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Background: Fertility rates have been decreasing both worldwide and in China. Although current policies have been aimed at raising the birth rate in China, their overall effects have been unclear. Therefore, exploration of fertility intention and related influencing factors is crucial. Methods: This study used a convergent parallel mixed methods combining descriptive and cross-sectional designs with a framework analysis. Convenience sampling was used to select mothers of childbearing age with two children (n = 603), living in Guangdong Province, China. Participants completed an online questionnaire investigating sociodemographic characteristics, as well as determinants and attitudes regarding the third-child fertility intention. Correlation coefficients and multivariate regression analyses were used to present quantitative findings. Eleven interviews were conducted, and a framework analysis method was used for data analysis. The results for the qualitative and quantitative study components were analyzed separately and were subsequently integrated through side-by-side comparison and joint display. Result: Attitudes toward fertility intention were negative, and the rate of fertility intention was 10.4% in Guangdong Province. In the quantitative component, women's age, perceived value of having a third child, and attitudes were found to be factors promoting the intention to have a third child, whereas monthly family income, grandparents' health status, and policy support were found to be factors hindering the intention to have a third child. Four major themes emerged regarding the perceptions and experiences regarding fertility intention in the qualitative component. After integrated analysis, younger age, knowledge regarding policy support, and access to childcare support were found to be factors significantly affecting the intentions of mothers with two children regarding having a third child. Conclusion: Fertility issues require continued attention. Our findings provide a reference for optimizing existing policies to increase fertility intentions. Providing policy support, such as public childcare support, flexible working hours for mothers, affordable childcare, and greater psychological support, would enable mothers to improve their parenting. In addition, increasing the dissemination of knowledge regarding policies is necessary to improve the level of public understanding and promote fertility intention. [ABSTRACT FROM AUTHOR]

Social media use for risk communication during the COVID-19 pandemic has caused considerable concerns about an overabundance of information, particularly misinformation. However, how exposure to COVID-19 information on social media can lead to subsequent misinformation sharing during the pandemic has received little research attention. This study adopted the social amplification of risk framework to delineate how exposure to COVID-19 vaccine information on social media can be associated with individuals' misinformation sharing through heuristic information processing. The role of social media trust was also examined. Results from an online survey (N = 1488) of Chinese Internet users revealed that exposure to COVID-19 vaccine information on social media was associated with misinformation sharing, mediated by both affect heuristics (i.e., negative affect toward the COVID-19 pandemic in general) and availability heuristics (i.e., perceived misinformation availability). Importantly, both high and low levels of trust in social media strengthened the mediating associations. While a low level of trust strengthened the association between exposure to COVID-19 vaccine information on social media and the affect heuristics, a high level of trust strengthened its association with the availability heuristics, both of which were associated with misinformation sharing. Our findings suggest that heuristic information processing is essential in amplifying the spread of misinformation after exposure to risk information on social media. It is also suggested that individuals should maintain a middle level of trust in social media, being open while critical of risk information on social media. [ABSTRACT FROM AUTHOR]

Purpose: To elucidate the underlying motivations, experiential dimensions, and cognitive perceptions in adolescents with depression and non-suicidal self-injury (NSSI). Method: A descriptive qualitative design was used. Participants were 18 Chinese adolescents with depression and NSSI. Conventional content analysis was used for data analysis. Results: Three primary themes and 11 subthemes were identified: Triggers of NSSI (personal, family, school, and social factors); Experiencing Emotional Complexity in NSSI Implementation (mitigating psychological distress, awakening a sense of existential life, generating secondary negative emotions, stimulating reflections on life and death); and Perceptions and Understandings of NSSI Are Diverse (NSSI as a form of seeking validation or approval, an addictive behavior, a means to attain a sense of control, and unacceptable behavior). Conclusion: Although nursing staff should provide comprehensive treatment and psychological support, efforts should also be made to strengthen caregiving skills of family members, thereby promoting overall physical and mental health of adolescents. [Journal of Psychosocial Nursing and Mental Health Services, 62(11), 47–55.] [ABSTRACT FROM AUTHOR]

Background: Chronic insomnia is a common yet often overlooked issue in primary health care. This study investigated the knowledge, attitude, and practices of chronic insomnia management among general practitioners (GPs). Methods: A cross-sectional online survey was conducted among GPs providing routine care to adults with insomnia in health facilities at all levels in Sichuan Province, China. Additionally, we designed an online questionnaire that included basic information and knowledge, attitudes, and practices regarding chronic insomnia management. Results: We included 420 GPs, 66.2% of whom were female and 58.1% were from community health service centers. Total 198 (47.1%) GPs had received specific training and only 2 GPs (0.5%) correctly answered the knowledge-related questions. Furthermore, only 44 GPs (10.5%) demonstrated excellent practice behaviors, while most GPs (70.2%) expressed high demand for training in insomnia management. Insomnia training experience was associated with higher practice scores (β = 3.318, p < 0.001). Conclusion: This study established an association and correlation between knowledge, attitude, and practice scores in treating insomnia and the sociodemographic characteristics of GPs in China. Although knowledge and practice performance in this field need to be improved, they mostly displayed a positive attitude towards insomnia management. Thus, offering continuing education opportunities to GPs would be highly beneficial. [ABSTRACT FROM AUTHOR]

Background Continuity of care is essential to older patients' health outcomes, especially for those with complex needs. It is a key function of primary healthcare. Despite China's policy efforts to promote continuity of care and an integrated healthcare system, primary healthcare centres (PHCs) are generally very underused. Objectives To explore the experience and perception of continuity of care in older cancer patients, and to examine how PHCs play a role in the continuity of care within the healthcare system in China. Methods A qualitative study using semi-structured interviews was conducted in two tertiary hospitals in Nantong city, Jiangsu province, China. A combination of deductive and inductive analysis was conducted thematically. Results Interviews with 29 patients highlighted three key themes: no guidance for patients in connecting with different levels of doctors, unmet patients' needs under specialist-led follow-up care, and poor coordination and communication across healthcare levels. This study clearly illustrated patients' lack of personal awareness and experience of care continuity, a key issue despite China's drive for an integrated healthcare system. Conclusion The need for continuity of care at each stage of cancer care is largely unmeasured in the current healthcare system for older patients. PHCs offer benefits which include convenience, less burdened doctors with more time, and lower out-of-pocket payment compared to tertiary hospitals, especially for patients with long-term healthcare needs. However, addressing barriers such as the absence of integrated medical records and unclear roles of PHCs are needed to improve the crucial role of PHCs in continuity of care. [ABSTRACT FROM AUTHOR]

In this research, I examined the complexities of women's understandings and practices during childbirth and used the theoretical tool of situated choices and socio-cultural risk theory to explore and conceptualise their limited agency during childbirth. Drawing upon the perspectives of the sociology of childbirth risk and childbirth choice, I analysed data collected through participant observations and in-depth interviews with women in urban parts of Jiangsu Province, China. In illuminating the women's assembled knowledges and rich understandings of birthing processes, it became apparent how they situated their choices regarding medicalised childbirth, and how they bricolaged multiple perspectives regarding the past and future on the delivery bed. These everyday rationales and knowledges were used actively and in tandem with a mainstream epistemology of biomedicine. [ABSTRACT FROM AUTHOR]

China has over 100 million people living with type 2 diabetes mellitus (T2DM). Interventions framed around pre-existing personal beliefs in the supernatural may improve T2DM self-management, but such interventions are lacking in China. This pilot randomized controlled trial (RCT) assessed the feasibility of a full-scale RCT to evaluate the efficacy of a supernatural beliefs-based intervention on T2DM management self-efficacy in China. In 2019, 62 T2DM patients were enrolled at two hospitals in Suzhou, China. Participants were randomly assigned to view a 30-s control or intervention video at baseline. The control video showed general diabetes self-management information. The intervention video showed identical information, but also indicated that some diabetics with supernatural beliefs (chao ziran xinnian) have lower glycemic levels, because their beliefs enhance their confidence in diabetes self-management. Development of the intervention was guided by the theory of planned behavior and literature on spiritual framing health interventions. Baseline and follow-up measures after two weeks were assessed by interviewer administered surveys in-person and by telephone, respectively. Diabetes management self-efficacy was assessed with the diabetes management self-efficacy scale. Randomization of intervention allocation appeared to be successful. However, follow-up retention was low, especially for the intervention group (3% vs. 31%). A full-size efficacy RCT using the current study design is unlikely to succeed. T2DM patients shown the supernatural beliefs-based intervention had significantly higher loss to follow-up that was insurmountable. T2DM patients in Suzhou, China may not be receptive to brief, non-tailored supernatural beliefs-based interventions delivered to a general population in clinical settings. [ABSTRACT FROM AUTHOR]

