Background: Ageism is a global challenge, which leads to a range of adverse outcomes for elderly people worldwide, which maybe more severe among urban older adults in a competitive society. However, how self-perceived ageism influences the quality of life in a sample of urban older adults remains inconclusive.Objectives: The current study aims to assess the status of self-perceived stigma among urban Chinese older adults, identify its relationship with quality of life, and further explore whether both attitude toward own aging and traditionality moderate this relationship.Materials and Methods: Primary data were collected through cross-sectional surveys among urban older adults in three provinces of China from October 2019 to December 2020. A total of 764 urban older adults were valid participants (effective response rate = 81.28%) and completed questionnaires via anonymous face-to-face interviews. Socio-demographic factors, self-perceived stigma, attitude toward own aging, traditionality, and quality of life were assessed using questionnaires that included the Self-perceived Stigma, Attitude Toward Own Aging, Traditionality, and SF-8 Scales.Results: For urban Chinese older adults, the average score of self-perceived stigma was 2.041 ± 0.726. Self-perceived stigma (β = −0.391, p < 0.05) and attitude toward own aging (β = −0.211, p < 0.05) both influenced quality of life. Additionally, attitude toward own aging (β = −0.530, p < 0.05) and traditionality (β = −0.525, p < 0.05) moderated the association between self-perceived stigma and quality of life. Simple slope analysis revealed that when the level of negative attitude toward own aging and traditionality was higher, the strength of the influence of self-perceived stigma on quality of life was stronger.Conclusion: Urban Chinese older adults were aware of the self-perceived stigma, which contributes to decreased quality of life. Attitude toward own aging and traditionality could moderate the association between self-perceived stigma and quality of life. When negative attitudes toward own aging and traditionality are higher, self-perceived stigma has a greater effect on the quality of life. More interventions related to relieving self-perceived stigma, traditionality, and negative attitude toward own aging should be considered to build a new modern society that emphasizes health, friendliness, well-being, and dignity for all ages.

To investigate the influence of the home environment, defined as family socioeconomic status (SES) (parent education level, household income), student resource-mediated SES (access to nutritional resources and cognitively stimulating experiences), reading ability, and difficulty with homework on quality of life in children and adolescents residing in urban and suburban areas in Hangzhou City, Zhejiang Province, China. This study included 3200 Grade 3–6 students from 8 elementary schools in Hangzhou City. Assessments included questionnaires that evaluated student quality of life, family SES, resource-mediated SES (dietary behavior and the home literacy environment), reading ability, and difficulty with homework. The effects of the home environment on student quality of life were analyzed by univariate analysis, multiple linear regression analysis, and structural equation modeling. Overall, 80.6% of students had a medium or better quality of life. Young age (Grade 3 or 4), female sex, household income of 10000–15000 RMB, high breakfast consumption, daily intake of fruit, a balanced diet, and good reading habits were positively correlated with student quality of life (P < 0.05), while overuse of electronic devices was negatively correlated with quality of life (P < 0.05). Dietary behaviors, home literacy environment, and student reading ability and difficulty with homework directly affected quality of life. Family SES indirectly affected student quality of life. Children and adolescents in China should have access to good nutrition and cognitively stimulating experiences to enhance their well-being and provide them with social and academic advantages.

Objective: Patient satisfaction reflects the social benefits of hospitals and is an important indicator of hospital performance. This study explores the mechanism through which inpatients’ trust in physicians, self-efficacy, and participation in medical decision-making impact their satisfaction with medical services.Methods: A questionnaire was administered to 814 inpatients in 10 randomly selected tertiary hospitals and 10 randomly selected secondary hospitals in Hangzhou, China. A correlation analysis and hierarchical linear regression were conducted to analyze the factors influencing inpatient satisfaction.Results: The outcome measures of trust in physicians and participation in medical decision-making behaviors had significant positive effects on inpatient satisfaction.Trust in physicians was shown to directly influence inpatient satisfaction, while inpatient participation in decision-making partially mediated this relationship. Inpatient participation in medical decision-making fully mediated the relationship between self-efficacy and inpatient satisfaction.Conclusion: While inpatients were relatively satisfied, there is room for improvement. Healthcare providers should improve patient trust by actively listening to their needs and providing feedback, establishing effective communication mechanisms. Patient self-efficacy can be enhanced through health education, special lectures, and case sharing. Patients should also be encouraged to actively participate in medical decision-making.Practical implications: Based on inpatient feedback during a preliminary survey, we refined this study’s questionnaire to enhance its feasibility for future research. This article shares key findings for healthcare managers and providers, advising that patient satisfaction can be enhanced through trust, self-efficacy, and participation.

