Rural Sichuan Research Articles

The Well-Being of Left-Behind Children in Rural Sichuan, China

Chinese scholars focused on the status of children's subjective well-being. However, one significant gap is the need to measure comprehensive child well-being in China's backward economic rural areas. The study adopted a multidimensional child well-being approach and child-centred perspective to measure rural left-behind children's material, physical, educational, psychological, and social well-being and present the multidimensional well-being of left-behind children in rural China. The study adopted a quantitative approach, and the survey method was the preferred approach for this study. A multistage random sampling technique was used to choose the geographical location of the study, study area, and children as survey respondents. Four hundred eighty left-behind children aged 10 to 16 in Sichuan province, China, were selected for the study. The selected left-behind children experienced a high level of well-being domains, except for moderate educational well-being. However, pocket money, physical exercise, academic achievement, child welfare for education, social services, coping strategies, and activity engagement were the core targets to promote the left-behind children's well-being through improving social expenditure on children, empowering the child welfare system, and providing sufficient social services in school in China.

A Survey Study on the Maturity of Schooling of Young Children in Rural Sichuan Province:Taking the Rural Area of Meishan City,Sichuan Province as An Example

The admission maturity level of preschoolers can predict their performance after entering schools to a certain extent. Therefore, how to prepare for children’s admission to primary school has become a key issue of social concern. In order to improve the admission maturity level of rural preschoolers in Sichuan Province, it is necessary to understand the admission maturity level of 5-6-year-old children in Sichuan Province, so as to provide theoretical and practical basis for taking targeted measures. In this study, the measurement method was used to investigate the admission maturity level of children in rural areas of Meishan City, Sichuan Province as the research sample. It was found that rural children's motor coordination ability did not differ significantly from the national average, and their scores in visual perception ability, auditory perception ability, motor coordination ability, perceptual conversion ability, mathematical preparation ability, verbal communication ability, social adaptation ability and learning quality were significantly lower than the national average, but in auditory perceptual ability, rural children's scores were significantly higher than the national average. The differences in eight abilities between males and females were compared. Except for motor coordination, perceptual conversion ability, and verbal communication ability, there were significant differences in all other aspects, and girls scored higher than boys in all abilities. In addition to this, there is also some discussion on mother's occupation and young children's maturity in school. Based on the findings, targeted improvement measures were proposed to provide a reference for home and school to improve children's admission to primary school.

Molecular network analysis of 308 newly diagnosed HIV infection and 210 ART failure patients from rural counties in Sichuan.

Few studies on molecular epidemiology have studied people with newly diagnosed HIV infection and ART Failure Patients at the same time in rural China. With more serious HIV epidemic than in other provinces in China, Sichuan is an area suitable for this study. To analyze the characteristics of HIV-1 molecular networks and factors related to network entry among newly diagnosed HIV infection and ART Failure Patients in three county-level cities (A, B, C) in Sichuan Province, to provide scientific basis for accurate prevention and control. Nested PCR amplification method was used to amplify HIV-1 pol gene region of 530 blood samples, Sequencer 4.9 was used to edit, clean and splice the gene sequence, Bioedit correction, Fastree 2.1.8 and Figtree 1.4.2 to construct evolutionary tree and determine genotype. HyPhy2.2.4 and Cytoscape 3.6.1 software were used to construct molecular network. Logistic regression analysis was applied. 523(98.68%) pol sequences were obtained, and a total of 518 valid sequences with basic information came into the final analyses. A total of 6 genotypes were detected, namely CRF01_AE (320,61.78%), CRF07_BC (149,28.76%), B (30,5.79%), CRF08_BC (11, 2.12%), CRF55_01B (6, 1.16%) and C (2, 0.39%). 186 of 518(35.91%) sequences entered the network at a genetic distance of 0.8%, forming 42 propagation clusters. "High-risk transmitters"(connected with two and more) accounted for 21.62%. Logistic regression showed that≥50 years old (OR = 2.474) were more risky than 18-49 years old, CRF07_BC sub-type (OR = 0.174) were less risky than CRF01_AE sub-type, B sub-type (OR = 6.698) is higher risky than CRF01_AE sub-type, and District B (OR = 0.077) less risky than that of A city. The sources of HIV infection in rural Sichuan are diversified and complicated. The prevention and control of HIV infection in Sichuan Province should focus on strengthening the long-term dynamic detection of elderly population, B strain sub-type, and in City A.