Chinese family caregivers of people with dementia (PWD) can suffer from physical and psychological burden. This study aimed to examine the effects of logotherapy-based interventions on Chinese family caregivers of older adults with dementia to decrease caregiver burden. This mixed-methods study used a pre-experimental design with pre-posttests and semi-structured interviews. A purposive sample of 13 family caregivers from a suburban district in Shanghai was enrolled with (1) caregiver burden and (2) access and capability to use smart devices. Participants received eight online group logotherapy sessions with a focus on hope and meaning construction. Participants completed the Zarit Burden Interview, a 22-item measure of caregiver burden, before and after the intervention, and a 30-min semi-structured interview post-intervention. From the quantitative data, dementia caregivers reported severe caregiving burdens at the baseline (M = 54.77, SD = 9.33). Caregiver burden significantly decreased after the logotherapy-based intervention (M = 52.15, SD = 8.80, p <.001). Two themes pertaining to participants' experiences in intervention emerged from the qualitative data: (1) improved attitudes toward suffering, and (2) enhanced sense of meaning in life and hope. The cultural relevance of logotherapy to Chinese familism and Confucianism may further enhance its feasibility in the Chinese context. [ABSTRACT FROM AUTHOR]

Aims: To explore the psychosocial experiences during dietary management among Chinese adults with inflammatory bowel disease. Design: Qualitative phenomenological design. Methods: Eighteen adults diagnosed with inflammatory bowel disease for more than 6 months were recruited using purposive sampling from June to December 2023. Two trained researchers used van Manen's approach to analyse the data. Results: The three themes with multiple subthemes emerged: facing the unknown: at a loss and aggrieved, trying to cope: uncertain and distressed, and growing in adaptation: relieved and transcendent. The first theme included unknown relapses, overlooking diet management and the absence of dietary rules. The second theme showed different coping situations, like complex dietary information and ever‐closing worlds. The third theme explores how participants adapted to disease and their eating patterns. Conclusion: The psychosocial experiences during dietary management are complex. The accumulation of diet‐related experience, acceptance of illness and social support facilitate patients in overcoming negative emotions and adhering to dietary management. Implications for the Profession and Patient Care: Nurses should provide tailored dietary guidance and appropriate psychological interventions to promote healthy eating in patients. Impact: This study may enhance healthcare professionals' understanding, particularly those in China, of the diet‐related experiences among patients. Reporting Method: The Consolidated Criteria for Reporting Qualitative Research checklist. Patient or Public Contribution: Participants contributed by sharing their first hand experiences. [ABSTRACT FROM AUTHOR]

Objective: This study examines Chinese international students' underlying beliefs and overall perception of the flu vaccination to inform effective health promotion efforts on U.S. college campuses. Participants: Data were collected in March 2020. Participants (N = 189) were recruited via email at a southeastern university in the U.S. Methods: Incorporating theory recommendations and recent vaccine-related research findings, this study designs a Four-Factor Measurement Model through confirmatory factor analysis (CFA) to examine Chinese international students' perception of flu vaccination. Results: Chinese international students' health beliefs, particularly their perceived susceptibility of the influenza virus, was the most important factor to explain their perception of flu vaccination. While normative beliefs were the least influential factor to account for Chinese international students' perception of flu vaccination, these students valued healthcare providers' opinions immensely. Conclusions: This study suggests the Four-Factor Measurement Model will help measure Chinese international students' perception of flu vaccination and can be applied to future vaccine-related research. [ABSTRACT FROM AUTHOR]

Background: The famous Tang Dynasty monk Yi Jing travelled to ancient India in 671 AD, visited more than 30 regions and returned to China in 695 AD. He wrote Nanhai Jigui Neifa Zhuan, which he completed in 691 AD. It describes the basic rules, namely 'Inner Dharma' (Neifa,内法) that Buddhist sites and monks should follow in their daily lives. Additionally, the author provided an overview of ancient Indian Buddhist medicine, covering aetiology, diagnosis, medication, acupuncture, health preservation and other aspects, which exhibited distinct characteristics. Methods: This article first delves into the original text of Nanhai Jigui Neifa Zhuan by reading it thoroughly and extracts core chapters related to hygiene, medicine and health care. Later, the extracted information is meticulously classified and organised. Lastly, through a systematic literature review, keywords search, data screening and comparative analysis, an in-depth and comprehensive exploration and analysis of Nanhai Jigui Neifa Zhuan is conducted within the domains of hygiene, medicine and health care. Results: Nanhai Jigui Neifa Zhuan emphasizes the importance of personal hygiene for ancient Indian monks and introduces the basic theories of ancient Indian medicine. It compares ancient Indian and Chinese medicinal materials, highlighting their respective roles in treating different diseases. Furthermore, it briefly discusses the storage and processing of ancient Indian medicinal materials, poisoning and toxicology, and ancient Indian health preservation ideologies. Conclusion: A comprehensive and in-depth study of traditional ancient Indian medicine, including Buddhist medicine and Ayurveda, and its application in the religious environment and communities of the Tang Dynasty (618–907 AD) aids in understanding the treatment methods and health practices of ancient Indian medicine. Additionally, it facilitates a deeper understanding of the similarities, differences and exchange between Chinese and Indian medicine, thereby opening up new horizons for future research. [ABSTRACT FROM AUTHOR]

Background: Depression affects the oral health of older adults; however, little is known about its impact on oral health among rural older adults in developing countries, which warrants further research. Taking China as an example, there is a large population base of rural older adults suffering from depression, and many rural older people also have long-term oral health problems, which have seriously affected their quality of life in later life. Therefore, this study aimed to explore linear and non-linear associations of depressive symptoms with oral health knowledge, attitudes, and practices among rural older adults in China. Methods: From November 2020 to December 2020, 1,902 rural community-dwelling older people aged 60 years and older were investigated, via a cross-sectional survey. The general information, depressive status, oral health knowledge, attitudes, and practices of the participants were obtained through face-to-face structured questionnaires. Among them, the Zung Depression Self-Rating Scale was used to investigate the depressive symptoms of the participants in this survey. The generalized linear model and classification and regression tree model were used, separately. Results: Based on linear analysis results, we found that minimal to mild depressive symptoms [regression coefficient (β) = -0.345; 95% confidence interval (CI): -0.582 to -0.109, P = 0.004] and depressive symptoms (β = -1.064; 95% CI: -1.982 to -0.146, P = 0.023) were significantly correlated with oral health knowledge. A negative correlation was observed between minimal to mild depressive symptoms (β = -0.385; 95% CI: -0.600 to -0.170, P < 0.001) and oral health attitudes. In addition, while both minimal to mild depressive symptoms (β = 0.018; 95% CI: -0.312 to 0.347, P = 0.916) and depressive symptoms (β = 0.604; 95% CI: -0.675 to 1.883, P = 0.355) were associated with oral health practices. Furthermore, the non-linear analysis showed a combined effect of depressive symptoms on oral health attitudes, indicating that older people of a younger age, not living alone, and not suffering from depressive symptoms are more likely to report better oral health attitudes. Conclusion: Both the linear and non-linear analyses in our study showed that depressive symptoms are significantly correlated with the poor oral health attitudes of older adults in rural communities. Furthermore, depressive symptoms were associated with oral health knowledge in the linear analysis. However, no statistically significant difference was found between depressive symptoms and oral health practices in either analysis. This research deepens our knowledge and understanding of relevant evidence in the mental and oral health of people in later life. In addition, analyzing the factors that affect the oral health of older people from the perspective of their depressive status provides new thinking directions and scientific references for improving the oral health of older adults in practical life. [ABSTRACT FROM AUTHOR]

Aims. To understand what domains of acculturation are experienced by Chinese immigrants with cardiovascular disease (CVD) in Australia and how these domains of acculturation influence their CVD self‐care behaviours. Design. A qualitative descriptive design. Methods. Individual phone interviews were conducted among Chinese immigrants with CVD in Sydney, recruited from Chinese Community associations and social media. Inductive and deductive thematic analysis was employed, guided by the Middle‐Range Theory of Self‐Care of Chronic Illness and the conceptual model of acculturation. Results. Twenty participants, mean age 69.9 years, were interviewed. The domains of acculturation in relation to CVD self‐care behaviours encompassed cultural practices, cultural values, healthcare system navigation, and new living environment. Retaining their Chinese culture and integrating into Australian culture regarding dietary practices, social networks, traditional values and family relationships served as both enablers and barriers of self‐care maintenance through factors such as heart‐healthy diets, physical activity, stress management and medication adherence. Many participants denied encountering difficulties to utilize primary care services, but language barriers deterred them from accessing acute services and heart‐health information from mainstream sources. Some preserved beliefs and practices in Traditional Chinese Medicine may complicate their self‐care maintenance (medication adherence) and self‐care management (responding to acute angina episodes). Conclusion. The influence of acculturation on CVD self‐care behaviours among Chinese immigrants is multifaceted and individualized. Clinicians and community health workers should assess patients' acculturation experiences to enable culturally sensitive practices. The lack of culturally and linguistically appropriate heart health information in the community should be addressed urgently to mitigate the cardiac health disparity. Collaboration with Chinese community associations offers an opportunity for co‐design and dissemination of information about Australian healthcare systems and heart health education to upskill CVD self‐care practices and mitigate the health inequities experienced by Chinese immigrants. [ABSTRACT FROM AUTHOR]

