Anxiety and its relationship with sleep disturbance and smartphone addition among Chinese medical students during COVID-19 home confinement — A Structural Equation Model Analysis (Preprint)

2021 ◽  
Author(s):  
Yang Song ◽  
Kristin Sznajder ◽  
Can Cui ◽  
Yajing Jia ◽  
Yilong Yang ◽  
...  
Keyword(s):  
Medical Students ◽  
Sleep Disturbance ◽  
Structural Equation ◽  
Short Form ◽  
Mediating Effect ◽  
Equation Modeling ◽  
Smartphone Addiction ◽  
Short Version ◽  
Live Streaming ◽  
Path Coefficient

BACKGROUND Medical students, the majority of whom have experienced home confinement and a reliance on online resources to study medicine since the outbreak of COVID-19, have been found to suffer increased level of anxiety. Since smartphones have become the most commonly used device for accessing the internet, more time spent studying online during the COVID pandemic may be a potential risk factor for unconscious smartphone addiction, which could lead to elevated levels of sleep disturbance and anxiety. However, there is a dearth of research examining anxiety and its relationship with sleep disturbance and smartphone addition among medical students during the COVID-19 pandemic. Further, no existing literature has examined sleep disturbance as a mediator in the relationship between smartphone addiction and anxiety. OBJECTIVE This study aimed to assess the association between anxiety, smartphone addiction and sleep disturbance among medical students during COVID-19 home confinement and to examine the mediating role of sleep disturbance between smartphone addiction and anxiety. METHODS This cross-sectional study was performed among medical students attending a university located in the northeast of China in April 2020, when all universities in China began to deliver live-streaming courses via various online platforms as part of the national COVID-19 prevention strategy (Ministry of Education of China, 2020). Altogether, 666 medical students validly answered a self-administered questionnaire, which included demographic information, the Chinese version of the Generalized Anxiety Disorder 7-item scale, Smartphone addiction scale - short version, and PROMIS Sleep Disturbance (short form). Hierarchical multiple regression analyses were employed to determine the extent to which each involved independent variable could contribute to the variance of anxiety. Structural equation modeling was conducted to test whether the hypothesized associations existed. RESULTS Anxiety exhibited robust positive associations with both smartphone addiction and sleep disturbance among medical students during the COVID-19 pandemic. Smartphone addiction not only directly affected anxiety but also exerted a significant indirect effect on anxiety via sleep disturbance. A significant decrease of the path coefficient of smartphone addiction on anxiety (from β=0.53 to β=0.22, P< .01) was observed with sleep disturbance being modeled as a mediator. CONCLUSIONS This study demonstrated a robust positive association between anxiety, smartphone addiction, and sleep disturbance among medical students during COVID-19 home confinement. Smartphone addiction exerted not only a direct effect on anxiety but also an indirect impact on anxiety through the mediating effect of sleep disturbance. Therefore, professional assistance and timely intervention should be provided to alleviate anxiety among medical students during the COVID-19 pandemic. The detrimental impact of smartphone addiction and the importance of sleep health on mitigating anxiety should be highlighted and incorporated into medical education.

scholarly journals Stress among medical students: factor structure of the University Stress Scale among Italian students

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e035255
Author(s):  
Igor Portoghese ◽  
Fabio Porru ◽  
Maura Galletta ◽  
Marcello Campagna ◽  
Alex Burdorf
Keyword(s):  
Medical Students ◽  
Convergent Validity ◽  
Structural Equation ◽  
Short Form ◽  
Equation Modeling ◽  
Italian Version ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Stress Scale ◽  
The University

