Background Occupational burnout in physicians is prevalent and can have many negative effects. The purposes of this study were to explore the prevalence of occupational burnout and to analyze the effects of social support and role stress on occupational burnout among Chinese physicians. Methods Using multistage-stratified cluster random sampling, physicians were selected to participate in the study and completed three questionnaires: the Chinese Maslach Burnout Inventory; the Cross-Cultural Role Conflict, Ambiguity and Overload Scale; and the Social Support Rating Scale. A path analysis was run to test the effects of role stress and social support on occupational burnout. Results Of 2530 physicians, 864 (34.2%) were experiencing moderate occupational burnout and 140 (5.5%) were experiencing severe occupational burnout. The path analysis results indicated that role conflict had direct positive effects on emotional exhaustion (EE) and depersonalization (DP), and role ambiguity had direct positive effects on DP and decreased personal accomplishment (DPA). Coworker support had direct negative effects on EE and positive effects on DP, family support had direct negative effects on DP and DPA. Coworker support mediated the effects of role ambiguity on EE and DP, and family support mediated the effects of role ambiguity on DP and DPA. Conclusions These findings suggest that occupational burnout is common in Chinese physicians, and that role stress and social support play important roles in occupational burnout. Interventions that aim to reduce role stress and increase social support can be effective approaches to prevent occupational burnout among physicians.

Purpose To explore the association of academic performance and general health status with health-related quality of life (HRQoL) in school-aged children and adolescents in China. Methods In this cross-sectional study conducted in 2018, students (grade 4–12) were randomly chosen from primary and high schools in Nanjing, China. HRQoL, the outcome measure, was recorded using the Child Health Utility 9D, while self-rated academic performance and general health were the independent variables. Mixed-effects regression models were applied to compute mean difference (MD) and 95% confidence interval (CI) of HRQoL utility score between students with different levels of academic performance and general health. Results Totally, 4388 participants completed the study, with a response rate of 97.6%. The mean HRQoL utility score was 0.78 (SD: 0.17). After adjustment for socio-demographic attributes, physical activity, sedentary behavior, dietary patterns, body weight status and class-level clustering effects, students with fair (MD = 0.048, 95% CI 0.019, 0.078) and good (MD = 0.082, 95% CI 0.053, 0.112) self-rated academic performance reported higher HRQoL utility scores than those with poor academic performance, respectively. Meanwhile, students with fair (MD = 0.119, 95% CI 0.083, 0.154) and good (MD = 0.183, 95% CI 0.148, 0.218) self-assessed general health also recorded higher HRQoL utility scores than those with poor health, separately. Consistent findings were observed for participants by gender, school type and residential location. Conclusions Both self-rated academic performance and general health status were positively associated with HRQoL among Chinese students, and such relationships were independent of lifestyle-related behaviors and body weight status.

Objectives To examine the association between health literacy (HL) and health-related quality of life (HRQoL) among primary and high school students in Nanjing, China. Methods A cross-sectional study was conducted among randomly selected primary (graders 4–6), junior (graders 7–9) and senior (graders 10–12) high school students in 2018 in Nanjing Municipality of China. HRQoL, the outcome variable, was assessed with the validated Chinese version of Child Health Utility 9D (CHU9D) and used as continuous variable, while HL, our independent variable, was measured with the validated Chinese Students’ Health literacy Assessment Scale and treated as categorical variable (“adequate” or “inadequate”) in the analysis. Mixed-effects linear regression models were introduced to calculate mean difference and 95% confidence interval (CI) for examining the association between HL and HRQoL. Results Totally, 4388 of 4498 students completed the survey. Among these responders, the mean score of CHU9D was 0.78 ± 0.17, and the proportion of participants with adequate HL was 85.8% (95% CI = 84.7%, 86.8%). After adjustment for potential confounders and class-level clustering effects, participants who had adequate HL were observed having, on average, an elevated HRQoL score of 0.08 (95% CI = 0.06, 0.11) units compared to their counterparts with inadequate HL. Such a positive HL-HRQoL association was also identified among each stratum of participants’ age, gender and residence. Conclusions HL was positively associated with HRQoL score among primary and high school students in China. It has public health implications that HRQoL may be improved through school-based health literacy intervention among children and adolescents in China.