Allomothering, the practice of child-rearing by caregivers other than childrens' mothers, has garnered more attention recently. This study examined allomothering within the matrilineal Mosuo, an ethnic group in Southwestern China known for its nonmarital reproductive and dual-residence system, in which partners maintain separate residences, fostering cooperative multigenerational child-rearing. Still, specific parental interactions within the Mosuo have not been completely investigated. Using the grounded theory approach, we conducted two rounds of semi-structured interviews to explore Mosuo's allomothering system and child socialization practices. Initial interviews (N = 19, M = 53.68) focused on child-rearing beliefs and family relationships. Subsequent interviews with caregivers (N = 17, M = 40.6) and children (N = 19, M = 15.7) delved into detailed intergenerational parental interactions. Our findings show that grandmothers primarily handled children's daily care, with mothers and sisters dividing responsibilities for financial provisions and co-caregiving. Mothers tended to enforce discipline, and aunts provided nurturing attention. A female-led "Huotang-focused" allomothering system is prevalent, where "Huotang" signifies the communal hearth, central to family interactions. Maternal uncles, while not directly involved in care, oversaw moral and behavioral guidance and assumed economic obligations. Fathers, exhibiting less authority than maternal uncles, predominantly engaged in rough-and-tumble play, marking their interactions with their children by distinctive friend-like characteristics. Children's socialization reflected legitimate peripheral participation, with the children observing and modeling their maternal caregivers' behaviors and beliefs. Mosuo's allomothering interactions offer fresh insights into cooperative strategies and prompt a reconsideration of traditional parental roles in child socialization. Highlights: Mosuo's Huotang-centered allomothering system is a female-led kinship structure wherein mothers predominantly rely on additional maternal figures for assistance. For example, grandmothers provide daily care and companionship to children and sisters offer complementary emotional support. Male investment in child-rearing varies by lineage, with fathers interacting directly with their children and maternal uncles disciplining their sisters' children and bearing economic responsibilities. Children adopt a strategy of legitimate peripheral participation, and they observe and model adults' behaviors from daily Huotang conversations. Support provision potentially includes direct parenting, emotional companionship, and moral and cultural socialization. As a result, society may find it beneficial to consider the distribution of physical resources and caregiving support required for efficient family-based child-rearing. [ABSTRACT FROM AUTHOR]

Introduction: Due to the widespread use of social media by young adults, the alcohol industry has been increasingly using social media marketing (SMM) to target potential customers. This study examines the prevalence and factors associated with past‐month exposure to alcohol SMM among young Chinese adults, a group with rapidly increasing uptake of alcohol consumption. Methods: An anonymous, random telephone survey was conducted between June and August 2021 on Hong Kong Chinese residents between 18 and 34 years old (n = 675). Results: Of respondents, 52.3% reported past‐month exposure to alcohol SMM (68.6% of past‐month drinkers and 48.0% of non‐past‐month drinkers, p < 0.05) while 71.6% reported exposure to non‐SMM alcohol marketing. Direct alcohol SMM exposure was reported by 40.9% (e.g., business‐to‐consumer postings, alcohol banner ads) while 27.4% of respondents reported exposure to indirect alcohol SMM marketing (e.g., shared/'liked' alcohol brand posts). Of those exposed to alcohol SMM, 13.7–15.5% reported that the various forms indirect alcohol SMM influenced them to drink more (vs. 6.2–8.9% for direct alcohol SMM). Being male, lower‐income, university educated and spirits/cocktail drinker were independently associated with exposure to direct alcohol SMM (ORmv 1.71–3.14). Past‐month exposure to indirect alcohol SMM was independently associated with lower income, not working full‐time and drinking any type of alcohol (ORmv 1.59–4.44). Discussion and Conclusion: The comparative effectiveness of indirect SMM on influencing young adults drinking intentions may be a form of peer endorsement of drinking. The pervasiveness of alcohol SMM and lack of alcohol SMM policies may indicate the need for greater alcohol marketing regulation in this region. [ABSTRACT FROM AUTHOR]

Objective: To explore their perceptions and attitudes toward condom use and the underlying reasons for the low usage frequency among Chinese older adults. Methods: A qualitative study design utilizing interpretive phenomenological analysis was employed. Data were collected through field observation and face‐to‐face in‐depth interviews among older adults aged 50 years or above and having engaged in sexual activities within the previous year. Results: Three main themes emerged: perceiving unnecessary due to misconceptions and low awareness, interactive stereotypes rooted in sociocultural beliefs, and stigmatized social norms including gender inequity and economic unbalance. Conclusions: Tailored interventions focusing on addressing misconceptions, increasing awareness, and reducing culturally ingrained stereotypes and stigma surrounding condom use are essential to promote condom use among older adults in order to prevent HIV transmission in China. [ABSTRACT FROM AUTHOR]

Background: The rising prevalence of depressive symptoms presents a pressing global public health concern, exacerbated by prevailing social inequality. Aim: This study seeks to identify latent profiles of social inequality perception and explore their associations with depressive symptoms. Methods: Data were obtained from the China Family Panel Studies (CFPS) involving 10,529 residents aged 18 years and above. Latent profile analysis (LPA) was used to identify different patterns of social inequality perception. Multiple linear regression analysis examined the links between these patterns and depressive symptoms. Results: Three distinct patterns of social inequality perception were identified: the disappointed pattern (TDP), the neutral pattern (TNP), and the positive pattern (TPP). Perceived social inequality was significantly associated with short-term and long-term depressive symptoms (β =.51, 95% CI [0.29, 0.72] vs. β =.51, 95% CI [0.27, 0.74]). Increases in social inequality perception patterns were also related to more severe depressive symptoms (β =.55, 95% CI [0.36, 0.74]). Conclusions: Increasing perceived social inequality is closely linked to elevated depressive symptoms in Chinese adults. This underscores the need for tailored strategies aimed at addressing heightened perceptions of social inequality to reduce the risk of depressive symptoms. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the relationship between control beliefs about stress and post‐traumatic growth among Chinese nurses during the COVID‐19 pandemic and to examine the mediating role of basic psychological needs satisfaction and optimism in this relationship. A total of 692 Chinese nurses participated in this online study, who completed the Beliefs about Stress Scale, Post‐Traumatic Growth Inventory, Positive Psychological Capital Questionnaire, Basic Psychological Needs Satisfaction Scale and demographic variables between September and October 2020. Results indicate that 48.8% (N = 388) of nurses reported significant post‐traumatic growth related to the COVID‐19 pandemic. Moreover, control beliefs about stress were positively related to post‐traumatic growth (r = 0.38, p < 0.001), basic psychological needs satisfaction (r = 0.44, p < 0.001) and optimism (r = 0.47, p < 0.001). In addition, basic psychological needs satisfaction and optimism were both independent and serial mediators of the relationship between control beliefs about stress and post‐traumatic growth. Nurses and hospital administrators should focus on increasing nurses' control beliefs about stress and thereby enhancing their post‐traumatic growth after experiencing events such as the COVID‐19 pandemic. To support this process, programs should be designed to meet nurses' basic psychological needs and increase their optimism. [ABSTRACT FROM AUTHOR]

Internet of Things (IoT) home care technologies have great potential to support older adults' everyday activities and compensate for age-related changes. This study aims to explore older adults' preferences for IoT home care technologies and factors influencing their acceptance from different perspectives. A total of 19 participants were purposively recruited, including 12 community-dwelling and nursing home older adults (74.8 ± 8.7 years), three adult children (48.3 ± 11.9 years), and four caregivers (43.8 ± 9.4 years). Their experiences and attitudes were explored through semi-structured interviews, assessing their general opinions toward IoT home care technologies and exploring what factors may hinder or facilitate their use. Twenty-two IoT home care services were included and the interview data were analyzed using thematic analysis. The results revealed that community-dwelling older participants preferred entertainment services, while the nursing home group preferred safety services. Eight factors affecting older adults' acceptance of IoT home care technologies were extracted: personality traits, self-health assessment, adult children support, roommate influence, affordability, credibility, compatibility, and substitutability. The impact of generational thrifty personality, adult children's support, and service credibility are highlighted in the Chinese cultural context. Promotion of and education on using IoT services among older adults' and their children is recommended. [ABSTRACT FROM AUTHOR]

