Dysfunctional attitudes,social support,negative life events,and depressive symptoms in Chinese adolescents:A moderated mediation model

BACKGROUND Depression is a prevalent psychological issue in adolescents that is significantly related to negative life events(NLEs)and dysfunctional attitudes.High levels of social support can significantly buffer NLEs’effect on depression.Currently,there is limited research on how social support moderates the relationship between NLEs,dysfunctional attitudes,and depression in adolescents in China.It is imperative to investigate this moderating effect to mitigate dysfunctional attitudes in adolescent undergoing depressive mood,ultimately enhancing their overall mental health.AIM To investigate the relationship and underlying mechanisms between specific dysfunctional attitudes,social support,and depression among Chinese adolescents.METHODS This is a cross-sectional study which selected five middle schools in Shandong Province for investigation in March 2022.Participants included 795 adolescents(49.87%male,mage=15.15,SD=1.84,age range=11-18 years old).All participants completed the Dysfunctional Attitude Scale,Adolescent Life Event Scale,Beck Depression Inventory,and Social Support Rating Scale.A moderated mediation model was conducted to examine the relationship between specific dysfunctional attitudes,social support,and depression.RESULTS Results indicated that NLEs affected depression through the mediating role of specific dysfunctional attitudes(autonomy attitudesβ=0.21;perfectionismβ=0.25).Moreover,social support was found to moderate the mediating effect between NLEs,specific dysfunctional attitudes,and depressive symptoms(autonomy attitudes b2=-0.08;perfectionism b2=-0.09).CONCLUSION Dysfunctional attitudes mediated and social support moderated the relationship between NLEs and depression.Social support can buffer depression symptoms among adolescents with autonomy attitudes and perfectionism.

Promoting Post-Traumatic Growth in Colorectal Cancer Patients:Exploring the Role of Social Support through a Chain Mediation Model

Colorectal cancer(CRC)poses significant physical and psychological challenges that necessitate an exploration of factors influencing post-traumatic growth(PTG)for patient well-being.This study aims to investigate the effects of positive psychological capital(PsyCap)and perceived stress on mediating the social support-PTG relation among 673 CRC patients.Social support,positive PsyCap,perceived stress,and PTG were assessed through questionnaires.The results indicated a direct prediction effect of social support on PTG(LICI=0.481,ULCI=0.644),with the direct effect being 59.5%.Both positive PsyCap and perceived stress exerted a mediating role in the correlation between social support and PTG,with the mediating effects occupying 29.4%(LICI=0.217,ULCI=0.343)and 5.7%(LICI=0.030,ULCI=0.082),respectively.Positive PsyCap further had a chain mediating effect on perceived stress(LICI=0.031,ULCI=0.074),with the chain effect accounting for 5.4%.The total impact of social support on PTG was 100%(LICI=0.882,ULCI=1.008).This model underscores the pivotal role of social support in promoting PTG in CRC patients.Positive PsyCap serves as a crucial mediator in the social support-PTG link,with perceived stress playing a sequential mediating role.Thesefindings suggest that strengthening social support networks and cultivating positive PsyCap may reduce perceived stress and promote the development of PTG in CRC patients.Consequently,intervention programs are recommended to improve the psychosocial well-being of CRC patients.

Interoception mediates the association between social support and sociability in patients with major depressive disorder

BACKGROUND Interoception dysfunction has an important impact on the onset and development of major depressive disorder(MDD).Social support serves as a protective factor against MDD,and sociability also plays a significant role in this condition.These interconnected constructs-social support and sociability-play pivotal roles in MDD.However,no research on the mechanisms underlying the associations be-tween social support and sociability,particularly the potential role of interocep-tion,have been reported.ception,social support,and sociability,respectively.A mediation analysis model for the eight dimensions of intero-ception(noticing,not distracting,not worrying,attention regulation,emotional awareness,self-regulation,body listening,and trust),social support,and sociability were established to evaluate the mediating effects.RESULTS A partial correlation analysis of eight dimensions of the MAIA-2,SSRS,and TSBI scores,with demographic data as control variables,revealed pairwise correlations between the SSRS score and both the MAIA-2 score and TSBI score.In the major depression(MD)group,the SSRS score had a positive direct effect on the TSBI score,while the scores for body listening,emotional awareness,self-regulation,and trust in the MAIA-2C had indirect effects on the TSBI score.In the HC group,the SSRS score had a positive direct effect on the TSBI score,and the scores for attention regulation,emotional awareness,self-regulation,and trust in the MAIA-2C had indirect effects on the TSBI score.The proportion of mediators in the MD group was lower than that in the HC group.CONCLUSION Interoceptive awareness is a mediating factor in the association between social support and sociability in both HCs and depressed patients.Training in interoceptive awareness might not only help improve emotional regulation in depressed patients but also enhance their social skills and support networks.

