Social Support Scale Research Articles

Depression, anxiety, and help-seeking among Slovenian postsecondary students during the COVID-19 pandemic

IntroductionThe COVID-19 pandemic has faced students with many challenges, contributing to their mental distress. This article explores the role of demographic characteristics, psychological status, year of study, and social support during the COVID-19 pandemic in explaining Slovenian university students’ mental health problems and help-seeking behavior.MethodsIn February and March 2021, data were collected on 5,234 full-time Slovenian postsecondary students who were enrolled in public and concessionary independent higher education institutions. Participants completed a questionnaire, which included The Patient Health Questionnaire (PHQ-9), General Anxiety Disorder questionnaire (GAD-7), Oslo Social Support Scale (OSSS-3), and items measuring psychological status, help-seeking behavior and demographics. Data were analyzed using multiple linear regression and hypothesis testing for differences.ResultsFactors, such as gender, age, psychological status and social support, contributed to experiencing anxiety and depression among Slovenian students during the COVID-19 pandemic, with year of study additionally contributing to experiencing depression. Similarly, gender, age, psychological status and social support contributed to help-seeking behavior. Higher levels of depression and anxiety were reported by female students, students with prior mental disorders, and students with lower social support levels. Female students and students with lower social support levels reported more frequent help-seeking behaviors.ConclusionThe results provide insight into the mental state of the Slovenian student population in the context of imposed public health measures at the end of the second COVID-19 wave in Slovenia. The findings can help identify vulnerable groups within the student population to whom we must be particularly attentive in times of crisis.

Effects of loneliness on short video addiction among college students: the chain mediating role of social support and physical activity

Loneliness is a common public health problem that affects physical and mental health. Prior research has demonstrated a connection between internet addiction and loneliness. Short video addiction is a novel internet addiction. It is necessary to study the potential psychological mechanisms between loneliness and short video addiction. This study investigated the associations between loneliness and short video addiction, as well as the mediating roles played by social support and physical activity.MethodsA sample of 388 college students was selected, and the questionnaires included the Loneliness Scale Short Version, the Short Video Addiction Scale, the Social Support Scale, and the Physical Activity Scale. The data were analyzed using SPSS for correlation analysis and PROCESS macros for mediation effect analysis.Results(1) Loneliness significantly positively affected short video addiction. (2) The association between loneliness and short video addiction was independently mediated by social support. (3) Physical activity independently mediated loneliness and short video addiction. (4) Social support and physical activity play a chain mediating role in the association between loneliness and short video addiction. Our research improves the literature on loneliness and short video addiction, enhances comprehension of the impacts, and offers college students effective ways to combat the addiction.

Latent Profile Analysis of Sleep Quality in Pregnant Women With Gestational Diabetes Mellitus and Its Influencing Factors.

Sleep problems are prevalent among individuals diagnosed with gestational diabetes mellitus (GDM), significantly impacting their overall quality of life. This study sought to adopt a person-centered methodology to unveil the latent profiles of sleep quality and identify factors influencing sleep patterns in patients with GDM. The cross-sectional study gathered sociodemographic features, clinical information, sleep problems (Pittsburgh Sleep Quality Index), personality traits (Type D Personality Scale), social support (Perceived Social Support Scale), and self-efficacy (General Self-efficacy Scale). Latent profile analysis was conducted to identify profiles of sleep quality, while multinomial logistic regression was employed to ascertain the factors influencing these identified profiles. Among the 431 participants, 423 (98.1%) completed the questionnaire, with 53.0% reporting moderate-to-poor sleep quality. This study identified 4 distinct profiles of sleep quality among patients with GDM: the "good sleep quality" group (47.0%), the "poor sleep quality-long sleep duration" group (10.0%), the "moderate sleep quality" group (25.3%), and the "poor sleep quality-short sleep duration" group (17.7%). Individuals with type D personality were associated with the "poor sleep quality-long sleep duration" [odds ratio (OR) = 3.21, P = .005], "moderate sleep quality" (OR = 2.65, P = .003), and "poor sleep quality-short sleep duration" group (OR = 2.31, P = .018). Individuals with a history of GDM were associated with "poor sleep quality-long sleep duration" group (OR = 3.46, P = .005). The research revealed significant classification characteristics of sleep quality in patients with GDM, offering valuable insights for tailoring interventions to address distinct subcategories of sleep-related issues.

