Unpacking the mediating role of classroom interaction between student satisfaction and perceived online learning among Chinese EFL tertiary learners in the new normal of post-COVID-19

Online learning has become increasingly prevalent in the era of digitalization, impacted by both internet penetration and the COVID-19 pandemic. Classroom interaction, as a key factor in evaluating students' learning experience in online settings, has been identified to be associated with their academic achievement. While previous research has underscored the significance of classroom interaction in language learning settings, there is relatively limited research on its relationships with student satisfaction and learning. This research intends to explore classroom interaction and its mediating role in the correlation between student satisfaction and perceived online learning in online contexts. Given this, the paper reports a quantitative-method study that examined how Chinese EFL tertiary students perceived three types of classroom interaction (i.e., learner-learner, learner-instructor, and learner-content), their satisfaction, and its influences on their perceived online learning. Data was collected from 319 Chinese university students through convenience sampling and a self-designed questionnaire, and then analyzed with the help of SPSS. The results showed that: 1) the students had moderately positive perceptions of classroom interaction and online learning, but were neutral about their satisfaction; 2) positive correlations were observed between classroom interaction, student satisfaction, and online learning; and 3) student satisfaction predicted perceived online learning, with classroom interaction partially mediating this relationship. The findings of this research have implications for strengthening the effectiveness of online language teaching in the post-COVID-19 era.

Relationships between muscle strength, lung function, and cognitive function in Chinese middle-aged and older adults: A study based on the China health and retirement longitudinal study (CHARLS)

OBJECTIVE

As the population ages, concerns about cognitive decline have become increasingly relevant in medical consultations. This study aims to analyze the interaction between muscle strength, lung function, and cognitive function in Chinese middle-aged and older adults, providing a theoretical basis for better prevention of cognitive decline.

METHODS

This study used data from the China Health and Retirement Longitudinal Study (CHARLS) wave 3, including 13 716 participants aged 45 years or older. Cognitive function was assessed through two dimensions, resulting in a total score ranging from 0 to 31 points, with higher scores indicating better cognitive function. Muscle strength was measured using normalized grip strength and chair-standing time, while lung function was evaluated using peak expiratory flow (PEF).

RESULTS

Total cognitive function scores exhibited significant correlations with grip strength, chair-standing time, and PEF. Muscle strength and lung function demonstrated significant associations with cognitive function, with lung function emerging as a notable mediating factor. This relationship persisted even after adjusting for potential confounding variables. Specifically, PEF played a substantial mediating role in linking grip strength to cognitive function scores (estimated indirect effect = 0.0132, boot-strapped standard error = 0.0015, boot-strapped standard 95% confidence interval = 0.0104, 0.0162). Additionally, PEF served as a significant mediator in the association between chair-standing time and cognitive function scores (estimated indirect effect = -0.0204, boot-strapped standard error = 0.0023, boot-strapped standard 95% confidence interval = -0.0251, -0.0159).

CONCLUSION

The study highlights the importance of addressing declines in muscle strength and lung function to identify risk factors associated with cognitive function. Understanding these relationships can provide insights into potential pathways linking these variables and may aid in better prevention of cognitive decline. Further long-term longitudinal cohort studies are needed to explore the causality between these factors.

Relationship between workplace violence, job satisfaction, and burnout among healthcare workers in mobile cabin hospitals in China: Effects of perceived stress and work environment

Background

Although workplace violence is prevalent in the healthcare system, the relationship between workplace violence, job satisfaction, and burnout among healthcare workers (HCWs) in mobile cabin hospitals in China during the COVID-19 pandemic has not yet been investigated. This study analyzes the mediating effects of perceived stress and work environment in the relationship between workplace violence, job satisfaction, and burnout.

Methods

A cross-sectional study was conducted in December 2022 on 1,199 frontline HCWs working in mobile cabin hospitals in Chongqing, China, during the COVID-19 pandemic. Multiple linear regression and mediation analysis were performed.

Results

A positive correlation was observed between workplace violence and burnout (r = 0.420, P < 0.01) and perceived stress (r = 0.524, P < 0.01), and a negative correlation was observed with job satisfaction (r = -0.254, P < 0.01). The perceived stress was positively correlated with burnout (r = 0.528, P < 0.01) and negatively with job satisfaction (r = -0.397, P < 0.01). Job satisfaction was negatively correlated with burnout (r = -0.300, P < 0.01). Perceived stress plays a significant mediating role between workplace violence and job burnout and between workplace violence and job satisfaction. The work environment has a significant moderating effect between workplace violence and job burnout and between workplace violence and job satisfaction.

Conclusion

To reduce burnout among HCWs, hospital administrators should focus on reducing the incidence of workplace violence and perceived stress from work and on improving the work environment and job satisfaction.

Preoperative contributing factors and the remission of diabetes after metabolic surgery: the mediating role of preoperative triglyceride

BACKGROUND AND OBJECTIVE

Limited understanding exists regarding the factors affecting the prognosis of surgical treatment for type 2 diabetes mellitus (T2DM), particularly in Chinese patients. In this study, we examined a cohort of early and intermediate obese T2DM patients to explore the potential impact of preoperative lipid metabolism in metabolic surgery on the postoperative remission of T2DM.

METHODS

Participants with T2DM and obesity underwent metabolic surgery. Clinical data, including baseline body mass index, percentage of excess weight loss, and preoperative biochemical indicators, were collected and analyzed. A multidisciplinary team conducted patient follow-up. Remission was defined as sub-diabetic hyperglycemia (HbA1c < 48 mmol/mol, fasting glucose 100-125 mg/dl) without pharmacological intervention for at least 12 months.

RESULTS

Over a median follow-up of 27 months, 96 T2DM patients with metabolic surgery were studied, with no laparotomies required. Among these patients, 61 (63.5%) achieved complete remission, and 85 (88.5%) experienced remission. In multivariable analysis models, preoperative fasting blood glucose (FBG) significantly correlated with all postoperative outcomes. Furthermore, mediation analysis indicated that preoperative triglycerides (TG) mediated 26.31% of the association between preoperative FBG and postoperative remission. Both preoperative FBG and TG were negatively associated with the postoperative remission of T2DM.