Background: The administration of anesthesia during gastrointestinal endoscopy potentially contributes to post-anesthesia cognitive dysfunction (PACD), with detrimental impacts for cognitive function. This study aimed to assess the knowledge, attitudes, and practices (KAP) towards PACD among patients undergoing gastrointestinal endoscopy in Wenzhou region. Methods: This cross-sectional study was conducted between June and August 2023, and recruited individuals undergoing gastrointestinal endoscopy. Demographic data and KAP scores were collected through questionnaires. Pearson correlation analysis was applied to evaluate correlations between KAP scores, and logistic regression was utilized to identify influential factors. Results: We collected 405 valid questionnaires, with 54.57% being male and 29.88% aged 31–40 years. Mean KAP scores were 13.99 ± 4.80, 16.19 ± 2.35, and 15.61 ± 2.86, respectively (possible range: 0–16, 0–25, and 0–25). Pearson correlation analysis demonstrated significant positive correlations between knowledge and practice (r = 0.209, P < 0.001), attitude and practice (r = 0.233, P < 0.001), and knowledge and attitude (r = 0.328, P < 0.001). Multivariate logistic regression revealed negative associations of opting for standard gastrointestinal endoscopy (without anesthesia) with knowledge (OR = 0.227, 95%CI: 0.088–0.582, P = 0.002) and practice scores (OR = 0.336, 95%CI: 0.154–0.731, P = 0.006). Additionally, the presence of cognitive-related diseases or symptoms before undergoing gastrointestinal endoscopy was negatively associated with knowledge scores (OR = 0.429, 95%CI: 0.225–0.818, P = 0.010). Conclusion: Patients undergoing gastrointestinal endoscopy demonstrated good knowledge, neutral attitudes, and moderate practices regarding PACD. Educational interventions and behavior modification are recommended, particularly for individuals with lower monthly income, undergoing standard gastrointestinal endoscopy, or experiencing cognitive-related conditions. [ABSTRACT FROM AUTHOR]

Background: Neonatal nurses should provide timely and high-quality palliative care whenever necessary. It's necessary to investigate the knowledge, attitude and behavior of palliative care among neonatal nurses, to provide references and evidences for clinical palliative care. Methods: Neonatal intensive care unit (NICU) nurses in a tertiary hospital of China were selected from December 1 to 16, 2022. The palliative care knowledge, attitude and behavior questionnaire was used to evaluate the current situation of palliative nursing knowledge, attitude and behavior of NICU nurses. Univariate analysis and multivariate logistic regression analysis were used to analyze the influencing factors. Results: 122 nurses were finally included. The average score of knowledge in neonatal nurses was 7.68 ± 2.93, the average score of attitude was 26.24 ± 7.11, the score of behavior was 40.55 ± 8.98, the average total score was 74.03 ± 10.17. Spearman correlation indicated that score of knowledge, attitude and behavior of palliative care in neonatal nurses were correlated with the age(r = 0.541), year of work experience(r = 0.622) and professional ranks and titles(r = 0.576) (all P < 0.05). Age (OR = 1.515, 95%CI: 1.204 ~ 1.796), year of work experience (OR = 2.488, 95%CI: 2.003 ~ 2.865) and professional ranks and titles (OR = 2.801, 95%CI: 2.434 ~ 3.155) were the influencing factors of score of knowledge, attitude and behavior of palliative care (all P < 0.05). Public contribution: NICU nurses have a positive attitude towards palliative care, but the practical behavior of palliative care is less and lack of relevant knowledge. Targeted training should be carried out combined with the current situation of knowledge, attitude and practice of NICU nurses to improve the palliative care ability and quality of NICU nurses. [ABSTRACT FROM AUTHOR]

The objective of this study was to identify variables that predict adherence to follow-up visits among people who are positive for diabetes during screening and to investigate barriers to follow-up. A retrospective cohort study linking individual-level registry data was performed. First, we compared the characteristics of attenders and non-attenders. Second, we investigated perceived barriers using a questionnaire in a random sample of people who failed to attend the follow-up visit. A total of 27,806 (16.4%) patients attended the follow-up visits. Multiple logistic regression analysis revealed that individuals aged ≥75 years were more likely to attend follow-up than were those aged 35–45 years (odds ratio [OR]: 1.97 [95% confidence interval {CI}: 1.82–2.15]), male (OR: 1.15 [95% CI: 1.12–1.18]), obese (OR: 1.36 [95% CI: 1.29–1.43]), had positive family history of diabetes (OR: 1.37 [95% CI: 1.30–1.45]), hypertension (OR: 1.05 [95% CI: 1.01–1.09]), high glucose levels (OR: 1.10 [95% CI: 1.09–1.11]), and high diabetes risk scores (OR: 1.02 [95% CI: 1.02–1.03]) facilitated follow-up. However, overweight (OR: 0.95 [95% CI: 0.92–0.99]) and central obesity (OR: 0.86 [95% CI: 0.83–0.90]) predicted no follow-up. Among nonattenders, diabetes beliefs, time restrictions and distance from home to hospitals were the top three barriers hindering follow-up visits. Specific individual-level characteristics predicted adherence to follow-up visits, and some personal and sociocultural barriers hindered follow-up visits. [ABSTRACT FROM AUTHOR]

Background: This study explores the medicinal plant knowledge of the Baiku Yao, a unique ethnic group in China. Despite existing research on their ethnobotanical practices, a comprehensive understanding of their medicinal flora remains lacking. This study aims to document and analyze the species distribution, utilization, and traditional knowledge of medicinal plants used by Baiku Yao. Methods: Ethnobotanical surveys were conducted in various Baiku Yao villages across different seasons from 2019 to 2023. Informants were interviewed, and plant specimens were collected and identified. Statistical analyses, including the Relative Frequency of Citation (RFC), were employed to understand plant importance in Baiku Yao culture. Results: In an ethnobotanical survey conducted in the Baiku Yao region, 434 medicinal plant species were documented, highlighting significant ethnobotanical diversity and a deep cultural integration of traditional medicinal practices. The study revealed pronounced geographical variations in plant knowledge among villages, with a notable reliance on wild plants, as 85.48% were sourced from the wild, reflecting unique local ethnobotanical knowledge. Predominantly herbs and shrubs were used due to their accessibility and abundance in the local environment. High Relative Frequency of Citation (RFC) values for certain species underscored their importance for local health needs and additional economic value. The utilization of various plant parts, particularly whole plants, roots, and leaves, indicates a holistic approach to medicinal applications, adapted to combat prevalent health issues such as skin and infectious diseases. The study also uncovered the Baiku Yao's cultural practices for countering "Gu" afflictions—a range of pathogenic conditions—with 18 diverse antidote plants used for skin, digestive, and musculoskeletal disorders. The study underscores the imperative of preserving this rich medicinal heritage through innovative models that engage youth and leverage new media, ensuring the inheritance and evolution of Baiku Yao's traditional knowledge. Conclusions: Baiku Yao's medicinal plant use reflects a deep, culturally ingrained knowledge, closely tied to local ecology. The study highlights the importance of preserving this unique ethnobotanical heritage and suggests interdisciplinary approaches for future research. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association of religious belief on the postoperative psychological status and quality of life of parents of children with congenital heart disease (CHD). This was a cross-sectional study conducted at a provincial children's hospital in Fujian Province, China. Parents of postoperative children with CHD in the early postoperative period were included in this study between January 2020 and September 2020. The parents were divided into a religious belief group (n = 39) and a nonreligious belief group (n = 42) depending on whether they had religious beliefs. The Religious Coping Questionnaire, WHOQOL-BREF scale, Self-rating depression scale (SDS), and Self-rating anxiety scale (SAS) were used to evaluate psychological status and quality of life. The results showed that the SDS and SAS scores in the religious belief group were significantly lower than those in the nonreligious belief group (P = 0.012 and P = 0.003, respectively). The WHOQOL-BREF scale results showed that the religious belief group's score was significantly higher than those in the nonreligious belief group on the subscale scores of physiology, psychology, social relations, and environment on the WHOQOL-BREF. The total score of quality of life in the religious belief group was significantly higher than that in the nonreligious belief group. Religious belief was associated with lower SDS score (β = − 0.324, P = 0.005) and SAS score (β = − 0.245, P = 0.026), while religious belief was positively correlated with the score of WHOQOL-BREF (β = 0.506, P < 0.001). In this study, we concluded that comparing to those with no religious beliefs, parents with religious belief experienced more positive emotions and higher quality of life when taking care of children in the early postoperative period after congenital heart surgery. [ABSTRACT FROM AUTHOR]

