Bo Qu

Quality of Life of Medical Students in China: A Study Using the WHOQOL-BREF

Objective The aim of this study was to assess the quality of life (QOL) of medical students during their medical education and explore the influencing factors of the QOL of students. Methods A cross-sectional study was conducted in June 2011. The study population was composed of 1686 medical students in years 1 to 5 at China Medical University. The Chinese version of WHOQOL-BREF instrument was used to assess the QOL of medical students. The reliability and validity of the questionnaire were assessed by Cronbach’s α coefficient and factor analysis respectively. The relationships between QOL and the factors including gender, academic year level, and specialty were examined using t-test or one-way ANOVA followed by Student-Newman–Keuls test. Statistic analysis was performed by SPSS 13.0. Results The overall Cronbach’s α coefficient of the WHOQOL-BREF questionnaire was 0.731. The confirmatory factor analysis provided an acceptable fit to a four-factor model in the medical student sample. The scores of different academic years were significantly different in the psychological health and social relations domains (p<0.05). Third year students had the lowest scores in psychological health and social relations domains. The scores of different specialties had significant differences in psychological health and social relations domains (p<0.05). Students from clinical medicine had the highest scores. Gender, interest in the area of study, confidence in career development, hometown location, and physical exercise were significantly associated with the quality of life of students in some domains (p<0.05). Conclusions The WHOQOL-BREF was reliable and valid in the assessment of the QOL of Chinese medical students. In order to cope with the influencing factors of the QOL, medical schools should carry out curriculum innovation and give the necessary support for medical students, especially for 3rd year students.

The 36-Item Short Form Health Survey: Reliability and Validity in Chinese Medical Students

Objective: The 36-Item Short Form Health Survey (SF-36) is widely validated and popularly used in assessing the subjective quality of life (QOL) of patients and the general public. The aim of the study is to assess the psychometric properties of the 36-Item Short Form Health Survey (SF-36) in medical students in mainland of China. Methods: The reliability and validity of the 36-Item Short Form Health Survey (SF-36) questionnaire were assessed by conducting a cross-sectional study of Chinese medical students in December 2011. All 1358 3rd year and 4th year medical students from 46 classes at China Medical University were investigated. Results: The overall Cronbachs α coefficient of the SF-36 questionnaire was 0.791, while the respective Cronbachs α coefficients for each of the seven dimensions were > 0.70, except where the social function dimension was 0.631. Results showed that the SF-36 questionnaire was reliable and valid. Conclusion: In general, this study provides evidence that the SF-36 questionnaire is suitable measures for assess the QOL of medical students in China.

Factors associated with HIV infection among men who have sex with men in Henan Province, China: a cross-sectional study

BackgroundHIV prevalence among men who have sex with men (MSM) has increased rapidly in China. Behavioral and biological interventions are key to controlling the spread of HIV in the MSM population and the primary strategy for reducing the spread of AIDS in China. The purpose of this study is to investigate the prevalence of HIV among MSM in Henan province and to assess their knowledge levels and risk behaviors related to HIV/AIDS.MethodA cross-sectional survey was conducted among 388 MSM in 2010 in Zhengzhou City, Henan province, China.ResultsOf the 388 respondents, 13.1% were infected with HIV and 10.3% were infected with syphilis. The results of multivariate analysis showed that participants who had a history of being infected by syphilis were more than 4 times more likely to be HIV positive (AOR=4.91; 95% CI: 1.70 to 12.02). For those who were residents from other provinces, the risk of HIV infection was 5.53 times higher (OR=5.53, 95% CI: 1.14, 6.25). Receipt of condoms (AOR = 0.15; 95% CI: 0.02 to 0.87), consistent condom use during last intercourse with a male (AOR=0.35; 95% CI: 0.14 to 0.87), and consistent condom use during last intercourse with a female (AOR=0.16; 95% CI: 0.08 to 0.90) were associated with a lower risk of HIV infection.ConclusionThe study suggests that some intervention strategies, including education intervention, condom promotion and distribution, and HIV counseling and testing are necessary to control HIV infection among MSM.

Factors associated with unprotected anal intercourse among men who have sex with men in Liaoning Province, China.