ObjectivesThe main purpose of the current study was to investigate the psychometric properties of the Italian version of the University Stress Scale (USS) among Italian medical students.Design, setting and participantsA cross-sectional observational study based on data from an online cross-sectional survey from 11 to 23 December 2018. A total of 1858 Italian medical students participated in the study.Outcome measuresWe measured perceived stress among medical students using the USS, the Effort-Reward Imbalance Student Questionnaire (ERI-SQ) and the Kessler-10 (K10).ResultsResults showed that a bifactor-Exploratory Structural Equation Modeling solution provided excellent levels of fit to the data. Our results suggest that the modified version of 19 items of the Italian version of the USS does not have a simple unidimensional structure. Overall, an inspection of ancillary indices (omega indices, ECV and percentage of uncontaminated correlations) revealed that these were too low to suggest the use of the USS as a composite measure of university stress. We tested an alternative unidimensional short form (eight items; USS-S) that assessed all the five sources of stress. This version provided a good fit to the data. Evidence of convergent validity of the USS-S was observed by analysing the correlations between the USS and ERI-SQ (ranging from −0.34 to 0.37, all p<0.01). Finally, based on the clinical cut-off recommended on the K10, results from receiver operating characteristic showed that considering the clinical cut-off of the USS is 7.5 and that 59.70% of medical students reported stress levels in the clinical range.ConclusionFinally, our results showed a lack of support for using the USS to measure a general university stress factor, as the general USS factor accounted for little variance in our sample. In this sense, stress scores among Italian students can be better assessed by the use of the USS-S.

scholarly journals Associations between Childhood Abuse, Resilience, Mindfulness, and Waterpipe Smoking: Implications for Cessation Interventions

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Mohammadreza Naghavi ◽  
Nouzar Nakhaee
Keyword(s):  
College Students ◽  
Childhood Abuse ◽  
Adverse Childhood Experiences ◽  
Structural Equation ◽  
Short Form ◽  
Mediating Effect ◽  
Equation Modeling ◽  
Waterpipe Smoking ◽  
Childhood Experiences ◽  
Adverse Childhood

Introduction. Recent research has established a link between childhood abuse and later drug abuse. For waterpipe smoking (WPS), such a role has not been adequately clarified. Aims. To explore the mediating effect of resilience and mindfulness on the association between childhood abuse and current WPS among college students. Methods. A cross-sectional study was conducted among a consecutive sample ( n = 776 ) of college students in Kerman, Iran. The Adverse Childhood Experiences Abuse Short Form, the 14-item Resilience Scale, and the Freiburg Mindfulness Inventory were used. Structural equation modeling was used to examine the complex associations between variables. Results. Nearly 95% of participants were aged between 18 and 27 years, and the mean (SD) age of students was 22.2 (3.1). Most of them were single (84.4), and 52.7% were female. Prevalence of lifetime and current WPS among students was 49.6% and 33.4%, respectively. Less than one-third ( n = 228 ) of lifetime users first tried smoking by the age of 18. The risk of current WPS was significantly higher in males than females ( β = 0.25 , P < 0.001 ). Childhood abuse was directly associated with current WPS ( β = 0.20 , P < 0.001 ) and resilience ( β = − 0.12 , P < 0.05 ). Adverse childhood experiences were also indirectly (mediated by the effect of the resilience, path coefficient = 0.06 , P < 0.001 ) associated with the risk of WPS. No relationship was seen between trait mindfulness and current WPS ( β = − 0.02 , P = 0.393 ). Resilience was negatively associated with current WPS ( β = − 0.47 , P < 0.001 ). Conclusion. The study revealed the potential importance of childhood abuse and low resilience as risk factors precipitating the onset of WPS. Further studies are warranted to examine the implications of this study for quitting WPS.

scholarly journals Stress and Problematic Smartphone Use Severity: Smartphone Use Frequency and Fear of Missing Out as Mediators

2021 ◽  
Vol 12 ◽  
Author(s):  
Haibo Yang ◽  
Bingjie Liu ◽  
Jianwen Fang
Keyword(s):  
Undergraduate Students ◽  
Structural Equation ◽  
Important Variable ◽  
Equation Modeling ◽  
Smartphone Addiction ◽  
Short Version ◽  
Depression Anxiety Stress Scale ◽  
Problematic Smartphone Use ◽  
Fear Of Missing Out ◽  
Smartphone Use

Problematic smartphone use (PSU) has been linked with stress. Higher levels of stress likely increased problematic smartphone use. We investigated relations between stress, fear of missing out, and problematic smartphone use. The aim of the current study was to analyze the mediating role of fear of missing out (FOMO) and smartphone use frequency (SUF) between stress and PSU. We surveyed a broad sample of 2,276 Chinese undergraduate students in July 2019, using the FOMO Scale, Smartphone Addiction Scale-Short Version, Smartphone Use Frequency Scale, and Depression Anxiety Stress Scale-21. The results showed that stress was associated with PSU severity. Gender differences were found in PSU severity. Furthermore, FOMO was positively associated with SUF and PSU severity. Structural equation modeling demonstrated that FOMO acted as a mediator between stress and PSU severity. FOMO and SUF acted as a chain of mediators between stress and PSU severity. SUF did not account for relations between stress and PSU severity. The study indicates that FOMO may be an important variable accounting for why some people with increased stress levels may overuse their smartphones.