CONCLUSION

In summary, our findings suggest that lower preoperative fasting glucose levels enhance the likelihood of postoperative T2DM remission. Moreover, preoperative TG could potentially play a mediating role in the postoperative remission of T2DM. Therefore, evaluating and managing fasting glucose and lipids before the procedure may aid in assessing the prognosis of metabolic surgery. Level of evidence Level III, designed cohort.

Risk perception and trust in the relationship between knowledge and HPV vaccine hesitancy among female university students in China: a cross-sectional study

BACKGROUND

Cervical cancer poses a heavy health burden in China, with the second highest incidence and mortality rate among female tumors, yet human papillomavirus (HPV) vaccination rate among female university students remain remains low. This study conducted a cross-sectional survey to assess the degree of HPV vaccine hesitancy among female university students and to explore the potential association between knowledge, risk perception, trust, and HPV vaccine hesitancy.

METHODS

A total of 1,438 female university students from four Chinese cities were recruited through stratified, multistage, cluster sampling method. The mediation model was constructed using the Bootstrap method, introducing trust and risk perception as mediating variables to examine the effect of knowledge on HPV vaccine hesitancy.

RESULTS

The study found that 8.9% (95%CI:7.4%∼10.4%) of the female university students exhibited HPV vaccine hesitancy. Pearson's correlation analysis revealed a negative association between vaccine hesitancy and knowledge, risk perception, and trust. The mediation model showed that knowledge had significant indirect effects on HPV vaccine hesitancy through trust (indirect effect: -0.224, 95% CI: -0.293 ∼ -0.167) and risk perception (indirect effect: -0.013, 95% CI: -0.033 ∼ -0.002).

CONCLUSION

HPV vaccine hesitancy among female university students has mitigated, but still needs to be addressed. In addition, trust and risk perception are mediators mediating the relationship between knowledge with HPV vaccine hesitancy. Therefore, there is a need to strengthen public health education to improve knowledge, with a particular focus on providing information about trust and risk perception to reduce HPV vaccine hesitancy.

The mediating role of loneliness in the relationship between smartphone addiction and subjective well-being

As smartphones become increasingly prevalent worldwide, the relationship between smartphone addiction and subjective well-being has become a focal point in academic circles. Prior research predominantly delved into the direct correlation between smartphone addiction and subjective well-being, yet there remains a dearth in exploring its underlying mechanisms. This study investigated the mediating role of loneliness in the relationship between smartphone addiction and subjective well-being among Chinese university students. Conducted across 16 universities in eight provinces and municipalities in China, this study encompassed 1527 university students. Data collection utilized scales measuring smartphone addiction, loneliness, and subjective well-being. The findings revealed that: (1) demographic variables such as place of origin, educational level, and family income influenced university students' subjective well-being; (2) a significant negative correlation existed between smartphone addiction and subjective well-being among university students, coupled with a significant positive correlation between smartphone addiction and loneliness, indicating the significant negative predictive effect of smartphone addiction on subjective well-being; (3) loneliness partially mediated the relationship between smartphone addiction and subjective well-being among university students, suggesting that smartphone addiction could directly impact university students' subjective well-being, or indirectly through its effect on loneliness.

Prenatal exposure to PM2.5 components and the risk of different types of preterm birth and the mediating effect of pregnancy complications: a cohort study

OBJECTIVES

This study aims to reveal the single and mixed associations of PM2.5 and its components with very, moderately, and late preterm births and to explore the potential mediating role of pregnancy complications in PM2.5-induced preterm birth.

STUDY DESIGN

This was a retrospective cohort study.

METHODS

We enrolled 168,852 mothers and matched the concentrations of PM2.5 and its five components (OM, SO42-, BC, NO3-, and NH4+) based on their geographical location. Next, we used generalized linear models, quantile g-computation, and mediation analysis to evaluate the associations of PM2.5 and its components with very, moderately, and late preterm births and the mediating role of pregnancy complications.

RESULTS

Prenatal exposure to PM2.5 and its components was associated with preterm birth, and the association was strongest in the third trimester. Preterm birth was associated with co-exposure to a mixture of PM2.5 components in the third trimester, and the contributions of NO3-, NH4+, and BC to the risk of preterm birth were positive. Meanwhile, pregnancy complications mediated PM2.5-induced preterm birth. Moreover, very and moderately preterm births were associated with PM2.5 and its components in the second and third trimesters, and very and late preterm births were associated with co-exposure to a mixture of PM2.5 components in the third trimester.

CONCLUSIONS

Later exposure to PM2.5 during pregnancy will cause earlier preterm birth. Targeted and positive interventions for anthropogenic sources of specific PM2.5 components and pregnancy complications are helpful for preterm birth prevention.

Prenatal exposure to fine particulate matter chemical constituents and the risk of stillbirth and the mediating role of pregnancy complications: A cohort study

Evidence on the association of fine particulate matter (PM2.5) exposure with stillbirth is limited and inconsistent, which is largely attributed to differences in PM2.5 constituents. Studies have found that the hazards of certain PM2.5 constituents to the fetus are comparable to or even higher than total PM2.5 mass. However, few studies have linked PM2.5 constituents to stillbirth. Moreover, the mediating role of pregnancy complications in PM2.5-related stillbirth remains unclear. To our knowledge, this study was the first to explore the individual and mixed associations of PM2.5 and its constituents with stillbirth in China. After matching the concentrations of PM2.5 and its constituents (sulfate [SO42-], nitrate [NO3-], ammonium [NH4+], organic matter [OM], and black carbon [BC]) for participants according to their geographical location, there were 170,507 participants included in this study. We found that stillbirth was associated with exposure to PM2.5 and its constituents in the year before pregnancy and during the entire pregnancy, and the associations in trimester 1 were strongest. The risk of stillbirth increased sharply when PM2.5 and its constituents during pregnancy exceeded the median concentrations. Moreover, stillbirth was associated with exposure to the mixtures of SO42-, NO3-, NH4+, OM, and BC before and during pregnancy (trimesters 1 and 2). Meanwhile, two-pollutant models also suggested stillbirth was associated with PM2.5 and its constituents in the year before and during pregnancy. The associations of PM2.5 and its constituents with stillbirth were stronger in mothers with advanced age and without cesarean delivery history. Additionally, hypertensive disorders in pregnancy, gestational diabetes, and placental abruption mediated the association of PM2.5 with stillbirth. Therefore, enhanced protection against PM2.5 for pregnant women before and during pregnancy and targeted interventions for pregnancy complications and anthropogenic sources of PM2.5 constituents are important to reduce stillbirth risk.

