Alexithymia, social support, depression, and burnout among emergency nurses in China: a structural equation model analysis

Abstract Background Several factors are associated with the incidence of burnout, including alexithymia, social support, and depression. The relative importance of these three key parameters as mediators of burnout, however, is not well understood. In addition, there have been few studies to date specifically examining the association between alexithymia and burnout among nurses in China. Purpose To evaluate the relationship of burnout with alexithymia, social support, and depression across emergency department nurses in China. Methods This descriptive, cross-sectional survey was conducted using a convenience sampling methodology to survey nurses responsible for direct emergency care (n = 413) from 18 tertiary hospitals in Western, Eastern, Northern, and Southern China between May 2020 and June 2020. A structural equation modeling approach was then used to assess a hypothetical model wherein alexithymia both directly and indirectly affects burnout among emergency nurses via impacting the incidence of depression and perceived social support. Results Results supported all driving hypotheses. Alexithymia was positive direct correlated with burnout (β = 0.35; P < 0.001) and depression (β = 0.50; P < 0.001), and exhibited a negative direct effect on social support (β = − 0.14; P = 0.041). Depression was associated with burnout, both directly (β = 0.24; P < 0.001) and indirectly (β = 0.15; P < 0.001) through its relationship with social support. Alexithymia was the factor most strongly associated with burnout, and it was able to affect burnout indirectly through depression and social support. Conclusions We found that among emergency nurses in China, alexithymia was correlated with burnout, depression, and social support. Alexithymia was the factor most strongly associated with burnout. These data suggest that providing better social support and alleviating alexithymia may decrease rates of burnout among emergency nurses.

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Factors Influencing the Acceptance of Pediatric Telemedicine Services in China: A Cross-Sectional Study

Frontiers in Pediatrics ◽

10.3389/fped.2021.745687 ◽

2021 ◽

Vol 9 ◽

Author(s):

Jingjin Shi ◽

Xueming Yan ◽

Miao Wang ◽

Ping Lei ◽

Guangjun Yu

Keyword(s):

Technology Acceptance ◽

Structural Equation ◽

Care Delivery ◽

Reliability And Validity ◽

Survey Study ◽

Equation Modeling ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factors Influencing ◽

Positive Direct

Background: Pediatrician workforce shortages have aroused great attention from health authorities in China. Telemedicine services have been known to enhance the management of children's health, yet the rate of adoption and usage in Chinese hospitals still at a quite low level, and the factors influencing the acceptance of telemedicine services remains unclear.Objective: The purpose of this empirical study was to evaluate the reliability and validity of a technology acceptance measurement instrument applied in healthcare, to investigate the perception of telemedicine services on the provider-side and demand-side, and to determine the factors that may drive individuals to adopt telemedicine services.Methods: A cross-sectional survey study based at Shanghai Children's Hospital, Shanghai Jiao Tong University, was conducted in March 2020. A total of 456 valid responses were obtained by convenience sampling. The internal consistency of items was assessed by Cronbach's alpha (α), composite reliability (CR) and average variance extracted (AVE) to evaluate both the reliability and validity of the questionnaire. Structural equation modeling analysis was used to test and verify the interrelationships among relevant variables.Results: Price value is the strongest predictor (β = 0.30, p = 0.02), facilitating conditions (β = 0.28, p = 0.01) and hedonic motivation (β = 0.13, p = 0.04) also have significantly positive direct effects on telemedicine acceptance. The results showed the perception of child patients' families were significantly more acceptable to telemedicine services than pediatricians (t = −2.99, p < 0.01). Participants with no prior experience and lower education may be more willing to adopt telemedicine.Conclusion: Telemedicine will likely continue to have an integral role in pediatric health care delivery, and the findings can assist policy makers and hospital administrators in determining the more valued characteristics of telemedicine services from a behavioral perspective. Future attention will be paid to the pricing, training and service quality of telemedicine in China.