Mediating role of social support in dysphoria,despondency,and quality of life in patients undergoing maintenance hemodialysis

BACKGROUND Dysphoria and despondency are prevalent psychological issues in patients undergoing Maintenance Hemodialysis(MHD)that significantly affect their quality of life(QOL).High levels of social support can significantly improve the physical and mental well-being of patients undergoing MHD.Currently,there is limited research on how social support mediates the relationship between dysphoria,despondency,and overall QOL in patients undergoing MHD.It is imperative to investigate this mediating effect to mitigate dysphoria and despondency in patients undergoing MHD,ultimately enhancing their overall QOL.AIM To investigate the mediating role of social support in relationships between dysphoria,despondency,and QOL among patients undergoing MHD.METHODS Participants comprised 289 patients undergoing MHD,who were selected using a random sampling approach.The Social Support Rating Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and QOL Scale were administered.Correlation analysis was performed to examine the associations between social support,dysphoria,despondency,and QOL in patients undergoing MHD.To assess the mediating impact of social support on dysphoria,despondency,and QOL in patients undergoing MHD,a bootstrap method was applied.RESULTS Significant correlations among social support,dysphoria,despondency,and quality in patients undergoing MHD were observed(all P<0.01).Dysphoria and despondency negatively correlated with social support and QOL(P<0.01).Dysphoria and despondency had negative predictive impacts on the QOL of patients undergoing MHD(P<0.05).The direct effect of dysphoria on QOL was statistically significant(P<0.05).Social support mediated the relationship between dysphoria and QOL,and this mediating effect was significant(P<0.05).Similarly,the direct effect of despondency on QOL was significant(P<0.05).Moreover,social support played a mediating role between despondency and QOL,with a significant mediating effect(P<0.05).CONCLUSION These findings suggest that social support plays a significant mediating role in the relationship between dysphoria,despondency,and QOL in patients undergoing MHD.

Optimism,Social Support,and Caregiving Burden among the Long-Term Caregivers:The Mediating Effect of Psychological Resilience

Background:As the elderly population grows,the demand for long-term care services is increasing.Despite significant investments in care quality and workforce training,long-term care workers often face challenges such as work fatigue,heavy workloads,and inadequate support.These issues can impact job satisfaction,mental health,and care quality,leading to staff turnover.This study examines how optimism,social support,and psychological resilience relate to caregiving burden,aiming to understand their effects on caregivers’well-being and performance to enhance the quality of long-term care services.Methods:The participants were 542 long-term care workers.Descriptive statistics,t-tests,one-way ANOVA,and hierarchical regression were used for data analysis.Results:(1)Optimism and social support were significantly and positively correlated with psychological resilience and significantly and negatively associated with caregiving burden.(2)Regarding differences in optimism,social support,psychological resilience,and caregiving burden among long-term care workers,females scored significantly higher than males in“social support;”married workers scored significantly higher than unmarried workers in“optimism,”“social support,”and“psychological resilience”;workers aged 45–65 scored significantly higher than those aged 25–45 in“optimism”;workers aged 25–45 scored significantly higher than those aged 45–65 in“caregiving burden”;social workers scored significantly higher than nursing staff in“optimism.”(3)Psychological resilience partially mediated the relationship between social support and caregiving burden concerning explanatory and predictive power.Conclusions:These findings suggest that optimism,social support,and psychological resilience are essential factors in reducing the caregiving burden among long-term care workers.The study highlights the importance of promoting psychological resilience and providing social support to alleviate the burden of caregiving.