Lessons learned from COVID-19 vaccination implementation: How psychological antecedents of vaccinations mediate the relationship between vaccine literacy and vaccine hesitancy

BACKGROUND

Enhancing the public's vaccine literacy is critical for curbing vaccine hesitancy and enhancing society's pandemic preparedness, particularly in an era of infodemic. Evidence on vaccine literacy as an influencing factor of hesitancy is scarce. Lessons could be learned from COVID-19 vaccination implementation. Taking the COVID-19 vaccines as an example, the current study aimed to examine the relationship between vaccine literacy and hesitancy and the mediating role of psychological antecedents of vaccination on the relationship.

METHODS

A baseline online questionnaire survey among the general public in China based on quota sampling was conducted in April 2021 to measure participants' vaccine literacy, psychological antecedents of vaccination, COVID-19 vaccination status, and vaccine hesitancy. A follow-up online survey tracked the updated COVID-19 vaccination status among those who hadn't taken COVID-19 vaccines at the baseline survey. Structural equation modeling has been applied to examine the direct and indirect effect of vaccine literacy on vaccine hesitancy. Time-to-event analysis was used to explore the effect of vaccine hesitancy on vaccination behavior.

RESULTS

Lower vaccine hesitancy was associated with higher vaccine literacy. The "3Cs" psychological antecedents were important mediators between vaccine literacy and vaccine hesitancy. The pathway between critical/interactive vaccine literacy and vaccine hesitancy through the "3Cs" psychological antecedents played a more important role. Time-to-event analysis showed participants with a higher vaccine hesitancy were prone to have a longer delay in vaccination.

CONCLUSIONS

Improving the public's ability to obtain and evaluate vaccination information can fix the public's psychological determinants of vaccination, reducing vaccine hesitancy and promoting vaccination. Governments need to put more effort into guiding and regulating the media to disseminate evidence-based information, rectifying misinformation, and improving the public's vaccine literacy through education, especially the public's capability to critically discern mixed information.

Correlation and pathways of behavioral activation systems mediating physical activity level and depressive symptoms among college students

BACKGROUND

Depression is a common mental disorder among college students. The main symptoms include being persistent low mood, sad emotional experiences, lack of pleasure, listlessness, and impaired cognitive function accompanied by tendencies of self-harm and suicide.

AIM

To clarify the pathways and effects of the behavioral activation system between physical activity and depressive symptoms in college students with depressive symptoms.

METHODS

This cross-sectional research screened 3047 college students. Of these, 472 had depressive symptoms, with a depression detection rate of 15.49%. Furthermore, 442 college students with depressive symptoms were analyzed. A one-way analysis of variance and Pearson's correlation, linear regression, and structural equation modeling analyses were used to explore the correlations and pathways of the interactions between the variables.

RESULTS

Depressive symptoms were significantly negatively correlated with physical activity (r = -0.175, P < 0.001), the behavioral activation system (r = -0.197, P < 0.001), and drive (r = -0.113, P = 0.017). Furthermore, it was negatively correlated with fun-seeking (FS) (r = -0.055, P = 0.251); however, it was not significant. Physical activity was significantly positively correlated with reward responsiveness (RR) (r = 0.141, P = 0.003) and drive (r = 0.124, P = 0.009) and not significantly positively correlated with FS (r = 0.090, P = 0.058). The mediating effect of RR between physical activity and depressive symptoms was significant [B = -0.025, 95% confidence interval (95%CI): -0.051 to -0.008, P = 0.001]. The direct and total effects of physical activity on depressive symptoms and were significant (B = -0.150, 95%CI: -0.233 to -0.073, P < 0.001; B = -0.175, 95%CI: -0.260 to -0.099, P < 0.001), respectively.

CONCLUSION

As physical activity levels increased, depression scores among college students decreased. The mediating effect of RR between physical activity and depressive symptoms was significant. Therefore, colleges and universities should encourage college students with depression to increase their physical activity and improve their behavioral activation system. Particular attention should be paid to RR, which may reduce the prevalence of depressive symptoms.

Longitudinal associations between social relationships and cognitive function among Chinese older adults: The mediating role of healthy lifestyles

BACKGROUND

We aimed to explore whether social relationships and cognitive function were reciprocally related and whether healthy lifestyles mediate their association.

METHODS

This study included 3372 Chinese adults from the years 2014-2018 wave of the Chinese Longitudinal Healthy Longevity Survey.

RESULTS

Baseline social relationships were negatively associated with a change in cognitive function (β = -0.030, p = 0.043). Participants with a 1 standard deviation (SD) increase in social relationships had an approximately 6% reduced risk of developing cognitive impairment. However, baseline cognitive function did not independently predict social relationships. The association between △social relationships and △cognitive function was partially mediated by △a healthy lifestyle (B = 0.025, 95% CI = 0.013-0.041).

CONCLUSIONS

The association between social relationships and cognitive function may be unidirectional. Policies that promote cognitive function based on social relationships would benefit by taking into account lifestyle factors.

Anxiety, depression, and sleep quality among breast cancer patients in North China: Mediating roles of hope and medical social support

BACKGROUND

Sleep disorders are highly prevalent among breast cancer patients and have a detrimental impact on their quality of life. This study aims to investigate the serial multiple mediating roles of social support and hope in the relationship between anxiety, depression, and sleep quality in breast cancer patients.

