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学者姓名：周忠良
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Abstract ：
目的 研制医学生对附属医院的教学满意度调查问卷,通过实际调查对其信度和效度进行评价和问卷的修正,为医学教育满意度测量提供可靠的工具.方法 检索2014-2020年间相关文献,选择可用于客观反映/评价教学质量或满意度的指标,组织问卷小组进行讨论,形成初稿.以在附属医院在读理论课的学生为调查对象,使用自制问卷对随机抽取的58名学生进行预调查.问卷的同质性采用内部一致性信度和重测信度、因素负荷量、相关分析法和主成分因子分析法进行分析.结果 经文献检索、讨论,初步确定包括针对课程体系、教学过程、教学管理服务、硬件设施、总体印象五个维度在内的50个条目的 量表.量表的内部一致性信度Cronbach''s α系数为0.957,KMO=0.864,P＜0.05,根据信度分析、相关分析和主成分分析法,逐步删减问题后形成5个因子38个条目的 问卷,共解释变异度72.85％.4周后进行重测,α系数为0.944.结论 医学生对附属医院教学满意度调查问卷具有良好的信度和效度,能够较好地反映医学生对附属医院教学的满意度,适用于附属医院教学评价.
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| GB/T 7714 | 刘瑛 , 沈迟 , 潘龙飞 et al. 附属医院教学满意度问卷的制作和信效度分析 [J]. | 医学教育研究与实践 , 2021 , 29 (5) : 738-742 . |
| MLA | 刘瑛 et al. "附属医院教学满意度问卷的制作和信效度分析" . | 医学教育研究与实践 29 . 5 (2021) : 738-742 . |
| APA | 刘瑛 , 沈迟 , 潘龙飞 , 程悦 , 周忠良 . 附属医院教学满意度问卷的制作和信效度分析 . | 医学教育研究与实践 , 2021 , 29 (5) , 738-742 . |
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Background Caring for grandchildren is regarded as one of the principle roles of middle- and old-aged adults, especially among rural Chinese grandparents. This study aims to examine the gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren, based on the gender differences in grandparental role engagement and the theories of role strain and role enhancement. Methods A total of 4833 rural citizens with one or more grandchildren were selected from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015. Grandchild care was measured by continuous variable (duration) and categorical variable (no care, low intensity, moderate intensity, high intensity). Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D). We used coarsened exact matching (CEM) to balance the covariates of caregivers and non-caregivers. Following CEM, 1975 non-caregivers and 2212 caregivers were identified (N = 4187). Multilevel linear regression was employed to examine the gender differences in depressive symptoms. We also tested for the moderating role of gender on the association between grandchild care and depressive symptoms. Results Grandmothers were more likely to provide grandchild care (54.42% vs 51.43%) at high intensity (61.46% vs 51.01%), with longer duration (39.24 h vs 33.15 h) than that given by grandfathers. Grandmothers suffered more from depressive symptoms than grandfathers, and such gap increased when grandparents were involved in high-intensity care. Grandmothers providing grandchild care, particularly at moderate intensity, were associated with fewer depressive symptoms (Coef. = - 0.087, 95%CI: - 0.163, - 0.010; Coef. = - 0.291, 95%CI: - 0.435, - 0.147), compared with non-caregivers. Grandmothers giving moderate intensity of grandchild care were also associated with fewer depressive symptoms (Coef. = - 0.171, 95% CI: - 0.313, - 0.029), compared with those with low-intensity care. However, such associations were not significant among grandfathers. Conclusions Our findings highlight the gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren. Grandparents should be encouraged to engage in grandchild care, but at moderate intensity. The health status of middle- and old-aged adults, particularly females, should be monitored closely. Humanistic care, preventive care and curative treatment strategies focusing on such populations should be developed and refined.
