Background: To examine the relationship between social support and depressive symptoms of Chinese family caregivers of older people with disabilities, and to evaluate the role of caregiver burden as a potential mediator of that relationship. Methods: A survey questionnaire was completed face-to-face by 567 primary family caregivers of older people with disabilities in four provinces in China. Covariates that may affect depressive symptoms, such as the characteristics of disabled people (socio-economic factors, functional and cognitive capacity) and caregivers (caregiver duration and self-rated health of caregivers) were collected. Social support was measured by the Multidimensional Scale of Perceived Social Support (MSPSS); depressive symptoms were assessed by the shortened 10 item version of Center for Epidemiological Studies Depression scale (CES-D); and the caregiver burden was assessed by the Zarit Burden Interview (ZBI). Results: The prevalence of depressive symptoms among caregivers was 37.7%. Higher levels of social support was negatively associated with lower depressive symptoms. This relationship was partially mediated by the caregiver burden, where higher levels of the caregiver burden were negatively associated with depressive symptoms. Furthermore, caregivers who were women, spent extended time in caregiving and were in poor health, reported significantly higher depressive symptoms. Conclusions: Our results indicated that social support was negatively associated with depressive symptoms in family caregivers and in the caregiver burden. The caregiver burden partially mediated the social support-depressive symptoms association. Interventions for family caregivers should include increasing social support, health monitoring and structured interventions to reduce the caregiver burden and attenuate family caregivers’ depressive symptoms.

The association between social capital and health-related quality of life (HRQoL) has not been thoroughly studied among older persons in rural China, especially among those who were left behind or not. This study investigates the association between social capital and HRQoL and examines possible differences of this association between being left behind or not in rural China. A cross-sectional survey of 825 people aged 60 years and older, residing in three rural counties in Jiangsu Province in China, was conducted in 2013. Factor analysis was performed to measure social capital. EQ-5D was used to measure HRQoL. Tobit regression analysis with upper censoring was conducted to explore the association between social capital and EQ-5D index. After controlling for individual characteristics, low social capital and being left behind were significantly associated with low HRQoL. Old people with low social capital had 0.055 lower EQ-5D index compared to those with high social capital. Old people being left behind had 0.040 lower EQ-5D index compared to those who were not left behind. For different dimensions of social capital, the main effects came from the domain of trust and reciprocity. There was a significant interaction between low social capital and being left behind on HRQoL, suggesting that low social capital was associated with low HRQoL among persons left behind. Our findings indicate that the left behind old people with low social capital were a potentially vulnerable group in rural China. Formulating and implementing initiatives and strategies which increase social capital may foster better HRQoL, especially for old people who were left behind.

Background: Social media addiction (SMA) is an increasing problem, especially among young adults. Little is known about university students’ SMA and family functioning. This study aimed to explore the mediating effect of depressive symptoms and the moderating effect of peer support in the relationship between family functioning and SMA among young adults. Methods: A sample of 1862 Chinese university students completed an online survey including the Bergen Social Media Addiction Scale (BSMAS), Family APGAR, the Patient Health Questionnaire (PHQ-9), peer support, and demographic characteristics. Hierarchical regression and moderated mediation analysis were used to test the effects and pathways among them. Results: Of the 1840 participants, 30.11% experienced SMA, 38.80% had family dysfunction and 15.98% had depressive symptoms. Hierarchical multiple regression showed better family functioning significantly predicted less SMA (β = -0.26, p < 0.001) and lower depressive symptoms (β = -0.58, p < 0.001), after adjusting for covariates. Mediation analysis verified that depressive symptoms mediated the effect of family functioning on SMA (indirect effect = -0.22, 95%CI[-0.28, -0.17]). Furthermore, the interaction of family functioning and peer support was negatively related to depressive symptoms (β= -0.03, 95% CI[-0.05, -0.01]) and the interaction of depressive symptoms and peer support was positively related to SMA (β = 0.01, 95%CI[0.004, 0.02]). Additional analysis further confirmed that peer support decreased depressive symptoms among young adults from dysfunctional families, and increased SMA behaviors in individuals with depressive symptoms. Conclusion: Better family functioning and lower depressive symptoms may contribute to less social media addiction among Chinese university students. Peer support could moderate the mediating role of depressive symptoms on social media addiction in individuals with family dysfunction.