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Social and cultural determinants of help-seeking in Cuba and Germany – A structural equation model approach

10.31234/osf.io/5tqwv ◽

2021 ◽

Author(s):

Laura Nohr ◽

Paul - Christian Bürkner ◽

Alexis Lorenzo Ruiz ◽

Juan Emilio Sandoval Ferrer ◽

Davide Capponi ◽

...

Keyword(s):

Social Support ◽

Cultural Values ◽

Measurement Invariance ◽

Help Seeking ◽

Structural Equation ◽

Structural Model ◽

Minority Groups ◽

Equation Model ◽

Equation Modeling ◽

Cross Sectional

Social support is an important determinant of help-seeking in the context of mental health. Previous evidence shows differences in the relation between social support and help-seeking between more collectivistic vs. more individualistic cultures. Especially the cultural informed role of the family might play a key role in help-seeking decisions. Still, many studies have been conducted with minority groups in Western societies which have to face additional struggles due to immigration. The current study investigates help-seeking, social support, cultural values, and help-seeking intentions in the Cuban and German general populations. A cross-sectional questionnaire survey was applied to n = 340 Cuban and n = 340 German adults. Multiple-group structural equation modeling was used to examine measurement invariance between the groups and to explore relationships between the concepts under study in both cultural groups. No measurement invariance could be established for the overall model and most of the measures separately which impedes cross-cultural comparisons. Using plausible values, the structural model was estimated in both samples separately. Not all hypotheses could be supported for the Cuban and German samples. Yet, social support and the importance of family predicted informal and formal help-seeking significantly but differently in both samples. In the light of methodological limitations, their potential to support or to prevent different forms of help-seeking are discussed and possible practical implications derived.

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DEVELOPING HOLISTIC CARE MODEL: THE PHYSICAL WELLBEING OF ELDERLY BASED ON SOCIAL SUPPORT AND CHARACTERISTIC

Public Health of Indonesia ◽

10.36685/phi.v4i3.147 ◽

2018 ◽

Vol 4 (3) ◽

pp. 108-115

Author(s):

Pipit Festi Wiliyanarti ◽

Asri Asri ◽

Kusuma Wijaya Ridi Putra

Keyword(s):

Social Support ◽

Structural Equation ◽

Survey Design ◽

Partial Least Square ◽

Least Square ◽

Holistic Care ◽

Equation Modeling ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Physical Wellbeing

Background: Elderly experiences with degenerative process in their life spam and physical condition as well as their ability to adopt with their environment. Those conditions will influence the achievement of elderly wellbeing.Purpose: This study aims to examine physical wellbeing in elderly based on social support and elderly characteristic.Method: This study employed cross-sectional survey design. The population was elderly who lived in east Surabaya. One hundred and ten of elderly were recruited. Their age was more than sixty years old, living with their family and under Medokan Ayu Public Health Center supervision. Multi stage random sampling was performed. The research instrument was physical wellbeing including elderly autonomy, cognitive, complaining about physical and disease as well. Structural Equation Modeling with Partial Least Square (SMART PLS) was used to analyze the data.Results: The research results showed that majority of emotional support in social support variable was good (98%). The majority of instrumental support was good (88.18%). Social wellbeing has significant relationship with the elderly physical wellbeing (p 0.312, t-statistic: 4.420, t-table: 1.65), elderly characteristic of holistic care (0.178, t-statistics 2.422, t-table: 1.65), and elderly characteristic of physical health (0.140. t-statistic 1.790, t table.1.65).Conclusion: Social support influences the physical wellbeing of elderly.