Maternal Dietary Diversity and Small for Gestational Age: The Effect Modification by Pre-Pregnancy Body Mass Index and Gestational Weight Gain in a Prospective Study within Rural Sichuan, China (2021-2022).

Infants born small for gestational age (SGA) remains a significant global public health concern, with potential interconnections among maternal diet, pre-pregnancy BMI, gestational weight gain (GWG), and SGA. This prospective study investigated the association between dietary diversity (DD) during pregnancy and the risk of SGA, as well as the synergistic effect of DD with pre-pregnancy BMI and GWG on SGA. Maternal dietary intake during pregnancy was assessed using 24 h dietary recalls, and dietary diversity scores (DDS) were calculated based on the FAO's Minimum Dietary Diversity for Women index. Infant information was followed up. The Poisson regression model was employed to determine the association between maternal DD and SGA. Interactions between DD and pre-pregnancy BMI or GWG were evaluated under additive and multiplicative models. Among the 560 singleton live births, 62 (11.07%) were classified as SGA. After adjusting for potential confounders, the DDS exhibited a protective effect against SGA (aRR: 0.76; 95% CI: 0.62-0.95). DD modified the association between being underweight prior to pregnancy and SGA on the additive scale (interaction contrast ratio = 7.39; 95% CI: 5.84, 8.94). These findings suggest that improving dietary diversity during pregnancy, particularly among women with a low pre-pregnancy BMI, may be a feasible strategy to reduce the risk of SGA newborns.

Associations of in-hospital postpartum feeding experiences with exclusive breastfeeding practices among infants in rural Sichuan, China

BackgroundIn rural China, exclusive breastfeeding (EBF) prevalence is low and hospitals often fail to attain baby-friendly feeding objectives, such as ≥ 75% of newborns exclusively breastfed from birth to discharge. Empirical evidence for the impact of increased hospital compliance with recommended feeding guidelines on continued EBF in rural China is lacking. We sought to measure and model the association of newborns’ in-hospital feeding experiences with EBF practice in infancy to inform policies for EBF promotion.MethodsData were cross-sectional from 785 caregivers of infants < 6 months of age, collected from November to December 2019 in four underdeveloped counties/districts in Sichuan Province. In-hospital feeding practices were determined, and prevalence of current infant feeding practices was calculated from 24-h recall and categorized according to WHO/UNICEF Infant and Young Child Feeding categories as EBF, breastfed with non-milk liquids, mixed feeding, breastfed with solids, and not breastfed. Relative risk ratios were estimated using adjusted multinomial logistic regression to examine risk factors for non-EBF practices compared to EBF, including in-hospital feeding experiences. The regression model was used to investigate change in EBF prevalence under alternative in-hospital experiences.ResultsOnly 38.1% of under-six-month-old infants were being exclusively breastfed when data were collected; 61.8% and 77.6% had been fed water and infant formula, respectively, in the hospital. Infants who were fed water or formula before discharge were estimated as 2–3 times as likely to be non-EBF than EBF up to age six months. According to our model, EBF prevalence would have increased to 53.7% (95% confidence interval (CI) 46.1, 61.2) had ≥ 75% of infants been exclusively breastfed and water-based feeds eliminated in-hospital.ConclusionsGiven the importance of infants’ first feeding experiences in the establishment and continuation of EBF, it is imperative that rural Chinese hospitals actively seek to limit infant formula feeds to medically indicated situations and eliminate water-based feeds.

The Practical Dilemma and Relief Countermeasures of The New Country Sages Participating in Rural Governance

Rural governance is crucial in the strategy of rural revitalization. While significant progress has been made, challenges persist. Diversified stakeholders pose a key factor affecting effective governance. The emergence of the new country sages group offers a valuable solution to address rural governance difficulties. This study examines their participation in rural governance, aiming to attract their engagement based on local conditions. Research was conducted in rural Sichuan province, utilizing literature review, interviews, and snowball sampling to gather 77 valid data points. Findings indicate that new country sages have diverse backgrounds and a strong willingness to participate, contributing to rural self-governance, rule of law, and virtue. However, their impact is limited in most areas, encountering challenges such as weak interaction with the government, uneven quality of new villagers, and low levels of cooperation. To overcome these obstacles, this study suggests countermeasures including system construction, rural civilization development, and improved supervision and management mechanisms.

Association of Physical Activity With Cognitive Function Among Older Adults in Rural Sichuan, China.