METHODS

A cross-sectional study was conducted in China from October 2021 to February 2022. A total of 315 breast cancer patients were assessed using self-reported questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Medical Outcomes Study Social Support Survey (MOS-SSS), Herth Hope Index (HHI), and Hospital Anxiety and Depression Scale (HADS). Mediation analysis was performed using the R Statistical Software.

RESULTS

Sleep quality exhibited a negative correlation with hope and medical social support (P < 0.01), and a positive correlation with anxiety and depression (P < 0.01). Anxiety and depression accounted for 18.8% and 12.8% of the variance in sleep quality, respectively. Bootstrap analyses of the anxiety-medical social support-hope-sleep quality pathway indicated the presence of direct effects [B = 0.331, 95%CI (0.215, 0.493)] and indirect effects of anxiety on sleep quality mediated solely by medical social support [B = 0.054, 95%CI (0.015, 0.108)] and hope [B = 0.041, 95%CI (0.018, 0.073)], as well as combined effects [B = 0.012, 95%CI (0.004, 0.025)]. Similarly, the depression-medical social support-hope-sleep quality pathway revealed direct effects [B = 0.235, 95%CI (0.104, 0.372)] and indirect effects of depression on sleep quality mediated solely by medical social support [B = 0.078, 95%CI (0.016, 0.150)] and hope [B = 0.049, 95%CI (0.018, 0.086)], as well as combined effects [B = 0.017, 95%CI (0.004, 0.034)].

CONCLUSIONS

This research validates the hypothesis that medical social support and hope serve as mediators between anxiety, depression, and sleep quality in breast cancer patients. Interventions targeting anxiety, depression, medical social support, and hope have the potential to effectively enhance sleep quality.

Mediating effect of resilience and fear of COVID-19 on the relationship between social support and post-traumatic stress disorder among campus-quarantined nursing students: a cross-sectional study

BACKGROUND

The emergency of Omicron variants, spreading in China and worldwide, has sparked a new wave of the coronavirus disease 2019 (COVID-19) pandemic. The high infectivity and persistence of the pandemic may trigger some degrees of post-traumatic stress disorder (PTSD) for nursing students experiencing indirect trauma exposure to the epidemic, which hinders the role transition from students to qualified nurses and exacerbates the health workforce shortage. Thus, it's well worth an exploration to understand PTSD and its underlying mechanism. Specifically, PTSD, social support, resilience, and fear of COVID-19 were selected after widely literature review. This study aimed to investigate the relationship between social support and PTSD among nursing students during COVID-19, to address the mediating role of resilience and fear of COVID-19 between social support and PTSD, and to provide practical guidance for nursing students' psychological intervention.

METHODS

From April 26 to April 30, 2022, 966 nursing students from Wannan Medical College were selected by the multistage sampling method to fill the Primary Care PTSD Screen for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Brief Resilience Scale, Fear of COVID-19 Scale, and Oslo 3 Items Social Support Scale. Data were analyzed by descriptive statistics, spearman's correlation analysis, regression analysis, and path analysis.

RESULTS

15.42% of nursing students had PTSD. There were significant correlations between social support, resilience, fear of COVID-19, and PTSD (r =-0.291 ~ 0.353, P <0.001). Social support had a direct negative effect on PTSD (β =-0.216; 95% confidence interval, CI: -0.309~-0.117), accounting for 72.48% of the total effect. Analysis of mediating effects revealed that social support influenced PTSD through three indirect pathways: the mediated effect of resilience was statistically significant (β =-0.053; 95% CI: -0.077~-0.031), accounting for 17.79% of the total effect; the mediated effect of fear of COVID-19 was statistically significant (β =-0.016; 95% CI: -0.031~-0.003), accounting for 5.37% of the total effect; the chain mediating effect of resilience and fear of COVID-19 was statistically significant (β =-0.013; 95% CI: -0.022~-0.006), accounting for 4.36% of the total effect.

CONCLUSION

The social support of nursing students not only directly affects PTSD, but also indirectly affects PTSD through the separate and chain mediating effect of resilience and fear of COVID-19. The compound strategies targeted at boosting perceived social support, fostering resilience, and controlling fear of COVID-19 are warranted for reducing PTSD.

Sense of coherence mediates perceived social support and depressive and anxiety symptoms in cervical cancer patients: a cross-sectional study

BACKGROUND

Depression and anxiety symptoms are two common psychological disturbances in cervical cancer patients. We tested whether sense of coherence (SOC) mediates the association of perceived social support (PSS) with depression and anxiety symptoms among cervical cancer patients in China.

METHODS

We conducted a survey involving 294 cervical cancer patients aged ≥ 18 years from July to December 2020 at three hospitals in Liaoning Province, China; 269 patients completed the survey. We included a demographic questionnaire, the Multidimensional Scale of Perceived Social Support (MSPSS), Antonovsky's Sense of Coherence Scale, the Hamilton Depression Rating Scale, and the Zung Self-Rating Anxiety Scale (SAS) in this study. We used hierarchical regression analysis to examine the relationship among PSS, SOC, and symptoms of depression and anxiety. We used asymptotic and resampling strategies to explore the mediating effect of SOC.

RESULTS

PSS was negatively associated with depressive symptoms (r = - 0.439, P < 0.01) and anxiety symptoms (r = - 0.325, P < 0.01). SOC was negatively related to depressive symptoms (r = - 0.627, P < 0.01) and anxiety symptoms (r = - 0.411, P < 0.01). SOC partially mediated the association between PSS and depressive symptoms (a*b = - 0.23, BCa95% CI: [- 0.31, - 0.14]) and anxiety symptoms (a*b = - 0.15, BCa95% CI: [- 0.23, - 0.08]). The proportions of the mediating effect accounting for SOC were 49.78% and 41.73% for depressive symptoms and anxiety symptoms, respectively.