To investigate the prevalence of male circumcision and the willingness to undergo male circumcision and influencing factors among MSM in Maanshan City, we conducted a cross-sectional study from June 2016 to December 2019. Respondent-driven sampling (RDS) was used to recruit participants. Influential factors of willingness to accept circumcision were identified by a multivariable logistic regression model. The multivariable logistic regression model revealed that five variables were independent influential factors for willingness to participate. The factors include that used condoms during last anal intercourse (OR = 1.87, 95% CI:1.03–3.41, P = 0.04), sex with female sex partners (OR = 0.499, 95% CI:0.298–0.860, P = 0.012, level of education (junior college: OR = 0.413, 95% CI:0.200–0.854, P = 0.017; bachelor's degree or higher: OR = 0.442, 95% CI:0.208–0.938, P = 0.033), condom use during oral sex in the last six months (OR = 4.20, 95% CI:1.47–12.0, P = 0.007) and level of knowledge of PrEP (OR = 5.09, 95% CI:1.39–18.7, P = 0.014). Given the willingness of MSM to accept circumcision was low in China, establishing a proper understanding of circumcision is essential if it is to be used as a strategy to prevent HIV infection among MSM. Therefore, publicity and education on the operation should be strengthened to increase the willingness to undergo male circumcision. [ABSTRACT FROM AUTHOR]

While vaccine hesitancy has become a salient issue, few studies have examined the influence of international collaboration and vaccine developments on people's attitudes towards vaccines. The international collaboration especially with China has been an integral part of the field of influenza. In recent years, attitudes towards vaccines and China are both heavily politicized in the USA with a deepening partisan divide. Republicans are more likely than Democrats to be vaccine hesitant, and they are also more likely to view China negatively. At the same time, the USA has economic, security, and medical collaboration with Japan and most Americans display a very positive view of the country. Thus, does a more international collaboration or more country-specific vaccine development have an influence on US vaccine hesitancy? This study conducts a survey-embedded question-wording experiment to assess the roles of US–China and US–Japan collaboration and partisanship in people's willingness to get the flu vaccine. Despite the previously successful and effective US–China collaboration, this study finds that respondents especially Republicans are much less likely to receive a US–China flu vaccine than a US–Japan or USA alone. Interestingly, both Democrats and Republicans are as willing to receive a US–Japan vaccine as USA alone. These results point to critical roles of partisanship and international relations. [ABSTRACT FROM AUTHOR]

Aim: Research on the health checkup status of urban residents in Southwest China is limited. In this study, we aimed to investigate the current status of health checkups and explore their influencing factors by analyzing the cognition, attitudes, and practices of urban residents in Southwest China. Methods: We sampled 1200 urban residents for a questionnaire survey. Statistical analysis was performed using SPSS 23, and logistic regression analysis was used to analyze the factors affecting cognition, attitudes, and practices regarding health checkups. A P value < 0.05 was used to identify variables significantly associated with the outcome variable. Results: Overall, 29% of the residents understood the importance of health checkups. The main ways urban residents acquire health-related knowledge are through the use of mobile media and medical staff health education. Only 40% of residents had undergone a regular checkup. Health self-assessment, economic reasons, and time are the factors that interfere with urban residents' health checkups. Logistic regression analysis showed that occupation status, educational background, self-assessed health status, exercise status, and monthly income level were the common influencing factors of health checkup cognition and planning. Whether residents had participated in a medical checkup program was also related to sex and age. Conclusions: Urban residents in Southwest China generally had a high willingness to undergo physical examinations, but there were differences in knowledge and practice; at the same time, residents lacked understanding of respiratory assessments. Improving the health literacy of medical staff, strengthening urban residents' health education, and enhancing the utilization rate of health checkups in urban residents are necessary and urgent. [ABSTRACT FROM AUTHOR]

Aim: To analyze the level of knowledge, attitudes, practices, and risk perception regarding COVID-19 among Chinese residents 1.5 years after the pandemic. Subject and methods: A cross-sectional study was carried out with both online and paper questionnaires. We included a variety of covariates that were characteristic-related factors such as age, gender, education level, and retirement status, as well as those closely associated with risk perception regarding COVID-19. Results: Participants (n = 3588), 53.49 ± 18.88 years old, from two provinces of China, of which 44.7% were male and 52.03% had a high school or greater level of education, answered the questions. More than 90% of participants had adequate background knowledge about COVID-19 and agreed or even strongly agreed with many attitude items related to the government's role in diagnosis, treatment, and dealing with COVID-19 infections. About three fifths of the participants reported fear of contracting COVID-19, but only a minority (18.63%) felt they were more susceptible than others. Respondents aged 45 years or younger were more likely to fear contracting the virus than those older than 45 years (adjusted OR = 1.464, 95% CI 1.196 to 1.794, P = 0.0002). High education level (adjusted OR = 1.503, 95% CI 1.187 to 1.904, P = 0.0007) and non-retired status (adjusted OR = 1.679, 95% CI 1.354 to 2.083, P < 0.0001) were associated with a higher perception of susceptibility to infection than others. Moreover, respondents who were not retired had a significantly reduced practice score (adjusted OR = 1.554, 95% CI 1.261 to 1.916, P < 0.0001). Age, retirement status, and education level were also associated with knowledge, attitude, and practice level. Conclusion: Our findings suggest that the public generally has trust in the COVID-19 vaccine and the government with regard to COVID-19 in China. We recommend that high-risk groups of communities, such as elders and patients with chronic diseases, be given greater consideration in the outbreaks. Health education campaigns combined with workplace preventive intervention should be aimed at improving COVID-19 knowledge and beliefs in order to encourage more optimistic attitudes and to maintain safe practices. [ABSTRACT FROM AUTHOR]

This systematic review of 54 cross-disciplinary peer-reviewed causal empirical studies helps public health officials, researchers, and healthcare professionals better comprehend the effects of fear appeals in vaccine promotional campaigns on message processing, persuasion, vaccination attitudes, and vaccination intentions. This review documents inconsistent findings across studies, which it attempts to clarify by considering differences in research designs, sample populations, and outcomes measured. In general, we find that fear appeals increase risk perceptions, message involvement, and vaccination attitudes. However, fear appeals have less influence on vaccination intentions, especially among female and general adult populations or populations from the U.S. and other Western cultures. On the other hand, the effect of fear appeals on vaccination intentions is stronger among student populations and those from China (People's Republic of China and Hong Kong) and other non-Western cultures. Also, fear appeals are less persuasive when promoting COVID-19 vaccines and boosters than they are for other vaccines (e.g., HPV, influenza, MMR). Future research should compare fear appeal effectiveness in messages across vaccines or when combined with other executional elements, such as the endorser or type of evidence provided. Finally, future studies should explore other methodological approaches and measure underexplored message outcomes, such as vaccine uptake behavior, in more naturalistic settings. [ABSTRACT FROM AUTHOR]

This is a Matters Arising about an article titled "A structural equation modeling approach to investigate HIV testing willingness for men who have sex with men in China" in the issue of AIDS Res Ther 20, 64 (2023) " of this journal has been published. While thanking and appreciating the good authors of this article, we would like to explain some of the methodological issues of this study in order to clarify and disambiguate the methodology part of this article and other articles submitted in this style. First of all, it should be known that the concept and definition of structural equation modeling, the reason and method of doing it, specifying the observable and latent variables in the model, the exogenous and endogenous variables of the model, the correct way to draw the SEM graph, should be properly considered. The authors of this Matters Arising do not seek to refute or confirm the authors of this article. Our final opinion is that the methodology section should be written better and scientific clarification should be made in the methodology section for readers and interested parties. Purpose of the article: Clarifying the methodology for the mentioned article and other articles sent to this journal so that the readers and interested parties can better understand and apply the methodology content. [ABSTRACT FROM AUTHOR]

Background: Inequities in access to human papillomavirus (HPV) vaccine are becoming a growing critical issue globally. Few studies investigate the factors determining HPV vaccine uptake disparities when vaccine supply is constrained, especially in low- and middle-income countries. The aim of this study was to investigate inequities of HPV vaccination and related factors under the constrained vaccine supply in China. Methods: A cross-sectional survey was conducted in a developed eastern coastal province and a developing western one in China between November and December 2022. Employing multistage stratified cluster random sampling, the study collected data from parents of children aged 9–14. Mixed-effects logistic regression models with school units as random effects were used for analysis. Results: From 4,127 eligible parents (as vaccine decision makers for girls), 1,346 (32.6%) intended to vaccinate their daughters against HPV, of which 836 (62.1%) attempted to schedule a vaccination appointment. Only 16.4% succeeded in booking an appointment. More than half of the intended parents expected the imported 9-valent HPV vaccine. There were significant disparities in HPV vaccine awareness, intention, and vaccination behavior across educational, income, geographic, ethnic, gender, and health literacy levels. Vaccine awareness and intentions were higher among parents with higher socioeconomic status; however, girls from lower socioeconomic families were more likely to receive the HPV vaccine and had a higher domestically produced vaccination rate. Significant disparities exist in vaccination intentions and actual vaccination behaviors, primarily due to large supply constraints of the HPV vaccine. Conclusions: Sustained health education campaigns are needed to raise awareness of the HPV vaccine, improve health literacy, and decrease over-preference for the 9-valent HPV vaccine. A mother's HPV vaccination behavior was positively associated with increased intention and actual vaccination behavior for her daughter. This study advocates for complementary cervical cancer prevention programs targeting both mothers and daughters. [ABSTRACT FROM AUTHOR]