Impact of perceived social support on anxiety and depression in women undergoing in vitro fertilization-embryo transfer: the role of psychological resilience.

This study aimed to analyze the current status of women's perception of social support levels, psychological resilience, anxiety, and depression levels during IVF-ET, as well as investigate the influence of perceived social support and psychological resilience on the anxiety and depression levels of women undergoing IVF-ET and the mediating role of psychological resilience in this process. In this study, a convenience sampling method was used to administer a questionnaire survey among 433 women undergoing IVF-ET. Then, multivariate linear regression models were applied to identify factors influencing anxiety and depression. Lastly, mediation effect analysis was conducted to explore the mediating role of psychological resilience. The incidence of anxiety and depression was 42% and 46.4%, respectively. The mean score of the Perceived Social Support Scale (PSSS) indicated a high to moderate level of support, while the mean score of the Conner-Davidson Resilience Scale (CD-RISC) suggested moderate psychological resilience. Perceived social support was positively correlated with psychological resilience, and both were negatively correlated with anxiety and depression. Perceived social support and psychological resilience were identified as influencing factors of anxiety and depression (P < 0.001). Moreover, there was a partial mediating effect of psychological resilience between perceived social support and both anxiety and depression (P < 0.01). These results highlight the need for healthcare providers to assess patients' levels of psychological resilience and perceived social support when developing mental health interventions in order to mitigate the risk of anxiety and depression and concomitantly enhance fertility outcomes.

Social Cognitive Predictors of Health Promotion Self-Efficacy Among Older Adults During the COVID-19 Pandemic.

To examine the relative importance of social cognitive predictors (ie, performance accomplishment, vicarious learning, verbal persuasion, affective state) on health promotion self-efficacy among older adults during COVID-19. Cross-sectional. Data collected online from participants in British Columbia (BC), Canada. Seventy-five adults (n = 75) aged ≥65years. Health promotion self-efficacy was measured using the Self-Rated Abilities for Health Practices Scale. Performance accomplishment was assessed using the health directed behavior subscale of the Health Education Impact Questionnaire; vicarious learning was measured using the positive social interaction subscale of the Medical Outcomes Survey - Social Support Scale (MOS-SSS); verbal persuasion was assessed using the informational support subscale from the MOS-SSS; and affective state was assessed using the depression subscale from the Depression Anxiety Stress Scale (DASS-21). Multiple linear regression was used to investigate the relative importance of each social cognitive predictor on self-efficacy, after controlling for age. Our analyses revealed statistically significant associations between self-efficacy and performance accomplishment (health-directed behavior; β = .20), verbal persuasion (informational support; β = .41), and affective state (depressive symptoms; β = -.44) at P < .05. Vicarious learning (β = -.15) did not significantly predict self-efficacy. The model was statistically significant (P < .001) explaining 43% of the self-efficacy variance. Performance accomplishment experiences, verbal persuasion strategies, and affective states may be the target of interventions to modify health promotion self-efficacy among older adults, in environments that require physical and social distancing.

Impact of perceived social support on family resilience in patients with ischemic stroke: A mediation model analysis

BackgroundIschemic stroke events impose a substantial burden on both families and society, underscoring the critical importance of early intervention and prevention strategies. The dearth of familial and societal support significantly impacts coping styles and family resilience, with negative coping styles potentially linked to diminished levels of family resilience. However, empirical evidence supporting these associations remains lacking. ObjectiveThe aim of this study was to examine the association between simplified coping style, perceived social support and family resilience in patients with ischemic stroke, while also investigating the potential mediating role of simplified coping style in the relationship between perceived social support and family resilience. MethodsConvenience sampling was employed to select patients with ischemic stroke from three tertiary hospitals in Hunan Province between May and November 2021. A comprehensive investigation was conducted using a General data questionnaire, Simplified Coping Style Questionnaire, Perceived Social Support Scale and Family Resilience Rating Scale. The mediating effect was analyzed using PROCESS macros in SPSS, while the significance was tested through the Bootstrap method. ResultsA total of 310 questionnaires were distributed, with 7 identified as containing errors, omissions, or losses. Of these, 303 valid questionnaires were collected, yielding an effective response rate of 97.74 %. The scores for family resilience among ischemic stroke patients showed significant positive correlations with simple coping style (r = 0.59, P < 0.01) and perceived social support (r = 0.69, P < 0.01). Additionally, there was a positive correlation between perceived social support and simple coping style (r = 0.56, P < 0.01). Furthermore, the simple coping style played a crucial mediating role in the relationship between perceived social support and family resilience by accounting for approximately 20.70 % of the effect size. ConclusionThe findings suggest that enhancing positive coping styles and effective social support can enhance the level of family resilience in patients with ischemic stroke. Therefore, medical professionals should focus on improving social support while targeting coping styles as an intervention strategy to actively adjust the coping modes, ultimately elevating the level of family resilience in patients with ischemic stroke.