scholarly journals Resilience as the Mediating Factor in the Relationship Between Sleep Disturbance and Post-stroke Depression of Stroke Patients in China: A Structural Equation Modeling Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Lina Zhao ◽  
Fengzhi Yang ◽  
Kristin K. Sznajder ◽  
Changqing Zou ◽  
Yajing Jia ◽  
...  
Keyword(s):  
Sleep Disturbance ◽  
Structural Equation ◽  
Well Being ◽  
Mediating Effect ◽  
Equation Modeling ◽  
Stroke Patients ◽  
Post Stroke ◽  
Increased Risk ◽  
Post Stroke Depression ◽  
The Relationship

Background: Stroke patients may suffer from a variety of symptoms which can result in sleep disturbance and post-stroke depression (PSD). Whereas, resilience can alleviate sleep disturbance and help maintain well-being after stroke.Objective: The aim of this study is to explore whether resilience plays a mediating role in the relationship between sleep disturbance and PSD of stroke patients in China.Methods: A cross-sectional study with a multi-stage sampling was carried out in Liaoning Rehabilitation Center and the Third People's Hospital of Chongqing in China from May to September 2019. A total of 353 stroke patients were enrolled in this study. Structural equation model (SEM) was used to test the mediating effect of resilience on the relationship between sleep disturbance and PSD.Results: The prevalence of PSD of stroke patients was 34.56%. Sleep disturbance contributed most to the variance of PSD and had a significantly positive association with PSD among stroke patients (P &lt; 0.01). Resilience was negatively associated with PSD, and acted as a mediator between sleep disturbance and PSD (a * b = 0.201, BCa 95% CI: 0.156~0.254).Conclusions: The prevalence of PSD was high among the Chinese stroke patients. Sleep disturbance was highly associated with PSD, resulting in the increased risk of PSD. Furthermore, resilience has a mediating effect on the relationship between sleep disturbance and PSD, and could reduce the negative effect of sleep disturbance on the development of PSD.

Does Gender Moderate the Direct and Indirect Relationships Between Different Sources of Social Support and Adolescents’ Physical Activity?

2016 ◽  
Vol 13 (8) ◽  
pp. 874-881 ◽  
Author(s):  
Han Chen ◽  
Jun Dai
Keyword(s):  
Physical Activity ◽  
Social Support ◽  
Family Support ◽  
Peer Support ◽  
Indirect Effect ◽  
Structural Equation ◽  
Cognitive Theory ◽  
Short Form ◽  
Mediating Effect ◽  
Equation Modeling

Background:Using the social cognitive theory, this study aims to examine how gender moderates the direct and indirect relationships of various sources of social support on Chinese adolescents’ physical activity (PA).Methods:A cross-sectional study was conducted. The final data includes 396 students (55.8% are boys) who were randomly selected from 2 middle schools and 4 high schools in Fuzhou city located in southeast China. Family support, peer support, and self-efficacy (SE) were measured using validated questionnaires. Participants’ PA was assessed using the International Physical Activity Questionnaire short form. Structural equation modeling was used to analyze the data. A bootstrapping method was used to determine and compare the direct and indirect effects of social support on PA across genders.Results:Peer support had no direct effect on PA; rather, peer support indirectly influenced PA through SE. Gender did not moderate this mediating effect. In addition, family support had neither a direct nor an indirect effect on PA via SE, and gender did not moderate these effects.Conclusions:Findings suggest that peer support played a more important role than family support on study participants’ PA indirectly through SE. SE also has a similar indirect effect across genders.

