time and gender differences. A total of 3,294 Chinese adolescents were recruited during two waves (T1: January 2023; T2: August 2023), and completed the questionnaires of social anxiety and problematic mobile phone use. Through network analysis, the results showed that 1) the central symptom of problematic mobile phone use was "loss of control" both at T1 and T2, 2) the central symptom of social anxiety was "fear of negative evaluation" both at T1 and T2, and 3) the bridge symptom between social anxiety and problematic mobile phone use was "withdrawal" both at T1 and T2. Moreover, the network comparison test indicated that the nodes of social anxiety were more strongly associated with "craving", "loss of control", and "negative life consequences" of problematic mobile phone use at T2 than at T1. The nodes of social anxiety were more strongly associated with "negative life consequences" of problematic mobile phone use for boys than for girls, while the "fear of negative evaluation" was more strongly associated with "loss of control" for girls than for boys. These findings provide new scientific basis for interventions targeting adolescents who are susceptible to social anxiety and problematic mobile phone use., 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 Ltd. All rights reserved.)

Objective: To explore the association between green space, multiple ambient air pollutants and depressive/anxiety symptoms and the mediating role of physical activity (PA) in Chinese adolescents., Method: A school-based health survey was conducted in eight provinces in China in 2021. 22,868 students aged 14.64 (±1.77) years completed standard questionnaires to record details of depressive, anxiety symptoms and PA. We calculated the average normalized difference vegetation index (NDVI) in circular buffers of 200 m, 500 m and 1000 m and estimated the concentrations of PM 10 , PM 2.5 , CO, NO 2 , O 3 , SO 2 around the adolescents' school addresses., Results: The exposure-response curves showed that the lower the NDVI value, the higher the risk of depressive and anxiety symptoms. CO, PM 2.5 and SO 2 and air pollution score were associated with increased risk of depressive and anxiety symptoms. NDVI in all circular buffers decreased the risk of depressive and anxiety symptoms at low levels of PA, but the associations were not significant at high levels of PA. In the subgroup analysis, PM 10 , PM 2.5 , CO, NO 2 , SO 2 , AQI and air pollution score increased the risk of depressive and anxiety symptoms at low PA levels, but the associations were not significant at high levels of PA. Mediation analysis indicated that the mediating effect of PA on the association between NDVI, NDVI-200 m NDVI-500 m, CO, PM 10 , PM 2.5 , SO 2 , AQI and depressive/anxiety symptoms was statistically significant（p < 0.05）., Conclusion: Middle-high level PA could reduce the strength of association between air pollution and depressive and anxiety symptoms. Meanwhile, the association between green space/air pollution and depressive/anxiety symptoms was partly mediated by PA., 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 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The long-term mental health consequences of COVID-19 in children and adolescents remain unclear. We investigated the impact of COVID-19 infection on mental health after China's zero-COVID policy relaxation, focusing on symptom-specific and social-family risk factors for mental health issues in children and adolescents. In a longitudinal study, 8348 youths (aged 10-18) were assessed twice (T1: September to October 2022 and T2: April to May 2023). Mental health changes (Δ=T1-T2) were compared between COVID-19-infected (COVID+, n = 4108) and non-infected (COVID-, n = 4240). After balancing social-family confounding factors at T1 with propensity score-based inverse probability weights, multivariable logistic regression was employed to assess associations between COVID-19 infection and the onset/worsening of mental health symptoms. Multivariable logistic regression was conducted to explore specific acute COVID-19 symptoms and social-family risk factors associated with the onset/worsening of mental health symptoms in COVID + group. Compared to COVID- group, COVID + group exhibited lower overall mental health improvement (Δ). COVID + group was associated with increased risks of depression worsening (OR 1.20, 95 % CI 1.04-1.39), anxiety worsening (OR 1.30, 95 % CI 1.15-1.47), stress worsening (OR 1.23, 95 % CI 1.03-1.46), insomnia worsening (OR 1.21, 95 % CI 1.05-1.39), and emotional symptoms worsening (OR 1.72, 95 % CI 1.27-2.33). Moderate-to-severe difficulty thinking, breathlessness, and gastrointestinal symptoms were specific COVID-19 symptoms associated with worsening of various mental health outcomes. Furthermore, academic difficulties, economic disadvantages, family conflicts, food addiction, and alcohol consumption were identified as social-family risk factors for worsening mental health symptoms in COVID + youths. COVID-19 infection leaves lasting mental health scars in youths, extending beyond the acute phase. Specific symptoms, particularly cognitive dysfunction and respiratory/gastrointestinal distress play a significant role in this vulnerability. Social-family factors further modulate these effects, highlighting the need for comprehensive interventions that address both biological and psychosocial aspects. This study provides valuable insights for tailoring mental health support to youths navigating the consequences of the COVID-19 pandemic., 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 The Author(s). Published by Elsevier Inc. All rights reserved.)