Health Literacy in Non-dialyzed Chronic Kidney Disease Patients: A Cross-Sectional Study

Objective: To explore the current status and influencing factors of health literacy in non-dialyzed chronic kidney disease (CKD) patients, and to provide a basis for developing more comprehensive and effective interventions. Methods: 206 CKD patients hospitalized or followed up in outpatient clinics in the Department of Nephrology of a tertiary hospital in Baoding City were conveniently selected from June to August 2024. General information questionnaire, Health Literacy Scale for Chronic Disease Patients, Perceived Social Support Scale, and Positive Psychological Questionnaire were used to conduct the survey. Results: The health literacy score of non-dialyzed CKD patients was (91.04±15.17); The results of multiple linear regression analysis showed that the number of comorbidities, education level, per capita monthly household income, family support, and optimism were the influencing factors of health literacy in CKD patients. Conclusion: The health literacy of non-dialyzed CKD patients is low, and healthcare professionals should develop scientific and reasonable intervention programs based on their influencing factors in order to enhance the health literacy and delay disease progression.

A Study on the Influence of Emotional Intelligence on Academic Satisfaction Among Chinese College Students: The Mediating Effect of Learning Engagement and the Moderating Effect of Social Support

This study primarily examines the interconnections among college students' Emotional Intelligence, Learning Engagement, Academic Satisfaction, and Social Support. A total of 535 college students participated in the survey utilizing the Emotional Intelligence Scale (EIS), the Learning Engagement Scale (UWES-S), the Perceived Social Support Scale (PSSS), and the University Version of Learning Satisfaction Scale. Findings indicate that the Emotional Intelligence of college students exhibits significant variability, with notable gender disparities. Emotional Intelligence is found to have a substantial positive influence on both Academic Satisfaction and Learning Engagement, while Learning Engagement further positively affects Academic Satisfaction. Additionally, Learning Engagement serves as a mediating factor between Emotional Intelligence and Academic Satisfaction, and Social Support acts as a moderating variable in the Emotional Intelligence-Academic Satisfaction dynamic.

Validation of the Multidimensional Scale of Perceived Social Support among LGBT population in Serbia

Abstract Background Social support represents the belief that one is valued, cared for, and loved by others in a social network and a lack of it may lead to adverse outcomes such as a relapse into depression or emotional distress in physically ill patients. The Multidimensional Scale of Perceived Social Support (MSPSS) is an instrument aimed to measure an individual’s perception of how much he or she receives outside social support. This study aimed to examine the validity and reliability of the Serbian version of MSPSS in a sample of LGBT population in Serbia. Methods The cross-sectional study included 504 respondents, members of the LGBT population living in Serbia. The instrument used was the MSPSS as a self-report measure, containing twelve items rated on a 7-point Likert scale. MSPSS consists of three sub-scales: Family, Friends, and Significant Others. Exploratory (EFA) and confirmatory factor analyses (CFA) were performed with two independent random samples. Results The average score on the scale of social support was 5.58±0.84 (scale of social support by family 4.62±1.41, scale of social support by friends 5.93± 1.99, and scale of social support by the significant others 6.20±0.96, respectively). The Cronbach’s alpha for the entire social support scale was α = 0.772. The three-factor structure of the MSPSS was proved with EFA and CFA. The factor loadings varied between 0.630-0.817. The three factors explained a total of 52.68% of the variance (factor 1- 28.62%, factor 2. 13.16%, factor 3- 10,90%). The three-factor model was adopted during the CFA when the three-factor model CFI (comparative fit index) was 0.969. Conclusions The MSPSS has shown good reliability, internal validity and construct validity and can be used as a convenient measure of social support among the LGBT population. Both EFA and CFA yield a three-factor structure consistent with the theory underlying the measure’s development. Key messages • The results of the study suggest that the Multidimensional Scale of Perceived Social Support has acceptable psychometric properties for use with the LGBT population. • This study supports the use of the MSPSS for assessing community-based collaboration using the three-factor model among the LGBT population.