Background HIV prevalence among men who have sex with men (MSM) has increased rapidly. MSM may play a bridging role in the spread of HIV and other STDs from the high-risk population to the general population. Interventions to reduce high-risk behavior are the key to controlling the spreading of HIV in the MSM population and the primary strategy for reducing the spread of AIDS in China. The purpose of the study was to examine the demographic characteristics of MSM, evaluate the HIV-related knowledge of MSM, and identify factors associated with unprotected anal intercourse (UAI) among MSM to make recommendations for future research. Methodology/Principal Finding A cross-sectional survey was conducted among 293 MSM in Fushun and Huludao City, China. A total of 91 participants (34.0%) reported engagement in UAI with a male partner during the previous six months. The results of univariate analysis showed that UAI was associated with older age, lower levels of education, less knowledge about HIV, and not receiving condoms, lubricant, peer education, AIDS counseling, STD checks, and informational materials (p<0.05). In a multivariate logistic regression model, awareness of the major HIV transmission routes (ORu200a=u200a2.191; 95% CI: 0.869 to 5.524), receiving condoms (ORu200a=u200a2.164; 95% CI: 1.149 to 4.076), receiving peer education (ORu200a=u200a2.632; 95% CI: 1.566 to 4.426), and AIDS counseling (ORu200a=u200a2.347; 95% CI: 1.260 to 4.372) were independently associated with a lower risk of UAI. Conclusions/Significance The study suggested that UAI could be decreased by improving education about AIDS, increasing the promotion of voluntary counseling and testing (VCT), and improving the accessibility and convenience of service.

The Influence of Social Support on Quality of Life of Men Who Have Sex with Men in China: A Preliminary Study

The quality of life (QOL) of men who have sex with men (MSM) has received increasing attention in recent years. Our study surveyed the QOL and explored the influence of social support on QOL in Chinese MSM. A cross-sectional survey was conducted from September 2013 to March 2014 of 438 MSM in Huludao and Zhengzhou City, China. The results of univariate analysis showed that higher QOL scores were associated with receiving psychosocial counseling, higher health education, younger age and marital status of being single or unmarried p < 0.05). The structural equation model fitted well, with χ2 = 2083.47 (p < 0.05), RMSEA = 0.07, and GFI = 0.88. Among the latent factors, social support, with a factor load of 0.47, had greater impact on QOL than demographic characteristics. Within social support, the item loads for psychosocial counseling and health education were 0.17 and 0.29, respectively. Basic demographic characteristics also influenced social support, with a factor load of -0.65. For demographic characteristics, the greatest item loads were for marital status and age (0.77 and 0.71, respectively). These findings suggest that strengthening social support, especially for older and married individuals, would improve QOL in MSM in China.

The Quality of Life of Men Who Have Sex with Men in China: Reliability and Validity Testing of the SF-36 Questionnaire

Objective The aim of the study was to assess the psychometric properties of the 36-Item Short Form Health Survey (SF-36) in the men who have sex with men (MSM) population in China. Methods A cross-sectional survey was conducted among 373 MSM from September to December, 2012, in Zhengzhou and Huludao City, China. Internal reliability of the questionnaire was calculated by Cronbach’s α coefficient. Validity was analyzed through construct validity, divisional validity, and collective validity testing. Results The overall Cronbach’s α coefficient of the SF-36 questionnaire was 0.943, while the Cronbach’s α coefficients for each of the dimensions were all > 0.70. Results showed that the SF-36 questionnaire was reliable and valid. Conclusions This study provided evidence that the SF-36 is an acceptable, valid and reliable instrument in evaluating the quality of life of MSM in Mainland China.

Influencing factors of alexithymia in Chinese medical students: a cross-sectional study

BackgroundA much higher prevalence of alexithymia has been reported in medical students compared with the general population, and alexithymia is a risk factor that increases vulnerability to mental disorders. Our aim was to evaluate the level of alexithymia in Chinese medical students and to explore its influencing factors.MethodsA cross-sectional study of 1,950 medical students at Shenyang Medical College was conducted in May 2014 to evaluate alexithymia in medical students using the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20). The reliability of the questionnaire was assessed by Cronbach’s α coefficient and mean inter-item correlations. Confirmatory factor analysis (CFA) was used to evaluate construct validity. The relationships between alexithymia and influencing factors were examined using Student’s t-test, analysis of variance, and multiple linear regression analysis. Statistical analysis was performed using SPSS 21.0.ResultsOf the 1,950 medical students, 1,886 (96.7%) completed questionnaires. Overall, Cronbach’s α coefficient of the TAS-20 questionnaire was 0.868. The results of CFA showed that the original three-factor structure produced an acceptable fit to the data. By univariate analysis, gender, grade (academic year of study), smoking behavior, alcohol use, physical activity, history of living with parents during childhood, and childhood trauma were influencing factors of TAS-20 scores (pu2009<u20090.05). Multiple linear regression analysis showed that gender, physical activity, grade, living with parents, and childhood trauma also had statistically significant association with total TAS-20 score (pu2009<u20090.05).ConclusionsGender, physical activity, grade, history of living with parents during childhood, and childhood trauma were all factors determining the level of alexithymia. To prevent alexithymia, it will be advisable to promote adequate physical activity and pay greater attention to male medical students and those who are in the final year of training.