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Stress and Its Impact on Academic and Social Life of Undergraduate University Students in Ghana: A Structural Equation Modeling Approach

Open Education Studies ◽

10.1515/edu-2020-0100 ◽

2020 ◽

Vol 2 (1) ◽

pp. 37-44

Author(s):

Koawo Edjah ◽

Francis Ankomah ◽

Ebenezer Domey ◽

John Ekow Laryea

Keyword(s):

Structural Equation Modeling ◽

Undergraduate Students ◽

Social Life ◽

Structural Equation ◽

Positive Impact ◽

Survey Design ◽

Equation Modeling ◽

Cross Sectional Survey ◽

Satisfaction Scale ◽

Cross Sectional

AbstractStress is concomitant with students’ life and can have a significant impact on their lives, and even how they go about their academic work. Globally, in every five visits by patients to the doctor, three are stress-related problems. This study examined stress and its impact on the academic and social life among students of a university in Ghana. The descriptive cross-sectional survey design was employed. Using the stratified and simple random (random numbers) sampling methods, 500 regular undergraduate students were engaged in the study. A questionnaire made up of Perceived Stress Scale and Students’ Life Satisfaction Scale was used to gather data for the study. Frequencies, percentages, means and standard deviation, and Structural Equation Modeling (SEM), with AMOS were used for the analyses. It was found that majority of the students were moderately stressed. Paramount among the stressors were academic stressors, followed by institutional stressors, and external stressors. Stress had a significant positive impact on the academic and social life of students. It was concluded that undergraduate students, in one way or the other, go through some kind of stress during the course of their study. It was recommended that the university, through its Students’ Affairs, and Counselling Sections, continue to empower students on how to manage and deal with stress in order to enhance their academic life.

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Love Hurts: The Influence of Social Relations on Exercise Self-Efficacy for Older Adults with Osteoarthritis

Journal of Aging and Physical Activity ◽

10.1123/japa.16.4.465 ◽

2008 ◽

Vol 16 (4) ◽

pp. 465-483 ◽

Cited By ~ 8

Author(s):

Kelly A. Cotter ◽

Aurora M. Sherman

Keyword(s):

Social Support ◽

Older Adults ◽

Social Relations ◽

Self Efficacy ◽

Structural Equation ◽

Physical Activity Behavior ◽

Well Being ◽

Equation Model ◽

Cross Sectional ◽

Social Strain

Exercise self-efficacy is a powerful predictor of physical activity behavior, which enhances health and well-being for older adults. Social relations have been proposed as influential precursors for exercise self-efficacy. In a longitudinal study of 160 older adults with osteoarthritis (76.9% women), the authors found that social support (but not social strain) significantly predicted exercise self-efficacy in a structural equation model examining cross-sectional data: χ2(178, N = 160) = 264.57, p < .01; RMSEA = .06; CFI = .92; TLI = .90. When data were examined longitudinally, however, social strain (but not social support) significantly predicted lower exercise self-efficacy 1 year later: χ2(233, N = 160) = 288.64, p < .01; RMSEA = .04; CFI = .96; TLI = .95. Results support the negativity effect, suggesting that social strain might be the more potent aspect of social relations and should be the target of interventions.

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Cyberchondria severity and quality of life among Lebanese adults: the mediating role of fear of COVID-19, depression, anxiety, stress and obsessive–compulsive behavior—a structural equation model approach

BMC Psychology ◽

10.1186/s40359-021-00674-8 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Clara Rahme ◽

Marwan Akel ◽

Sahar Obeid ◽

Souheil Hallit

Keyword(s):