The purpose of this study was to explore the relationship between total physical activity and different dimensions of cognitive function (orientation, attention, and memory) among older adults in rural Sichuan, China. This cross-sectional study involved 715 older adults (average age of 72years). Total PA was measured by the Physical Activity Scale for the Elderly, and cognitive function was assessed by the Telephone Interview for Cognitive Status (TICS) questionnaire. The multivariate linear regression analysis indicated that total PA and household PA were significantly associated with the overall Telephone Interview for Cognitive Status score (β = 0.143, p < .001; β = 0.115, p = .002, respectively), the orientation dimension (β = 0.142, p < .001; β = 0.131, p = .001, respectively), and the memory dimension (β = 0.179, p < .001; β = 0.134, p = .001, respectively). The study showed a positive association between total PA, household PA, and cognitive function in older adults, especially in the orientation dimension and the memory dimension of cognitive function.

Care Scales:DibaoAllowances, State and Family in China

AbstractExamining the “world's largest cash-based social policy” through the lens of care reveals widely shared scalar imaginaries and the productivity of care in constituting scale. In standardizing the minimum livelihood guarantee (dibao), officials, applicants and researchers in rural Sichuan cited both “too much” and “not enough” care at the scale of the family in recommending or rejecting state assistance. Different levels of organization (scale1) were not stable bases with specific sizes and qualities (scale2) that enabled or limited care.Dibao-related practices were evaluated as an appropriate (“filial piety”), insufficient (“individualism”) or excessive (“corruption”) amount of family care. Care became an indicator of kinship measurements and a marker of state boundaries. Thus, scale (in both meanings) was enacted in China, as elsewhere, through negotiations of needs and responsibilities, through evaluations of care practices and their outcomes. In this sense, care scales.

When my friends and relatives go solar, should I go solar too? —— Evidence from rural Sichuan province, China

Solar energy is vital for solving the problems of rural environmental pollution and energy poverty. Using the sample from China, the study combines the theory of conformity tendencies and the theory of strong-weak ties, and utilizes the Logistic model and propensity score matching (PSM) method to investigate the conformity tendencies in farmers' adoption of solar energy. Inspired by the diffusion of innovation theory and technology acceptance model, the study also provides insights into the mechanism of conformity tendencies. It was found that, when relatives and friends (RF) use solar energy, farmers are also more likely to adopt solar energy, but that the use of solar energy by strong ties (ST) had a more significant effect on farmers than weak ties (WT). Apart from that, farmers' perceptions of the health benefits (PHB) and environmental benefits (PEB) of solar technology played a significant mediating effect in the conformity tendencies, although the magnitude of the effect varied across the strong and weak ties.

Will farmers follow their peers in adopting straw returning? Evidence from rural Sichuan Province, China.

From the perspective of conformity tendency, based on 540 farmers' data in Sichuan Province, China, the study used the probability score matching (PSM) model and mediator model to explore the role of four types of peers' straw returning behavior on farmers' preferences to implement straw returning and the realization paths. It was found that (1) farmers' preferences to implement straw returning were influenced by the straw returning behavior of neighbors, relatives, wealthy villagers, and village cadres, i.e., there were conformity tendencies in farmers' straw returning decisions. (2) The degree of conformity tendencies formed by different peers varied. Among the peers affecting farmers' preferences to implement straw returning, the effect of village cadres was the largest, followed by neighbors, relatives, and the wealthy villagers. (3) The degree of conformity tendencies varied by decision-makers. The younger and less educated the farmers were, the more willing they were to adopt straw returning driven by their neighbors, relatives, wealthy villagers, and village cadres. (4) In the conformity tendencies (including conformity to neighbors, relatives, wealthy villagers, and village cadres) of straw returning, farmers' perceptions of income benefits and environmental benefits played a significant mediating role, and the perception of environmental benefits was more vital.

Are Rural Primary Care Providers Able to Competently Manage Common Illnesses? A Cross-Sectional Study in Rural Sichuan, Western China.

Background: Strengthening primary care is a key focus of the latest healthcare reforms in China. However, many challenges, including the workforce competence, still exist. This study aimed to evaluate the common disease management competency of rural primary care providers in Sichuan Province, western China. Methods: A cross-sectional study was conducted in 9 township health centers and 86 village clinics in 3 counties. Diarrhea and respiratory infection were selected as the evaluation cases. General partitioners were assessed through their abilities to (1) take history; (2) make diagnoses; (3) propose treatment; and (4) deal with clinical cases. Results: In total, 362 healthcare workers were surveyed, and 130 general practitioners were enrolled into our study. On average, rural primary care providers could only answer 46.4% of questions absolutely correctly, with 29.7% partly correctly and 23.8% incorrectly. Conclusion: We suggest strengthening training to improve rural primary care providers’ competencies, especially their capacities of history taking. Policy action is also needed to address regional disparities.