Keyword ：
Depressive symptoms Gender differences Grandchild care Intensity Rural China
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| GB/T 7714 | Zhao, Dantong , Zhou, Zhongliang , Shen, Chi et al. Gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren [J]. | BMC PUBLIC HEALTH , 2021 , 21 (1) . |
| MLA | Zhao, Dantong et al. "Gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren" . | BMC PUBLIC HEALTH 21 . 1 (2021) . |
| APA | Zhao, Dantong , Zhou, Zhongliang , Shen, Chi , Ibrahim, Sahardid , Zhao, Yaxin , Cao, Dan et al. Gender differences in depressive symptoms of rural Chinese grandparents caring for grandchildren . | BMC PUBLIC HEALTH , 2021 , 21 (1) . |
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Previous studies have been limited by not directly comparing the quality of public and private CHCs using a standardized patient method (SP). This study aims to evaluate and compare the quality of the primary care provided by public and private CHCs using a standardized patient method in urban China. We recruited 12 standardized patients from the local community presenting fixed cases (unstable angina and asthma), including 492 interactions between physicians and standardized patients across 63 CHCs in Xi'an, China. We measured the quality of primary care on seven criteria: (1) adherence to checklists, (2) correct diagnosis, (3) correct treatment, (4) number of unnecessary exams and drugs, (5) diagnosis time, (6) expense of visit, (7) patient-centered communication. Significant quality differences were observed between public CHCs and private CHCs. Private CHC physicians performed 4.73 percentage points lower of recommended questions and exams in the checklist. Compared with private CHCs, public CHC providers were more likely to give a higher proportion of correct diagnosis and correct treatment. Private CHCs provided 1.42 fewer items of unnecessary exams and provided 0.32 more items of unnecessary drugs. Private CHC physicians received a 9.31 lower score in patient-centered communication. There is significant quality inequality in different primary care models. Public CHC physicians might provide a higher quality of service. Creating a comprehensive, flexible, and integrated health care system should be considered an effective approach towards optimizing the management of CHC models.
Keyword ：
China primary care private CHCs public CHCs quality standardized patient
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| GB/T 7714 | Su, Min , Zhou, Zhongliang , Si, Yafei et al. Comparing the Quality of Primary Care between Public and Private Providers in Urban China: A Standardized Patient Study [J]. | INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH , 2021 , 18 (10) . |
| MLA | Su, Min et al. "Comparing the Quality of Primary Care between Public and Private Providers in Urban China: A Standardized Patient Study" . | INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 18 . 10 (2021) . |
| APA | Su, Min , Zhou, Zhongliang , Si, Yafei , Sylvia, Sean , Chen, Gang , Su, Yanfang et al. Comparing the Quality of Primary Care between Public and Private Providers in Urban China: A Standardized Patient Study . | INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH , 2021 , 18 (10) . |
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BackgroundIn China, achieving health equity has been regarded as a key issue for health reform and development in the current context. It is well known that unemployment has a negative effect on health. However, few studies have addressed the association between unemployment and inequity in health-related quality of life (HRQOL). This study aims to compare the inequality and inequity in HRQOL between the unemployed and employed in China.MethodsThe material regarding this study was derived from the Chinese National Health Services Survey of Shaanxi Province for 2013. We controlled for confounding factors by utilizing the coarsened exact matching method. Finally, 7524 employed individuals and 283 unemployed individuals who were 15 to 64years old in urban areas were included in this study. We used HRQOL as the outcome variable, which was evaluated by using the Chinese version of EQ-5D-3L. The health concentration index, decomposition analysis based on the Tobit model, and the horizontal inequity index were employed to compute the socioeconomic-related equity between the unemployed and employed and the contribution of various factors.ResultsAfter matching, unemployed people tended to have poorer EQ-5D utility scores than employed people. There were statistically pro-rich inequalities in HRQOL among both employed and unemployed people, and the pro-rich health inequity of unemployed people was substantially higher than that of employed people. Economic status, age, education, smoking and health insurance were the factors influencing inequality in HRQOL between employed and unemployed individuals. Education status and basic health insurance have reduced the pro-rich inequity in HRQOL for unemployed people.ConclusionIt is suggested that unemployment intensifies inequality and inequity in HRQOL. According to policymakers, basic health insurance is still a critical health policy for improving health equity for the unemployed. Intervention initiatives aiming to tackle long-term unemployment through active labour market programmes, narrow economic gaps, improve educational equity and promote the health status of the unemployed should be considered by the government to achieve health equity.