Depressive symptoms among medical students

Abstract Background Adolescence is a period of psychological development which is associated with an increased risk of developing mental health disorders. Medical students have a higher prevalence of depression compared to the general population, but they are given low priority in the healthcare system. The aim of this study was to examine the prevalence of clinically significant scores on the Patient Health Questionnaire 9 (PHQ-9), and factors associated with clinically significant scores. Methods The research was conducted through a cross-sectional study among fifth-year medical students, using a 95-item questionnaire anonymously filled out. The questionnaire examined: socio-demographic and socio-economic characteristics of the students; students’ lifestyles (including alcohol consumption, binge drinking, smoking cigarettes, electronic cigarettes, use any of other tobacco products); Patient Health Questionnaire (PHQ-9); International Physical Activity Questionnaire (IPAQ); Zung’s Anxiety Scale; and Problematic Internet Use Scale. Based on the score on PHQ-9, the participants were classified in two groups: with clinically significant scores (score ≥10) and without clinically significant scores (score &amp;lt;10). Results The study included 461 medical students who completed the PHQ-9. Average score on PHQ-9 scale was 5.25±4.53 and total of 66 students (14.3%) had the PHQ-9 indicative of clinically significant depressive symptoms (PHQ-9 ≥10). The clinically significant depression was associated with smoking of any tobacco product (OR:3.02, 95% CI: 1.37-6.63), score on social support scale (0.94, 95% CI: 0.90-0.98), age (OR: 1.42, 95% CI: 1.06-1.90) and score on Zung anxiety scale (OR: 1.15, 95% CI: 1.16-1.34). Conclusions Considering that medical students, are at higher risk of developing clinically significant symptoms of depression, it is crucial to form psychological and social support programs. Key messages • Monitoring the mental health of young individuals holds significant importance. • It is crucial to detect risk factors in time and develop prevention programs.

Kontribusi Dukungan Sosial dan Intensitas Penggunaan Media Sosial terhadap Kesehatan Mental Gen Z

This study was conducted to determine how social support and intensity of social media use contribute to Gen Z's mental health. The research method used was a quantitative approach with a correlational type. The research sample was taken using purposive sampling technique with the criteria of Gen Z students, aged 20-22 years and actively using social media on average more than 3 hours a day. Gen Z who participated as research subjects amounted to 100 people. The instruments used in this study were the social support scale, SONTUS to measure the intensity of social media use, and GHQ-12 for mental health, all of which were structured using the Likert model. The data analysis technique used was multiple linear regression analysis. The results showed that social support and intensity of social media use contributed to mental health by 17.5%. So that the higher the social support and intensity of social media use, the higher Gen Z's mental health will be.

Relationships between work-family conflict, infertility-related stress, resilience and social support in patients undergoing infertility treatment

ABSTRACT Fertility treatments can be physically and psychologically exhausting for those who do it due to high expectations and possible frustration with the negative results. Moreover, it demands time and high financial investment, which are sometimes stressful factors for the working patient. Two aspects that can ease this context are resilience and social support. The present article aims to investigate the levels of work-family conflict in individuals undergoing infertility treatment and their associations with stress, resilience, and social support. The survey of 242 patients addressed sociodemographic data, Infertility-Related Stress Scale-Brazil (IRSS-BP), Connor-Davidson Resilience Scale 10 (CD-RISC 10), Perceived Social Support Scale (PSSS), and Work-Family Conflict Scale. Data were analyzed using R (4.3.2). Findings suggest that the level of Work-Family Conflict is higher in men (p = 0.020). The scale is also positively associated with Infertility Stress and negatively correlated with Resilience and Social Support.