Validating the Factor Structure of the Stigma of Suicide Scale–Short Form Spanish Version Among Healthcare Students

Crisis ◽  
2020 ◽  
pp. 1-5
Author(s):  
Ruthmarie Hernández-Torres ◽  
Paola Carminelli-Corretjer ◽  
Nelmit Tollinchi-Natali ◽  
Ernesto Rosario-Hernández ◽  
Yovanska Duarté-Vélez ◽  
...  
Keyword(s):  
Factor Structure ◽  
Structural Equation ◽  
Short Form ◽  
Small Sample Size ◽  
Small Sample ◽  
Spanish Version ◽  
Equation Modeling ◽  
Cross Sectional ◽  
Healthcare Students ◽  
Spanish Speaking

Abstract. Background: Suicide is a leading cause of death among Spanish-speaking individuals. Suicide stigma can be a risk factor for suicide. A widely used measure is the Stigma of Suicide Scale-Short Form (SOSS-SF; Batterham, Calear, & Christensen, 2013 ). Although the SOSS-SF has established psychometric properties and factor structure in other languages and cultural contexts, no evidence is available from Spanish-speaking populations. Aim: This study aims to validate a Spanish translation of the SOSS-SF among a sample of Spanish-speaking healthcare students ( N = 277). Method: We implemented a cross-sectional design with quantitative techniques. Results: Following a structural equation modeling approach, a confirmatory factor analysis (CFA) supported the three-factor model proposed by Batterham and colleagues (2013) . Limitations: The study was limited by the small sample size and recruitment by availability. Conclusion: Findings suggest that the Spanish version of the SOSS-SF is a valid and reliable tool with which to examine suicide stigma among Spanish-speaking populations.

Analysis of Natural Resources and Environment, Politico-Economic Conditions and their influences on Tourist Behavioural Intentions in Hunza: Mediating effect of Tourist Satisfaction

2020 ◽  
Vol 4 (4) ◽  
pp. 55-74
Author(s):  
Faqeer Muhammad ◽  
Kifayat Ullah ◽  
Rehmat Karim
Keyword(s):  
Natural Resources ◽  
Structural Equation ◽  
Positive Impact ◽  
Partial Least Square ◽  
Least Square ◽  
Mediating Effect ◽  
Economic Conditions ◽  
Primary Data ◽  
Equation Modeling ◽  
Tourist Satisfaction

This study aims to explore the influence of Natural Resources and Environment (NRE), Politico-Economic Conditions (PEC) on Tourist Behavioral Intension (TBI) in Hunza, Pakistan. The study further investigates the mediating role of Tourist Satisfaction (TS) on the given variables. Partial Least Square Structural Equation Modeling (PLS-SEM) technique has been applied to conceptualize the research frame and to test the proposed hypotheses. Primary data was collected by using convenient sampling technique for analysis from 220 tourists who visited tourism nucleus sites of Hunza. The finding of the study reveals that Natural resources and Environment, Politico-and Economic Conditions have a significant positive impact on Tourist’s Behavioral Intensions. Moreover, Tourist’s Satisfaction partially mediates the positive relationships among Natural Resources and Environment, Political & Economic Conditions and Tourist’s Behavioral Intensions. The findings of the study extend the understanding that presence of natural resources along with healthy environment and stable political & economic conditions of a destination are the key determinants for sustainable tourism development.

scholarly journals Psychometric properties of the Chinese version of Five Facet Mindfulness Questionnaire—short form in cancer patients: a Bayesian structural equation modeling approach

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ted C. T. Fong ◽  
Adrian H. Y. Wan ◽  
Venus P. Y. Wong ◽  
Rainbow T. H. Ho
Keyword(s):  
Psychometric Properties ◽  
Cancer Patients ◽  
Structural Equation ◽  
Short Form ◽  
Equation Modeling ◽  
Five Facet Mindfulness Questionnaire ◽  
Health Measures ◽  
Acting With Awareness ◽  
Colorectal Cancer Patients ◽  
Bayesian Structural Equation Modeling