The Impact of Social Support on the Mental Health of Cancer Patients:Evidence from China

Exploring the relationship between social support and the mental health of cancer patients is a vital endeavor for enhancing mental well-being.The objective of this study was to explore the relationship between social support and psychological well-being in cancer patients and to provide new empirical evidence for psychological improvement in cancer patients.This research holds significant practical implications for optimizing China’s public health system and strengthening the development of a healthy China.Using data from the 2018 China Health and Retirement Longitudinal Study(CHARLS)database,we empirically examined the influence of social support on the mental health of cancer patients.Models such as Ordered Probit and OLogit were used to provide empirical evidence and theoretical insights for enhancing the mental health of cancer patients in a context marked by a high prevalence of cancer.The findings indicated that both formal and informal social support mechanisms were effective in improving the mental health of cancer patients.Furthermore,we utilized the propensity score matching(PSM)model to eliminate the endogeneity issue associated with sample selectivity bias.The results obtained through PSM demonstrated robustness,underscoring the importance of addressing sample selectivity bias when assessing the impact of social support on the mental health of cancer patients.Therefore,the Chinese government is recommended to prioritize the use of social support as a means to proactively enhance the mental health of cancer patients,thereby continuously elevating their overall quality of life.

Enhancing adolescent mental health through cognitive and social support:Insights from study on depression in Chinese adolescents

Adolescent depression is a growing global health concern,affecting 14%of adolescents and leading to severe consequences such as academic failure,substance abuse,and suicidal ideation.The study by Yu et al,investigates the cognitive and social factors influencing depression in 795 Chinese adolescents.Findings reveal that negative life events(NLEs)and dysfunctional attitudes are strongly associated with depressive symptoms,while social support moderates the impact of NLEs but not dysfunctional attitudes.The study highlights the need for cognitivebehavioural interventions targeting perfectionism and autonomy,and the importance of strengthening social support systems in schools and communities.Culturally sensitive,holistic approaches to adolescent mental health are crucial for addressing both the internal vulnerabilities and external pressures contributing to depression.Further research is needed to explore the roles of peer and parental support and the long-term effects of these factors across diverse cultural contexts.

Correlation among anxiety and depression,fear of disease progression,and social support in coronary heart disease

BACKGROUND The mental well-being of individuals with coronary heart disease(CHD)during the intensive care unit(ICU)transition period is a multifaceted and significant concern.In this phase,the individuals might encounter psychological challenges like anxiety and depression,which can impede their recuperation and potentially have lasting effects on their health.AIM To investigate the correlation among psychological factors in CHD patients in the ICU transition period.METHODS A questionnaire survey was conducted with 119 patients admitted to the ICU after coronary artery bypass grafting between March and December 2023.Variations in Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD),Fear of Progression Questionnaire-Short Form(Fop-Q-SF),and Social Support Rating Scale(SSRS)were collected and analyzed among diverse populations.We used Pearson’s correlation analysis to examine the correlation.Multiple linear regression analysis was used to explore whether these indicators influenced depression and anxiety in the patients.RESULTS The total scores for anxiety,depression,fear of disease progression,and social support were(7.50±1.41)points,(8.38±1.62)points,(35.19±8.14)points,and(36.34±7.08)points,respectively(P<0.05).Multivariate regression analysis showed that both the level of disease progression and social support affected the level of postoperative depression and anxiety in patients.CONCLUSION The anxiety and depression levels were positively related to each dimension of phobia disease progression and negatively related to each dimension of social support among patients with CHD.

Correlation Analysis between Self-Disclosure and Social Support in Patients with Breast Cancer

Objective: Describe the status quo of self-disclosure and social support in breast cancer patients and analyze the correlation between them. Methods: General data questionnaire, distress disclosure Index scale and Chinese version of medical social support scale were used to investigate the correlation between self-disclosure and social support in breast cancer patients by Pearson correlation analysis. Results: 1) The total self-disclosure score was (38.75 ± 9.18);the total score of social support was (70.57 ± 14.04) scores, including emotional information support dimension (28.39 ± 6.06) scores, practical support dimension (15.62 ± 3.31) scores, elastic support dimension (14.85 ± 3.23) scores, and emotional support dimension (11.70 ± 2.56) scores. 2) Self-disclosure was positively correlated with social support (r = 0.433, p Conclusion: Breast cancer patients had a moderate level of self-disclosure, and the higher the level of self-disclosure, the better the social support. It is suggested that improving the self-disclosure level of breast cancer patients can help them obtain more social support.