Postnatal mental health, breastfeeding beliefs, and breastfeeding practices in rural China

BackgroundThe importance of breastfeeding in low- and middle- income countries is well recognized, yet the importance of postnatal mental health on breastfeeding practices and beliefs in these settings has been understudied. This study investigates the associations between maternal mental health problems, breastfeeding beliefs and breastfeeding practices in rural China.MethodsCross-sectional data were collected in November and December 2019 from 742 mothers of infants under 6 months old in rural Sichuan Province, China. Maternal mental health (depression, anxiety, and stress symptoms) was assessed using the Depression, Anxiety, and Stress Scale (short form). Breastfeeding beliefs were assessed using the Iowa Infant Feeding Attitude Scale and Breastfeeding Self-Efficacy Scale (short form). Breastfeeding practices were assessed through a 24-h dietary recall questionnaire. Ordinary least squares regression, multiple logistic regression and heterogeneous effects analyses were used to identify associations between symptoms of mental health problems and breastfeeding outcomes.ResultsThe average age of sample infants was 2.7 months. Among mothers, 13% showed symptoms of depression, 16% anxiety, and 9% stress. The prevalence of exclusive breastfeeding in the previous 24 h was 38.0%. Depression symptoms were significantly associated with breastfeeding attitude (\U0001d6fd= − 1.11, 95% CI: − 2.07, − 0.14) and breastfeeding self-efficacy (\U0001d6fd= − 3.19, 95% CI: − 4.93, − 1.45). Anxiety and stress symptoms were significantly associated with breastfeeding self-efficacy (\U0001d6fd= − 1.81, 95% CI: − 3.43, − 0.18 and \U0001d6fd = − 2.88, 95% CI: − 4.98, − 0.78, respectively). There were no significant associations between symptoms of mental health problems and exclusive breastfeeding. The heterogeneous effects analyses revealed that less educated mothers with symptoms of stress had lower odds of exclusive breastfeeding than educated mothers without symptoms of stress (OR: 0.53, 95% CI: 0.25,1.10). Mothers of younger infants had higher odds of exclusive breastfeeding than the mother of older infants, regardless of depression, anxiety, or stress symptoms.ConclusionSymptoms of maternal mental health problems are significantly associated with breastfeeding attitude and self-efficacy; however, these symptoms are not associated with breastfeeding practices. Maternal educational level and infant age may play a role in mothers’ breastfeeding practices. To improve breastfeeding practices, interventions should employ a multi-dimensional approach that focuses on improving maternal mental well-being and considers demographic characteristics.

The know-do gap in quality of health for chronic non-communicable diseases in rural China.

Proper management of non-communicable diseases (NCDs) is a severe challenge to China's rural health system. This study investigates what influences the poor medical treatment of NCDs (diabetes and angina) by evaluating the "know-do gap" between provider knowledge and practice. To determine whether low levels of provider knowledge low quality of patient care is the primary constraint on the quality of NCDs diagnosis and treatment in rural China. Providers from Village Clinics (VC) and Township Health Centers (THC), and Standardized Patients (SP) were selected by a multi-stage random sampling method. Clinical vignettes were administered to 306 providers from 103 VCs and 50 THCs in rural Sichuan Province. SPs presented diabetes symptoms completed 97 interactions with providers in 46 VCs and 51 THCs; SPs presented angina symptoms completed 100 interactions with providers in 50 VCs and 50 THCs. Process quality, diagnosis quality, and treatment quality were assessed against national standards for diabetes and angina. Two-tailed T-tests and tests of proportions for continuous outcomes and tests of proportions for binary dependent variables were used to compare vignette and SP results. Differences between vignette and SP data calculated the know-do gap. Regression analyses were used to examine the providers/facility characteristics and knowledge/practice associations. THC providers demonstrated significantly more knowledge in vignettes and better practices in SP visits than VC providers. However, levels of knowledge were low overall: 48.2% of THC providers and 28.2% of VC providers properly diagnosed type 2 diabetes, while 23.8% of THC providers and 14.7% of VC providers properly diagnosed angina. With SPs, 2.1% of THC providers and 6.8% of VC providers correctly diagnosed type 2 diabetes; 25.5% of THC providers and 12.8% of VC providers correctly diagnosed angina. There were significant know-do gaps in diagnosis process quality, diagnosis quality, and treatment quality for diabetes (p < 0.01), and in diagnosis process quality (p < 0.05) and treatment quality for angina (p < 0.01). Providers in rural China display low levels of knowledge when treating diabetes and angina. Despite low knowledge, evidence of the know-do gap indicates that low-quality healthcare is the primary constraint on the quality of NCD diagnosis and treatment in rural China. Our research findings provide a new perspective for the evaluation of the medical quality and a technical basis for the development of new standardized cases in the future.