Abstract Background Mindfulness has emerged as an important correlate of well-being in various clinical populations. The present study evaluated the psychometric properties of the 20-item short form of the Five Facet Mindfulness Questionnaire (FFMQ-SF) in the Chinese context. Methods The study sample was 127 Chinese colorectal cancer patients who completed the FFMQ-SF and validated physical and mental health measures. Factorial validity of the FFMQ-SF was assessed using Bayesian structural equation modeling (BSEM) via informative priors on cross-loadings and residual covariances. Linear regression analysis examined its convergent validity with the health measures on imputed datasets. Results The five-factor BSEM model with approximate zero cross-loadings and one residual covariance provided an adequate model fit (PPP = 0.07, RMSEA = 0.06, CFI = 0.95). Satisfactory reliability (ω = 0.77–0.85) was found in four of the five facets (except nonjudging). Acting with awareness predicted lower levels of perceived stress, negative affect, anxiety, depression, and illness symptoms (β = − 0.37 to − 0.42) and better quality of life (β = 0.29–0.32). Observing, nonjudging, and nonreacting did not show any significant associations (p > .05) with health measures. Acting with awareness was not significantly correlated (r < 0.15) with the other four facets. Conclusion The present findings provide partial support for the psychometric properties of the FFMQ-SF in colorectal cancer patients. The nonjudging facet showed questionable validity and reliability in the present sample. Further studies with larger sample sizes are needed to elucidate the viability of FFMQ-SF as a measure of mindfulness facets in cancer patients.

scholarly journals Impact of Industry 4.0 on Corporate Financial Performance: A Moderated Mediation Model

2021 ◽  
Vol 13 (11) ◽  
pp. 6069
Author(s):  
Hong-Long Chen
Keyword(s):  
Financial Performance ◽  
Industry 4.0 ◽  
Structural Equation ◽  
Moderated Mediation ◽  
Mediating Effect ◽  
Equation Modeling ◽  
Corporate Financial Performance ◽  
Bootstrap Sampling ◽  
Mediation Effects ◽  
Moderated Mediation Model

Many studies advance the contemporary technologies of Industry 4.0. However, relatively little is known about how Industry 4.0 affects corporate financial performance. Using a survey, bootstrap sampling, and structural-equation modeling, this study evaluates the moderated mediation effects of Industry 4.0 maturity on financial performance. The results show that Industry 4.0 maturity significantly affects internal business process performance (IBPP), which influences customer performance through the mediating effect of supply chain performance (SCP), and IBPP and SCP affect financial performance fully through the mediating effect of customer performance. The results also show that Industry 4.0 maturity moderates the positive relationship between customer performance and financial performance. Customer performance and IBPP have the largest direct and total effects on financial performance in the context of Industry 4.0 implementation, respectively. The results indicate that Industry 4.0 magnifies the potential returns to companies mainly through IBPP, SCP, and customer performance. This study offers an enhanced understanding of the financial implications of Industry 4.0 implementation and provides insights into the factors through which Industry 4.0 maturity influences financial performance.

scholarly journals Perceived Environmental Responsibilities and Green Buying Behavior: The Mediating Effect of Attitude

2020 ◽  
Vol 13 (1) ◽  
pp. 35
Author(s):  
Guang-Wen Zheng ◽  
Abu Bakkar Siddik ◽  
Mohammad Masukujjaman ◽  
Syed Shah Alam ◽  
Alvina Akter
Keyword(s):  
Structural Equation ◽  
Environmental Concern ◽  
Mediating Effect ◽  
Primary Data ◽  
Equation Modeling ◽  
Buying Behavior ◽  
Exploratory Testing ◽  
Green Business ◽  
The Government ◽  
Questionnaire Surveys

The unsustainable operations of producers account for significant carbon emission and subsequent adverse impacts on nature. This study aims to identify the factors that influence consumers’ green buying behavior. The research focuses on the exploratory testing of theories using standardized questionnaires and interviews. Using a convenience selection approach, questionnaire surveys were used to gather primary data from a sample size of 305. The sample demographic reflects people who often make purchases; data were also obtained from shopping centers and elsewhere. The hypothesis testing of variables measured via five-point Likert scale questions was performed using structural equation modeling. We applied closed-ended questions relating to green buying behavior for the convenience of respondents. The empirical result established the effects of attitude, perceived severity of environmental problems, environmental concern, and subjective norms on Bangladeshi consumers’ green buying behavior. Additionally, it was discovered that attitude mediates the association between the perceived environmental responsibility and green buying behavior. Therefore, the government should play a constructive role in educating the public and promoting green business initiatives through improved coordination and legislative intervention.

Sign in / Sign up

Export Citation Format

Share Document