Quality Of Life ◽

Structural Equation ◽

Equation Model ◽

Mediating Effect ◽

Equation Modeling ◽

Obsessive Compulsive ◽

Online Questionnaire ◽

Cross Sectional ◽

Compulsive Disorder

Abstract Background This study highlights the significant association between cyberchondria and quality of life among the Lebanese population in the time of COVID-19. The aim was to assess the association between cyberchondria and quality of life (QOL) of Lebanese community during the COVID-19 pandemic and assess the mediating effect of fear of COVID-19, depression, anxiety, stress and Yale-Brown Obsessive–Compulsive Scale in this association. Methods This cross-sectional study was carried out between December 2020 and January 2021, during the COVID-19 pandemic. A total of 449 persons participated in this study by filling the online questionnaire. Structural equation modeling (SEM) was performed to examine the structural relationship between cyberchondria severity, the mediator (anxiety, stress, depression, obsessive–compulsive disorder (OCD) and fear of COVID-19) and physical/mental QOL. Results Having a university level of education and older age were significantly associated with higher physical QOL scores, whereas higher obsession-compulsion disorder, higher stress and higher anxiety were significantly associated with lower physical QOL scores. Higher anxiety was significantly associated with lower mental QOL scores. The results of the SEM showed that stress, fear of COVID-19 and to a lesser limit OCD, mediated the association between cyberchondria severity and physical QOL, whereas anxiety, stress and fear of COVID-19 mediated the association between cyberchondria severity and mental QOL. Conclusion This research reported interesting results encouraging more exploration of cyberchondria and its association with quality of life during this unique period of the pandemic. However, this virus has altered the lives of individuals all across the world, and the consequences will last for a long time. Along with all of the steps done to stop the development of COVID-19 and improve physical outcomes, mental health requires immediate care. More research is needed to determine the coping techniques people are employing to deal with the pandemic.

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Efeito da gamificação na intenção de uso de treinamentos on-line: uma adaptação do modelo UTAUT aplicado no TRT-2

Revista de Administração da UFSM ◽

10.5902/1983465921624 ◽

2019 ◽

Vol 12 (3) ◽

pp. 472

Author(s):

Ludmilla Cavarzere de Oliveira ◽

Luis Hernan Contreras Pinochet ◽

Ricardo Luiz Pereira Bueno ◽

Mauri Aparecido de Oliveira

Keyword(s):

Structural Equation ◽

Statistical Significance ◽

Learning By Doing ◽

Equation Modeling ◽

Intention To Use ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Regional Labor ◽

On Line ◽

Facilitating Conditions

The objective of this research was to analyze the effect of gamification on intention to use online training from the partial validation of the UTAUT model for qualification of members and servers of the Regional Labor Court of the 2nd Region (TRT-2). The study analyzed the relationship between constructs performance expectancy, effort expectancy, facilitating conditions, and familiarity with the intention to use gaming in distance media. This was conducted through an empirical application, which used the Structural Equation Modeling (SEM) for data analysis. The research was a single cross-sectional survey, carried out with TRT-2 members and servers who participated in the distance-feeding course ‘Healthy Living’ in 2015. Of the four hypotheses, only familiarity (F) was not significant as it did not serve as a behavioral intentions (BI) predictor of gamification for distance learning courses. Some explanations for such phenomenon may be career promotion and additional qualifications, learning by doing and sample size. The results confirmed that most hypotheses have a high statistical significance of the structural paths and have demonstrated that the model proposed in this study is consistent and can be applied in future studies with appropriate adjustments.

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Attachment style, serial argument, and taking conflict personally

Journal of Argumentation in Context ◽

10.1075/jaic.4.1.04ham ◽

2015 ◽

Vol 4 (1) ◽

pp. 63-86 ◽

Cited By ~ 8

Author(s):

Dale Hample ◽

Adam S. Richards

Keyword(s):

Structural Equation Model ◽

Attachment Style ◽

Attachment Styles ◽

Structural Equation ◽

Close Relationships ◽

Equation Model ◽

Personal Relationships ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Relationship

Serial argument theory explains recurring conflict within personal relationships. The theory specifies that an arguer’s goals influence his/her tactics, leading to argument outcomes which include effects on the relationship. We extend this model in two ways. First we suggest that attachment styles predict serial argument goals. Second, we hypothesize that taking conflict personally (TCP) is an outcome of such arguments. University students (N = 682) completed a cross-sectional survey about their attachment styles and felt personalization regarding a serial argument they experienced. A structural equation model tested relationships between attachment styles, goals, tactics, outcomes, and TCP. Results indicated that attachment styles predict goals of serial arguing and serial argument outcomes predict TCP. The study shows that attachment styles have modest but statistically significant effects on goals of serial arguing in close relationships and that the tactics used in serial arguing predict the degree to which people take recurring conflict personally.