In the medical field, value co-creation involves patients’ active involvement. By collaborating with service providers, patients can contribute to the creation of more targeted and effective value. Patients’ self-efficacy and behavior are crucial in this process, as their active participation and support can enhance their service experience. This study investigated the impact of chronic disease patients’ self-efficacy and value co-creation behaviors on the outcomes of value co-creation. Relevant data were acquired through a questionnaire survey using statistical methods, such as the t-test, analysis of variance, and stratified linear regression. This approach was used to examine the current conditions and factors influencing value co-creation outcomes among community-dwelling patients with chronic diseases. Additionally, a structural equation model was employed to systematically investigate and validate the impact pathways and mechanisms related to the influence of self-efficacy and value co-creation behaviors on value co-creation outcomes. We also explored the moderating effect of digital health technology application capabilities on the relationship between self-efficacy and value co-creation behaviors. Self-efficacy, information search, interactive collaboration, feedback provision, and shared decision-making exert significant positive influences on the value co-creation outcomes among individuals with chronic diseases. The path analysis of the structural equation model indicates that self-efficacy and value co-creation behaviors may directly impact value co-creation outcomes. Concurrently, value co-creation behaviors partially mediate the association between self-efficacy and value co-creation outcomes. Furthermore, the digital health technology application capability exhibits a negative moderating effect in the pathway from self-efficacy to value co-creation behaviors. The implementation of health education and social support measures by healthcare institutions and communities may augment patient self-efficacy, facilitate doctor-patient interactions, and promote shared decision-making. These initiatives could enhance the value of chronic disease services and optimize patient experiences. Additionally, healthcare institution managers are encouraged to focus on optimizing internet hospital platforms, organizing digital health training for patients, and bolstering patients’ proficiency in digital health technology applications. This strategy aims to instill a sense of health responsibility among patients with chronic diseases by fostering positive behaviors in interactive collaboration, information search, feedback provision, and other dimensions.

Appropriate healthcare technologies (AHTs) are an important strategy for improving the availability and accessibility of healthcare services. It is not clear what impact AHTs have on health workers and consumers; and whether those AHTs can continue in place without special or ongoing financial support. This study investigated the attitudes of health workers and consumers towards AHTs. Health facilities from five counties in Zhejiang were surveyed. Participants of the study included all health workers who were involved in the delivery of AHTs in the selected organizations and a group of randomly selected patients who sought services from the participating organizations. A total of 822 questionnaires from health workers and 693 questionnaires from patients were collected for data analyses. The questionnaires measured perceptions and attitudes of respondents towards AHTs using a Likert scale. The respondents delivering public health services rated the highest scores to AHTs (4.42 ± 0.7), followed by those engaged in management of chronic conditions (4.41 ± 0.57) and Traditional Chinese Medicine (TCM) (4.29 ± 0.55). Around 90 % of health workers believed that AHTs were meaningful for rural patients; however, only 69 % of health workers believed that the technologies encouraged by the government were sufficiently developed or “mature”, and more than 24 % acknowledged difficulties in using those technologies. Overall, patients were satisfied with AHTs, with 71.6 % feeling “very satisfied” or “satisfied”, 24.2 % feeling “acceptable” and 1.6 % feeling “dissatisfied”. Most (83 %) patients were satisfied or very satisfied with Traditional Chinese Medicine, compared with management of chronic conditions (80 %), family planning (67 %), public health services (64 %), and finally with maternal and child health care (59 %). Local acceptability should be taken into consideration in determination of AHTs; consumer health literacy needs improvement, particularly in relation to public health and preventive services.

This study assesses inpatients’ preferences for participating in medical decision-making and determines the factors’ rankings in order of importance and whether they vary for respondents with different characteristics. Case 1 best-worst scaling (BWS) was used for the study design. Thirteen attributes influencing inpatient medical decision-making participation were identified based on a literature review and interview results. A balanced incomplete block design was used to form choice sets for the BWS questionnaire for a cross-sectional study examining inpatients’ preferences for participating in medical decision-making. Based on results from 814 inpatient participants, the three most important factors influencing inpatients’ medical decision-making participation were inpatients’ trust in physicians, physicians’ professional expertise, and physicians’ attitudes. The mixed logit model results reflect the significant heterogeneity in respondents’ preferences for shared decision-making. To facilitate resource allocation, improve the physician-patient relationship, and encourage patient decision-making participation more actively and effectively, decision-makers should emphasize patients’ trust, enhance physicians’ ability to diagnose and treat diseases, and improve their attitudes toward providing care and communication from the perspectives of patients, physicians, and the social environment. Further research is needed on the heterogeneity of patients’ preferences for participating in medical decision-making and how to improve patient participation.