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Zhao J, Nie L, Pan L, Pang M, Wang J, Zhou Y, Chen R, Liu H, Xu X, Zhou C, Li S, Kong F. Association between social capital, mental health, and digital health literacy among the university students in China: a multigroup analysis based on major difference. BMC Public Health 2024; 24:2193. [PMID: 39138431 PMCID: PMC11321090 DOI: 10.1186/s12889-024-19672-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 08/01/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND This study aimed to clarify medical-nonmedical difference on the relationship between social capital, mental health and digital health literacy of university students in China, and furtherly provide evidence-based suggestions on the improvement of the digital health literacy for the university students. METHODS The snowball sampling method was used to collect data from the university students (including medical students and nonmedical students) through online questionnaires, and finally 1472 university students were included for the data analysis, of whom, 665 (45.18%) were medical students, 807 (54.82%) were nonmedical students; 462 (31.39%) were male, 1010 (68.61%) were female. Mean value of the age was 21.34 ± 2.33 for medical students vs. 20.96 ± 2.16 for nonmedical students. Descriptive analysis, chi-square test analysis, one-way Analysis of Variance (conducted by SPSS) and structural equation modeling (conducted by AMOS) were employed to explore the difference on the relationship between social capital, mental health and digital health literacy between the medical students and nonmedical students. RESULTS The mean value of the digital health literacy was 36.27 (37.33 for medical students vs. 35.39 for nonmedical students). The SEM analysis showed that there was a statistically positive correlation between social capital and digital health literacy (stronger among the nonmedical students (0.317) than medical students (0.184)). Mental health had a statistically positive impact on the digital health literacy among medical students (0.242), but statistically significant correlation was not observed in nonmedical students (0.017). Social capital was negatively correlated with the mental health for both medical students and NMS (stronger among the nonmedical students (0.366) than medical students (0.255)). And the fitness indices of SEM were same between medical students and nonmedical students (GFI = 0.911, AGFI = 0.859, CFI = 0.922, RMSEA = 0.074). CONCLUSION The digital health literacy of the university student was relatively high. Both social capital and mental health could exert a positive effect on digital health literacy, while social capital was found to be positively associated with mental health. Statistical difference was found between medical students and nonmedical students on the above correlations. Implications were given on the improvement of the digital health literacy among university students in China.
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Affiliation(s)
- Jiajia Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Limei Nie
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Lutong Pan
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Mingli Pang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Jieru Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Yue Zhou
- Department of Mathematics, College of Art and Science, New York University, New York, 10003, USA
| | - Rui Chen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Hui Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Xixing Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
- Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China.
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Wan DWJ, Goh LSH, Teo MYK, Loh CJL, Yak GHK, Lee JJH, Ravindran N, Abdul Rahman ND, Chiam M, Ong EK, Somasundaram N, Lim YY, Phua GLG, Krishna LKR. Enhancing self-care education amongst medical students: a systematic scoping review. BMC MEDICAL EDUCATION 2024; 24:37. [PMID: 38191374 PMCID: PMC10773141 DOI: 10.1186/s12909-023-04965-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/11/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Reports of emotional, existential and moral distress amongst medical students witnessing death and suffering of patients during their clinical postings have raised awareness on the need for better psycho-emotional support during medical school. Furthermore, the stress experienced by medical students stemming from the rigours of their academic curriculum underlines the need for greater awareness on mental health issues and better self-care practices across medical training. With such programmes lacking in most medical schools, we propose a systematic scoping review (SSR) to map and address our research question, "what is known about self-care education interventions amongst medical students?". METHODS We adopted the Systematic Evidence-Based Approach to guide a systematic scoping review (SSR in SEBA) of relevant articles published between 1st January 2000 and 30th June 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles were independently and concurrently thematically and content analysed, with complementary categories and themes combined using the Jigsaw Approach. The domains created from the Funnelling Process framed the discussion. RESULTS A total of 6128 abstracts were identified, 429 full-text articles evaluated, and 147 articles included. The 6 domains identified were definition, topics, pedagogy, influences, outcomes and assessment. Most interventions were promising, though peer-led mindfulness-based interventions showed most promise in enhancing engagement, positively impacting personal wellbeing, and improving patient care. Overall, however, self-care education was poorly recognized, adopted and integrated into curricula. CONCLUSION Greater dedicated time and conducive practice environments within medical school curricula is required to enhance medical student wellbeing. Host organizations must ensure faculty are appropriately selected to instil the importance of self-care, be trained to assess and personalize self-care interventions and provide longitudinal assessment and support. Further study into assessing self-care capabilities is required.