Keyword ：
China Coarsened exact matching EQ-5D Health equity Health-related quality of life Unemployment
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| GB/T 7714 | Zhao, Yaxin , Zhou, Zhongliang , Fan, Xiaojing et al. Comparison of inequity in health-related quality of life among unemployed and employed individuals in China [J]. | BMC PUBLIC HEALTH , 2021 , 21 (1) . |
| MLA | Zhao, Yaxin et al. "Comparison of inequity in health-related quality of life among unemployed and employed individuals in China" . | BMC PUBLIC HEALTH 21 . 1 (2021) . |
| APA | Zhao, Yaxin , Zhou, Zhongliang , Fan, Xiaojing , Nawaz, Rashed , Zhao, Dantong , Xu, Tiange et al. Comparison of inequity in health-related quality of life among unemployed and employed individuals in China . | BMC PUBLIC HEALTH , 2021 , 21 (1) . |
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This study aims to investigate the difference of pelvic size and shape between Tibetan and Chinese Han women. Data on pelvic dimension measures including interspinous diameter (IS), intercrestal diameter (IC), external conjugate (EC) and transverse outlet (TO) were acquired from two population-based studies amongst Tibetan women in Lhasa, and Chinese Han women in Shaanxi province in China. After coarsened exact matching, there was no statistical difference between any characteristics amongst Tibetan and Chinese Han women (p>.05). The generalised estimating equation models showed Tibetan women had significantly lower IS and IC means than Chinese Han women (IS: 24.39 cm vs. 24.77 cm, p<.001; IC: 26.35 cm vs. 26.93 cm, p<.001) but statistically higher in TO mean (9.12 cm vs. 9.03 cm, p<.001). This study showed Tibetan women have smaller pelvis compared to Chinese Han women. This should offer a useful literature on the comparison of pelvis between Tibetan and Chinese Han women although the difference is small.Impact Statement What is already known on this subject? Previous studies in China indicated different populations have different dimensions of pelvis, with the pelvis of Uighur women being bigger than Chinese Han women, and that of Zhuang and Tu women being smaller than Chinese Han women. Little research reports the specific size of Tibetan women's pelvis. Living at high altitude, the Tibetan population have differentiated demographics and show local adaptions, such as unelevated haemoglobin, and significant catch-up growth for infants compared with Chinese Han infants. Therefore, there is a strong rationale for better understanding pelvic characteristics amongst this population. What the results of this study add? This study showed Tibetan women have smaller pelvises compared to Chinese Han women. Tibetan women have a smaller interspinous diameter and intercrestal diameter than Chinese Han women, which leads to relatively narrow hip. What the implications are of these findings for clinical practice and/or further research? This study provides useful comparative information on pelvic features between Tibetan and Chinese Han women although the findings of differences were small. In addition, during the formulation of women's health policy, the results of this study can provide data to support the selection of appropriate indicators of obstetrics and gynaecology for different populations of pregnant women during antenatal care and delivery.
Keyword ：
Chinese Han women coarsened exact matching Pelvis population-based study Tibetan women
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| GB/T 7714 | Fan, Xiaojing , Zhou, Zhongliang , Stewart, Martyn et al. Comparing the pelvis of Tibetan and Chinese Han women in rural areas of China: two population-based studies using coarsened exact matching [J]. | JOURNAL OF OBSTETRICS AND GYNAECOLOGY , 2021 , 42 (3) : 403-409 . |
| MLA | Fan, Xiaojing et al. "Comparing the pelvis of Tibetan and Chinese Han women in rural areas of China: two population-based studies using coarsened exact matching" . | JOURNAL OF OBSTETRICS AND GYNAECOLOGY 42 . 3 (2021) : 403-409 . |
| APA | Fan, Xiaojing , Zhou, Zhongliang , Stewart, Martyn , Wang, Duolao , Lan, Xin , Dang, Shaonong et al. Comparing the pelvis of Tibetan and Chinese Han women in rural areas of China: two population-based studies using coarsened exact matching . | JOURNAL OF OBSTETRICS AND GYNAECOLOGY , 2021 , 42 (3) , 403-409 . |
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The unbalanced allocation of healthcare resources and the underutilization of primary care facilities are the core problems that restrict the current healthcare reforms in China. In order to encourage residents to go to primary care facilities, China implemented the Hierarchical Medical System (HMS) in 2015. This study aims to evaluate the effect of HMS on health seeking behavior in China using panel data. Statistics for the study were derived from China Family Panel Studies (CFPS) 2012, 2014, 2016 and 2018, and China health and family planning statistical yearbook 2012, 2014, 2016 and 2018. We employed the difference-in-differences (DID) model with multiple periods. In total, 61,932 residents were incorporated for a final sample covered 25 provinces. The results indicated that the implementation of HMS had a significantly positive effect on the probability of urban residents going to primary care facilities for contact. However, the effect of HMS was not significant for rural residents. Basic health insurance was a significant factor for directing residents to primary care facilities. Self-assessed health, chronic disease, economic level and educational status were also found to be focal factors of health seeking behavior. In conclusion, the introduction of HMS has led to improved health seeking behavior and is worth putting more effort into. For policy makers, basic medical insurance is still an important health policy that enables systematic health seeking behavior. Initiatives to continue to expand the adjustment range of economic incentives should be adopted to promote the implementation of HMS. However, the effect of HMS in chronic disease is poor and efforts to formulate chronic disease as a breakthrough to HMS should be carried out. Moreover, the government should increase the publicity of HMS.