Aims. This study aimed to identify and analyze the factors significantly influencing long‐term insulin medication adherence among outpatients and to evaluate whether pharmaceutical interventions targeting these factors can improve patient medication adherence and glycemic control. Methods. A cohort of 180 patients was recruited from a tertiary hospital in Nanjing, China. Factors potentially influencing insulin adherence were scrutinized employing the KAP (knowledge, attitude/belief, and practice) health behavior model. Baseline characteristics were extracted from the hospital information system, while patient knowledge of the disease and medication, medication adherence, medication beliefs, and management self‐efficacy were assessed, respectively, using self‐developed questionnaires, MMAS‐8, C‐DMSES, and BMQ scales. Univariate and multivariate analyses were conducted to determine the impact of these factors on insulin adherence. Following this, participants were randomly allocated to either the intervention or control group. The intervention group received three months of weekly telephone sessions and educational interventions targeting facets such as medication knowledge and beliefs, while the control group received standard care. After the intervention, insulin adherence and glycemic control conditions of both groups were collected and re‐evaluated. Results. After excluding lost‐to‐follow‐up patients, 152 individuals were analyzed (intervention: 75 and control: 77). Multivariate analyses revealed factors influencing insulin adherence, including age, diabetes duration, health insurance status, HbA1c level, disease and medication knowledge, diabetes management self‐efficacy, and medication beliefs (P < 0.05). Before targeted pharmaceutical care, no significant differences existed in insulin adherence, HbA1c levels, management self‐efficacy, knowledge, or medication beliefs between intervention and control groups (P > 0.05). However, subsequent pharmaceutical intervention notably improved adherence, HbA1c levels, self‐efficacy, knowledge, and medication beliefs (P < 0.05). Conclusion. This study examines the impact of glycemic control, health insurance status, management self‐efficacy, level of knowledge, and medication beliefs on improving insulin medication adherence in patients with type 2 diabetes mellitus. Targeted pharmaceutical intervention can enhance medication adherence, improve glucose control, and promote rational insulin use. This trial is registered with ChiCTR2300074444. [ABSTRACT FROM AUTHOR]

Background: Few studies have evaluated the perceptions of healthcare providers in China regarding pediatric palliative care, particularly in critical care units (PICUs), where many children receive palliative care. To evaluate the knowledge, attitudes and practices of PICU personnel in China regarding pediatric palliative care. Methods: This cross-sectional study was conducted in five cities in China (Shanghai, Suzhou, Chongqing, Chengdu and Yunnan) between November 2022 and December 2022. Results: The analysis included 204 participants (122 females), with 158 nurses and 46 physicians. The average knowledge, attitude and practice scores were 9.75 ± 2.90 points (possible range, 0–13 points), 38.30 ± 3.80 points (possible range, 12–60 points) and 35.48 ± 5.72 points (possible range, 9–45 points), respectively. Knowledge score was higher for physicians than for nurses (P < 0.001) and for personnel with previous training in pediatric palliative care (P = 0.005). According to structural equation modelling knowledge had a direct positive effect on attitude (β = 0.69 [0.28–1.10], p = 0.001), and indirect on practice (β = 0.82 [0.36–1.28], p < 0.001); attitude had significant effect on practice as well (β = 1.18 [0.81–1.56], p < 0.001). Conclusions: There is room for improvement in the knowledge, attitudes and practices of PICU personnel in China regarding pediatric palliative care. The findings of this study may facilitate the design and implementation of targeted education/training programs to better inform physicians and nurses in China about pediatric palliative care. [ABSTRACT FROM AUTHOR]

The lived experience of tinnitus has biopsychosocial characteristics which are influenced by sociocultural factors. The main purpose of this study is to investigate how tinnitus affects people in their everyday life in China. A deductive qualitative analysis examined whether an a priori Western-centric conceptual framework could extend to an Asian context. A large-scale prospective survey collected patient-reported problems associated with tinnitus in 485 adults attending four major ENT clinics in Eastern and Southern mainland China. The evidence suggests that patients in China express a narrower range of problem domains associated with the lived experience of tinnitus. While 13 tinnitus-related problem domains were confirmed, culture-specific adaptations included the addition uncomfortable (a novel concept not previously reported), and the potential exclusion of concepts such as intrusiveness, loss of control, loss of peace and loss of sense of self. The sociocultural context of patients across China plays an important role in defining the vocabulary used to describe the patient-centred impacts of tinnitus. Possible explanatory factors include cultural differences in the meaning and relevance of certain concepts relating to self and in help-seeking behaviour, low health literacy and a different lexicon in Chinese compared to English to describe tinnitus-related problems. [ABSTRACT FROM AUTHOR]

Objective: To explore whether/how the willingness of Chinese college students to receive the influenza vaccines in the sample is affected by different information channels. Participants: Two hundred and four volunteers were recruited to participate in an anonymous online survey. All participants were college students, mainly undergraduates (81.86%), with a higher proportion of women (56.86%). Methods: Participants answered anonymous questionnaires through the website, including demographic data (age, gender, education, etc.), media exposure channels and frequency, views and attitudes toward influenza vaccines, etc. An ordered logistic regression analysis was conducted to explore the effects of different information sources on influenza vaccination among college students. Results: Exposure to traditional media, digital media, and interpersonal communication promotes college students' understanding of influenza vaccines. Exposure to digital media alleviates college students' hesitation to vaccinate, while interpersonal interaction and digital media exposure promote college students' willingness to vaccinate. Conclusions: Digital media is increasingly important in the lives of Chinese college students to promote healthy behaviors such as influenza vaccinations. [ABSTRACT FROM AUTHOR]

The popularity of contracted family doctor services in China has been growing in recent years, but community-family-doctor-based type 2 diabetes mellitus (T2DM) intervention programs have yet to be adequately studied. This study was to evaluate the short- and long-term effects of community-family-doctor-based self-management interventions for T2DM and to explore strategies for long-term glycemic control. This was a randomized controlled trial. A total of 144 eligible participants were randomly assigned to intervention and control groups. The control group received only routine community diabetes care, and the intervention group received community-family-doctor-based interventions involving the same standard of care. The interventions lasted for 3 months, and the follow-up was continued for 15 months. Intention-to-treat analysis and generalized estimation equations were then used to determine the short- and long-term effects of the interventions on glycated hemoglobin (HbA 1c), diabetes self-management, and medication adherence. There were statistically significantly greater improvements in all aspects of the intervention group after 3 months of intervention. Compared with baseline, changes in the attitude (β = 0.384, 95% confidence interval [CI; 0.194, 0.574], P < 0.001), practice (β = 1.751, 95% CI [0.762, 2.739], P = 0.001), and knowledge, attitudes, practice total scores (β = 2.338, 95% CI [0.682, 3.995], P = 0.006) of patients in the intervention group were statistically significant after 15 months, and the HbA 1c (8.19 ± 1.73%), knowledge (16.42 ± 3.21), and medication adherence (5.53 ± 1.76) scores were slightly better than those at baseline, although not statistically significant (P > 0.05). T2DM self-management interventions based on community family doctors improved patients' HbA 1c , diabetes self-management, and medication adherence, did not do so significantly in the long term. [ABSTRACT FROM AUTHOR]

Prior studies demonstrated that perceived social support is negatively associated with behavioral and mental health problems among people living with HIV (PLWH). However, longitudinal data regarding the associations between perceived social support, internalized HIV stigma, future orientation, and depressive symptoms are limited. The current study aimed to investigate the possible indirect relationship between these variables using four-wave follow-up data (6-month intervals) from a sample of 1,098 Chinese PLWH (Mage = 38.63, SD = 9.20, age range: 18–60 years; 63.9% men). All participants were asked to complete an adapted version of Perceived Social Support Scale, Internalized HIV Stigma Scale, Optimism About the Future Scale, and Center of Epidemiological Studies Depression Scale. Results indicated that perceived social support at baseline was negatively related to depressive symptoms at wave 4. Internalized HIV stigma at wave 2 and future orientation at wave 3 indirectly affected the linkage between perceived social support at baseline and depressive symptoms serially over time. This study highlights the essential role of perceived social support in alleviating depressive symptoms among PLWH, and underscores the complex interplay in which internalized HIV stigma and future orientation serially mediated the relationship between perceived social support and depressive symptoms. These findings suggest the need for integrated interventions to enhance social support, address HIV-related stigma, and promote positive future orientation, which could potentially alleviate depressive symptoms and promote mental well-being among PLWH. [ABSTRACT FROM AUTHOR]