The Relationship between Mental Health Literacy and Subjective Well-Being of Young and Middle-Aged Residents: Perceived the Mediating Role of Social Support and Its Urban-Rural Differences

This study investigates mental health literacy among young and middle-aged urban and rural residents and the differences in mental health literacy,perceived social support and subjective well-being.From January to February 2022,620 participants(320 rural and 300 urban residents)from three provinces of China were selected by con-venience sampling.A general data questionnaire,mental health literacy scale,perceived social support scale and subjective well-being scale were administered.The mental health literacy scores of urban residents were 3.34±0.57 and those of rural residents were 2.73±0.79.The results of multiple regression analysis showed that the mental health literacy scores of rural residents were more significant than those of urban residents in terms of sex and age,while urban residents’mental health literacy scores were more significant than those of rural resi-dents in terms of monthly income.Mental health literacy,perceived social support and subjective well-being of young and middle-aged urban and rural residents were all positively correlated(P<0.01).While the level of mental health literacy is better among urban residents than rural residents,perceived social support plays a partial mediating role between mental health literacy and subjective well-being of both urban and rural residents,and should be the focus of researchers seeking to improve the level of well-being of residents.

Relationship between primary caregivers’social support function,anxiety,and depression after interventional therapy for acute myocardial infarction patients

BACKGROUND An acute myocardial infarction(AMI)is often treated with direct coronary intervention and requires home-based rehabilitation.Caregivers of patients with AMI need adequate social support to maintain high-quality care;however,their social support function is low,and relevant indicators for intervention must be identified.AIM To analyze the correlation between social support for primary caregivers,their anxiety,and depression,when caring for patients with AMI after interventional therapy.METHODS Using convenience sampling,we selected 300 primary caregivers of patients with AMI who had undergone interventional therapy.The Social Support Rating Scale(SSRS),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to assess the primary caregivers.A Pearson’s correlation analysis was used to analyze the correlations between the SSRS,SAS,and SDS,and a multiple logistic regression analysis was used to analyze the factors influencing the low social support function of primary caregivers.The receiver operating characteristic curve and area under the curve(AUC)were used to evaluate the predictive ability of the SAS and SDS for low social support function in primary caregivers.RESULTS Considering the norm among Chinese people,AMI caregivers’objective support,subjective support,support utilization,and SSRS scores were lower,while their SAS and SDS scores were higher.The SSRS scores of female caregivers were higher than those of the male caregivers(t=2.123,P=0.035).The Pearson correlation analysis showed that objective support,subjective support,support utilization,and SSRS total scores were significantly correlated with both SAS(r=-0.414,-0.460,-0.416,-0.535)and SDS scores(r=-0.463,-0.379,-0.349,-0.472).Among the 300 AMI caregivers,56 cases(18.67%)had a low level of support function(SSRS≤22 points).Logistic regression model analysis showed that SAS and SDS were independent risk factors for low social support function of AMI caregivers,regardless of adjustment for other variables(P<0.05).SAS and SDS predicted that the AUC of AMI caregivers with low support function was 0.84,sensitivity was 67.9 and 71.4,and specificity was 84.0 and 70.9,respectively.CONCLUSION The social support function of the primary caregiver of patients with AMI after interventional therapy was lower and negatively correlated with anxiety and depression in the primary caregiver.

Relationship between Moral Elevation and Prosocial Behavior among College Students: The Mediating Role of Perceived Social Support and Moderating Role of Moral Identity

Objectives:The present study examined the relationship between college students’moral elevation and prosocial behavior.As well as the mediating role of perceived social support and the moderating role of moral identity.Methods:A sample of 489 college students were recruited for the study.They were asked to complete a series of questionnaires,including Moral Elevation Scale(MES),Perceived Social Support Scale(PSSS),Moral Identity Scale(MIS)and Prosocial Tendency Measure(PTM).As part of the data analysis,we used correlation analysis and the method of constructing latent variable structural equation model to explore the mechanism of action among variables.Results:After controlling for gender,discipline,the research found that:(1)Moral elevation positively predicted the prosocial behavior among the college students;(2)Perceived social support mediated the relationship between moral elevation and prosocial behavior;(3)Moral identity moderated the second half of the model(i.e.,the link between perceived social support and prosocial behavior).Specifically,the mediating effect of perceived social support was stronger for college students with high-level moral identity compared to those with low-level moral identity.Conclusions:Moral identity significantly moderates the mediating effect of perceived social support,and the mediating model with moderated is established.

