Objective:To develop a scale to measure the sense of gain of the elderly, and to evaluate its reliability and validity.Methods:According to the content of the sense of gain, combined with the literature research method and interview method, the scale entry pool was established.After the expert consistency evaluation and the optimal test assembly method (OTA) analysis, the formal version of the scale was formed.The stratified sampling method was used to select 1 043 community-dwelling elders for the survey, and the reliability and validity of the scale were evaluated by methods based on classical test theory.Results:The scale of elderly sense of gain, which was screened by OTA method, included four dimensions: health status, relationship and communication, social security, and ideal expectation, with a total of 17 items. The Cronbach's α value of the formal version of the scale was 0. 850, and the Cronbach's α coefficients of the four dimensions were 0.721, 0.772, 0.779, and 0.930, respectively. The CR values of the combined reliabilities of each dimension were all above 0.7. In terms of AVE values, except for the health status dimension was acceptable, the other three dimensions were all above 0.36. The correlation coefficient between the sense of health acquisition and life satisfaction of the elderly was 0.531 ( P<0.01). Conclusion:The developed scale for measuring the sense of gain of the elderly has good reliability and validity, which can be used as an effective tool for measuring the sense of gain of the elderly.

Objective:To explore the influencing factors of the subjective well-being of elderly individuals and improve the accuracy of well-being predictions.Methods:A multi-stage stratified sampling method was conducted in Guangdong province and Guangxi Zhuang autonomous region from August 2019 to October 2020. The health status and subjective well-being of older adults were assessed using a self-administered multidimensional health questionnaire, while overall well-being was evaluated with a single-item 5-point scale. The statistical analysis was performed using R software (version 4.3.2), with analytical methods including χ2 tests, univariate analysis, quantile regression and random forest model. Results:A total of 2 620 participants were recruited, and 70.9% of whom reported feeling happy.The depression symptom score of the elderly was 3.00(1.00, 6.00), emotional status score was (28.26±4.14), activities of daily living (ADL) score was 69.00(52.00, 81.00), and the body mass index(BMI) was (22.68±3.81)kg/m 2.The quantile regression results indicated that marital status (married)(Q 10: β=0.049; Q 50: β=0.014; Q 90: β=0.005) and depressive symptoms (no depression, depressive tendency)(Q 10: β=1.000; Q 50: β=1.000; Q 90: β=0.025) had varying effects on older adults' subjective well-being across three quantiles (Q 10, Q 50, Q 90)(all P<0.05). In contrast, social activity (no social activity)(Q 10: β=-0.072; Q 50: β=-0.011; Q 90: β=-0.006), ADL (severe disability, moderate disability, mild disability)(Q 10: β=-0.103, Q 50: β=-0.006, Q 90: β=-0.048; Q 10: β=-0.063, Q 50: β=-0.012, Q 90: β=-0.005; Q 10: β=-0.078, Q 50: β=-0.016, Q 90: β=-0.009), and emotional status (poor emotion, fair emotion)(Q 10: β=-0.261, Q 50: β=-0.009, Q 90: β=-0.025; Q 10: β=-0.140, Q 50: β=-0.017, Q 90: β=-0.029) had a negative impact on elderly subjective well-being at the three quantile points(all P<0.05). Random forest results indicated that depressive symptoms, ADL, emotional status, household monthly income per capita, BMI, social activity, multimorbidity status, and marital status were the most important determinants of subjective well-being. Conclusion:Depressive symptoms and emotional status have a significant impact on the subjective well-being of older adults. Additionally, ADL, household income per capita, BMI, and social engagement also play important roles in influencing well-being, while the emotional support provided by marriage should not be overlooked.

Objective:To develop a scale to measure the sense of gain of the elderly, and to evaluate its reliability and validity.Methods:According to the content of the sense of gain, combined with the literature research method and interview method, the scale entry pool was established.After the expert consistency evaluation and the optimal test assembly method (OTA) analysis, the formal version of the scale was formed.The stratified sampling method was used to select 1 043 community-dwelling elders for the survey, and the reliability and validity of the scale were evaluated by methods based on classical test theory.Results:The scale of elderly sense of gain, which was screened by OTA method, included four dimensions: health status, relationship and communication, social security, and ideal expectation, with a total of 17 items. The Cronbach's α value of the formal version of the scale was 0. 850, and the Cronbach's α coefficients of the four dimensions were 0.721, 0.772, 0.779, and 0.930, respectively. The CR values of the combined reliabilities of each dimension were all above 0.7. In terms of AVE values, except for the health status dimension was acceptable, the other three dimensions were all above 0.36. The correlation coefficient between the sense of health acquisition and life satisfaction of the elderly was 0.531 ( P<0.01). Conclusion:The developed scale for measuring the sense of gain of the elderly has good reliability and validity, which can be used as an effective tool for measuring the sense of gain of the elderly.