Background: Delirium is an acute mental state associated with poor outcomes. The incidence of delirium is high, especially in the paediatric intensive care unit (PICU). It is important for staff, particularly nurses, to understand delirium and implement interventions to prevent it. We performed a survey with the aim of evaluating and analysing the factors influencing the knowledge, attitudes and behaviour of PICU nurses towards delirium. Methods: This cross-sectional descriptive study included 215 PICU nurses in 6 PICUs from five teaching hospitals in Sichuan Province, China. An online survey about the knowledge, attitudes and practices related to delirium care was conducted among PICU nurses used a self-made and validated questionnaire. The data were analysed using descriptive statistics; differences between groups were compared using t tests, ANOVA and rank-sum tests. Variables with a significance level of 0.05 in the univariate analysis were entered into the multivariable regression analysis to identify predictors. Results: Only 14.4% of the nurses had a good understanding of delirium, and 40.9% had received relevant training. The mean knowledge score was 9.01 ± 3.86, and the overall passing rate of knowledge was 49.8%. The mean attitude and behaviour scores were 40.95 ± 5.62 and 40.33 ± 8.01, respectively. Among the hospitals, different delirium assessments for children and specific training were performed, explaining approximately 10% of the variability in knowledge scores (F = 6.152), approximately 10% of the variability in attitude/belief scores (F = 5.908), and approximately 17% of the variability in practice scores (F = 10.767). Conclusions: PICU nurses have poor knowledge of delirium, particularly regarding its clinical manifestations, influencing factors and medications used, and they have adequate attitudes and confidence and good behaviour regarding delirium in children. To better prevent delirium, we suggest that PICU departments routinely assess delirium and conduct delirium training for nurses. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Background: The prevalence of burnout among healthcare workers remains chronically high. Former studies have indicated that strength use is a promising approach to reduce burnout. However, relatively little is known about the psychological mechanisms underlying the ability of strength use to reduce burnout, especially among healthcare workers. Aim: This study sought to examine the link between strength use and burnout in Chinese healthcare workers, and to explore the mediating roles of beliefs about stress and basic psychological needs satisfaction in that relationship. Methods: This study was conducted in two time periods, from September to October 2020 and from February to September 2022. A total of 812 healthcare workers completed a multi-section questionnaire. Results: Strength use was negatively associated with burnout and negative stress beliefs, and positively associated with positive stress beliefs, control beliefs, and basic psychological needs satisfaction. Moreover, negative stress beliefs, control beliefs, and basic psychological needs satisfaction fully mediated the relationship between strength use and burnout. Furthermore, effect contrasts revealed that the mediating effect of basic psychological needs satisfaction was stronger than that of negative stress beliefs and control beliefs. Conclusion: Our findings revealed that negative stress beliefs, control beliefs, and basic psychological needs satisfaction act as mediators in the association of strength use with burnout. Furthermore, basic psychological needs satisfaction plays a more important mediating role than negative stress beliefs and control beliefs in the strength use–burnout relationship. [ABSTRACT FROM AUTHOR]

Help-seeking for depression and anxiety disorders from primary care physicians in Western countries is at three times the rate of China. Western help-seeking models for common mental disorders have limitations in the Chinese settings. This article argues that an adapted model based on Andersen's Behavioral Model of Health Services Use could be an appropriate tool to better understand patients' help-seeking behaviors and improve outcomes. We applied a narrative review approach to integrate research findings from China into Andersen's model to generate a model that fits the Chinese context. We found 39 relevant articles in PubMed, MEDLINE, and Chinese journal databases from 1999 to 2022. Findings were mapped onto predisposing, enabling, and need factors of the model. This model emphasizes that predisposing factors including demographics, social norms, and health beliefs influence help-seeking preferences. Mental health service users in China tend to be older and female. Chinese generally have high concern about psychotropic medications, and social norms that consider psychological distress a personal weakness may discourage help-seeking. However, help-seeking can be enhanced by enabling factors in the health system, including training of primary care physicians, longer consultation time, and continuity of care. Need factors for treatment increase with the severity of distress symptoms, and doctor's skills and attitudes in recognizing psychosomatic symptoms. While predisposing factors are relatively hard to change, enabling factors in the health system and need factors for treatment can be targeted by enhancing the role of family doctors and training in mental health. [ABSTRACT FROM AUTHOR]

This study used a self-administered questionnaire to investigate the relationship between HIV/AIDS knowledge, social discrimination, HIV self-efficacy, sexual behavioral characteristics and HIV testing behavior among young students with a history of sexual activity in Chongqing. Propensity score matching was used to construct a control group with similar demographic characteristics to the HIV testing group, only without HIV testing behaviors. Structural equation modeling was used to conduct chain-mediated effect analysis. The HIV testing rate among young students with a history of sexual behavior was 17.16%. Young students with HIV testing behavior had higher levels of HIV/AIDS knowledge, lower social discrimination, better self-efficacy, and no difference in sexual behavior characteristic scores between the two groups (P = 0.062). The mediated effect values of social discrimination and self-efficacy were 0.022 and 0.063, respectively, while their chain mediated effect value was 0.007. There was no mediated effect of sexual behavior characteristics. The level of young students' HIV/AIDS knowledge does not directly influence their HIV testing behavior but plays a complete chain mediating effect on HIV testing behavior through social discrimination and self-efficacy. HIV testing behavior should be promoted through the perspectives of enhancing HIV/AIDS knowledge level, reducing social discrimination, and improving self-efficacy. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic has increased the risk of psychological distress among adolescents. Moreover, adolescents in 70 countries have suffered simultaneously from the COVID-19 pandemic and flood disasters. Research on the protective role of mindfulness on psychological distress is warranted; moreover, the practical needs arising from disasters require a deeper understanding of the potentially complex interplay between mindfulness and psychological distress. Using social–ecological systems theory, this study examined the moderating effects of self-harm and negotiable fate on the relationship between mindfulness and psychological distress in adolescents suffering from concurrent dual disasters (COVID-19 and flood disasters). High school adolescents (N = 1679; 49.3% adolescent boys) in Zhengzhou, China, completed the Child and Adolescent Mindfulness Measure, Suicide Thoughts and Behaviors Checklist, Negotiable Fate Questionnaire, and Depression Anxiety Stress Scales-21. A three-way interaction model was developed. The results indicate that mindfulness has a significant negative relationship with psychological distress during disasters. Moreover, self-harm and negotiable fate significantly moderated the negative associations between mindfulness and psychological distress in adolescents enduring concurrent dual disasters (three-way interaction effects model). These findings highlight the significance of the interactions between different ecological system factors in the negative associations between mindfulness and psychological distress amid disasters. [ABSTRACT FROM AUTHOR]

The aim of this qualitative systematic review is to analyze the barriers and facilitators to the uptake of antihypertensive medication in hypertensive patients. The databases of PubMed, Embase, Web of Science, CINAHL, Cochrane Library, MEDLINE, China National Knowledge Infrastructure, Wanfang, VIP, and Chinese Biomedical were searched from inception to June 2023. The studies were screened, extracted, and assessed independently by two researchers. Previously, the researchers used the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research to assess the quality of the included studies. A total of 27 studies were considered, resulting in two combined findings: a good level of knowledge, belief, and behavior and adequate social support were facilitators of medication adherence in hypertensive patients. In contrast, lack of medication literacy, difficulty adapting to roles, reduced sense of benefit from treatment, limited access to healthcare resources, and unintentional nonadherence were barriers. Medication adherence in hypertensive patients remains a challenge to be addressed. Future research should explore how complex interventions using a combination of evidence-based strategies and targeting multiple adherence behaviors (eg, long-term adherence to medication) are effective in improving medication adherence. [ABSTRACT FROM AUTHOR]

Background. There was a remarkable downgrade in China's COVID-19 response strategies in January 2023. The COVID-19 infection rate grew rapidly in the early stages following the management policy shift. This study attempted to explore the associations between SARS-CoV-2 infection and mental or physical health status in pregnant and postpartum women and the role of perceived health risks and family members' SARS-CoV-2 infection status on these associations by capturing the impact of policy shifts in a short period of time. Methods. This cross-sectional study with a random sample from a convenience sample of hospitals was conducted in pregnant and postpartum women in January 2023. Standardized assessment tools were employed to assess anxiety, depressive and physical symptoms, and feelings of hopelessness. Hierarchical multiple logistic regressions were conducted to examine the mechanisms of associations of interests by including a range of sociodemographic factors, self-perceived health, SARS-CoV-2 infection status, and perceived health risks as covariates. Results. Of the 1,013 pregnant and postpartum women aged 32.0 ± 0.3 years, 58.2% (n = 590) were diagnosed with COVID-19, and 49.4% (n = 500) had family members who were infected with SARS-CoV-2. Nearly 98% of the included participants took measures to prevent SARS-CoV-2 infection. A COVID-19 diagnosis was positively associated with feelings of hopelessness (OR = 1.68, 95% CI: 1.20–2.35), probable anxiety (OR = 6.42, 95% CI: 2.18–24.61), possible depression (OR = 2.56, 95% CI: 1.07–6.70), and physical symptoms (OR = 6.28, 95% CI: 1.63–42.03) after adjusting for sociodemographic and health characteristics, while the associations presented no statistical significance when family members' SARS-CoV-2 infection status and perceived health risks were introduced into the models. Conclusions. Our results suggested that pregnant and postpartum women may experience physical and mental health challenges when they or their family members contracted COVID-19 in the context of a considerable shift in COVID-19 management. Early detection of poor health status and its risk factors for vulnerable groups during shifts in health policy and administrative practice is very necessary, and health services, including easy access to psychosocial support and obstetric counselling, should be prioritized. [ABSTRACT FROM AUTHOR]