The Relationship between Rural Left-Behind Children’s Physical Activity and Hope:The Mediating Effects of Perceived Social Support

It has been confirmed in previous studies that there is a positive correlation between physical activity and hope.In this study,rural left-behind children in China was taken as the participants to investigate the impact of physical activity on hope in rural left-behind children and examine the mediating role of perceived social support in the relationship between physical activity and hope.797 valid copies of the questionnaire were collected from China.Pearson correlation coefficient was employed to analyze the relationship between physical activity and hope;SEM and Bootstrap were used to test the mediating effect of perceived social support.The results show that physical activity can not only directly and positively predict the level of hope in rural leftbehind children but can also predict the level of hope through perceived social support;perceived social support plays a mediating role in the relationship between physical activity and hope.These results highlight the necessity to pay more attention to the physical activity of left-behind children and the possibility to improve the level of hope by increasing their physical activity;at the same time,the acquisition of more material,emotional and psychological support from teachers and guardians is more conducive to improving the sense of hope in left-behind children.These findings can deepen the understanding of the sense of hope in left-behind children,and provide new methods for and enlightenments on improving the level of hope in left-behind children.

Preventing Health Anxiety:The Role of Self-Evaluation,Sense of Coherence,Self-Rated Health and Perceived Social Support

Background:Components of Self,completed with the perceived social support determine the individual differences in theevaluation of a stressor and the behavioral responses toward it,such as health-related anxiety.The study set as a goal theanalysis of associations between the components of Self,such as self-evaluation,sense of coherence,perceived social support,and reported health-related anxiety in an adult sample.Methods:147 adults from the 18–73 age group(mean age 37.5)voluntarily completed the questionnaire through Qualtrics online platform containing the Short Health Anxiety Inventory,Core Self-Evaluation Scale,Social Support Assessing Scale,and one Health Self-Evaluation Item.Results:ANOVA foundrelevant differences in total scores and subscales’scores of the health anxiety scale depending on the positive self-evaluation.Linear regression shows that the analyzed variables were responsible for the prediction of a higher value on the“Perceivedprobability of becoming ill”subscale in a proportion of 45.6%and for the“Perceived consequence of illness”subscale in aproportion of 20.2%The predictive value of the linear regression model for the total score on the health anxiety scale was46.3%.Our findings show that negative Core Self-Evaluation is linked with perceived health anxiety.Conclusions:Selfevaluation,sense of coherence and perceived social support influence the perceived health and can explain the differences inthe reported health-related anxiety.

Effect of Family Cohesion on Depression of Chinese College Students in the COVID-19 Pandemic: Chain Mediation Effect of Perceived Social Support and Intentional Self-Regulation

Individuals’perceptions,attitudes,and patterns of getting along with family members are important factors influencing Chinese people’s self-evaluation.The aim of this study was to investigate the effect of family cohesion on depression and the role of perceived social support and intentional self-regulation in this association.A hypothesized model of the association of family cohesion,perceived social support,intentional self-regulation,and depression was examined.A convenience sampling method was used to survey 1,180 college students in Yunnan Province using self-report.Data were collected using the Family Cohesion Scale,the Perceived Social Support Scale,the Intentional Self-Regulation Scale,and the Center for Epidemiological Studies Depression Scale.The findings revealed low to moderate correlation between the variables studied.College students’family cohesion was a negative predictor of their depression.This association was also mediated by the knock-on effect of perceived social support and intentional self-regulation.These findings show how family cohesion affects college students’depressive status.Specifically,these results help demonstrate the importance of family cohesion,perceived social support,and intentional self-regulation in optimizing students’depression,which in turn can promote better psychological states.