Relationship of Tetrad Dark Personality Traits and Delinquent Behavior among Adolescents: Moderating Role of Social Support

The current research studies the relationship between Dark Tetrad personality dimensions: Machiavellianism, narcissism, psychopathy, sadism, and delinquency in adolescence while considering the role of social support as the moderator. For this study the cross-sectional research design was used and the sample included 300 adolescents comprising 150 males and 150 females in the age group of 10 to 19 years randomly selected from twin cities of Islamabad and Rawalpindi. The data were collected using the Short Dark Tetrad (SD4) self-reported delinquency – Problem Behavior Frequency Scale and Child and Adolescent Social Support Scale (CASSS). The analyses conducted found positive and significant correlations between the dark personality traits and the delinquent behaviors with each of the dark personality traits being positively correlated with the manifests of delinquent behaviour. Furthermore, the study revealed that social support acted as a moderator that could help decrease the delinquency rate among the adolescents who possess a high level of dark personality traits. These imply that dark personality facets and insufficient social support should be targeted to reduce delinquency among adolescents. The results imply that any prevention or treatment programs targeted at decreasing delinquency must take into account the presence of dark personality features in adolescents, especially through modulating the perceived usefulness of social support. The insights from the research can be quite useful for schools, families, and community-oriented programs to design effective interventions not only to address behavior management but also to address the potentially detrimental effects associated with these personality traits.

The impact of work-family conflict on occupational fatigue among endoscopy nurses in China: a moderated mediation model.

Endoscopy nurses in China face significant work-family conflicts, where the clash between high work demands and family responsibilities markedly increases the risk of occupational fatigue. This not only affects the nurses' physical and mental health and overall well-being, but also poses a threat to the quality of care and patient safety. This study, grounded in the Conservation of Resources theory, constructs a moderated mediation model to examine the mediating role of positive coping style in the relationship between work-family conflict and occupational fatigue among endoscopy nurses in China, as well as the moderating effect of perceived social support. A convenience sampling method was employed to select 315 endoscopy nurses from 25 tertiary hospitals across 14 provinces in China. A questionnaire survey was conducted using the Fatigue Assessment Instrument, the Work-Family Conflict Scale, the Simplified Coping Style Questionnaire, and the Perceived Social Support Scale. The moderated mediation model was validated using Stata16.0. Our findings reveal that work-family conflict is a significant predictor of occupational fatigue, with a negative impact on positive coping style. Positive coping style, in turn, is negatively associated with occupational fatigue. Furthermore, positive coping style partially mediates the relationship between work-family conflict and occupational fatigue, accounting for 35.52% of the total effect. Additionally, perceived social support mitigates the negative effects of work-family conflict on positive coping style and occupational fatigue. There exists a moderated mediation effect between work-family conflict and occupational fatigue among endoscopy nurses in China, wherein positive coping style serve as a mediating variable. Perceived social support mitigates the negative impact of work-family conflict on positive coping style, while enhancing the alleviating effect of positive coping style on occupational fatigue. Therefore, improving endoscopy nurses' levels of perceived social support and coping strategies may help to prevent and alleviate the occurrence of occupational fatigue.

Prevalence and associated factors of suicide-related behaviors in Iranian students: a large sample cross-sectional study

BackgroundAdmission to the university changes life conditions and thereby increases mental pressure. If the students cannot bear the psychological pressure of being a student, that may lead to suicide among the vulnerable persons. Therefore, in this research, we would like to investigate the prevalence and associated factors of suicide-related behaviors in Iranian students.MethodsThis online, cross-sectional survey was performed from March 18 to April 15, 2023, in Iran. The questionnaires were completed by 2181 students. In this study, Perceived Stress Scale (PSS-4), Meaning in Life Questionnaire (MLQ), Generalized Anxiety Disorder Scale (GAD-7), and Suicidal Behaviors Questionnaire-Revised (SBQ-R), and Oslo Social Support Scale (OSSS-3) were used. Finally, we identified the factors associated with suicide-related behaviors using univariate and multiple regression.ResultsThe prevalence of suicidal behaviors in students was 57.95%. According to the results, male gender, marriage, having meaning in life, occasional smoking, sleeping after 1 a.m., and having social support were associated with a reduced risk of suicide. In addition, a history of sexual abuse, more anxiety, and higher perceived stress were associated with an increased risk of suicide.ConclusionsThe prevalence of suicide-related behaviors in Iranian students was higher than expected. Urgent interventions should be considered to prevent students from committing suicide. Helping students find meaning in life, as well as eliminating the causes of students’ anxiety and stress, may be effective in this respect. Additionally, teaching students how to control anxiety and stress may be helpful.