Relationship between quality of life and unprotected anal intercourse among Chinese men who have sex with men: a cross-sectional study

BackgroundThe prevalence of unprotected anal intercourse (UAI) is high among Chinese men who have sex with men (MSM). As important aspects of quality of life (QOL), psychological health and social relationships have been found to be associated with UAI among MSM, which was of great concern for intervening on UAI.MethodsWe conducted a cross-sectional study in Zhengzhou, Henan province, and in Huludao, Liaoning province, China, to measure quality of life (QOL) using the brief version of the World Health Organization Quality of Life (WHOQOL-BREF). Cronbachs α coefficient was used to test the internal consistency of the questionnaire items, and construction validity was assessed by exploratory factor analysis. T-test, chi-square test and multivariate logistic analysis were carried out to test the relationship between quality of life and unprotected anal intercourse.ResultsThe questionnaires of 320 of the 373 men who have sex with men that were surveyed met our validity criteria (response rate: 85.8xa0%). A total of 161 subjects (50.3xa0%) reported having unprotected anal sex in the last 6xa0months. The results of univariate analysis indicated that having unprotected anal sex was significantly associated with psychological health (PSYCH), social relationships (SOCIL), age, and marital status (P-value <0.05). The 3 items (“Negative feelings”, “Hopeness on your life”, and “Be able to concentrate”) in the PSYCH subscale were associated with UAI significantly (P-value <0.05). Multivariate analysis showed that psychological health (adjusted odd ratio (AOR) 0.979, 95xa0% confidence interval (CI) 0.961-0.998) was independent factor affecting the likelihood of having UAI in the population of Chinese MSM, and participants who aged 45 or more had higher odds of UAI (AOR 3.986, 95xa0% CI 1.199-13.255).ConclusionsWHOQOL-BREF was acceptable for evaluating the quality of life of MSM. Psychological health, as one important aspect of quality of life, was negatively associated with unprotected anal intercourse. The finding underscored the needs to incorporate the strategies on improving psychological health into the UAI intervention to reduce the HIV transmission among MSM.

The relation between mental health, homosexual stigma, childhood abuse, community engagement, and unprotected anal intercourse among MSM in China

The aim of the study was to explore the relation of various factors with unprotected anal intercourse (UAI) and provide some insight for HIV intervention on Chinese men who have sex with men (MSM). The current cross-sectional study recruited 365 MSM in Dalian, China. More than half of the respondents (117 respondents, 51.8% of the sample) had engaged in UAI. The multivariable logistic regression model suggested that poorer mental health (AOR: 7.16; 95% CI: 3.14–16.31), self-stigma (AOR: 1.53; 95% CI: 1.00–2.34), and experience(s) of physical abuse in childhood (AOR: 5.85; 95% CI: 1.77–19.30) were significantly and positively related to UAI. Community engagement was negatively associated with UAI (pu2009<u20090.05). It appears it is necessary to incorporate mental health services, eliminate the stigma against homosexuality, and facilitate MSM-related community engagement into intervention strategies to prevent UAI among Chinese MSM. Targeted UAI interventions in the subgroup with a history of childhood physical abuse should also be of great concern.

The psychological health and associated factors of men who have sex with men in China: A cross-sectional survey

Objectives The psychological health of men who have sex with men (MSM) has received increased attention in recent years. We thus investigated the psychological status and associated factors among MSM in China. Methods A cross-sectional survey of 248 MSM was conducted from April to September 2015 using Symptom Checklist 90 (SCL-90) in Huludao and Zhengzhou, China. Statistical analyses utilized SPSS version 19.0 for Windows. Results All Cronbach’s α coefficients of the SCL-90 subscales exceeded 0.7, suggesting acceptable reliability. The coefficient range of the collective validity for all the subscales was >0.4. For the divisional validity, each item correlated better with the hypothetical subscale than with other subscales. Collective validity and divisional validity were both acceptable. The four most frequent types of psychological distress among MSM were depression, obsessive-compulsive behavior, interpersonal sensitivity, and anxiety. Results of the univariate analysis revealed that the following groups had significantly higher SCL-90 scores (P < 0.05): peasantry, married MSM, respondents who reported condomless anal intercourse and a greater number of male partners, and respondents who had not undergone psychosocial counseling and whose family or friends did not know about their sexual identity. In a multivariate logistic regression model, the following parameters were independently associated with higher SCL-90 scores: being married (AOR [adjusted odds ratio] = 3.19; 95% CI [confidence interval]: 1.96 to 5.93), condomless anal intercourse (AOR = 1.16; 95% CI: 1.02 to 1.31), number of male partners (AOR = 1.66 and 1.81; 95% CI: 1.08 to 2.34 and 1.32 to 2.69), family or friends not knowing about sexual identity (AOR = 2.13; 95% CI: 1.17 to 4.92), and lack of psychosocial counseling (AOR = 2.09; 95% CI: 1.06 to 4.09). Conclusions Our results indicate that psychological health problems among MSM in China are of concern. It is thus necessary to strengthen intervention efforts, with more emphasis on intervention programs to improve psychological health among Chinese MSM.