Relationship between perceived social support and post-traumatic growth in coronavirus disease 2019 patients discharged from the hospital

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has affected mental health and physical health negatively in some individuals.Examining perceived social support and post-traumatic growth(PTG)in COVID-19 patients could facilitate our understanding of how patients maintain their mental health.AIM To examine the relationship between the level of perceived social support and PTG in COVID-19 patients discharged from the hospital.METHODS This descriptive study was carried out between August and September 2022 with patients who were hospitalized due to COVID-19 in a university hospital in Erzurum and who were discharged at least 3 mo prior to the beginning of the study.The study was completed by 196 patients.Study data were collected faceto-face using a personal information form,multidimensional scale of perceived social support and PTG inventory.RESULTS The total mean score of the multidimensional scale of perceived social support was 63.82±15.72.The PTG inventory total mean score was 47.77±19.85.In addition,a direct significant correlation was found between perceived social support in COVID-19 patients and PTG.CONCLUSION The study results showed that perceived social support variables affected PTG significantly.Therefore,it is recommended for healthcare professionals to implement interventions to promote social support from healthcare professionals and the patient’s family and friends.Considering the negative effects of the ongoing COVID-19 pandemic,it is very important and necessary to implement effective public health interventions to promote PTG to reduce mental health problems.

Gender Differences in the Incidence and Related Factors of Low Social Support among Adolescents with Subthreshold Depression

Background:Social support is related to depression,but the gender differences and related factors that contribute to low social support among adolescents with subthreshold depression remain to be elucidated.This study explores the relationship between social support and depression,in addition to the gender difference in the incidence of low social support among adolescents with subthreshold depression and its related factors.Methods:A total of 371 Chinese adolescents with subthreshold depression were recruited.All subjects were rated on the Social Support Scale for Adolescents,the Response Style Scale,the Self-Perception Profile for Children,the Individualism-collectivism scale.Results:Binary logistic regression indicated that the stability dimension of cognitive style,the generality dimension of the Cognitive Style Questionnaire,and the social acceptance dimension of the Self-Perception Profile for Children scale were significantly correlated with social support level in male adolescents with subthreshold depression.In contrast,the total score of the Self-Perception Profile for Children scale,the social acceptance of the Self-Perception Profile for Children scale,total individualism,and total collectivism were significantly correlated with social support level in female adolescents with subthreshold depression.Limitations:This study is a cross-sectional study,and its effectiveness in explaining factors that influence levels of social support is limited.Conclusions:The gender difference between low social support among adolescents with subthreshold depression is related to cognitive style,self-perception,and collectivism–individualism.

A Clinical Investigation: Study on Psychosocial Characteristics, Social Support and Intervention Strategies of Outpatient Cancer Pain Patients

Background and Objective: The presence of pain in cancer patients is a prevalent concomitant symptom, exerting significant impacts on their physical, psychological, and social functioning. However, the psychological and social aspects are often overlooked. This study aims to explore the factors influencing the provision of psychological and social support for patients experiencing cancer-related pain while proposing intervention measures to enhance treatment compliance, confidence levels, and overall quality of life. Materials and Methods: According to the inclusion and exclusion criteria, a total of 108 patients with moderate to severe advanced cancer pain who had received outpatient analgesia treatment for at least one month were selected as the study subjects. The psychological characteristics and social support of these patients were further examined using the Self-Rating Symptom Scale (SCL-90) and Social Support Rating Scale (SSRS). The influencing factors were compared with the national norms. Results: The total score of SCL-90 was significantly different from that of the domestic norm (P < 0.05), and the total score of social support was significantly different from that of the domestic norm (P < 0.01). In addition to hostile symptoms, Somatic, obsessive, sensitive, depression, anxiety, terror, paranoia, psychosis and other symptoms were correlated with subjective support (P 0.05). Conclusion: Patients with cancer pain are more vulnerable to physical symptoms, psychological distress, lack of social support, and other contributing factors. Implementing standardized treatment protocols can effectively alleviate physical symptoms while also emphasizing the importance of psychosocial interventions to address negative emotions and enhance social support. By bolstering patient confidence through these measures, we can ultimately improve treatment outcomes and enhance patients’ overall quality of life.

