Background: China is one of the most rapidly aging countries in Asia, and nearly 90% of elderly individuals with disabilities choose to receive traditional, family-based, long-term care. A majority of family caregivers have insufficient care capacity and experience physical and emotional distress, which in turn affects the elderly.Objective: To describe the dyadic care experiences of elderly individuals with disabilities and their caregivers from the perspective of family resilience.Methods: A phenomenological research method was used. Semi-structured, in-depth, face-to-face interviews with 9 dyads of elderly people with disabilities and their families were conducted from August 2020 to February 2021. The Colaizzi method was used to analyze, summarize, and refine the interview data.Results: The dyadic care experiences of elderly individuals with disabilities and their caregivers can be summarized in terms of two themes. Theme 1 is dyadic pressure, which includes the following subthemes: (1) substantial objective burden; (2) dual negative experiences, i.e., the perceived low value of elderly individuals and low positive gains by caregivers; and (3) dyadic emotional transmission. Theme 2 is dyadic cooperative coping, which includes the following subthemes: (1) adjustment of family beliefs, including by giving meaning to stress, maintaining a positive outlook toward the future and ensuring spiritual sustentation; (2) changes in family patterns, including flexible adjustment of family patterns and multichannel utilization of social resources; and (3) improvement of family communication, including effective information transmission, rational emotional expression and emotional connection, and cooperation to solve and prevent problems.Conclusion: Elderly individuals with disabilities and their family caregivers face multiple physical, psychological, and social difficulties and demands during daily care, in which context negative experiences exert influence on this dyad. They collaborate to exhibit family resilience via the adaptation and improvement of family beliefs, family patterns and family communication. The family as a unit expends a great deal of effort to adapt to conditions of stress in the context of caring and shows family resilience, which is closely related to the family's cultural background and community situation. Dyadic resilience-based interventions can be developed based on core elements found by this study.

Background: Mental health literacy (MHL) is crucial to address issues related to mental illness. Nurses’ MHL is even more important because they are expected to deal with both the physical and psychological consequences of mental disorders.Objective: This study investigated the level, discrepancy, and characteristics of MHL among Chinese nurses from both public general and psychiatric hospitals; identified influential factors; and explored the relationship between MHL and mental health status.Methods: Using a stratified cluster sampling method to select participants, a cross-sectional survey was conducted to describe the MHL of 777 nurses from 13 general and 12 psychiatric hospitals using the Chinese version of the Mental Health Literacy Scale, Patient Health Questionnaire-2, Generalized Anxiety Disorder-2, and a demographic questionnaire. A multiple regression analysis was used to determine the factors influencing MHL among the nurses recruited.Results: The participants’ total score on the Chinese version of the Mental Health Literacy Scale was 93.25 (SD = 10.52). Multiple regression analysis revealed that nurses who worked in psychiatric or higher-level hospitals, with higher professional titles or higher education had higher levels of overall MHL and core MHL, while those working in general hospitals, with shorter work duration, or who were unmarried had higher social acceptance of patients. Nurses’ MHL was closely correlated with their mental health status.Conclusion: The overall and core MHL of Chinese nurses were at a moderate level, with social acceptance remaining at a relatively low level. There is an urgent need for MHL promotion programs to improve the MHL of clinical nurses. The focus must be given to overall MHL, especially core MHL, for non-psychiatric nurses to enhance their competence in mental health promotion and identification; more emphasis should be placed on the social acceptance of patients with mental illnesses for psychiatric nurses to improve their provision of professional services. Better MHL would be a formula for improving nurses’ own mental health and their mental health service competence.

Introduction: Network theory conceptualizes somatic symptoms as a network of individual symptoms that are interconnected and influenced by each other. In this conceptualization, the network's central symptoms have the strongest effect on other symptoms. Clinical symptoms of patients with depressive disorders are largely determined by their sociocultural context. To our knowledge, no previous study has investigated the network structure of somatic symptoms among Chinese patients with depressive disorders. The aim of this study was to characterize the somatic symptoms network structure in patients with depressive disorders in Shanghai, China.Method: A total of 177 participants were recruited between October 2018 and June 2019. The Chinese version of the Patient Health Questionnaire-15 was used to assess somatic symptoms. In order to quantify the somatic symptom network structure, indicators of “closeness,” “strength,” and “betweenness” were employed as identifiers for network-central symptoms.Result: The symptoms of “feeling your heart pound or race,” “shortness of breath,” and “back pain” had the highest centrality values, indicating that these symptoms were central to the somatic symptom networks. Feeling tired or mentally ill had the strongest positive correlation with insomnia or other sleep problems (r = 0.419), followed by chest pain and breathlessness (r = 0.334), back pain, and limb or joint pain (r = 0.318).Discussion: Psychological and neurobiological research that offers insights into somatic symptoms may focus on these central symptoms as targets for treatment and future research.