Introduction: Epilepsy is the third most common neurological disorder in elderly people. Patients with epilepsy (PWEs) are more likely to have comorbidities. Social support is very important for PWEs. However, there are many gaps in the research on social support in older PWEs, especially the correlation between social support and comorbidities., Methods: A cross-sectional study was conducted in three hospitals in China. Social support was assessed using the Social Support Rate Scale. The burden of physical comorbidities was assessed using the CCI, and global disability was assessed using the mRS. The NDDIE was used to assess depression, the GAD7 was used for anxiety, the CDR was used for cognitive status, and the NPI was used for psychotic symptoms., Results: A total of 154 older PWEs participated in the study. There were 97 patients with at least one physical comorbidities. The burden of physical comorbidities was negatively correlated with overall social support (Adj. r = -0.35, P < 0.001) and global disability (Adj. r = -0.45, P < 0.001). In terms of psychiatric comorbidities, anxiety, depression, and cognitive status were not correlated with overall social support (Adj. r = -0.03, -0.02, and -0.11, P > 0.05). Psychotic symptoms were correlated with overall social support (Adj. r = -0.20, P < 0.05). The overall burden of psychiatric comorbidities was associated with overall social support (r = 0.30, P < 0.01)., Discussion: Neurologists and social workers should consider more personalized biopsychosocial care to improve the quality of life of older PWEs., 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.)

This research frames student teachers' professional identity formation through the lenses of emotions and dilemmas based on semi-structured interviews and emotional journals. Utilizing grounded-theory analysis method, this paper reveals a pattern of the emotional trajectories that the six student teachers experienced from the beginning to the end of the practicums: eagerness and anxiety at the beginning of the teaching practicums, shock and embarrassment immediately after the student teaching, anger and puzzlement at the middle of the internship, helplessness and loneliness toward the end of the practicums, and guilt and regret after the teaching practice. Furthermore, the participants were faced with four dilemmas: (1) tensions between classroom authority and the ethic of caring, (2) acting as a community member or an "outsider," (3) working as an office assistant or a "real teacher," (4) conflicting pedagogies regarding teaching different academic performance levels of students. All these dilemmas contribute to the complexity of the teaching practicum in China. Finally, implications for teacher education, especially for preservice teachers' pedagogy of identity and ethical professionalism, are discussed.