Depressive symptoms are prevalent in university students and may impair their social, educational, and economic transition into adulthood. Identifying the factors that determine depressive symptoms is crucial for the design of effective policy interventions. This study aims to examine the associations between health literacy and depressive symptoms among medical students, and to evaluate the effect of different types of social support as a potential mediator. A cross-sectional survey of medical students was conducted through convenience sampling in East China. Associations between variables were explored using OLS and the mediation effect was estimated using the Karlson, Holm and Breen method. A total of 746 valid questionnaires were collected. The prevalence of depressive symptoms among the sample was 32.4%. Higher health literacy levels and social supports were significantly associated with lower levels of depressive symptoms. Social support partially mediated the association between health literacy and depressive symptoms, accounting for a 54.03% of the total effect size. These findings suggest that interventions for medical student mental wellbeing could improve health literacy. Whilst family support reflects greatest impact, Universities can also lead and innovate novel interventions for this critical stage of life. Future research can extend this study by exploring the dynamic interactions between health literacy, depressive symptoms, and other sources of social support. Comparisons of these findings across the different regions of China and in other university subject disciplines are also warranted.

Background: As the population ages, senior care for older adults in China has become increasingly important and has attracted the attention of both government and society. This study aimed to explore preferences and influencing factors related to senior care among older Chinese adults and thus propose effective and targeted strategies for the development of a comprehensive care system for older adults in the aging Chinese population. Methods: Data were obtained from a cross-sectional survey conducted in sixteen communities or villages in Jiangsu Province, China, from July to September 2021. Guided by the Andersen Behavioral Model, multivariate logistic regression was conducted to identify factors associated with preferences for senior care arrangements. Results: A total of 870 respondents were included in the study, 60.11% of whom preferred receiving care in their own homes, while only 13.68% chose residential care facilities (RCFs). For predisposing factors, rural respondents preferred receiving care in their own homes compared to urban respondents (children’s home: OR = 0.55, P < 0.01; RCF: OR = 0.58, P < 0.01). Concerning enabling factors, respondents who were not employed (OR = 2.30, P < 0.01) and those without financial support (OR = 2.73, P < 0.05) preferred RCFs to their own homes. Respondents receiving life assistance (sometimes: OR = 2.76, P < 0.001; regularly: OR = 2.57, P < 0.01; every day: OR = 3.57, P < 0.001) preferred their children’s homes to their own homes. In terms of need factors, respondents with noncommunicable diseases (NCDs, OR > 1, P < 0.05), those who knew about RCFs (some: OR = 0.53, P < 0.005; no: OR = 0.10, P < 0.001) and those with a good impression of RCFs (fair: OR = 3.72, P < 0.05; good: OR = 11.91, P < 0.001) preferred receiving care in RCFs compared to their counterparts. Conclusions: Older Chinese adults’ senior care preferences were affected by predisposing factors, enabling factors, and need factors. Policy-makers should consider targeted measures to identify more precise senior care services and thus address aging challenges in China.

Long-term care insurance (LTCI) projects were an essential components of health systems designed to support disabled people and their families. Despite LTCI has been getting more and more attention and promotion, there was a lack of qualitative study to explore the experiences of family caregivers who were directly involved in the care of disabled people enrolled in these projects. This study aimed to explore the experiences of family caregivers in the caregiving process within the context of LTCI. This qualitative study used inductive content analysis to explore the experiences of family caregivers of disabled people. Fifteen family caregivers from long-term care service companies and communities in Nantong city were purposively selected to participate in the study between December 2023 to February 2024. Semi-structured in-depth interviews were conducted to collect data. The interviews were audio-recorded and transcribed verbatim. The results revealed a total of five major themes with thirteen sub-themes including: (1) caregiver fatigue (i.e. heavy daily care tasks, and lack of rest); (2) emotional stress (helplessness and depression, and isolated and alone); (3) perceived benefits of caregiving (emotional connection, and a new outlook on life); (4) more expectations for LTCI (expect respite care, expect medical care facilities, expect longer service duration and frequency, and expect more economic subsidies); and (5) positive evaluations of LTCI (provide psychological support, reduce the burden of care, and professional care services). This study’s findings improved our understanding of caregiving experiences among family caregivers of disabled people enrolled in LTCI. Identifying caregivers’ experiences enabled the authorities to develop support strategies and interventions focused on helping them reduce the caregiver burden.