The Mediating Role of Perceived Stress in Associations Between Self-Compassion and Anxiety and Depression: Further Evidence from Chinese Medical Workers

References

• Pereira-Lima K, Loureiro S. Burnout, anxiety, depression, and social skills in medical residents. Psychol Health Med. 2015;20(3):353–362. doi:10.1080/13548506.2014.93688925030412
   PubMed Web of Science ®Google Scholar
• Kerrien M, Pougnet R, Garlantézec R, et al. Prevalence of anxiety disorders and depression among junior doctors and their links with their work. Presse medicale. 2015;44(4 Pt 1):e84. doi:10.1016/j.lpm.2014.06.042
   Google Scholar
• Atif K, Khan HU, Ullah MZ, Shah FS, Latif A. Prevalence of anxiety and depression among doctors; the unscreened and undiagnosed clientele in Lahore, Pakistan. Pak J Med Sci. 2016;32(2):294.27182226
   PubMed Web of Science ®Google Scholar
• Cheung T, Yip PS. Depression, anxiety and symptoms of stress among Hong Kong nurses: a cross-sectional study. Int J Environ Res Public Health. 2015;12(9):11072–11100. doi:10.3390/ijerph12091107226371020
   PubMed Web of Science ®Google Scholar
• Maharaj S, Lees T, Lal S. Prevalence and risk factors of depression, anxiety, and stress in a cohort of Australian nurses. Int J Environ Res Public Health. 2019;16(1):61. doi:10.3390/ijerph16010061
   Web of Science ®Google Scholar
• Adams JG, Walls RM. Supporting the health care workforce during the COVID-19 global epidemic. JAMA. 2020;323(15):1439–1440. doi:10.1001/jama.2020.397232163102
   PubMed Web of Science ®Google Scholar
• Gold JA. Covid-19: adverse mental health outcomes for healthcare workers. BMJ. 2020;369:m1815. doi:10.1136/bmj.m181532371465
   PubMed Web of Science ®Google Scholar
• Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun. 2020;88:901–907. doi:10.1016/j.bbi.2020.05.02632437915
   PubMed Web of Science ®Google Scholar
• Chen Z. Launch of the health-care reform plan in China. Lancet. 2009;373(9672):1322–1324. doi:10.1016/S0140-6736(09)60753-419376436
   PubMed Web of Science ®Google Scholar
• Fu W, Zhao S, Zhang Y, Chai P, Goss J. Research in health policy making in China: out-of-pocket payments in Healthy China 2030. BMJ. 2018;k234. doi:10.1136/bmj.k23429437565
   PubMed Web of Science ®Google Scholar
• Meng Q, Mills A, Wang L, Han Q. What can we learn from China’s health system reform? BMJ. 2019;l2349. doi:10.1136/bmj.l234931217222
   PubMed Web of Science ®Google Scholar
• Yip WC-M, Hsiao WC, Chen W, Hu S, Ma J, Maynard A. Early appraisal of China’s huge and complex health-care reforms. Lancet. 2012;379(9818):833–842. doi:10.1016/S0140-6736(11)61880-122386036
   PubMed Web of Science ®Google Scholar
• He AJ, Qian J. Explaining medical disputes in Chinese public hospitals: the doctor-patient relationship and its implications for health policy reforms. Health Econ Policy Law. 2016;11(4):359–378. doi:10.1017/S174413311600012827018911
   PubMed Web of Science ®Google Scholar
• Xiaoming Y, Ma B-J, Chang CL, Shieh C-J. Effects of workload on burnout and turnover intention of medical staff: a study. Stud EthnoMed. 2014;8(3):229–237. doi:10.1080/09735070.2014.11917638
   Google Scholar
• Yang S, Liu D, Liu H, Zhang J, Duan Z. Relationship of work-family conflict, self-reported social support and job satisfaction to burnout syndrome among medical workers in southwest China: a cross-sectional study. PLoS One. 2017;12(2):e0171679.28207821
   PubMed Web of Science ®Google Scholar
• Chen S, Lin S, Ruan Q, Li H, Wu S. Workplace violence and its effect on burnout and turnover attempt among Chinese medical staff. Arch Environ Occup Health. 2016;71(6):330–337. doi:10.1080/19338244.2015.112887426654585
   PubMed Web of Science ®Google Scholar
• Tang N, Thomson LE. Workplace violence in Chinese hospitals: the effects of healthcare disturbance on the psychological well-being of Chinese healthcare workers. Int J Environ Res Public Health. 2019;16(19):3687. doi:10.3390/ijerph16193687
   Web of Science ®Google Scholar
• Zhou J, Yang Y, Qiu X, et al. Serial multiple mediation of organizational commitment and job burnout in the relationship between psychological capital and anxiety in Chinese female nurses: a cross-sectional questionnaire survey. Int J Nurs Stud. 2018;83:75–82. doi:10.1016/j.ijnurstu.2018.03.01629702357