Aims: This study aims to examine the prevalence of anxiety symptoms and identify predictors of anxiety among pregnant women with gestational diabetes mellitus and their partners and explore the mediating role of marital satisfaction between maternal and paternal anxiety. Design: A cross‐sectional study was conducted in Guangzhou, China, from July 2021 to May 2022. Methods: A total of 306 dyads of pregnant women with gestational diabetes mellitus and their partners completed the State–Trait Anxiety Inventory, Locke–Wallace Marital Adjustment Test and the socio‐demographic and clinical data sheet. Results: The prevalence of anxiety symptoms was 32.4% and 36.6% in pregnant women with gestational diabetes mellitus and their partners, respectively. The predictors of maternal anxiety were paternal anxiety, maternal marital satisfaction, maternal monthly salary, fasting glucose value and 1‐h glucose value. By contrast, the predictors of paternal anxiety were maternal anxiety, paternal marital satisfaction and paternal monthly salary. Moreover, the relationship between maternal and paternal anxiety was mediated by marital satisfaction. Conclusions: The anxiety symptoms of pregnant women with gestational diabetes mellitus and their partners influence each other, and this relationship was mediated by marital satisfaction. Every couple should be screened for anxiety symptoms and treated as a team rather than focusing solely on the pregnant woman. Summary statement: What is already known about this topic? Gestational diabetes mellitus is strongly associated with various short‐ and long‐term adverse maternal and neonatal outcomes.The diagnosis of gestational diabetes mellitus is stressful for pregnant women and their partners.No studies have been conducted to examine and compare the anxiety symptoms among pregnant women with GDM and their partners in mainland China. What this paper adds? The anxiety symptoms of pregnant women with gestational diabetes mellitus and their partners influence each other.The prevalence of anxiety symptoms was high in both pregnant women with gestational diabetes mellitus and their partners.Marital satisfaction played a mediating role between maternal and paternal anxiety. The implications of this paper: Study findings provide important information to guide future practice for nurses and other health‐care professionals.For the future, routine screening for anxiety symptoms is necessary for both pregnant women with gestational diabetes mellitus and their partners; mental health support should be delivered in a timely fashion for couples.Pregnant women with gestational diabetes mellitus and their partners should be treated as a team rather than focusing solely on pregnant women, with couples given training on enhancing marital satisfaction skills to prevent and reduce their anxiety symptoms. [ABSTRACT FROM AUTHOR]

Aim: This review aimed to synthesize the available evidence on the effectiveness of nurse‐led multidisciplinary interventions in primary health care. Methods: The following Chinese and English databases were searched for relevant articles: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang and Chinese Biomedical Literature Database (CBM), from the establishment of the databases until the last updating search 1 April 2022. Two researchers screened the studies independently and extracted the data. Meta‐analysis was performed using the RevMan 5.3 software. Results: A total of 12 studies were included in this review. It was found that nurse‐led multidisciplinary interventions significantly shortened patients' length of stay in hospital (standardized mean differences [SMD] = −1.28, 95%CI: −2.03 to −0.54; P<0.001) and decreased incidences of complications (RR = 0.24, 95%CI:0.10 to 0.54; P = 0.0006) compared to the control group, and lowered patients' anxiety levels (SMD = −1.21, 95%CI: −1.99 to −0.44; P<0.01) and depression levels (SMD = −1.85, 95%CI: −3.42 to −0.28; P<0.0001). Furthermore, the results of subgroup analysis indicated that nurse‐led multidisciplinary interventions had significant effects on patients' self‐management ability (SMD = 4.45, 95%CI:2.45 to 6.44; P<0.0001) and quality of life (SMD = 1.01, 95%CI: 0.63 to 1.40; P<0.0001) compared to the control group. Conclusions: Nurse‐led multidisciplinary interventions had strong effects in primary health care, contributing to shorten patients' length of stay in hospital, decrease incidences of complications and reduce the levels of anxiety and depression. Moreover, nurse‐led multidisciplinary interventions also improved patients' self‐management ability and quality of life. Summary statement: What is already known about this topic? Chronic diseases with long duration and slow recovery are one of the priorities for management in primary health care.In China and other countries around the world, primary health care is highly regarded for its efforts for the health of all.Several randomized controlled trials have explored the effectiveness of nurse‐led multidisciplinary interventions in primary health care, but the findings of these studies are contradictory. What this paper adds? The review demonstrates that nurse‐led multidisciplinary interventions could shorten patients' length of stay in hospital, decrease the incidence of complications and reduce the levels of anxiety and depression.Nurse‐led multidisciplinary interventions also improve patients' self‐management ability and quality of life.Nurse‐led multidisciplinary interventions are beneficial for promoting health and preventing disease in primary health care. The implications of this paper: Community primary health‐care personnel should be aware of the importance of nurse‐led multidisciplinary interventions in preventing disease and safeguarding health.For people with chronic diseases, community health‐care personnel should adopt multidisciplinary care methods to improve outcomes for patients.High‐quality studies are needed to verify the effects of interventions for patients. [ABSTRACT FROM AUTHOR]