CONCLUSION

The study showed that SOC could mediate the association between PSS and symptoms of depression and anxiety. This suggests that SOC might serve as a potential target for intervention in symptoms of depression and anxiety that accompany cervical cancer.

Association between emotional abuse and depressive symptoms in Chinese children: The mediating role of emotion regulation

BACKGROUND

Emotional abuse has been identified as a risk factor for children's depressive symptoms. However, the specific psychological mechanisms mediating this relation are not well understood.

OBJECTIVE

This longitudinal study examined the relation of emotional abuse to subsequent depressive symptoms and the possible mediating role of emotion regulation among Chinese children.

PARTICIPANTS AND SETTING

The sample included 3633 children (45.5 % girls) with an average age of 9.96 years from a large city in southern China.

METHOD

Participants completed multiple measurements of emotional abuse, emotion regulation, and depressive symptoms on five occasions at six-month intervals, controlling for sex, age, and physical abuse and emotional neglect at Time 1. Latent growth curve modeling was applied to examine the longitudinal relations among the variables.

RESULTS

Results showed (a) emotional abuse was significantly positively associated with subsequent depressive symptoms; (b) cognitive reappraisal mediated the relation between emotional abuse and depressive symptoms, but expressive suppression did not.

CONCLUSIONS

The results highlighted the mediating role of cognitive reappraisal in the relation between emotional abuse and depressive symptoms, suggesting that intervention programs targeting cognitive reappraisal may be effective to reduce the likelihood of depressive symptoms among Chinese children.

Slack resources and individual performance of clinicians: the mediating role of job satisfaction and empirical evidence from public hospitals in Beijing, China

BACKGROUND

Clinicians in Chinese public hospitals face a complex and severe clinical practice environment, and the individual performance of clinicians is key to improving the output of the healthcare industry. This study aims to explore the mechanism of slack resources in improving individual performance of clinicians and the role of job satisfaction in this process, while the study framework is based on the widely applied Job-Demands Resources theory.

METHODS

Based on the study framework composed of slack resources, individual performance, and job satisfaction, hypotheses have been put forward, and questionnaires have been distributed to representative clinicians in tertiary public hospitals. Finally, 318 valid data collected from clinicians have been obtained. To verify the hypotheses, multiple linear regression models have been established to explore the relationship between variables, and the three-stage regression models have been used to verify the presence of mediating role.

RESULTS

All four hypotheses proposed in this study have been proved to be held. Clinicians' job satisfaction has played a mediating role in the impact of slack resources and its three dimensions on individual performance. Among them, there has been a complete mediating role for staff slack, while time and space dimensions have played a partial mediating role in the impact of slack resources on individual performance.

CONCLUSIONS

In public hospitals in environments where behavior is subject to significant government interference, it is necessary and feasible to retain appropriate slack resources to improve individual performance. From the perspective of resources management in hospitals, it is necessary for public hospitals to implement a strategy of reserving an appropriate portion of time, staff and space in order to have the conditions to improve clinicians' satisfaction. The existence of slack resources in public hospitals can improve the job satisfaction of clinicians, and then improve the individual performance through the process.

Mediating role of psychological flexibility in the effect of obsessive-compulsive symptoms on sleep quality among nurses during the COVID-19 pandemic

Front-line nurses suffered unprecedented mental distress and severe insomnia during the COVID-19 pandemic. Present study aimed to explore the relationship between obsessive-compulsive symptoms and sleep quality and examine the potential mediating role of psychological flexibility between obsessive-compulsive symptoms and sleep quality. A total of 496 nurses from a Chinese large-scale Class 3 A Comprehensive Hospital were included in an online cross-sectional survey and completed the revised obsessive-compulsive inventory (OCI-R), Multidimensional Psychological Flexibility Inventory (MPFI) and Pittsburgh Sleep Quality Index (PSQI). As predicted, obsessive-compulsive symptoms were negatively associated with psychological flexibility and sleep quality, and psychological flexibility was positively associated with sleep quality. In addition, the relationship between obsessive-compulsive symptoms and sleep quality was partially mediated by psychological flexibility, which can provide some reference for the treatment of the obsessive-compulsive disorder (OCD) and insomnia, and lead to improvements in clinical and psychotherapy planning.

Quality of life as a mediating factor in the relationship between fatigue and perception of safety among critical care nurses in the United Arab Emirates

BACKGROUND

A scientific understanding of the relationships between intensive care unit nurses' well-being and patient safety will allow nurse managers, administrators, and policymakers to simultaneously manage crucial organisational goals of nurses' health and patient safety. Understanding predictors of fatigue among intensive care unit nurses may help to balance personal and organisational impacts (e.g., turnover intention, sick leave) and provide a way to positively influence their safety perception.

OBJECTIVE

The aim of this study was to explore the association between work fatigue and perception of patient safety among nurses working in critical care units and determine whether their quality of life levels mediated this relationship.

METHODS

This study used a cross-sectional correlational comparative design. Participants were a sample of 250 intensive care unit nurses recruited conveniently from three large hospitals in the United Arab Emirates. The self-reported questionnaire included the Nursing Quality of Life Scale, the Fatigue Severity Scale, and the Safety Attitudes Questionnaire (SAQ)-ICU version, as well as sociodemographic characteristics and work-related information.

RESULTS

Of the 250 participating nurses, 76.8 % reported low QoL. There was a statistically significant correlation between nurses' Quality of Life and fatigue levels (r = 0.234, P = 0.000). Overall, 52.8 % of the sample had high fatigue and 49.6 % had poor safety perception. Multiple regression analysis using the Baron and Kenny approach showed that QoL, marital status, gender, and work environment were predictors of nurses' perception of safety.

CONCLUSION

Intensive care unit nurses had high levels of fatigue and poor Quality of Life. High Quality of Life and a favourable work environment were independent predictors of good patient safety perception. Efforts should be directed to maximize staffing resources that positively impact patient safety. These findings are comparable with international studies, suggesting that these issues may be ubiquitous.