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Affiliation(s)
- Darius Wei Jun Wan
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, 1E Kent Ridge Road NUHS Tower Block Level 11, Singapore, 119228, Singapore
| | - Laura Shih Hui Goh
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, 1E Kent Ridge Road NUHS Tower Block Level 11, Singapore, 119228, Singapore
| | - Mac Yu Kai Teo
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, 1E Kent Ridge Road NUHS Tower Block Level 11, Singapore, 119228, Singapore
| | - Celestine Jia Ling Loh
- Obstetrics and Gynaecology, KK Women's and Children's Hospital (KKH), 100 Bukit Timah Road, Singapore, 229899, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Gerald Hng Kai Yak
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, 1E Kent Ridge Road NUHS Tower Block Level 11, Singapore, 119228, Singapore
| | - Joanna Jing Hui Lee
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, 1E Kent Ridge Road NUHS Tower Block Level 11, Singapore, 119228, Singapore
| | - Nila Ravindran
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, 1E Kent Ridge Road NUHS Tower Block Level 11, Singapore, 119228, Singapore
| | - Nur Diana Abdul Rahman
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Eng Koon Ong
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Assisi Hospice, 823 Thomson Road, Singapore, 574627, Singapore
| | - Nagavalli Somasundaram
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ying Yin Lim
- Division of Palliative Care, Alexandra Hospital, 378 Alexandra Rd, Singapore, 159964, Singapore
| | - Gillian Li Gek Phua
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, National University of Singapore, 8 College Rd, Singapore, 169857, Singapore
| | - Lalit Kumar Radha Krishna
- Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, 1E Kent Ridge Road NUHS Tower Block Level 11, Singapore, 119228, Singapore.
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road L3 9TA, Liverpool, UK.
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, #02-03, Singapore, 117597, Singapore.
- PalC, The Palliative Care Centre for Excellence in Research and Education, Singapore, PalC c/o Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore.
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Dijk SW, Caulley LM, Hunink M, Labrecque J. From complexity to clarity: how directed acyclic graphs enhance the study design of systematic reviews and meta-analyses. Eur J Epidemiol 2024; 39:27-33. [PMID: 37650986 PMCID: PMC10811040 DOI: 10.1007/s10654-023-01042-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/12/2023] [Indexed: 09/01/2023]
Abstract
While frameworks to systematically assess bias in systematic reviews and meta-analyses (SRMAs) and frameworks on causal inference are well established, they are less frequently integrated beyond the data analysis stages. This paper proposes the use of Directed Acyclic Graphs (DAGs) in the design stage of SRMAs. We hypothesize that DAGs created and registered a priori can offer a useful approach to more effective and efficient evidence synthesis. DAGs provide a visual representation of the complex assumed relationships between variables within and beyond individual studies prior to data analysis, facilitating discussion among researchers, guiding data analysis, and may lead to more targeted inclusion criteria or set of data extraction items. We illustrate this argument through both experimental and observational case examples.
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Affiliation(s)
- Stijntje W Dijk
- Department of Epidemiology, Erasmus MC University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, The Netherlands.
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Lisa M Caulley
- Department of Epidemiology, Erasmus MC University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, The Netherlands
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Canada
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Myriam Hunink
- Department of Epidemiology, Erasmus MC University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Centre for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Jeremy Labrecque
- Department of Epidemiology, Erasmus MC University Medical Center, P.O. Box 2040, 3000CA, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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