   PubMed Web of Science ®Google Scholar
• Scott JG, Zhou J, Yang Y, et al. Relationship between anxiety and burnout among Chinese physicians: a moderated mediation model. PLoS One. 2016;11(8):e0157013. doi:10.1371/journal.pone.015701327479002
   PubMed Web of Science ®Google Scholar
• Zhang Y, Feng X. The relationship between job satisfaction, burnout, and turnover intention among physicians from urban state-owned medical institutions in Hubei, China: a cross-sectional study. BMC Health Serv Res. 2011;11(1):235. doi:10.1186/1472-6963-11-23521943042
   PubMed Web of Science ®Google Scholar
• Wang Y, Zhang B. Impact of personality trait and professional identity on work-related depression, anxiety and irritation among Chinese nurses. Southeast Asian J Trop Med Public Health. 2017;48(2):447–454.29642307
   PubMed Web of Science ®Google Scholar
• Zeng HJ, Zhou GY, Yan HH, Yang XH, Jin HM. Chinese nurses are at high risk for suicide: a review of nurses suicide in China 2007–2016. Arch Psychiatr Nurs. 2018;32(6):896–900. doi:10.1016/j.apnu.2018.07.00530454635
   PubMed Web of Science ®Google Scholar
• Weaver MD, Vetter C, Rajaratnam SMW, et al. Sleep disorders, depression and anxiety are associated with adverse safety outcomes in healthcare workers: a prospective cohort study. J Sleep Res. 2018;27(6):e12722. doi:10.1111/jsr.1272230069960
   PubMed Web of Science ®Google Scholar
• Jin HM, Guo LL. Suicide in medical doctors: a review from Mainland China, 2008–2016. 2018.
   Google Scholar
• Wu Q, Zhao L, Ye X-C. Shortage of healthcare professionals in China. BMJ. 2016;354:i4860. doi:10.1136/bmj.i486027659864
   PubMed Web of Science ®Google Scholar
• Van Dam NT, Sheppard SC, Forsyth JP, Earleywine M. Self-compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression. J Anxiety Disord. 2011;25(1):123–130. doi:10.1016/j.janxdis.2010.08.01120832990
   PubMed Web of Science ®Google Scholar
• Proeve M, Anton R, Kenny M. Effects of mindfulness-based cognitive therapy on shame, self-compassion and psychological distress in anxious and depressed patients: a pilot study. Psychol Psychother. 2018;91(4):434–449. doi:10.1111/papt.1217029345803
   PubMed Web of Science ®Google Scholar
• MacBeth A, Gumley A. Exploring compassion: a meta-analysis of the association between self-compassion and psychopathology. Clin Psychol Rev. 2012;32(6):545–552. doi:10.1016/j.cpr.2012.06.00322796446
   PubMed Web of Science ®Google Scholar
• Sirois FM, Hirsch JK. Self-compassion and adherence in five medical samples: the role of stress. Mindfulness. 2019;10(1):46–54. doi:10.1007/s12671-018-0945-930662571
   PubMed Web of Science ®Google Scholar
• Neff KD, Germer CK. A pilot study and randomized controlled trial of the mindful self-compassion program. J Clin Psychol. 2013;69(1):28–44. doi:10.1002/jclp.2192323070875
   PubMed Web of Science ®Google Scholar
• Lu F, Xu Y, Yu Y, et al. Moderating effect of mindfulness on the relationships between perceived stress and mental health outcomes among Chinese intensive care nurses. Front Psychiatry. 2019;10(260). doi:10.3389/fpsyt.2019.00260
   Web of Science ®Google Scholar
• Gu J, Strauss C, Bond R, Cavanagh K. How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clin Psychol Rev. 2015;37:1–12. doi:10.1016/j.cpr.2015.01.00625689576
   PubMed Web of Science ®Google Scholar
• Zhu T, Xue J, Montuclard A, Jiang Y, Weng W, Chen S. Can mindfulness-based training improve positive emotion and cognitive ability in chinese non-clinical population? A pilot study. Front Psychol. 2019;10:1549. doi:10.3389/fpsyg.2019.0154931333552
   PubMed Web of Science ®Google Scholar
• Luo Y, Meng R, Li J, Liu B, Cao X, Ge W. Self-compassion may reduce anxiety and depression in nursing students: a pathway through perceived stress. Public Health. 2019;174:1–10. doi:10.1016/j.puhe.2019.05.01531265974
   PubMed Web of Science ®Google Scholar