IMPLICATIONS FOR CLINICAL PRACTICE

Intensive care practitioners, managers and policymakers should adopt measures to modify intensive care nurses' exhausting working conditions and provide a supportive environment. these interventions might improve nurses' perception of patient safety and consequently prevent safety incidents.

The effect of childhood socioeconomic status on depressive symptoms in middle-old age: the mediating role of life satisfaction

BACKGROUND

Some studies have shown that childhood socioeconomic status (SES) can influence the development and progression of depression in adulthood. This study aimed to analyze the effects of childhood SES on depressive symptoms in individuals of middle-old age and examine the potential mediating role of life satisfaction based on national data in China.

METHODS

Data were derived from the 2018 China Health and Retirement Longitudinal Study (CHARLS) data. A total of 17,129 individuals who were aged 45 years and older were included. The dependent variable was depressive symptoms in middle-old age. Childhood SES was the independent variable, and life satisfaction was the mediator. This study controlled four factors: general demographic characteristics, adult SES, childhood adversity and health and living status. Pearson correlations and hierarchical multiple regression analysis were performed, and the Baron and Kenny method was used to test the mediating role.

RESULTS

The score of depressive symptoms among all participants was 7.88 ± 6.65. Gender, age, adult SES, childhood adversity and health and living status all affected the development of depression symptom in middle-aged and elderly individuals in China. After adjusting for all covariates, the higher the childhood SES, the lower the depressive symptom score (β = - 0.422, P < 0.001). Life satisfaction had a partial mediating effect between childhood SES and depressive symptoms. Low childhood SES may improve life satisfaction (β = 0.051, P < 0.001) and life satisfaction indirectly decreases depressive symptom scores (β = - 0.403, P < 0.001).

CONCLUSIONS

Life satisfaction was a partial mediator between childhood SES and depressive symptoms in middle and old age. Improving life satisfaction may serve as an intervention to reduce the incidence of depression symptoms in the future.

Social support, anxiety, and depression in patients with prostate cancer: complete mediation of self-efficacy

BACKGROUND

Social support and self-efficacy are important factors to improve negative emotions such as depression and anxiety in patients with prostate cancer after surgery; however, little is known about the relationship between them. The objective of the study was to comprehensively explore the relationship between social support, self-efficacy, and anxiety and depression.

METHOD

A cross-sectional design and a convenience sampling method were used to recruit patients with prostate cancer from a comprehensive hospital in Zhejiang Province. Structured scales were used for data collection, including the Social Support Rating Scale, Strategies Used by People to Promote Health, and the hospital anxiety and depression scale.

RESULTS

The result showed that anxiety and depression were negatively correlated with self-efficacy (r =  - 0. 434, P < 0. 01) and social support (r =  - 0. 212, P < 0. 01), while self-efficacy and social support were positively correlated (r = 0. 356, P < 0. 01). A structural equation model showed that the effect value of social support on self-efficacy was (β = 0.386, p < 0.01) and the effect value of self-efficacy on negative emotions was (β =  - 0.497, p < 0.01). Self-efficacy fully mediated the effect between social support and negative emotions with a 100% mediation rate.

CONCLUSION

Social support and self-efficacy did contribute to the improvement of depression and anxiety in patients with radical prostatectomy, and they were associated with a full mediating effect of self-efficacy. Providing social support that matches the coping needs of the stressor can maximize the role of social support. Therefore, it is necessary to identify the patient's stressor and coping needs in advance, which will help us to provide matching social support, so as to alleviate patients' bad emotions more effectively and improve their prognosis.

Exploring the role of finance, natural resources, and governance on the environment and economic growth in South Asian countries

We studied the influence of finance, natural resources, and governance on environmental degradation and economic growth for seven countries of the South Asian Association for Regional Cooperation (SAARC) using the latest panel data over 1996-2018. Panel cointegration tests and the long-run algorithms capable of addressing endogeneity and cross-sectional dependence have been applied to analyze the variables' linkages. To explore the short-run causalities, we further utilized a panel heterogeneous causality test. Empirical estimates concluded that there is a mediating role of finance and governance on improving environmental quality and have a significant positive impression on the economic growth of the SAARC countries. The results supported the natural resources curse theory and substantially contributed to environmental emissions in the study area. The causal results concluded the unilateral causality from the environment to governance and bidirectional causality between finance and environmental degradation. Similarly, there were unilateral causal linkages between economic growth and natural resources, where links are bidirectional between natural resources and environmental degradation for SAARC countries. Based on the outcomes of the study, some policy implications are provided for theory and practice.

The effects of green innovation and environmental management on the environmental performance and value of a firm: an empirical study of energy-intensive listed companies in China

There is a debate in the literature about the relationship between green innovation, environmental management, environmental performance, and the value of a firm. Herein, the effects of green innovation and environmental management on environmental performance are analysed using a stochastic frontier model for energy-intensive listed companies from 2011 to 2017; the effects thereof on the value of a firm are assessed empirically. The results show that green innovation and environmental management have a positive effect on corporate environmental performance, and green innovation plays a complete mediating role between environmental management and environmental performance. The significant positive effect of green innovation on value of a firm confirms Porter's hypothesis, but the positive effect of environmental management on value of a firm is not verified. Finally, recommendations that are aimed at improving corporate environmental performance are given.

In-service training and teaching resource proficiency amongst Chemistry teachers: the mediating role of teacher collaboration

This study aims to determine the level of collaboration, in-service training and teaching resource proficiency amongst Chemistry teachers by investigating the intermediary role of collaboration for training and teaching resources competency. A total of 184 Chemistry teachers in Riau, Indonesia, have participated in the survey. Using AMOS and SPSS 25.0 software to analyse the research data, we find a high level of collaboration, training and teaching resource proficiency amongst Chemistry teachers. Male teachers have higher proficiency level on all aspects than female teachers. The MANOVA test results show a significant difference in teacher resource competency based on gender. Male teachers are significantly more proficient than their female counterparts. However, they do not significantly differ in terms of collaboration and in-service training. The structural equation modelling test results show that collaboration has a significant role in Chemistry teachers’ involvement in training and teaching resources. These research findings encourage relevant parties to design effective collaborations amongst Chemistry teachers. They also offer new insights for Chemistry teachers to keep on mastering teaching resources nationally and internationally.