Keyword ：
China Difference in differences Health seeking behavior Hierarchical medical system Primary care facilities
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| GB/T 7714 | Zhou Zhongliang , Zhao Yaxin , Shen Chi et al. Evaluating the effect of hierarchical medical system on health seeking behavior: A difference-in-differences analysis in China. [J]. | Social science & medicine , 2021 , 268 . |
| MLA | Zhou Zhongliang et al. "Evaluating the effect of hierarchical medical system on health seeking behavior: A difference-in-differences analysis in China." . | Social science & medicine 268 (2021) . |
| APA | Zhou Zhongliang , Zhao Yaxin , Shen Chi , Lai Sha , Nawaz Rashed , Gao Jianmin . Evaluating the effect of hierarchical medical system on health seeking behavior: A difference-in-differences analysis in China. . | Social science & medicine , 2021 , 268 . |
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There is an increasing trend on the practices of parental self-medication with antibiotics (PSMA) around world, accelerating the antibiotic abuse. This study aims to examine the nationality differences in the practices of PSMA and knowledge, attitudes and practices (KAP) toward antibiotic use, and understand the practices of PSMA among parents of various nationalities in China.A cross-sectional study based on a structured questionnaire survey was conducted in Xi'an, Shaanxi Province, China, from September 2018 to October 2018. A total of 299 respondents participated in. The practices of PSMA (a dichotomous variable) and KAP toward antibiotic use (a continuous variable) served as dependent variables. Participant's nationality was regarded as the independent variable. Binary logistic regression and ordinary least square regression were employed to examine the association between parent's nationality and the practices of PSMA, and KAP toward antibiotic use, respectively.121 (40.88%) Chinese, 100 (33.76%) other Asians and 75 (25.34%) Occidentals were included in final analysis, with a sample size of 296. Chinese were more likely to practice PSMA (OR = 7.070; 95% CI 1.315, 38.01), with worse knowledge (Coef. = - 0.549; 95% CI - 1.021, - 0.078), attitudes (Coef. = - 3.069; 95% CI - 4.182, - 1.956) and practices (Coef. = - 1.976; 95% CI - 3.162, - 0.790) toward antibiotic use, compared to their Occidental counterparts. The main reasons for the practices of PSMA were enough previous medication experience (80.49%) and same ailments with no need to see a doctor (39.02%), with common symptoms such as fever (60.98%) and cough (58.54%). Purchasing antibiotics at pharmacies (92.08%) and using leftover antibiotics (26.83%) were usual approaches.The study highlights the gaps in the practices of PSMA and KAP toward antibiotic use among parents of different nationalities. The access to obtain antibiotics from pharmacies reflects the pharmacists' unaware of laws on prescription of antibiotics, fierce competition in the pharmacy market, and the government's lax supervision in China. It suggests the need to improve pharmacists' training, enforce current legislations on pharmacy market regarding the sale of antibiotics, and provide practical and effective educational interventions for residents about antibiotic use.