• Strauss C, Gu J, Pitman N, Chapman C, Kuyken W, Whittington A. Evaluation of mindfulness-based cognitive therapy for life and a cognitive behavioural therapy stress-management workshop to improve healthcare staff stress: study protocol for two randomised controlled trials. Trials. 2018;19(1):1–10. doi:10.1186/s13063-018-2547-129298706
   PubMed Web of Science ®Google Scholar
• Burton A, Burgess C, Dean S, Koutsopoulou GZ, Hugh‐Jones S. How effective are mindfulness‐based interventions for reducing stress among healthcare professionals? A systematic review and meta‐analysis. Stress Health. 2017;33(1):3–13. doi:10.1002/smi.267326916333
   PubMed Web of Science ®Google Scholar
• Patel V, Saxena S, Lund C, et al. The lancet commission on global mental health and sustainable development. Lancet. 2018;392(10157):1553–1598. doi:10.1016/S0140-6736(18)31612-X30314863
   PubMed Web of Science ®Google Scholar
• Meng R, Li J, Wang Z, et al. The Chinese version of the Perceived Stress Questionnaire: development and validation amongst medical students and workers. Health Qual Life Outcomes. 2020;18(1):70. doi:10.1186/s12955-020-01307-132169070
   PubMed Web of Science ®Google Scholar
• Meng R, Yu Y, Chai S, et al. Examining psychometric properties and measurement invariance of a Chinese version of the Self-Compassion Scale–Short Form (SCS-SF) in nursing students and medical workers. Psychol Res Behav Manag. 2019;12:793–809. doi:10.2147/PRBM.S21641131565007
   PubMed Web of Science ®Google Scholar
• Luo Y, Gong B, Meng R, et al. Validation and application of the Chinese version of the Perceived Stress Questionnaire (C-PSQ) in nursing students. PeerJ. 2018;6:e4503. doi:10.7717/peerj.450329568711
   PubMed Web of Science ®Google Scholar
• Goldberg D, Bridges K, Duncan-Jones P, Grayson D. Detecting anxiety and depression in general medical settings. BMJ. 1988;297(6653):897–899. doi:10.1136/bmj.297.6653.8973140969
   PubMed Web of Science ®Google Scholar
• Raes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the Self-Compassion Scale. Clin Psychol Psychother. 2011;18(3):250–255. doi:10.1002/cpp.70221584907
   PubMed Web of Science ®Google Scholar
• Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate Data Analysis: Pearson New International Edition. 7th ed. London: Pearson Higher Education; 2014.
   Google Scholar
• Kline RB. Principles and Practice of Structural Equation Modeling. 4th ed. New York, NY: Guilford publications; 2016.
   Google Scholar
• Marsh HW, Hau K-T GD. Goodness of fit in structural equation models In: Contemporary Psychometrics: A Festschrift for Roderick P. McDonald. Mahwah, NJ, US: Lawrence Erlbaum Associates Publishers; 2005:275–340.
   Google Scholar
• McDonald RP, Ho M-HR. Principles and practice in reporting structural equation analyses. Psychol Methods. 2002;7(1):64. doi:10.1037/1082-989X.7.1.6411928891
   PubMed Web of Science ®Google Scholar
• Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling. 1999;6(1):1–55. doi:10.1080/10705519909540118
   Web of Science ®Google Scholar
• Cheung GW, Rensvold RB. Evaluating goodness-of-fit indexes for testing measurement invariance. Struct Equ Modeling. 2002;9(2):233–255. doi:10.1207/S15328007SEM0902_5
   Web of Science ®Google Scholar
• Chen FF. Sensitivity of goodness of fit indexes to lack of measurement invariance. Struct Equ Modeling. 2007;14(3):464–504. doi:10.1080/10705510701301834
   Web of Science ®Google Scholar
• Meade AW, Johnson EC, Braddy PW. Power and sensitivity of alternative fit indices in tests of measurement invariance. J Appl Psychol. 2008;93(3):568. doi:10.1037/0021-9010.93.3.56818457487
   PubMed Web of Science ®Google Scholar
• Brannick MT. Critical comments on applying covariance structure modeling. J Organ Behav. 1995;16(3):201–213. doi:10.1002/job.4030160303
   Web of Science ®Google Scholar
• Kelloway EK. Structural equation modelling in perspective. J Organ Behav. 1995;16(3):215–224. doi:10.1002/job.4030160304
   Web of Science ®Google Scholar
• Association WM. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–2194. doi:10.1001/jama.2013.28105324141714
   PubMed Web of Science ®Google Scholar
• Pougnet R, Verdier G, Saliou P, et al. Anxiety among health care workers of a teaching hospital. Occup Environ Med. 2018;75(Suppl 2):A141–A141.