Mediating role of post-traumatic stress disorder in post-traumatic growth in adults who experienced the 2017 Pohang earthquake

BACKGROUND

The largest earthquake recorded in Korea occurred in Pohang in 2017. This study aimed to investigate the mediating role of post-traumatic stress disorder (PTSD) on the relationship between earthquake exposure level and post-traumatic growth (PTG) in adults who experienced the earthquake.

METHODS

We used a cross-sectional survey via convenience sampling to collect data from 200 respondents 18 months after the earthquake.

RESULTS

PTSD was severe in individuals who were married, had no religious affiliation, lower income, and higher earthquake exposure. PTG was higher in older, married, and more religious respondents. PTSD and PTG had a positive relationship, with PTSD fully mediating the relationship between earthquake exposure level and PTG.

LIMITATIONS

The Pohang earthquake, with limited damage to life and property, may have had different effects on exposed individuals than more destructive earthquakes. Additionally, this study used the Korean version of the Posttraumatic Growth Inventory; most of the participants reporting a religious affiliation were Christians, which may have affected the results.

CONCLUSIONS

Exposure to the Pohang earthquake was strongly associated with PTSD, which indirectly affected PTG. Future research should focus on developing an adequate PTG tool for natural disaster victims, more extensively investigating PTSD and PTG, and analyzing PTSD and PTG in terms of the disaster type.

Paediatric nurses' general self-efficacy, perceived organizational support and perceived professional benefits from Class A tertiary hospitals in Jilin province of China: the mediating effect of nursing practice environment

Background

General self-efficacy is considered one of the most influential parameters affecting the quality of clinical practice and nurses’ perceived professional benefits (NPPB). Perceived organizational support (POS) is regarded as being central in understanding job-related attitudes, and it is important to enhance POS for nurses to maintain their current employment. NPPB can further reduce nurses’ job burnout and turn-over intention. Many studies have explored the relationships among general self-efficacy, POS, nursing practice environment (NPE) and NPPB. However, a moderating effect of NPE has not been fully explored in nurses, especially among paediatric nurses.

Methods

A descriptive cross-sectional study was conducted from July to October 2018 with 300 paediatric nurses from 3 Class A tertiary hospitals in Jilin Province. The respondents completed the General Self-Efficacy Scale, Perceived Organizational Support Scale, Practice Environment Scale and Nurses’ Perceived Professional Benefits Scale. The data were analyzed using path analysis and SPSS (version 23.0, IBM).

Results

General self-efficacy and POS were significantly positively associated with NPPB, which showed that the model had a good fit to the data. NPE was found to play a partial mediating role between POS and NPPB and also had a complete mediating role between general self-efficacy and NPPB.

Conclusions

The results suggest that general self-efficacy indirectly influences NPPB, and POS directly and indirectly influences NPPB by NPE. Effective measures should be taken to improve nurses’ practice environment in hospitals to raise nurses’ enthusiasm and confidence in their work.

The Effect of Workplace Violence on Depressive Symptoms and the Mediating Role of Psychological Capital in Chinese Township General Practitioners and Nurses: A Cross-Sectional Study

OBJECTIVE

The most existing research has predominantly focused on city rather than township hospitals. This study aimed to explore depressive symptoms and its associated factors among general practitioners and nurses in Chinese township hospitals.

METHODS

This cross-sectional study was carried out in Liaoning, China in 2016. 2,000 general practitioners and nurses in Chinese township hospitals were recruited and 1,736 of them became final subjects (effective response rate: 86.8%). Data on depressive symptoms, workplace violence (WPV), psychological capital (PsyCap), and demographic factors were collected through questionnaires. Hierarchical multiple regression was used to explore the factors related to depressive symptoms. Asymptotic and resampling strategies were applied to examine the potential mediating effect of PsyCap.

RESULTS

The prevalence of depressive symptoms among the participants was 49.9%. Workplace violence was positively associated with depressive symptoms, whereas psychological capital and its components of hope, optimism and resilience were negatively associated with depressive symptoms. Psychological capital and its components of hope, optimism and resilience all played partial mediating roles between workplace violence and depressive symptoms.

CONCLUSION

Nearly half of general practitioners and nurses surveyed suffered from depressive symptoms. Reduction of workplace violence and development of psychological capital can be targeted for interventions to combat depressive symptoms.

Sense of coherence and physical health-related quality of life in Italian chronic patients: the mediating role of the mental component

OBJECTIVE

To examine the relationship between sense of coherence (SOC) and physical health-related quality of life in patients with chronic illnesses by focusing on the mediating role of the mental component of quality of life.

DESIGN

Cross-sectional survey design.

SETTING

Secondary care; three departments of an Italian university hospital.

METHODS

The participants (n=209) in the study were adult (≥18 years) outpatients with a chronic pathology (eg, diabetes, thyroid disorders or cancer) at any phase in the care trajectory (eg, pre-treatment, undergoing treatment, follow-up care). They agreed to participate in the study after providing their informed consent. Data were collected using a structured self-reporting questionnaire. Data analysis was carried out using SPSS, and mediation analysis was performed via PROCESS macro.

RESULTS

The SOC score of the study sample was equivalent to that of the general population (mean difference=-2.50, 95% CI -4.57 to 0.00). Correlation analysis showed that SOC was mainly correlated to the mental component (MCS) (r=0.51, p<0.01) of quality of life and then to the physical component (PCS) (r=0.35, p<0.01). Mediation analysis showed that SOC was directly related to MCS (p<0.001, 95% CI 0.62 to 0.99) but not to PCS (p=0.42, 95% CI -0.27 to 0.12). In turn, MCS was directly related to PCS (p<0.001, 95% CI 0.76 to 1.01). The indirect effect of SOC on PCS through MCS was significant (0.71, p<0.001, bootstrap 95% CI 0.54 to 0.91), thus supporting the mediating role of the mental component of quality of life.