This paper evaluates the effects of economic shocks to current and expected income reduction on mental wellbeing. We use individual-level data from three East Asian countries; China, Japan, and South Korea, during the early phases of the pandemic when the COVID-induced economic shocks were severe. The findings reveal significant causal effects from current and expected income reduction on different aspects of mental health deterioration, including anxiety, trouble sleeping, boredom, and loneliness. Interestingly, we found that expectations of future income loss have a significantly larger effect on people's mental wellbeing compared to current falls in income. This has significant implications for the design of policies to support income during pandemics., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Aims: Glioma patients are at high risk for postoperative delirium (POD), yet studies focusing on this population in general neurosurgical ward settings are limited. This paper investigates the incidence of POD and related risk factors in glioma patients hospitalized in general wards. Design: Prospective observational study. Methods: This prospective study included 133 adult glioma patients hospitalized in the general neurosurgery ward. In addition to collecting routine perioperative general clinical data, patients' psychological status was assessed preoperatively using the Hospital Anxiety and Depression Scale (HADS). POD was assessed within 3 days postoperatively using the Confusion of Consciousness Assessment method, twice daily. The incidence of POD was calculated, and risk factors were identified using logistic regression analysis. Results: The incidence of POD in glioma patients admitted to the general ward was 31.6% (40/133). Multivariate regression revealed advanced age (age > 50 years), frontal lobe tumour, presence of preoperative anxiety or depression, retention of a luminal drain, postoperative pain, indwelling catheter these six factors were independent risk factors for the development of delirium in patients after surgery. Conclusion: In general ward settings, supratentorial glioma patients exhibit a high risk of POD. Critical risk factors include preoperative psychological conditions, as well as postoperative pain, drainage and catheterization. Rigorous preoperative evaluations, effective pain management strategies and the integration of humanistic care principles are essential in mitigating the risk of POD for glioma patients. Relevance to Clinical Practice: In general ward settings, this study reveals the high occurrence of POD in glioma patients and identifies preoperative psychological states, age, tumour location and several postoperative factors as significant risk factors for POD, which provides a framework for targeted interventions. By integrating these insights into clinical practice, healthcare teams can better identify glioma patients at risk for POD and implement preventive measures, thereby enhancing recovery and overall care quality for glioma patients in general neurosurgical wards. Reporting Method: This study adheres to the STROBE guidelines, ensuring a transparent and comprehensive reporting of the observational research methodology and results. Patient or Public Contribution: Patients involvement was limited to the provision of data through their participation in the study's assessments and the collection of clinical information. The study did not involve a direct patient or public contribution in the design, conduct, analysis, or interpretation of the data, nor in the preparation of the manuscript. [ABSTRACT FROM AUTHOR]

This study explores the challenges faced by young lecturers in managerial transformation in elite Chinese academic institutions which aim to develop into world-class universities. Drawing on data from in-depth interviews, the paper discusses how a group of lecturers on tenure-track contracts at a research university in China perceived the impacts of this managerial personnel reform. The study revealed intensified academic pressure and consequent feelings of insecurity, uncertainty and anxiety among the participants. Rigid tenure requirements pushed down research quality, and detracted from the efforts the participants could have devoted to teaching. Further negative impacts were strengthened power hierarchies and increasingly gendered nature of the academic culture.

Drawing on ethnographic fieldwork on young white-collar women training bodies after work in Shanghai, I demonstrate that core muscles serve as visual indexes of discipline and hard-work, and that women create social spaces to collectively cultivate such dispositions. The socially sanctioned value of core muscles is connected to the discourse of 'having it all' increasingly popular among professional women in corporate, urban China. This paper elaborates on how bodily training transposes dispositions of work ethics beyond the workplace and on women's anxieties about their bodies at the intersection of productive and reproductive demands from the society. This paper builds on and critiques existing approaches to the body, and attends not only to the woman's body at the intersection of production and reproduction but also to the social aspect of bodily training in spaces between home and work. [ABSTRACT FROM AUTHOR]

In teacher identity research, limited attention has been paid to how pre-service teachers constructed their identities by negotiating with different emotions in their practice. To fill this gap, the present study, drawing upon the approach of narrative inquiry, explores how a student-teacher--Ming--negotiated and navigated conflicting emotions in the process of becoming a teacher. The findings show that while Ming experienced some negative feelings in his work, which challenged his self-belief as a teacher, the positive emotions derived from his students' progress and recognition contributed to his teacher identity. However, due to the constraints imposed by his mentor and the school context, his negative emotions gradually escalated, posing severe impediments to his teacher identity. The emotional flux and identity change of the student-teacher can be attributed to his professional learning in the structural and cultural working conditions with hidden "emotional rules" embedded in the practicum school. This paper argues for the inclusion of teacher emotions as an indispensable part of pre-service teacher education.