Construction and Validation of Academic Support Scale in Middle School (ASSMS)

Research on social support in China has been relatively comprehensive as psychological development cannot be separated from the social environment. Family, teachers, and friends are the main sources of social support for middle school students. If we can fully utilize the academic support provided by families, teachers, and classmates in daily life, improve students’ personal efficacy, stimulate their learning motivation and desire, and provide corresponding emotional, resource, behavioral, and willingness support for middle school students, it will help them better enhance their learning adaptability, increase their investment in learning, and then improve their learning consciousness, ultimately promoting the enhancement of academic achievement and the development of their abilities. Therefore, based on the existing scales of social support and academic support, this study determined the academic support scale for middle school students, exploring the source of academic support from four dimensions: willingness support, resource support, emotional support, and behavioral support. Based on a literature review and questionnaire, a formal scale was formed to measure the academic support of middle school students. In total, 762 students from two middle schools in Shijiazhuang and Hengshui were selected as subjects for data analysis. Exploratory factor analysis showed that the scale was composed of four factors: willingness support, resource support, emotional support, and behavioral support, with a cumulative contribution rate of 54.15%. The factor loadings of the items ranged from 0.423 to 0.783. The indicators obtained by confirmatory factor analysis were χ2/df of 2.98, RMSEA of 0.072, GFI of 0.841, IFI of 0.902, TLI of 0.891, and CFI of 0.901. The Cronbach’s α coefficient was 0.955, the Spearman–Brown coefficient was 0.939, and the correlation coefficients between each dimension and the total scale were 0.892–0.945. The results show that the reliability and validity of the scale are within the acceptable range, in line with the standards of measurement, and can be used as a tool to measure the academic support of middle school students. This measurement can be used to evaluate the multidimensional academic support systems in middle schools and inform the development of targeted interventions to promote student success and well-being.

Relationship between post-traumatic stress disorder and fear of progression in stroke patients: the mediating role of perceived social support and coping styles.

Fear of progression (FoP) among stroke patients is closely associated with post-traumatic stress disorder (PTSD), perceived social support, and coping styles. However, there is still limited research on the mechanism of interaction among these four factors. The purpose of this study was to investigate the mediating role of coping styles and perceived social support in the relationship between FoP and PTSD among stroke patients. The study included 240 stroke patients and utilized a cross-sectional design. Data was collected using a general data questionnaire, the Fear of Progression-Questionnaire-Short Form (FoP-Q-SF), the Perceived Social Support Scale (PSSS), Medical Coping Modes Questionnaire (MCMQ), and the Post-traumatic Stress Disorder Check-list-Civilian Version (PCL-C). Structural equation modeling was used to assess the mediating relationship between PSSS and MCMQ between FoP and PTSD. A total of 112 (46.7%) patients exhibited mental dysfunction with FoP scores ≥34, and 89 (37.1%) patients presented with a PTSD score of at least 38had certain PTSD symptoms. FoP was negatively correlated with PSSS and facing coping styles, and positively correlated with PTSD and yielding coping styles. PSSS, facing coping styles, and yielding coping styles partially mediated the relationship between FoP and PTSD, accounting for 42.69% of the total effect. PTSD can impact FoP directly or indirectly through perceived social support, confrontation, and submissive coping styles. Therefore, it is important to urge patients to reasonably use social support and coping styles to increase well-being, and strive to mitigate the ongoing impact of PTSD symptoms, and reduce the risk of FoP.