CONCLUSION

The indirect effect suggests that SOC is a marker of quality of life, especially of the mental component. The findings show that SOC is a psychological process that impacts patients' mental health status, which in turn affects physical health. Better knowledge of a person's SOC and how it affects his/her quality of life may help to plan tailoring interventions to strengthen SOC and improve health-related quality of life.

The impact of workplace violence on job satisfaction, job burnout, and turnover intention: the mediating role of social support

BACKGROUND

Workplace violence (WPV) is a global public health problem and has caused a serious threat to the physical and mental health of healthcare workers. Moreover, WPV also has an adverse effect on the workplace behavior of healthcare workers. This study has three purposes: (1) to identify the prevalence of workplace violence against physicians; (2) to examine the association between exposure to WPV, job satisfaction, job burnout and turnover intention of Chinese physicians and (3) to verify the mediating role of social support.

METHODS

A cross-sectional study adopted a purposive sampling method to collect data from March 2017 through May 2017. A total of nine tertiary hospitals in four provinces, which provide healthcare from specialists in a large hospital after referral from primary and secondary care, were selected as research sites based on their geographical locations in the eastern, central and western regions of China. Descriptive analyses, a univariate analysis, a Pearson correlation, and a mediation regression analysis were used to estimate the prevalence of WPV and impact of WPV on job satisfaction, job burnout, and turnover intention.

RESULTS

WPV was positively correlated with turnover intention (r = 0.238, P < 0.01) and job burnout (r = 0.150, P < 0.01), and was negatively associated with job satisfaction (r = - 0.228, P < 0.01) and social support (r = - 0.077, P < 0.01). Social support was a partial mediator between WPV and job satisfaction, as well as burnout and turnover intention.

CONCLUSIONS

The results show a high prevalence of workplace violence in Chinese tertiary hospitals, which should not be ignored. The effects of social support on workplace behaviors suggest that it has practical implications for interventions to promote the stability of physicians' teams.

TRIAL REGISTRATION

(Project Identification Code: HMUIRB2014005), Registered March 1, 2014.

The Association of Occupational Stress and Depressive Symptoms among Employed Persons with Benign Breast Disease: The Mediating Role of Psychological Capital

BACKGROUND

To evaluate the association between depressive symptoms and occupational stress, and the possibility of psychological capital (PsyCap) in alleviating depressive symptoms and occupational stress, we investigated the mediating role of PsyCap on the association between depressive symptoms and occupational stress among employed persons with benign breast disease (BBD) diagnosed by using ultrasonography.

METHODS

A cross-sectional survey was conducted in 371 employed persons with BBD. Self-administered questionnaires, including the items of depressive symptoms, occupational stress, the 24-item Psychological Capital Questionnaire, as well as the age, education, marital status, occupation, monthly income, and weekly working hours, were obtained from all patients. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure the depressive symptoms, an effort-reward imbalance model was used to assess occupational stress, while 24-item Psychological Capital Questionnaire measurements were used to measure the PsyCap. Baron and Kenny's technique was used to test the mediating effect of PsyCap.

RESULTS

In total, 62% of employed persons with BBD had scores equal to or above the cutoff point (CES-D ≥16). Overcommitment was not significantly correlated with PsyCap (r = -0.096, p = 0.066). Depressive symptoms were positively correlated with the effort-reward ratio (ERR) (β = 0.327, p < 0.001) in model 2, and it was negatively correlated with PsyCap (β = -0.339, p < 0.001) in model 3. PsyCap associated with ERR mediated the depressive symptoms.

CONCLUSIONS

Besides the medical intervention, the management of depressive symptoms and decrease in occupational stress should be considered to alleviate the depressive symptoms associated with employed persons with BBD. PsyCap is an active resource for relieving depressive symptoms and reducing occupational stress in persons with BBD.

Positive resources for combating job burnout among Chinese telephone operators: Resilience and psychological empowerment

Job burnout is a major concern within the service industry. However, there is a lack of research exploring positive resources for combating burnout among telephone operators. The purpose of this study was to examine the associations between resilience, psychological empowerment, and job burnout, and the mediating role of psychological empowerment. A cross-sectional survey of 575 telephone operators was conducted in 2 call centers in Shandong Province, China. Self-report questionnaires were used to assess job burnout symptoms, resilience, and psychological empowerment. Hierarchical linear regression was performed to analyze the degree to which resilience and psychological empowerment are associated with job burnout, and the mediating role of psychological empowerment. The results showed that resilience and psychological empowerment had significant "net effects" on job burnout, which may represent positive resources for combating job burnout. Psychological empowerment may partially mediate the relationship between resilience and job burnout. Thus, interventions focused on resilience and psychological empowerment may be useful options for managers concerned about burnout.

Nurses well-being in intensive care units: study of factors promoting team commitment

BACKGROUND

Intensive care units (ICUs) are challenging work environments because of the critical condition of patients, and ICU nurses frequently lament low job satisfaction and high staff turnover. Nevertheless, organizational and work characteristics, and the quality of relationships with staff can help to maintain nurses' enthusiasm and increase job satisfaction.

AIM

The aim of this study was to analyse how nursing work environment factors affect identification and commitment among ICU nurses.

DESIGN

A cross-sectional study was carried out in 12 ICUs from four Italian urban hospitals.

METHOD

A total of 222 nurses participated and completed a self-reported questionnaire.

RESULTS AND CONCLUSION

Results show that nursing work characteristics are directly related to team commitment, and that the nursing work characteristics and team commitment relationship was mediated by both perceived supervisor support and job satisfaction.

RELEVANCE TO CLINICAL PRACTICE

Our findings may concretely contribute to literature and offer additional suggestions to improve nurses' work conditions and patient health in ICUs.