This study aimed to assess the prevalence of depression in middle-aged and elderly patients with diabetes in China, determine the risk factors of depression in these patients, and explore the internal relationship between influencing factors and depression by constructing a pathway model. Methods: Data were collected from the 2018 China Health and Retirement Longitudinal Study (CHRLS). We included 1743 patients with diabetes who were assessed using the CES-D10, which is used to measure depressive symptoms in Chinese older adults. Based on the theory of psychological stress, data were analyzed using SPSS software version 22.0 and MPLUS 8.0. A correlation analysis was used to explore the relationship between the variables and depression scores. A path model was constructed to explore the interrelationships between variables and verify the relationships between variables and depression in patients with diabetes. Results: The prevalence of depression among patients with diabetes was 42.5%. The path analysis results showed that income, diabetes duration, sleep duration, pain distress, self-rated health, and glycemic control directly affected depression, and self-rated health had the largest effect value. With self-rated health and glycemic control as mediator variables, income, diabetes duration, sleep duration, pain distress, glycemic control, and insulin use had indirect effects on depression by influencing self-rated health. Age, frequency of blood glucose monitoring, and exercise glycemic control awareness indirectly affected depression by affecting glycemic control, self-rated health status, and depression. Conclusion:We found that the path analysis model could construct the interaction between the influencing factors and explore the potential interrelationship between the influencing factors and diabetes-related depression. Patients with diabetes must adhere to regular medication, maintain a healthy lifestyle, and have effective glycemic control. Diabetes depression can be effectively prevented by making psychological knowledge publicly available, providing health education, and establishing corresponding for diabetes.
Background Paying attention to the health-related quality of life (HRQOL) of rural residents in poverty-stricken areas is an important part of China's poverty alleviation, but most studies on health-related quality of life have focused on rural residents, elderly individuals, and patients; evidence on the HRQOL of rural minority residents is limited. Thus, this study aimed to assess the HRQOL of rural Uighur residents in remote areas of Xinjiang, China, and determine its influencing factors to provide policy opinions for realizing a healthy China strategy. Methods A cross-sectional study was performed on 1019 Uighur residents in rural areas. The EQ-5D and self-administered questionnaires were used to assess HRQOL. We applied Tobit and binary logit regression models to analyse the factors influencing HRQOL among rural Uighur residents. Results The health utility index of the 1019 residents was − 0.197,1. The highest proportion of respondents reporting any problem was for mobility (57.5%), followed by usual activity (52.8%). Low levels of the five dimensions were related to age, smoking, sleep time, Daily intake of vegetables and fruit per capita. Gender, age, marital status, physical exercise, sleep duration, daily intake of cooking oil per capita, daily intake of fruit per capita, distance to the nearest medical institution, non-infectious chronic diseases (NCDs), self-rated health score, and participation in community activities were correlated with the health utility index of rural Uighur residents. Conclusions HRQOL was lower for rural Uyghur residents than for the general population. Improving health behavioural lifestyles and reducing the incidence of poverty (return to poverty) due to illness are effective means of promoting the health in Uyghur residents. The region must fulfil the health poverty alleviation policy and focus on vulnerable groups and low-income residents to improve the health, ability, opportunity, and confidence of this population to live well.
Background Depressive symptoms has become an increasingly important public health issue, contributing to disability and disease burden around the world. Studies have found that social support is strongly associated with depression in rural older people, so it is important to explore the factors influencing depression in rural older people in a comprehensive manner and to analyze the association between social support and depression. Methods On the basis of a theoretical model of health ecological, data were obtained from The China Health and Retirement Longitudinal Study in the 2018, with a sample consisting of 5,660 rural individuals aged ≥ 60 years. Then, Chi-square test and logistic regression analyses were used for statistical description and inference. Results Results indicate that the prevalence of depressive symptoms amongst rural older adults in China is 41.18%. The logistic regression analysis reveals that being female (OR = 1.406, 95% CI: 1.170–1.689), having ≥ 3 non-communicable diseases (OR = 1.736, 95% CI: 1.447–2.082), being not satisfied with spouse (OR = 2.978, 95% CI: 2.304–3.849), and being not at all satisfied with children (OR = 3.640, 95% CI: 1.736–7.635) are significantly correlated with depression. Conclusions The prevalence of depression amongst rural Chinese older adults is obviously high. Women and the elderly with chronic diseases need to be focused on. Hence, this study suggests that promoting interactivity amongst family members, increasing their relationship satisfaction, and encouraging active participation in social activities are necessary to further reduce the risk of depression amongst rural Chinese older adults. The government should not only improve the social security system, but also provide financial support and assistance to the elderly in rural China.
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