Aims: The purpose of this study was to identify risk factors for cognitive impairment in advanced cancer patients and to develop predictive models based on these risk factors. Background: Cancer‐related cognitive impairment seriously affects the quality of life of advanced cancer patients. However, neural network models of cognitive impairment in patients with advanced cancer have not yet been identified. Design: A cross‐sectional design was used. Methods: This study collected 494 questionnaires between January and June 2022. Statistically significant clinical indicators were selected by univariate analysis, and the artificial neural network model and logistic regression model were used for multivariate analysis. The predicted value of the model was estimated using the area under the subject's working characteristic curve. Result: The artificial neural network and the logistic regression models suggested that cancer course, anxiety and age were the major risk factors for cognitive impairment in advanced cancer patients. All the indexes of artificial neural network model constructed in this study are better than those of the logistic model. Conclusion: The artificial neural network model can better predict the risk factors of cognitive impairment in patients with advanced cancer. Better prediction will enable nurses and other healthcare professionals to provide better targeted and timely support. Summary statement: What is already known about this topic?: Cancer‐related cognitive impairment has significantly affected the quality of life of patients with advanced cancer.Risk factors associated with cognitive impairment in patients with advanced cancer have not been adequately documented, and neural network models have not been identified. What this paper adds?: This study found that long a cancer course, anxiety and ageing were the most important risk factors for cognitive impairment in patients with advanced cancer.The artificial neural network showed good predictive indicators, indicating that it can be used to predict cognitive impairment in patients with advanced cancer. The implications of this paper: Neural network models can help nurses and other clinicians predict cognitive impairment in advanced cancer patients early which will allow provision of timely intervention. [ABSTRACT FROM AUTHOR]

This paper investigated a research area worthy of greater attention: foreign language classroom anxiety (hereafter FLCA) and enjoyment (hereafter FLE) of older adults learning English as a foreign language in Chinese Universities of the Third Age. Understanding the largely overlooked emotional involvement of older language learners contributes to sustaining their motivation in lifelong learning for more remarkable personal growth and successes. Based on the survey of 587 Chinese older learners of English between the age of 50 and 80, paired sample t-test showed that more FLE was reported than FLCA. The results of Welch's ANOVA suggested that those who were better educated had less FLCA and those who believed themselves healthier had more FLE. The language performance evaluation (i.e. relative standing in class and English mastery) affects both FLE and FLCA. Further interviews with 34 older participants revealed three major sources of FLE, including the language use in life situations, the favorable attitude toward FL learning in the cognitive, aesthetic cultural and pragmatic aspects and the social interactions in the U3As. FLCA occurs when the language performance is perceived as dissatisfying and when aspects of mental health (e.g. worsening memory) impede effective learning. Although FLCA and FLE had only a very weak correlation, Chinese older adult learners commented on a shared belief that anxiety usually precedes and subsequently enhances enjoyment in learning, indicating a sign of emotional resilience later in life. This paper demonstrates a need for understanding the emotions in language learning across life stages and socio-cultural contexts. [ABSTRACT FROM AUTHOR]