Psychological Distress, Social Support and Medication Adherence in Patients with Ischemic Stroke in the Mainland of China

Stroke research and rehabilitation have traditionally focused on the physical and functional impact of a stroke. Less attention has been given to the psychosocial factors associated with this chronic condition. By the few studies that have specifically focused on psychosocial factors in the context of stroke, poststroke depression is demonstrated to significantly influence stroke outcomes. Associations of stroke with psychological symptoms other than depression have rarely been evaluated. This study was aimed to investigate the changes of psychological stress, social support and medication adherence in patients with ischemic stroke in the mainland of China. In this study, 90 patients with hemiplegia one year after first-ever middle cerebral artery infarction（stroke group） in the Zhongnan Hospital of Wuhan University from June 2008 to June 2011 were recruited for interview. Ninety age- and sex-matched normal volunteers（control group） were also examined at the same period. The psychological distress was assessed by the Symptom Checklist 90（SCL-90）, the social support by the Social Support Rating Scale（SSRS）, and medication adherence by Morisky＇s self-reported inventory, respectively. Group differences were analyzed using unpaired-t test and chi-squared test. The results showed that total mean scores of the SCL-90 in the stroke group were higher than those in the control group（P〈0.01）. Except two dimensions, paranoid ideation and psychoticism, mean scores of the rest dimensions（including somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, and phobic anxiety） of SCL-90 were significantly higher in the stroke group than those in the control group（P〈0.05, or P〈0.01）. The objective support, subjective support, support availability and total social support scores in the stroke group were significantly higher than those in the control group（P〈0.05, or P〈0.01）. Those in the ＂SCL-90 total scores 〉150 group＂ were significantly higher than in the ＂SCL-90 total scores 〈100 group＂ and the ＂SCL-90 total scores between 100 to 150 group＂（P〈0.05, or P〈0.01）. Those in the ＂SCL-90 total scores between 100 to 150 group＂ were significantly higher than in the ＂SCL-90 total scores 〈100 group＂（P〈0.05）. In 90 patients with ischemic stroke, 26（28.89%） patients obtained high medication adherence, 47（52.22%） patients medium medication adherence, and 17（18.89%） patients low medication adherence, respectively. Among these stroke patients, there were 17（50.00%） patients with high medication adherence in the ＂SCL-90 total scores 〉150 group＂, 28（75.67%） patients with medium medication adherence in the ＂SCL-90 total scores between 100 to 150 group＂, and 12（61.16%） patients with low medication adherence in the ＂SCL-90 total scores 〈100 group＂, respectively. There was significant difference in the medication adherence rate among the different SCL-90 scores groups in these stroke patients（P〈0.05 or P〈0.01）. It was led to conclude that ischemic stroke patients one year after hemiplegia have psychological distress, low level of social support and poor medication adherence in the mainland of China. Therefore, it is necessary to mobilize the government, medical institutions and various social support groups to offer psychological interventions to relieve the stress of patients with ischemic stroke, and improve their medication adherence.

The impact of perceived social support, loneliness, and physical activity on quality of life in South Korean older adults

Purpose: The purpose of this study was to propose and test a conceptual model that explains the interrelationships among perceived social support, loneliness, physical activity(PA), and quality of life(QoL) among active older adults in South Korea.Methods: Data were collected from 332 individuals over the age of 65 using a systematic stratified convenience sampling method. Survey data were collected and analyzed using a structural equation model(SEM).Results: Perceived social support had a significantly positive effect on PA(b = 0.14, p < 0.01) and QoL(b = 0.28, p < 0.001) while decreasing loneliness(b = —0.55, p < 0.001). PA had a significant positive effect on QoL(b = 0.12, p < 0.01), and loneliness had a negative effect on QoL(b = —0.37, p < 0.001). Loneliness mediated the relationship between perceived social support and QoL.Conclusion: The SEM results of the current study support the proposed model that explained the interrelationships among perceived social support, loneliness, PA, and QoL among active older adults in South Korea. These findings suggest the importance of incorporating social support mechanisms for PA interventions in order to enhance QoL. The findings of this study can help create more effective health and physical education programs for the older generations in South Korea to enhance their QoL.