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The Moderating Effect of Job Satisfaction on Physicians’ Motivation to Adhere to Financially Incentivized Clinical Practice Guidelines

Medical Care Research and Review ◽

10.1177/1077558716628354 ◽

2016 ◽

Vol 74 (2) ◽

pp. 148-177 ◽

Cited By ~ 3

Author(s):

Anthony C. Waddimba ◽

Howard B. Beckman ◽

Thomas L. Mahoney ◽

James F. Burgess

Keyword(s):

Structural Equation ◽

Census Data ◽

Pay For Performance ◽

Population Characteristics ◽

Equation Modeling ◽

Moderating Effects ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Adherence To Guidelines ◽

Primary Physicians

We examined moderating effects of professional satisfaction on physicians’ motivation to adhere to diabetes guidelines associated with pay-for-performance incentives. We merged cross-sectional survey data on attitudes, from 156 primary physicians, with prospective medical record-sourced data on guideline adherence and census data on ambulatory-care population characteristics. We examined moderating effects by testing theory-driven models for satisfied versus discontented physicians, using partial least squares structural equation modeling. Results show that attitudes motivated, while norms suppressed, adherence to guidelines among discontented physicians. Separate models for satisfied versus discontented physicians revealed motivational differences. Satisfied physicians disregarded intrinsic and extrinsic influences and biases. Discontented physicians, alienated by social pressure, favored personal inclinations. To improve adherence to guidelines among discontented physicians, incentives should align with personal attitudes and incorporate promotional campaigns countering resentment of peer and organizational pressure.

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Assessing a national policy on strengthening chronic care in primary care settings of a middle-income country using patients’ perspectives.

10.21203/rs.3.rs-57447/v2 ◽

2020 ◽

Author(s):

Wichai Aekplakorn ◽

Paibul Suriyawongpaisal ◽

Samrit Srithamrongsaw ◽

Phanuwich kaewkamjonchai

Keyword(s):

Primary Care ◽

Structural Equation ◽

Health Care Services ◽

Chronic Care ◽

Care Quality ◽

Equation Modeling ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Mixed Effect ◽

Validated Questionnaire

Abstract Background To improve care for patients with chronic diseases, a recent policy initiative in Thailand focuses on strengthening primary care including training of the team to deliver healthcare based on the concept of Chronic Care Model (CCM). This study aimed to assess the perception of patients on the health care services after the implementation. Methods We conducted a cross-sectional survey of 4,071 patients with hypertension and/or diabetes registered to 27 primary care units and 11 hospital Non-communicable diseases (NCDs) clinics in 11 provinces.The patients were interviewed at home using a validated questionnaire of the Patient Assessment of Chronic Illness Care (PACIC+). It contains 20 items from the original PACIC, which measure different parts of the CCM, and an additional 6 items assess the 5A Model including assess, advise, agree, assist, and arrange subscales. Upgraded primary care unit (PCUs) were ordinary PCUs with the multi-professional team including a physician. Trained upgraded PCUs were upgraded PCUs with the training input. Structural equation modeling was used to create subscale scores for CCM and 5 A model characteristics. Mixed effect models were employed to compare subscale of patient perception of the care quality between trained upgraded PCUs, upgraded PCUs, ordinary PCUs and NCD clinics.Results There was an independent association between every PACIC subscale (as a measure of CCM) and facility type with the maximum likelihood for patients of ordinary PCU reporting high to highest scores (ORs: 1.46-1.85; p<0.05) compared to hospital NCD clinics. This is also the case for patients: seeing the same doctor on repeated visits (ORs: 1.82-2.17; p<0.05) or having phone contacts of the providers (ORs:1.53-1.99; p<0.05). Similarly, across all of the 5A model subscales, ORs for patients attending ordinary PCU responded with high to highest scores were 1.48-2.10 times compared to those for patients attending hospital NCD clinics (p<0.05). Conclusions The training and allocation of family physician approach in PCU may not satisfy the patients’ perception on quality of chronic care. Further studies might focus on other factors such as mismatch between health workforce and workload as a key factor influencing the success of the policy implementation.

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