A Multilevel Physical Activity Intervention Among Chinese Rural Older Adults (Stay Active While Aging): A Study Protocol for a Clustered Randomized Controlled Trial

BackgroundAlthough a large number of studies have confirmed the benefits of physical activity (PA) in preventing age-related diseases and disabilities, a growing number of older people spent more time in sedentary behavior as opposed to PA. To reverse the alarming trend, numerous studies have corroborated the effectiveness of PA interventions in improving PA among older adults. However, such research is scarce in rural China, where a majority of older adults do not meet the PA recommendation. The Stay Active While Aging (SAWA) aimed to conduct an intervention to improve the PA level among older adults in rural China.MethodsThe SAWA is designed as a single-blind, clustered randomized controlled trial carried out in rural Sichuan, China with an 8-week intervention and a 24-month follow-up. The intervention group will receive a multilevel intervention (individual, interpersonal, and community levels), while the control group will not. The primary outcome is the PA level. Secondary outcome measures include sedentary behavior level, self-efficacy, self-regulation, cognitive function, night-time sleep quality, and anthropometry. The difference-in-differences (DID) will be performed to investigate the between-group differences, adjusted for baseline data and covariates.DiscussionThe SAWA trial will provide a multilevel intervention based on the socio-ecologic model among older adults in rural China. We target the PA level and health status changes while also focus on the maintenance of such intervention during 24 months. If the SAWA produces positive results, it will be possible to recommend similar strategies to be implemented in other Chinese older adults and beyond.Trial registrationChiCTR2100045653 (https://www.chictr.org.cn/index.aspx).

Controlling Civil Society from the Bottomup: China’s Strategic Arrangement of the State-CSO-Individual Trialism in Managing State-society Relations

ABSTRACT It is often the conception in the literature that civil society’s major challenge in an authoritarian country like China would be from the state directly. This study utilizes over 1200 surveys conducted in Sichuan Province, 67 in-depth interviews with local government officials and CSO leaders, and case studies from communities that CSOs operated to provide an often-overlooked challenge. Based on the research in rural Sichuan, this article finds that the Chinese state at the local level does not spend a significant amount of energy directly interfering with CSOs, but uses institutional constraints to create divisions between the citizenry and CSOs. This article proposes the trialism conception in understanding civil society in authoritarian countries. The state could create conditions that reduce the confidence of individual citizens in CSOs and thus control society from the bottom up without having to apply a significant amount of direct repressions to the CSOs.

"Whose Fault Is It?" How Rural Chinese Women Explain Intimate Partner Violence: A Qualitative Study.

Women are often the victims of intimate partner violence (IPV). Though China has established its first statute against domestic violence, the service developments for victims fall behind. It is important to assess community members' perceptions of what causes IPV to create interventions to prevent and address IPV. This study completed the Short Explanatory Model Interview (SEMI) among a subset sample from a large epidemiology study in rural Sichuan China. The social ecological model was applied to analyze qualitative interviews. Among 339 participants, the average age was 46.01 ± 12.42 years old. There were 31.86% of them had been educated, 14.75% of them had migrant worker partners, and 49.26% of them had experienced violence from their partners in the last year. There were 252 participants attributed IPV to individual factors, and they primarily discussed the social characteristics, behaviors, personalities or even health problems of the husband or the wife in the vignette. Under this theme, there were 86 participants blaming the victim for being anxious, social disconnectedness or lazy; and there were 166 participants blaming to the perpetrator being abusive, irresponsibility, lack of understanding, and cheating. There were 44 women believed the cause was relational, in which there were 41 participants attributed the problem to the broken relationship between the couple and three participants attributed to the lack of support. There were 28 participants believed the cause was communal and societal, such as being poor, family problems, fate, and believed IPV was a common scene. There were 15 participants could not identify the cause of IPV. These participants usually provided very brief responses and barely had insight on violent behaviors or confidence in discussing the cause. Our findings offer a direction for understanding the rural Chinese women's beliefs about the etiology of IPV to better develop interventions which must consider raising a public awareness campaign about the risk factors of IPV and focus on reducing self-blame among victims.