Objective:To explore the influencing factors of the subjective well-being of elderly individuals and improve the accuracy of well-being predictions.Methods:A multi-stage stratified sampling method was conducted in Guangdong province and Guangxi Zhuang autonomous region from August 2019 to October 2020. The health status and subjective well-being of older adults were assessed using a self-administered multidimensional health questionnaire, while overall well-being was evaluated with a single-item 5-point scale. The statistical analysis was performed using R software (version 4.3.2), with analytical methods including χ2 tests, univariate analysis, quantile regression and random forest model. Results:A total of 2 620 participants were recruited, and 70.9% of whom reported feeling happy.The depression symptom score of the elderly was 3.00(1.00, 6.00), emotional status score was (28.26±4.14), activities of daily living (ADL) score was 69.00(52.00, 81.00), and the body mass index(BMI) was (22.68±3.81)kg/m 2.The quantile regression results indicated that marital status (married)(Q 10: β=0.049; Q 50: β=0.014; Q 90: β=0.005) and depressive symptoms (no depression, depressive tendency)(Q 10: β=1.000; Q 50: β=1.000; Q 90: β=0.025) had varying effects on older adults' subjective well-being across three quantiles (Q 10, Q 50, Q 90)(all P<0.05). In contrast, social activity (no social activity)(Q 10: β=-0.072; Q 50: β=-0.011; Q 90: β=-0.006), ADL (severe disability, moderate disability, mild disability)(Q 10: β=-0.103, Q 50: β=-0.006, Q 90: β=-0.048; Q 10: β=-0.063, Q 50: β=-0.012, Q 90: β=-0.005; Q 10: β=-0.078, Q 50: β=-0.016, Q 90: β=-0.009), and emotional status (poor emotion, fair emotion)(Q 10: β=-0.261, Q 50: β=-0.009, Q 90: β=-0.025; Q 10: β=-0.140, Q 50: β=-0.017, Q 90: β=-0.029) had a negative impact on elderly subjective well-being at the three quantile points(all P<0.05). Random forest results indicated that depressive symptoms, ADL, emotional status, household monthly income per capita, BMI, social activity, multimorbidity status, and marital status were the most important determinants of subjective well-being. Conclusion:Depressive symptoms and emotional status have a significant impact on the subjective well-being of older adults. Additionally, ADL, household income per capita, BMI, and social engagement also play important roles in influencing well-being, while the emotional support provided by marriage should not be overlooked.

Objective To evaluate the performance of the Quality of Life Instrument for Chronic Dis-ease Nephrotic Syndrome [QLICD-NS(V2.0)] in patients with nephrotic syndrome.Methods A total of 203 patients with nephrotic syndrome (NS) diagnosed in the Department of Nephrology,Affiliated Hospital of Guangdong Medical University from March 2021 to November 2021 were selected for QLICD-NS(V2.0) eval-uation,and the evaluation methods were generalization theory (GT) and item response theory (IRT).The dif-ficulty,discrimination coefficient and information amount of each item were obtained by using Multilog 7.0 software to analyze the grade response model (GRM) of IRT.Results The results of GT showed that the contribution ratio of the global total score in the four domains of QLICD-NS(V2.0) scale was evenly distribu-ted,and the generalization coefficient of the four domains was greater than 0.50.Except for social function,the variance component of the participants in the other three domains were greater than the item variance compo-nent,and the reliability index of each domain was greater than 0.50.The results of IRT showed that the dis-crimination degree of QLICD-NS(V2.0) scale was 0.82.Except for items TNS7 and TNS8,the difficulty coef-ficients of the other items ranged from -3 to 3 and increase monotonically.Conclusion The QLICD-NS (V2.0) scale has good reliability in physiological function and psychological function,and is acceptable in so-cial field and special function.The QLICD-NS(V2.0) scale developed in this study has good performance.

Objective To understand the status of family well-being of university and high school students in Guangdong Province,and to analyze the factors affecting students'family well-being.Methods Using cluster sampling,students enrolled in two universities and six high schools in Guangdong Province were collected,and quartile regression was used to analyze the factors affecting the family well-being of these students.Results A valid sample of 4987 cases was obtained with the percentage of students who clearly feel happy being 73.5%.The quantile regression results showed that:gender(Q10,Q25,Q50,Q75),household registration(Q75,Q90),grade level(Q25,Q75),father's occupation(Q75),mother's occupation(Q75),father's education(Q90),freedom to develop hobbies and interests(Q10,Q50,Q75),freedom to make decisions(Q25,Q75),family members'transposition of thinking(Q75),parental interference(Q10,Q25,Q50,Q75),freedom to organize time(Q75,Q90),parental harshness(Q75),parental constraints(Q75),family closeness,family caring level,family atmosphere,and family solidarity are all related to family well-being among university and high school students.Among them,the family well-being are positively related to family closeness,family care,family atmosphere and family solidarity,and negatively related to parental interference.Conclusion Family well-being is relatively high among university and high school students in Guangdong Province.In order to enhance students'well-being,we should increase the degree of intimacy among family members to create a relaxing,happy and warm family atmosphere,and at the same time,parents should moderately reduce the amount of interference in their children's affairs.

