Introduction A notable deficiency lies in the absence of tailored instruments for comprehensively evaluating the health literacy of middle-aged and elderly residents in rural areas of China. Given the context of China’s ageing demographic and the increasing urban–rural disparities, it becomes imperative to formulate a dedicated assessment tool for appraising the health literacy of rural middle-aged and elderly populations. Methods A systematic and rigorously structured development approach was used. First, the concept of health literacy was used to create a pool of items. Second, the Delphi method was used to revise and finalise the initial version of the Chinese Rural Middle-aged and Elderly Health Literacy Scale (CREHLS). Third, pretesting was used to assess the rationality of the item settings within the CREHLS. Finally, a large-sample survey was used to assess the reliability and validity of the finalisation CREHLS. Results The CREHLS, which comprises 26 items distributed across four dimensions, is designed to evaluate the capacity to access, comprehend, assess and apply pertinent health information related to disease treatment, disease prevention, health promotion and environmental health. Multiple test results affirm the robust reliability and validity of the CREHLS, adhering to the established development standards. Conclusions This study expects that the CREHLS will be validated in different rural regions of China and will be a reference for assessing the health literacy of rural middle-aged and elderly people in other countries, thereby increasing our attention to the health literacy of rural people.

Objective: The aim of this study was to examine the effects of patient-centered communication, patient participation, and patient preference on patient trust in the context of China. Methods: A cross-sectional survey was conducted involving 217 cancer patients in China. Mediation and moderation analyses were performed to examine the relationships among the study variables. Results: First, patient-centered communication increased patient participation in decision-making, which, in turn, enhanced patient trust. Second, patient-centered communication did not have a direct effect on patient trust. Third, patient preference for a passive role in decision-making weakened the relationship between patient participation and patient trust. Conclusion: The results underscore the significant effect of facilitating patient participation in linking patientcentered communication to patient trust. However, medical communication should also respond to patients' preferred roles in the decision-making process. Practice implications: Doctors should provide patients with opportunities to ask questions and express their concerns. In addition, they should evaluate patients' preferred degree of involvement before inviting them to contribute so as to respect their preferences and values.

Maintaining independence in instrumental activities of daily living is crucial for older adults in an ageing society. This study, utilizing longitudinal data, aims to explore the relationship between remote intergenerational communication and independent activities in older adults. The sample consisted of 2353 participants from the longitudinal data of the fourth (2016), fifth (2018), and sixth (2020) waves of the China Family Panel Studies. We employed a logistic regression model and a bootstrap test method to analyze the data. The results indicate that each unit increase in remote intergenerational communication reduces the odds of IADL impairment by 14.3

The relationship between depression and personality traits has been a central focus of psychological research. However, investigations into how personality traits, particularly the Big Five traits, influence the trajectory of depression are limited. This study aims to investigate the role of personality traits in the trajectory of depression among Chinese youth. Using data from the China Family Panel Studies for 2016, 2018, and 2020, we analyzed a sample of 4,999 individuals aged 16–35 years. The findings indicate that individuals with higher levels of conscientiousness and agreeableness tend to start with lower levels of depression, although these traits do not seem to affect the rate at which depression progresses. In contrast, those with stronger extraversion traits not only present lower initial depression levels but also experience a slower increase in depression over time. Conversely, individuals with a tendency toward neuroticism show higher initial depression levels and a more rapid worsening of symptoms over time. The study also revealed that the openness trait does not significantly influence either the initial level or the trajectory of depression. These results highlight the need for greater awareness of how personality traits impact the trajectory of depression among youth within communities, schools, and families. Additionally, the findings underscore the importance of enhanced mental health monitoring and early intervention strategies, particularly for young individuals with neurotic tendencies, to reduce the prevalence of depression in this population.

目的:探讨北京市2 所医院癌症患者参与医疗决策对患者信任状况的影响,为增进患者信任、建立和谐的医患关系提供依据.方法:对北京市2 所三甲医院共 271 例癌症患者进行问卷调查,采用有调节的中介模型对调研数据进行分析.结果:癌症患者的患者信任状况与患者参与医疗决策的评分分别为(41.59±7.82)和(42.70±8.68),领悟社会支持与以患者为中心的沟通评分分别为(68.93±11.20)和(27.19±5.76);有调节的中介模型显示,领悟社会支持在癌症患者参与医疗决策与患者信任之间起中介作用(ab=0.06),以患者为中心的沟通在癌症患者参与医疗决策与领悟社会支持之间具有调节作用(B=0.03,t=2.02,P<0.05).结论:癌症患者参与医疗决策可以显著提高患者信任水平,促进和谐医患关系的建立,应鼓励并支持癌症患者参与临床决策.此外,医务人员应在诊疗过程中应秉持以患者为中心的沟通方式,帮助患者提高领悟社会支持水平.这有利于促进患者参与决策,并对患者信任具有积极作用.

The number of doctor–patient conflicts and disputes in China has been increasing recently. In order to solve the current social problems of the tense doctor–patient relationship and frequent medical disputes, this article, based on grounded theory, uses qualitative analysis software to conduct grounded coding on 622 cases of doctor–patient disputes randomly selected by stratification. After successively adopting open, axial, and selective coding, the relationship structure between the causes and development of medical disputes is summarized. Furthermore, this relationship structure can be used to analyze further and discuss the causes of doctor–patient disputes from the perspective of multiple co-governance and the governance framework of doctor–patient disputes. Finally, it reminds us of the need to standardize government’s regulatory responsibilities, promote the equal distribution of medical resources, strengthen the communication awareness between doctors and patients, reduce the information asymmetry between doctors and patients, and build a preventive mechanism-oriented multi-subject collaborative governance path to promote the relationship between doctors and patients in China. We provide relevant countermeasures and suggestions for harmonious development and the smooth resolution of doctor–patient conflicts.

Objective:The aim of this study is to examine the extent to which individuals' cognitive evaluation of the importance of the Internet is associated with depressive symptoms, and in what ways.Methods:This study utilized a sample of 4,100 participants from the fourth (2016), fifth (2018), and sixth (2020) waves of the China Family Panel Studies. Structural equation modeling was employed for data analysis.Result:The findings of this study reveal that individuals' cognitive evaluation of the importance of the Internet in 2016 was positively linked with the frequency of Internet use and subjective socioeconomic status in 2018. Furthermore, the frequency of Internet use and subjective socioeconomic status in 2018 were found to be negatively associated with depressive symptoms in 2020. These results indicate that the perceived importance of the Internet has an indirect effect on depressive symptoms through the identified pathway.Conclusion:The present findings contribute to the existing literature by highlighting the importance of individuals' perceived importance of the internet as a significant factor that influences depressive symptoms. The results suggest that policy makers should take actions to increase public awareness of the importance of the Internet in the digital era, and to ensure equitable access to the internet, thus facilitating convenient internet use and helping individuals adapt to the digital age.