Aim Older adults living alone is becoming the main family structure in rural China. This study aimed to explore the mediating effect of coping style on the relationship between perceived stress and mental health in rural older adults living alone in China. Methods 356 rural older adults living alone were recruited in Huzhou, China. Subjects were investigated using the Chinese Perceived Stress Scale (CPSS), Chinese Coping Style Questionnaire (CCSQ), and Mental Health Questionnaire (MHQ). Data were analysed using a structural equation. Bootstrapping was used to validate the mediation effects. Results Mental health showed significant correlations with a sense of nervousness, of uncontrollability, and with positive and negative coping styles (P < 0.05). The results of structural equation modeling showed a good fit for the total sample (χ2/df = 2.684, NFI = 0.927, GFI = 0.944, RMSEA = 0.069). Perceived stress (sense of nervousness and uncontrollability) impacted the mental health of rural older adults living alone mainly through two mediating variables, including positive and negative coping styles. The double mediating contribution rates were 42.11%, and 61.82%. Conclusion Coping style partially mediated the relationship between perceived stress and mental health of rural older adults living alone in China. Consequently, to improve the mental health of rural older adults living alone, perceived stress and coping styles should be the focus. Geriatr Gerontol Int 2022; 22: 523–528.

Background: Developing students’ metacognition awareness is a goal of university education as it can help equip students with life-long learning skills and promote holistic personal development. This study aimed to explore the effect of nursing comprehensive skill training course (NCST-C) on metacognitive awareness of nursing students in China, to provide a scientific foundation for improving metacognitive awareness.Design: A quasi-experimental two-group, matched pretest, post-test, and follow-up test.Methods: A total of 96 Junior nursing students were recruited using a convenience sampling and assigned to 2 groups by drawing lots with odd and even numbers in a nursing school at Huzhou University, China. The control group was received the traditional skill-training course. The intervention group was received training in NCST-C. Nursing students were evaluated metacognitive awareness inventory (MAI) at the baseline, 16-week, and 20-week follow-up points, respectively. A repeated-measures, two-way analysis of variance, and a simple effect test were used to compare each outcome measure of 2 groups.Results: The NCST-C resulted in a greater benefit for nursing students’ metacognition awareness and various dimensions (knowledge of cognition and regulation of cognition) in the intervention group. Combined with a simple effects test, the MAI and dimensions scores of those in the intervention groups significantly improved at 16 weeks after the baseline (F = 44.03-9.78); all P <0.01); and the sustainable effect of NCST-C lasted for 1 month after the intervention (F = 14.24-56.75, all P <0.01), which reached statistical significance (P < 0.05).Conclusions: The NCST-C was an effective course to develop metacognition awareness of nursing students,which design provides a new form of experimental course to improve metacognition awareness.Trial registration: http://www.chictr.org.cn/listbycreater.aspxRegistration number:ChiCTR2200057910. First registration date 22/3/2022