Keyword ：
Attitudes Knowledge Nationality Parental self-medication with antibiotics Practices
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| GB/T 7714 | Zhou Zhongliang , Zhao Dantong , Zhang Huarui et al. Understanding parental self-medication with antibiotics among parents of different nationalities: a cross-sectional study. [J]. | Global health research and policy , 2021 , 6 (1) : 42 . |
| MLA | Zhou Zhongliang et al. "Understanding parental self-medication with antibiotics among parents of different nationalities: a cross-sectional study." . | Global health research and policy 6 . 1 (2021) : 42 . |
| APA | Zhou Zhongliang , Zhao Dantong , Zhang Huarui , Shen Chi , Cao Dan , Liu Guanping et al. Understanding parental self-medication with antibiotics among parents of different nationalities: a cross-sectional study. . | Global health research and policy , 2021 , 6 (1) , 42 . |
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BackgroundPatient experience is a key measure widely used to evaluate quality of healthcare, yet there is little discussion about it in China using national survey data. This study aimed to explore rural and urban differences in patient experience in China.MethodsData regarding this study were drawn from Chinese General Social Survey (CGSS) 2015, with a sample size of 9604. Patient experience was measured by the evaluation on healthcare services. Coarsened exact matching (CEM) method was used to balance covariates between the rural and urban respondents. Three thousand three hundred seventy-two participants finally comprised the matched cohort, including 1592 rural residents and 1780 urban residents. Rural and urban differences in patient experience were tested by ordinary least-squares regression and ordered logistic regression.ResultsThe mean (SD) score of patient experience for rural and urban residents was 72.35(17.32) and 69.45(17.00), respectively. Urban residents reported worse patient experience than rural counterparts (Crude analysis: Coef.=-2.897, 95%CI: -4.434, -1.361; OR=0.706, 95%CI: 0.595, 0.838; Multivariate analysis: Coef.=-3.040, 95%CI: -4.473, -1.607; OR=0.675, 95%CI: 0.569, 0.801). Older (Coef.=2.029, 95%CI: 0.338, 3.719) and healthier (Coef.=2.287, 95%CI: 0.729, 3.845; OR=1.217, 95%CI: 1.008, 1.469) rural residents living in western area (Coef.=2.098, 95%CI: 0.464, 3.732; OR=1.276, 95%CI: 1.044, 1.560) with higher social status (Coef.=1.158, 95%CI: 0.756, 1.561; OR=1.145, 95%CI: 1.090, 1.204), evaluation on adequacy (Coef.=7.018, 95%CI: 5.045, 8.992; OR=2.163, 95%CI: 1.719, 2.721), distribution (Coef.=4.464, 95%CI: 2.471, 6.456; OR=1.658, 95%CI: 1.312, 2.096) and accessibility (Coef.=2.995, 95%CI: 0.963, 5.026; OR=1.525, 95%CI: 1.217, 1.911) of healthcare resources had better patient experience. In addition, urban peers with lower education (OR=0.763, 95%CI: 0.625, 0.931) and higher family economic status (Coef.=2.990, 95%CI: 0.959, 5.021; OR=1.371, 95%CI: 1.090,1.723) reported better patient experience.ConclusionsDifferences in patient experience for rural and urban residents were observed in this study. It is necessary to not only encourage residents to form a habit of seeking healthcare services in local primary healthcare institutions first and then go to large hospitals in urban areas when necessary, but also endeavor to reduce the disparity of healthcare resources between rural and urban areas by improving quality and capacity of rural healthcare institutions and primary healthcare system of China.
Keyword ：
China Coarsened exact matching Patient experience Rural and urban differences
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| GB/T 7714 | Zhao, Dantong , Zhou, Zhongliang , Shen, Chi et al. Rural and urban differences in patient experience in China: a coarsened exact matching study from the perspective of residents [J]. | BMC HEALTH SERVICES RESEARCH , 2021 , 21 (1) . |
| MLA | Zhao, Dantong et al. "Rural and urban differences in patient experience in China: a coarsened exact matching study from the perspective of residents" . | BMC HEALTH SERVICES RESEARCH 21 . 1 (2021) . |
| APA | Zhao, Dantong , Zhou, Zhongliang , Shen, Chi , Nawaz, Rashed , Li, Dan , Ren, Yangling et al. Rural and urban differences in patient experience in China: a coarsened exact matching study from the perspective of residents . | BMC HEALTH SERVICES RESEARCH , 2021 , 21 (1) . |
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BackgroundThe aim of this study was to assess the trends in equity of receiving inpatient health service utilization (IHSU) in China over the period 2011-2018.MethodsLongitudinal data obtained from China Health and Retirement Longitudinal Studies were used to determine trends in receiving IHSU. Concentration curves, concentration indices, and horizontal inequity indices were applied to evaluate the trends in equity of IHSU.ResultsThis study showed that the annual rate of IHSU gradually increased from 7.99% in 2011 to 18.63% in 2018. Logistic regression shows that the rates of annual IHSU in 2018 were nearly 3 times (OR=2.86, 95%CL: 2.57, 3.19) higher for rural respondents and 2.5 times (OR=2.49, 95%CL: 1.99, 3.11) higher for urban respondents than the rates in 2011 after adjusting for other variables. Concentration curves both in urban and rural respondents lay above the line of equality from 2011 to 2018. The concentration index remained negative and increased significantly from -0.0147 (95% CL: -0.0506, 0.0211) to -0.0676 (95% CL: -0.0894, -0.458), the adjusted concentration index kept the same tendency. The horizontal inequity index was positive in 2011 but became negative from 2013 to 2018, evidencing a pro-low-economic inequity trend.ConclusionsWe find that the inequity of IHSU for the middle-aged and elderly increased over the past 10years, becoming more focused on the lower-economic population. Economic status, lifestyle factors were the main contributors to the pro-low-economic inequity. Health policies to allocate resources and services are needed to satisfy the needs of the middle-aged and elderly.