   Google Scholar
• Ruitenburg MM, Frings-Dresen MH, Sluiter JK. The prevalence of common mental disorders among hospital physicians and their association with self-reported work ability: a cross-sectional study. BMC Health Serv Res. 2012;12(1):292. doi:10.1186/1472-6963-12-29222938170
   PubMed Web of Science ®Google Scholar
• Yip J, Zeig-Owens R, Webber MP, et al. World trade center-related physical and mental health burden among New York City fire department emergency medical service workers. Occup Environ Med. 2016;73(1):13–20. doi:10.1136/oemed-2014-10260125876606
   PubMed Web of Science ®Google Scholar
• Cankaya S, Topbas M, Beyhun NE, Can G, Kizilay Cankaya P. The evaluation of the effects of daytime sleepiness, anxiety and depression on the quality of life in 112 emergency medical staff. Eur Psychiatry. 2016;33:S174. doi:10.1016/j.eurpsy.2016.01.365
   Web of Science ®Google Scholar
• Lin TC, Lin HS, Cheng SF, Wu LM, Ou-Yang MC. Work stress, occupational burnout and depression levels: a clinical study of paediatric intensive care unit nurses in Taiwan. J Clin Nurs. 2016;25(7–8):1120–1130. doi:10.1111/jocn.1311926914523
   PubMed Web of Science ®Google Scholar
• Heffernan M, Quinn Griffin MT, McNulty SR, Fitzpatrick JJ. Self-compassion and emotional intelligence in nurses. Int J Nurs Pract. 2010;16(4):366–373. doi:10.1111/j.1440-172X.2010.01853.x20649668
   PubMed Web of Science ®Google Scholar
• Atkinson DM, Rodman JL, Thuras PD, Shiroma PR, Lim KO. Examining burnout, depression, and self-compassion in veterans affairs mental health staff. J Altern Complement Med. 2017;23(7):551–557. doi:10.1089/acm.2017.008728590766
   PubMed Web of Science ®Google Scholar
• Aziz A. Sources of perceived stress among American medical doctors: a cross-cultural perspective. Cross Cult Manag. 2004;11(4):28–39. doi:10.1108/13527600410797864
   Google Scholar
• Lindegard A, Larsman P, Hadzibajramovic E, Ahlborg G. The influence of perceived stress and musculoskeletal pain on work performance and work ability in Swedish health care workers. Int Arch Occup Environ Health. 2014;87(4):373–379. doi:10.1007/s00420-013-0875-823609321
   PubMed Web of Science ®Google Scholar
• Laranjeira CA. The effects of perceived stress and ways of coping in a sample of Portuguese health workers. J Clin Nurs. 2012;21(11–12):1755–1762. doi:10.1111/j.1365-2702.2011.03948.x22151103
   PubMed Web of Science ®Google Scholar
• McCarthy VJC, Power S, Greiner BA. Perceived occupational stress in nurses working in Ireland. Occup Med. 2010;60(8):604–610. doi:10.1093/occmed/kqq148
   Google Scholar
• Judd CM, Kenny DA. Process analysis: estimating mediation in treatment evaluations. Eval Rev. 1981;5(5):602–619. doi:10.1177/0193841X8100500502
   Web of Science ®Google Scholar
• Diamantopoulos A. Modelling with LISREL: a guide for the uninitiated. J Mark Manag. 1994;10(1–3):105–136. doi:10.1080/0267257X.1994.9964263
   Google Scholar
• MacCallum RC, Roznowski M, Mar CM, Reith JV. Alternative strategies for cross-validation of covariance structure models. Multivariate Behav Res. 1994;29(1):1–32. doi:10.1207/s15327906mbr2901_126771552
   PubMed Web of Science ®Google Scholar
• Wenxin X, Mengjuan C, Jiwei Y, Longfei C. Influence of the exercise-psychology adjustment mode on the mental health of medical workers. Iran J Public Health. 2017;46(6):782.28828320
   PubMed Web of Science ®Google Scholar
• Spinelli C, Wisener M, Khoury B. Mindfulness training for healthcare professionals and trainees: a meta-analysis of randomized controlled trials. J Psychosom Res. 2019;120:29–38. doi:10.1016/j.jpsychores.2019.03.00330929705
   PubMed Web of Science ®Google Scholar
• Hubley AM, Zumbo BD. Validity and the consequences of test interpretation and use. Soc Indic Res. 2011;103(2):219. doi:10.1007/s11205-011-9843-4
   Web of Science ®Google Scholar
• Mittinty MN, Vansteelandt S. Longitudinal mediation analysis using natural effect models. Am J Epidemiol. 2020;kwaa092. doi:10.1093/aje/kwaa092
   Web of Science ®Google Scholar