Background: The previous studies an association between dietary patterns and psychiatric symptoms. However, few studies have examined the association of quality of dietary patterns and anxiety, depressive symptoms in the Chinese population., Methods: Between 2017 and 2019, a population-based, cross-sectional survey was carried out in China. Uniformed questionnaires collected the demographic characteristics and food data. The dietary quality of the adults was evaluated using the revised Diet Balance Index 2016 (DBI-16). We measured anxiety and depression symptoms using the the Generalized Anxiety Disorder (GAD)-7 and Patient Health Questionnaire (PHQ)-9., Results: A total of 73,737 participants were recruited during the survey period. 17.6 % and 13.7 % of residents suffer from anxiety and depression symptoms, respectively. The DBI-16 indicates that participants with anxiety or depression symptoms had higher scores of low bound score (LBS, refers to inadequate food intake) and dietary quality distance (DQD, refers to unbalanced food intake) than those without anxiety or depression. The logistic regression models showed that high levels of LBS and DQD problems were more strongly associated with anxiety (LBS:OR = 1.20, DQD:OR = 1.30) and depressive symptoms (LBS:OR = 1.21, DQD:OR = 1.44). On the contrary, higher bound score (HBS, refers to excessive food intake) was significantly negatively correlated with symptoms of anxiety and depression. Moreover, each increase in the food group was associated with 4 % lower odds of anxiety and 6 % lower odds of depression symptoms., Limitations: Cross-sectional design and self-reporting of psychological symptoms and dietary information limit the generalizability of the results., Conclusion: The dietary quality of adults aged 40 years and over in China is suboptimal, with excessive and inadequate food intake simultaneously. Dietary imbalance, and low dietary diversity may be related to anxiety and depressive symptoms., 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 © 2023 Elsevier B.V. All rights reserved.)

Mental health disorders are prevalent among biomedical students, and scientific research is one of their main activities, yet less is known about the relationship between research activities and mental health among these students. The aim of this cross-sectional study was to assess the associations between research activities and mental health and to identify the potential risk factors for anxiety and depression among biomedical students in China. This study enrolled 1,079 participants between November 2020 and December 2020 from 29 Chinese provinces and collected participants' basic characteristics, work situations, scientific achievements, and potential stress sources via an online questionnaire. Anxiety and depression were evaluated by two widely used scales, the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), respectively. The study also assessed the associations between scientific research duration and mental health. Univariate and multivariate analyses were performed to identify the predictors of anxiety and depression. Among the participants, 39.02% scored as having moderate to severe anxiety, and 37.54% scored as having moderate to severe depression. When the Youden index reached its maximum, the optimal cutoff was 7.17 h for the GAD-7 and 6.83 h for the PHQ-9. After adjustment for confounders, a longer research work duration was significantly associated with a higher anxiety [odds ratio (OR) = 1.32, 95% confidence interval (CI): 1.21–1.44, p < 0.01] and depression (OR = 1.27, 95% CI: 1.17–1.39, p < 0.01). Of all the participants working for 7 h a day, 37.04% had already published at least one paper and 25.93% had at least one Science Citation Index paper. Anxiety and depression are common among biomedical students. The research work duration of 7 h a day is the best cutoff for mental health, and it is associated with acceptable scientific research achievements. Not more than 7 h a day on research is recommended for biomedical students to maintain a balance between mental health and scientific research achievements. [ABSTRACT FROM AUTHOR]

Medical students in China and other non-English speaking countries are susceptible to English as a Foreign Language (EFL) writing anxiety. English writing is not only a vital component tested for admission to postgraduate and doctoral programs, but it is also critical for the publication of academic papers. Although there is mounting evidence indicating relationships between anxiety, self-esteem and mobile phone addiction, pathways between these three constructs within a structural equation model have not yet been examined. Furthermore, there has been a dearth of studies exploring EFL writing anxiety, from which medical students in China as well as other non-English speaking countries are prone to suffer. The study was to assess EFL writing anxiety among Chinese medical students and to examine the relationships between EFL writing anxiety, self-esteem, and mobile phone addiction, with an aim to offer empirical evidence for effective preventive or intervention measures to alleviate EFL writing anxiety. Cross-sectional data were obtained from 1,238 medical students in China, with the administration of a self-administered questionnaire comprising the Second Language Writing Anxiety Inventory (SLWAI), the Rosenberg Self Esteem Scale (RSES) and the Mobile Phone Addiction Tendency Scale (MPATS). The results indicated that both self-esteem and mobile phone addiction exerted significant direct effects on EFL writing anxiety. Self-esteem also had a significant indirect effect on EFL writing anxiety via the mediating role of mobile phone addiction. The path coefficients of self-esteem on EFL writing anxiety were significantly reduced when mobile phone addiction was modeled as a mediator. Efforts to alleviate EFL writing anxiety among medical students may benefit from enhancing self-esteem and establishing a healthy relationship with mobile phones., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Song et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)