Keyword ：
Equity Inpatient health service utilization Middle-aged and elderly
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| GB/T 7714 | Fan, Xiaojing , Su, Min , Zhao, Yaxin et al. Trends in equity of inpatient health service utilization for the middle-aged and elderly in China: based on longitudinal data from 2011 to 2018 [J]. | BMC PUBLIC HEALTH , 2021 , 21 (1) . |
| MLA | Fan, Xiaojing et al. "Trends in equity of inpatient health service utilization for the middle-aged and elderly in China: based on longitudinal data from 2011 to 2018" . | BMC PUBLIC HEALTH 21 . 1 (2021) . |
| APA | Fan, Xiaojing , Su, Min , Zhao, Yaxin , Si, Yafei , Zhou, Zhongliang . Trends in equity of inpatient health service utilization for the middle-aged and elderly in China: based on longitudinal data from 2011 to 2018 . | BMC PUBLIC HEALTH , 2021 , 21 (1) . |
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Background: Determining the mental health status of parents who chronically care for a child with speech impairment is important for developing appropriate interventions to improve both parents' and children's health and achieve a win-win situation. Unfortunately, no study in China has explored this issue. This study investigated the differences in four aspects of mental health between maternal and paternal caregivers for the Mandarin-speaking children with speech impairment and determine whether depressive symptoms mediate the relationships between anxiety symptoms and suicidal ideation, hopelessness and suicidal ideation. Methods: This cross-sectional questionnaire survey was conducted in February 2020 by sending a link to the predesigned electronic questionnaire in WeChat. Standardized assessment tools were employed. Hierarchical multiple logistic regression was conducted to examine the associations between various factors and suicidal ideation, and two separate structural equation models were performed to evaluate the mediating effects of depressive symptoms in the relationship between anxiety symptoms and suicidal ideation as well as between hopelessness and suicidal ideation. Results: This study included 446 parental caregivers of Mandarin-speaking children with speech impairment. Paternal caregivers had greater score than maternal caregivers on loss of motivation (one of the subdomains of hopelessness). Somatic complications of the child (OR = 2.73, 95% CI: 1.09-6.67) and depressive symptoms (OR = 3.38, 95% CI: 1.83-6.30) were positively associated with caregivers' suicidal ideation. Having speech therapy of child (OR = 0.54, 95% CI: 0.29-0.98) was negatively correlated with caregivers' suicidal ideation. There was direct effect of depressive symptoms on suicidal ideation. Depressive symptoms play mediating roles on the relationships between anxiety symptoms (beta = 0.171, p < 0.001) as well as between hopelessness and suicidal ideation (beta = 0.187, p < 0.001). Conclusions: Paternal and maternal caregivers of Mandarin-speaking children with speech impairment suffered from mental health problems. Preventive strategies and interventions to ameliorate parental psychological well-being, and health care policies to increase the accessibility to speech therapy care of children with speech impairment are imperative.
Keyword ：
anxiety symptoms children China depressive symptoms hopelessness parental caregiver speech impairment suicidal ideation
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| GB/T 7714 | Ma, Si-Wei , Lai, Sha , Yang, Yan-Yan et al. Relationships Between Anxiety Symptoms, Hopelessness and Suicidal Ideation Among Parental Caregivers of Mandarin-Speaking Children With Speech Impairment: The Mediating Effect of Depressive Symptoms [J]. | FRONTIERS IN PSYCHIATRY , 2021 , 12 . |
| MLA | Ma, Si-Wei et al. "Relationships Between Anxiety Symptoms, Hopelessness and Suicidal Ideation Among Parental Caregivers of Mandarin-Speaking Children With Speech Impairment: The Mediating Effect of Depressive Symptoms" . | FRONTIERS IN PSYCHIATRY 12 (2021) . |
| APA | Ma, Si-Wei , Lai, Sha , Yang, Yan-Yan , Zhou, Zhongliang , Yang, Bin-Ting , Zheng, Gu-Zheng-Yue et al. Relationships Between Anxiety Symptoms, Hopelessness and Suicidal Ideation Among Parental Caregivers of Mandarin-Speaking Children With Speech Impairment: The Mediating Effect of Depressive Symptoms . | FRONTIERS IN PSYCHIATRY , 2021 , 12 . |
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