Public concern regarding safety policies serious consequences is anticipated to persist over an extended duration. A study examining a case of rapid public health policy adaptation in China during the COVID-19 epidemic was conducted by gathering public opinion data from major social media platforms. A systematic approach to comprehend public opinion was developed. Five fundamental elements and four dimensions were delineated. An indicator system was established utilizing the K-means text clustering model. Public prediction, expectation, and their evolution underlying public concern were elucidated employing TF–IDF text mining models. The HMM elucidated the way public opinion influences policy adjustments. The findings underscore that public concern regarding enduring events undergoes temporal shifts, mirroring the evolution of public opinion towards policy. Public opinion aroused by both the original event and derived events collaboratively influence policy adjustments. In China, public opinion serves as a mechanism for policy feedback and oversight; notably, negative public sentiment plays a pivotal role in expediting policy transitions. These findings aid in refining policies to mitigate emergencies through a feedback loop, thereby averting the emergence of safety risks such as social unrest prompted by public opinion. [ABSTRACT FROM AUTHOR]

INTRODUCTION Smoking prevalence is high in China, and healthcare workers are important for tobacco control. This study aimed to determine the smoking status, cognition of tobacco hazards, and smoking cessation-related knowledge among respiratory healthcare workers, and to explore their ability to provide smoking cessation assistance. METHODS A cross-sectional study was conducted in 2021 among 1028 respiratory healthcare workers from 89 hospitals in Fujian Province, China. A self-designed electronic questionnaire was used to collect data on smoking status, knowledge of smoking hazards, and smoking cessation knowledge. Descriptive statistics were calculated for all questions. Logistic regression analysis was used to explore the relationship between awareness of the tobacco control goals of Healthy China 2030 and demographic characteristics. RESULTS Among the healthcare workers surveyed, 3.4% were smokers, all of whom were male. Most respondents (99.4%) were aware of smoking as a cause of lung cancer, but awareness of smoking as a cause of non-respiratory cancer was lower. The awareness rate of smoking cessation support was high (>90%), but only 40.0% of participants were aware of the Healthy China 2030 tobacco control targets. Male (HR=2.16; 95% CI: 1.69-2.80) and participation in the cessation clinic (HR=1.47; 95% CI: 1.10-1.96) were associated with higher awareness of the targets. CONCLUSIONS Respiratory healthcare workers in Fujian Province demonstrated a high level of awareness regarding behavioral and pharmacotherapy support for smoking cessation. In order to enable healthcare workers to play a more active role in tobacco control, there is a need to increase public awareness of smoking cessation services in Fujian Province. [ABSTRACT FROM AUTHOR]

Our research sought to explore post-traumatic growth experience among Chinese women with breast cancer. Constructivist grounded theory methodology was utilised to understand Chinese women's post-traumatic growth experience. 24 women with breast cancer were recruited from China. Data was collected through semi-structured, interviews. Three categories were developed from the data: renewing self-perception, encountering changes in relationships, and altering philosophical values and beliefs. The unique manifestations of post-traumatic growth highlight the need for development and adaption of the post-traumatic growth inventory to reduce cultural biases within the assessment tool and incorporate new culturally appropriate items. [ABSTRACT FROM AUTHOR]

The psychosocial underpinnings of vaccine hesitancy are complex. Research is needed to pinpoint the exact reasons why people hesitate to vaccinate themselves or their children against vaccine-preventable diseases. One possible reason are concerns that arise from a misunderstanding of vaccine science. We examined the impact of scientific reasoning on vaccine hesitancy and human papillomavirus (HPV) vaccination intent through a cross-sectional study of parents of vaccine-eligible children (N = 399) at immunization clinics in Shanghai, China. We assessed the relationship between science reasoning and both vaccine hesitancy and HPV vaccine acceptance using general additive models. We found a significant association between scientific reasoning and education level, with those with less than a high school education having a significantly lower scientific reasoning that those with a college education (ß = -1.31, p-value = 0.002). However, there was little evidence of a relationship between scientific reasoning and vaccine hesitancy. Scientific reasoning therefore appears not to exert primary influence on the formation of vaccine attitudes among the respondents surveyed. We suggest that research on vaccine hesitancy continues working to identify the styles of reasoning parents engage in when determining whether or not to vaccinate their children. This research could inform the development and implementation of tailored vaccination campaigns. [ABSTRACT FROM AUTHOR]

Objectives: To understand the attitudes and health behaviors of middle-aged and older adults in China after receiving elevated results of tumor markers (TMs) test in the annual health examinations (AHEs) and explore the influencing factors. Methods: A three-section online questionnaire survey was conducted from March 1 to April 30, 2020 in Hangzhou, China, to people who were aged 45 and older and had at least one elevated result of TMs test. Clinical information was collected from the online survey and medical records. Descriptive statistics were carried out followed by regression analyses. Results: Of 380 participants, 76.1% were unwilling to quit the TMs test in AHEs, whereas 75.3% would take the doctor’s advice and quit unnecessary TMs test; 67.4% felt stressed about their TMs. Among participants with elevated TMs, 76.8% changed lifestyle to keep healthy, 74.2% sought health information, 58.9% requested a TMs retest, and 50.3% did further tests to confirm a diagnosis. Family history of cancer was associated with lifestyle changing; education level, area of residence and health insurance were associated with health information seeking; comorbidity were associated with retests and sequential confirming tests. Conclusion: The application of the TMs test in AHEs among Chinese people may lead to positive and negative behavioral consequences and psychological distress. Doctors have a significant impact on patients’ health behaviors. Accurate indications and adequate communication with patients before and after the TMs test are in great need. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to explore the influence of Chinese culture and customs on the beliefs and health‐related behaviours of Chinese women with gestational diabetes mellitus (GDM). Methods: This descriptive qualitative study conducted semi‐structured interviews with 15 Chinese women between November 2022 and January 2023. The interview data were analysed using thematic analysis. Results: Three major themes are found: (1) beliefs in health, (2) beliefs in illness and GDM and (3) beliefs in health‐related behaviours. They worried about the negative effects of GDM on the infant and family, so they actively sought medical advice to maintain health. However, it is challenging for them to balance adhering to healthcare professionals' advice and avoiding practical difficulties in the impact of the Chinese sociocultural context. Conclusion: This study emphasizes the influence of Chinese culture and customs on the beliefs and health‐related behaviours of women with GDM. Healthcare providers should recognize the influence of Chinese culture, customs and beliefs on women with GDM and their families, in order to provide individualized education to help them maintain health‐related behaviours. Summary statement: What is already known about this topic? The prevalence of gestational diabetes mellitus (GDM) is increasing in China and affects 14.8% of pregnant women.Some personal beliefs about illness and health can lead to inadequate self‐care behaviours and thus failure to achieve optimal self‐management and health goals.Factors of Chinese sociocultural content and Chinese traditional culture and customs may have different influences on Chinese married women's beliefs in health, illness and health‐related behaviours. What this paper adds? Influenced by Chinese culture and customs, Chinese women's perspectives on gestational diabetes are bidirectional. They fear the negative effects of the disease on infants' and families' health and actively seek help, while some try to balance following professional advice and practical difficulties, such as diet control and self‐glucose monitoring.The low‐risk self‐management awareness, lack of adequate healthcare knowledge, and self‐care practice in Chinese women with GDM are one of the factors that lead to practical difficulties in GDM management.Understanding the impact of traditional Chinese culture and customs on the beliefs and health‐related behaviours of women with GDM, well‐trained healthcare professionals can disseminate personalized health education to individuals, families and communities to improve GDM management in these women. The implications of this paper: Health providers need to constantly update the GDM guidelines with Chinese cultural characteristics based on the cultural acceptance and customs of Chinese women with GDM in order to offer them individualized care and scientific advice.The findings of this study could act as a clinical resource for health professionals to investigate the impact of differences in culture and customs across countries or regions on individual beliefs and health‐related behaviours in different populations. [ABSTRACT FROM AUTHOR]