The lived realities of left‐behind children in Mainland China: Life and values education in the home and at school

AbstractLeft‐behind children (LBC) are a social and educational concern in China. Researchers have identified psychological and behavioural effects on LBC. This study creates a profile of LBC in rural Sichuan and identifies life and values education (LVE) as a beneficial intervention. Interviews were conducted with six LBC, two parents and one teacher. The data indicate that LBC face challenges in the areas of parental communication, being raised in non‐parental homes, family and social networks, and regulation of emotions. LVE may help minimise the negative consequences experienced by LBC but lack of parental and educator LVE knowledge may hinder implementation.

Polanyi and the Peasant Question in China: State, Peasant, and Land Relations in China, 1949–Present

This article applies Karl Polanyi’s concept of a double movement to the trajectory of rural state policies in China since 1949. It argues that Chinese socialism created a contradictory social contract that has fueled an ongoing struggle between state and peasantry over the surplus generated from rural land. This struggle has shaped a historical oscillation between state policies that facilitate extraction of agricultural surpluses and policies that introduce social protections in the form of household farming and revitalized collective ownership. Based on secondary sources, this article compares the arc of rural policies during the Mao era and in the transition to and during the current state capitalist period. Then, based on original interview-based and ethnographic fieldwork undertaken in rural Sichuan Province, it analyzes the current introduction of urban and agrarian capital into the rural economy, revealing dynamics of a current countermovement from state-led extraction to compromise.

P0297 / #1851: PREVALENCE OF ANEMIA IN INFANTS UNDER 6 MONTHS OF AGE IN RURAL CHINA

Aims & Objectives: Childhood anemia has been linked to low cognitive scores and developmental delay. Anemia is highly prevalent in rural Chinese children but information on infants younger than 6 months is lacking. The goal of this cross-sectional study was to measure the mean hemoglobin levels of infants under 6 months in rural Sichuan, compare them to published age-matched standards, describe factors associated with anemia, and investigate whether anemia was correlated with health symptom reporting and health-seeking behavior. Methods: A survey of health and feeding practices was conducted in 80 randomly selected rural townships in Nanchong prefecture, Sichuan province. All infants under 6 months living within 1 hour drive of the township center were surveyed (N=938). Hemoglobin was measured in 586 infants and adjusted for altitude. The China Clinical Pediatrics threshold for infants 0-3 months old of 90g/L and 4-6 months of 100g/L was used to define anemia. Results:The prevalence of anemia was 12.6% for 0-3-month-old infants and 27.4% for 4-6-month-old infants. Factors significantly associated with anemia included older age of infant, lower birth weight, formula feeding, and mother’s poor overall health status, but not male sex, household income, or mother’s educational attainment. Caregivers of infants with anemia reported bringing the infant for healthcare visits more frequently than those of non-anemic infants. Conclusions: Anemia is prevalent in rural Chinese infants and is associated with some but not all of the characteristics often predictive of anemia. In addition, anemia in infants may predispose to increased health care utilization.

Relationship of psychological factors with daily activities and quality of life in patients with chronic obstructive pulmonary disease in a Chinese rural population.

Chronic obstructive pulmonary disease (COPD) is a major burden and a leading cause of death worldwide. Comorbidities such as gastroesophageal reflux, arrhythmia, musculoskeletal disorders and cancer affect the quality of life of COPD patients. Psychological factors, such as disease perception, active coping with the disease, anxiety and depression may also affect daily activities and quality of life. This cross-sectional study surveyed 86 patients from rural Sichuan in China who had grade 1-3 COPD based on the Global Initiative for Chronic Obstructive Lung Disease scale in order to clarify the relationship of psychological factors with daily activities and quality of life. Respondents filled out the following questionnaires: the Brief Illness Perception Questionnaire (as an assessment of disease perception), Utrecht Proactive Coping Competence Questionnaire (active coping), the Hospital Anxiety Depression Scale (anxiety and depression), the Modified Medical Research Council Scale (dyspnea), the Functional Performance Inventory-Short Form (daily activities) and the Clinical COPD Questionnaire (quality of life). Linear regression was used to explore potential relationship of these psychological factors with daily activities and quality of life. Active coping (β=-0.696, P<0.001) was related to less restricted daily activities, and better quality of life was associated with better disease perception (β=0.680, P<0.001) and lower anxiety (β=0.479, P<0.001). These results suggest that appropriate psychological interventions may benefit COPD patients, which deserves further investigation.