Flourishing Pada Mahasiswa Yang Mengikuti Organisasi Kemahasiswaan Ditinjau Dari Spiritualitas Dan Dukungan Sosial

Flourishing is an important construct for students to have, because it has a positive impact or influence on them. These impacts include the good influence of flourishing on academic achievement and improving student performance. This research aims to determine the relationship between spirituality and social support and the flourishing of students who join student organizations. This research uses a correlational quantitative approach with 92 students as respondents who are currently actively participating in student organizations. The instruments used in this research were the flourishing scale (α = 0.832), the spirituality scale (α = 0.936) and the social support scale (α = 0.900). The data collection technique uses non-probability sampling techniques, especially purposive sampling techniques. In analyzing the data, researchers used multiple linear regression test techniques. The research results show that there is a relationship between spirituality and social support and the flourishing of students who join student organizations.

Structural equation modeling analysis of factors influencing decisional conflict between dialysis modality among end-stage kidney disease patients in Wuhan

ObjectivesTo explore the influencing factors and relationships associated with decisional conflict of dialysis modality in End-stage kidney disease (ESKD) patients.MethodsThis study was a survey-based cross-sectional investigation conducted on 150 ESKD patients in a third-class hospital in Wuhan. The general information questionnaire, decisional conflict scale, Montreal cognitive assessment, frail scale, perceived social support scale, and brief health literacy screen were used for investigation. SPSS 25.0 was used to compare the differences between the decisional and non-decisional conflict groups, and AMOS 23.0 was used to construct a structural equation model to explore the influencing factors.ResultsThe incidence of decisional conflict in 150 ESKD patients was 33.3% (50/150). Binary logistic regression analysis showed that the independent risk factors for decisional conflict of dialysis modality in ESKD patients included monthly household income (OR = 0.184), cognitive function (OR = 7.0), social support (OR = 0.891), health literacy (OR = 0.608), the level of eGFR (OR = 1.488), and the level of cTnI (OR = 9.558). The constructed path analysis model had a good fit (x2/df = 1.499, GFI = 0.957, AGFI = 0.911, NFI = 0.906, CFI = 0.967, RMSEA = 0.055). The path analysis showed that health literacy (0.577) had the greatest impact on the decisional conflict, with a direct effect of 0.480 and an indirect effect of 0.097 through cognitive function and monthly household income. Next was social support, with an effect value of 0.434.ConclusionsIn clinical practice, it is important to enhance the health literacy of patients and their families and to provide advanced education on dialysis plans. Additionally, in managing and planning chronic kidney disease progression and dialysis, it is recommended to regularly and systematically assess cognitive function, particularly before the patient’s cognitive impairment worsens or the severity of the disease progresses. Advanced care planning can be established through collaboration between healthcare professionals and patients to ensure appropriate decision-making and management.Implications for the profession and patient careThis paper finds that the factors that influence and relate to dialysis methods in end-stage renal disease patients help nurses exercise autonomy better, assist patients in reducing their decisional conflict, and improve clinical outcomes.Patient or public contributionPatients received a relevant questionnaire survey, and caregivers assisted in conducting the study.

Stressors and suicidal ideation in low-income adults in Malaysia: A serial mediation analysis of social support and mental health symptoms.

Studies have documented a heightened risk of suicidal ideation in response to stressors, especially among people from socioeconomically disadvantaged backgrounds. However, the mechanisms of this association remain elusive. Drawing on the social deterioration and counteractive models, this study aims to elucidate the pathways linking stressors to suicidal ideation through serial mediation of social support and mental health symptoms in Malaysia. Data were collected from 404 low-income adults (33.2% male and 66.8% female) receiving monthly financial assistance from Malaysia's social welfare department. We employed stressor measures (i.e. financial, family and work), the Oslo Social Support Scale, the Patient Health Questionnaire and the Suicidal Behaviour Questionnaire-Revised. A total of 46.8% of participants reported mild-to-severe anxiety and depressive symptoms, with 11.1% classified as high risk for suicide. Direct and indirect effects were found. After controlling for age and gender, social support and mental health symptoms mediated the link between stressors and suicidal ideation. The serial mediation analysis indicates that stressors are connected to heightened suicidal ideation through a sequence involving insufficient social support, followed by elevated levels of mental health symptoms. Understanding the multifaceted relationships among stressors, social support, mental health symptoms and suicide ideation expands the potential for developing targeted interventions and preventive strategies tailored for vulnerable populations. Clinical work with low-income individuals may include implementing early systematic efforts to develop accessible mental health and integrated care services.