Representations of Mental Health Among Middle-Aged Urban Chinese Men

Parenting and family experiences of Chinese fathers with mental illness

WHAT IS KNOWN ON THE SUBJECT?: Having a mental illness may undermine men's self-image as a father while having children may facilitate their recovery. Many fathers who experience mental health issues experience stigma and are reluctant to seek support in their parental role. Most studies in this field focus on fathers from Western countries. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: Similar to Western fathers, Chinese fathers reported both negative parenting (parenting disengagement, harsh parenting and inconsistent discipline) and positive father-child interactions when ill. Unlike their Western counterparts, Chinese fathers relied on extended family support in their parenting role, though this support was problematic at times. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This research helps mental health nurses understand the experiences of Chinese fathers with mental illness. Findings suggest that specific cultural adaptions to family-focused interventions are needed for the Chinese context including considering extended family members (e.g. grandparents).

ABSTRACT

INTRODUCTION: Parenting roles are important for those with a mental illness. While research on mothers is well established there is scant focus on fathers with mental illness, especially in non-Anglophone countries.

AIM

To better understand the parenting and family experiences of fathers, who have a mental illness, from the People's Republic of China.

METHOD

Qualitative semi-structured interviews were conducted with nine Chinese fathers with mental illness, using Interpretative Phenomenological Analysis.

RESULTS

Seven superordinate themes were identified: (i) mental illness undermines idealized images of fatherhood; (ii) parenting in the context of mental illness; (iii) concerns about the negative impact of their illness on children; (iv) children as a burden and a source of hope; (v) stigma; (vi) relying on family support; and (vii) unmet professional and peer support needs.

DISCUSSION

Chinese fathers held a gendered image of fatherhood, and experienced self-stigma for not living up to their ideal sense of fatherhood, which resulted in a reluctance to seek support. This study adds to the existing literature by focusing on Chinese fathers. Although many of their experiences are similar to fathers from Western countries, some differences were found, notably around a reliance on extended family support.

IMPLICATIONS FOR PRACTICE

Nurses and other mental health professionals need to adopt a family-focused, culturally informed approach to supporting Chinese fathers with mental illness and their families.

Weekly Variations of Intracerebral Hemorrhage Occurrence Among Different Populations: A Cross-Sectional Study

Background and purpose: The causes of the higher incidence of intracerebral hemorrhage (ICH) on a given day are unclear. Previous studies have shown that it may vary by region and population. The purpose of this study was to detect weekly variations in ICH occurrence in southwest China and to assess differences in ICH occurrence among different populations.

Methods: This hospital-based study included patients with first-onset ICH that occurred from January 1, 2012, to December 31, 2019. The weekly variation in ICH occurrence was analyzed and stratified by sex, age, comorbidities, living habits, and residence.

Results: A total of 5,038 patients with first-onset ICH were enrolled. ICH occurrence was higher on Monday [odds ratio (OR), 1.22; 95% CI, 1.09–1.36; P < 0.001] and Friday (OR, 1.15; 95% CI, 1.03–1.28; P < 0.001) among all patients, and this pattern was consistent with that of men, whereas women showed a higher incidence on Mondays, Saturdays, and Sundays. The increase in the number of ICH events on Monday and Friday was pronounced in the age range of 41–60 years; however, no significant weekly variation in ICH occurrence was observed among other age groups. After stratifying by comorbidities, a significant weekly variation in ICH occurrence was observed in patients with hypertension or diabetes. Smoking and alcohol consumption was associated with a higher incidence of ICH on Friday; otherwise, a Monday excess was observed. The urban population demonstrated a significant weekly variation in ICH occurrence, whereas the rural population did not.

Conclusions: Intracerebral hemorrhage occurrence showed weekly variations in southwest China and was significantly affected by sex, age, comorbidities, living habits, and residence. This suggests that weekly variations in ICH occurrence maybe dependent on the region and population.

Cross-cultural adaptation, validity and reliability of the Chinese Version of Miller Behavioral Style Scale

BACKGROUND

Health education basing on patients' information-seeking styles can improve the effectiveness of health education and patients' health outcomes. The Miller Behavioral Style Scale (MBSS) is widely used to identify individual's information-seeking styles, but the Chinese version is lacking. The study aim was to translate and culturally adapt the MBSS into Chinese version and test the content validity, construct validity and internal consistency reliability of the Chinese version of MBSS (C-MBSS).

METHODS

The forward-back-translation procedure was adopted in the translation of the MBSS. Content validity was assessed in a panel of experts. In a sample of 1343 individuals including patients, patients' caregivers, university students, and medical staff, reliability and construct validity were assessed using Cronbach's alpha coefficient and factor analysis. The measurement invariance across samples was tested using multigroup confirmatory factor analysis (MGCFA). Floor and ceiling effects were checked.

RESULTS

The C-MBSS achieved conceptual and semantic equivalence with the original scale. The item-level content validity index (I-CVI) of each item ranged from 0.78 to 1, and the averaging scale-level content validity index (S-CVI/ Ave) was 0.95. The exploratory factor analysis resulted in 2-factor assumption for each hypothetical threat-evoking scenario. Confirmatory factor analysis demonstrated a good fit between theoretical model and data, which provided confirmatory evidence for the second-order factor structure of 2-factor solution (Monitoring and Blunting). The Cronbach's alpha coefficients for the Monitoring and Blunting sub-scales of the C-MBSS were 0.75 and 0.62 respectively. MGCFA results supported the measurement invariance for the Monitoring sub-scale of the C-MBSS across samples. No floor or ceiling effects occurred.

CONCLUSIONS

This study indicates that the C-MBSS has good content and construct validity. The Monitoring sub-scale of the C-MBSS had acceptable internal consistency reliability while the Blunting sub-scale had unsatisfactory one, which suggest that the Monitoring sub-scale of the C-MBSS can be used to identify individuals' information-seeking styles in Chinese contexts across different populations.

Care-seeking behavior and disclosure on self-reported mental health among young women in urban Shanghai, China

Mental health is a major public health concern in China. Help-seeking behavior typically does not involve professionals. Aim of the study was to assess Shanghai women’s care-seeking behavior for common mental health disorders. Using an online survey, fielding questions regarding perinatal mental health status and help-seeking behavior. A total of 487 women participated. One fifth of participants reporting badwell-being did not seek help for mental distress. A total of 82.2 percent seek online support. A majority entrusted in family and avoided professional contact. Mother-in-laws were the least trusted source of support. Shanghai women avoid seeking professional help for mental health issues. Friends, spouses, and online resources are preferred venues.