The Mental Health Literacy Scale (MHLS) is the most widely used and strong theory-based measurement tool to gain an understanding of mental health knowledge and ability. This study aimed to test the psychometric properties of the Chinese version of the Mental Health Literacy Scale (MHLS-C) and to document the norm and its influential factors of mental health literacy among nurses. The MHLS was translated following Brislin’s translation model and tested with a sample of 872 clinical registered nurses. The Jefferson Scale of Empathy-Health Professionals (JSE-HP), Patient Health Questionnaire-2 (PHQ-2), and Generalized Anxiety Disorder-2 (GAD-2) were administered to assess convergent validity. The minimum average partial test, parallel analysis and confirmatory factor analysis supported 4 first-order 2 second-order structure. The 4 factors were named “knowledge of mental disorder,” “ability to seek information and help,” “recognition of mental disorder,” and “acceptance of patients with mental illness,” with factor 1-3 were summarized into MHLS-Core (Core literacy subscale) and factor 4 as MHLS-SA (Social acceptance subscale). The MHLS-C was moderately negatively correlated with the PHQ-2 and GAD-2 (-0.111, -0.081) and highly positively correlated with JSE-HP (0.492). The Cronbach’s α was 0.85 for the overall scale and 0.89 and 0.93 for two subscales. The test-retest reliability was good, with intraclass correlation coefficients (ICCs) of 0.80 for the whole scale, and 0.79 and 0.94 for two subscales. As an approximately normal distribution, the 50^th percentile for the MHLS-C was 99, with 50^th percentiles of 74 and 20 for MHLS-Core and MHLS-SA. Higher position, higher professional credentials, higher hospital hierarchy, other specialist hospital, psychiatric hospital and unmarried status were positive predictors. The 29-item MHLS-C, with two subscales of MHLS-Core and MHLE-SA, is a stable and validated tool to measure mental health literacy. MHLS-Core could be used independently to measure the core content of mental health literacy. It may be applicable for Chinese health professionals, but need further validation among the general public. MHL curriculum and a targeted culturally appropriate program for acceptance for health professionals, especially for those in general hospitals and with less working tenure, may be recommended.

Depressive disorder is the most prevalent mental illness and is characterised by the presence of mental and somatic symptoms, with the latter affecting 65.0% to 98.2% of patients with their general function and quality of life. The purpose of this study aimed to explore the experiences and coping strategies of somatic symptoms in Chinese patients with depressive disorder, and to gain new insight into the illness and the health care provided to patients. Semi-structured, in-depth interviews were conducted with 15 patients diagnosed with depressive disorder according to international classification of diseases 10th revision. The interviews were transcribed verbatim and the thematic analysis was adapted to the data. MAXQDA10 software was used to organise, encode, classify, induce, and extract themes. Four major themes were extracted from the interviews: (1) descriptions of symptoms; (2) perceptions of the symptoms; (3) symptom disturbance; and (4) coping strategies of symptoms. Within the first theme, patients identified the following sub-themes: complex experiences of somatic symptoms, which were mainly in the neuromuscular system, circulatory respiratory system, gastrointestinal system and some symptoms without obvious systemic classification; difficulty in locating symptoms accurately; and being not consistent with examination results. The second theme included patient's inadequate understanding of somatic symptoms; and denial of the link between physical discomfort and depression. Disturbance of somatic symptoms embraced three sub-themes: (1) Uncertainty about somatic symptoms; (2) Struggling with daily life; (3) Impact on social activities; (4) feeling a decrease in family support. Lastly, coping strategies taken by patients in the face of various symptoms mainly included relying on drug treatment, avoiding stressors, diverting attention, and compromise or acceptance. Patients with depressive disorder experience a variety of somatic symptoms that have a negative impact on social function and reduce their quality of life. Patients did not have an adequate understanding of their physical discomfort and lacked effective coping strategies for these somatic symptoms. Professional staff should pay more attention to patients' somatic symptoms and focus on targeted symptom management to facilitate patient recovery.