Objective:To analyze and evaluate the items of the general module of multidimensional health measurement instruments system for elderly patients with chronic disease (MHIEC-GM)(V1.0) based on classical test theory (CTT) and item response theory (IRT).Methods:A self-administered survey of 2 375 elderly patients with chronic diseases was conducted using the MHIEC-GM(V1.0) scale. The quality of items was analyzed using the variability method, correlation coefficient method, factor analysis method, and Cronbach's α coefficient method based on CTT. The difficulty coefficient, differentiation coefficient, and information content of items were analyzed using the IRT analysis software MULTILOG 7.03.Results:The CTT results showed that the standard deviations of all nine items were greater than 0.9. The results of the correlation coefficient method, the factor analysis method and the Cronbach′s α coefficient method showed that except for the GMI9 item, the correlation coefficients between the other items and the total scale were all greater than 0.5, and the factor loads were all greater than 0.5, and the Cronbach′s α coefficients after the deletion of the items were all less than 0.763. Based on the results of the four analysis methods, except for the GMI9 item, all the other items had good characteristics. The IRT results showed that the information contents of all items were >0.333 (5/15) except for the GMI4, GMI6, and GMI8, and the differentiation coefficient of each item was 1.44. The items that difficulty coefficient met the [-4, 4] inclusion criteria were the GMI2, GMI3, GMI5, GMI7 and GMI9, showing a monotonically increasing trend with increasing difficulty level. The items of GMI1, GMI4, GMI6, and GMI8 needed further improvement.Conclusion:Most of items of the MHIEC-GM(V1.0) scale have good psychometric properties, but some items need to be further revised and validated according to the characteristics of chronic diseases in the elderly.

Objective To analyze and evaluate the items of the QLICD-CPHD(V2.0)scale for chronic pulmonary heart disease using classical test theory(CTT)and item response theory(IRT).Methods 184 patients with chronic pulmonary heart disease were investigated by QLICD-CPHD(V2.0)scale.The items of the QLICD-CPHD(V2.0)scale was evaluated by some statistical methods based on CTT including correlation coefficient method,variance method,factor analysis method and Cronbach's α coefficient method.Meanwhile,Samejima hierarchical response model of item response theory was utilized to calculate the difficulty,information and differentiation coefficient content of each item in the scale.Results CTT results showed that 7 items failed meet at least three or more statistical requirements,including 6 items in the general module and 1 item in the disease specific module.IRT results showed that the range of item differentiation was 1.18～1.44,which was suitable.The difficulty coefficient increases monotonously with the increase of the difficulty level(B1→B4),and some items exceed the standard value range.The average information amount of each item ranges from 0.185～0.576.Conclusion By CTT and IRT analysis,most items of the QLICD-CPHD(V2.0)scale have good performance and good differentiation,but a few items still need further revision.

ObjectiveTo analyze the quality of life and related factors in patients with depression， and to provide evidence for formulating the corresponding measures to improve the patients' quality of life. MethodsA total of 117 inpatients who met the International Classification of Diseases， tenth edition（ICD-10） for depression were selected in Central People's Hospital of Zhanjiang， Affiliated Hospital of Guangdong Medical University and Guangdong 999 Brain Hospital from November 19， 2018 to September 7， 2019. The values of patients' clinical objective indicators consisted of routine blood test， routine urine examination， blood biochemical tests and blood gas analysis were collected by reviewing their medical records， and all subjects were assessed using Quality of Life Instruments for Chronic Diseases-Depression V2.0 ［QLICD-DE（V2.0）］. Simple correlation analysis was used to explore the correlation between the QLICD-DE （V2.0） scores and various clinical objective indicators， and multiple linear regression was adopted to further screen factors affecting quality of life of patients with depression. ResultsSimple correlation analysis suggested that QLICD-DE （V2.0） total score was positively correlated with total protein and platelet distribution width in patients with depression （r=0.198， 0.281， P<0.05 or 0.01）， and negatively correlated with hematocrit （r=-0.300， P<0.01）. Multiple linear regression analysis showed that albumin-to-globulin ratio and treatment compliance （B=-19.836， -3.711， P<0.05 or 0.01） were influential factors for physical function. Platelet distribution width （B=2.706， P<0.01） was an influential factor for psychological function. Bilirubin （B=-6.375， P<0.05） was an influential factor for social function. Platelet distribution width （B=2.101， P<0.05） was an influencing factor for specific module. The albumin-to-globulin ratio and platelet distribution width （B=-10.653， 2.114， P<0.05 or 0.01） were influencing factors for total score of QLICD-DE （V2.0）. ConclusionTreatment compliance and clinical objective indicators platelet distribution width， bilirubin and albumin-to-globulin ratio may be the influencing factors of quality of life in patients with depression.

Objective To study patient delay and the influencing factors of the elderly patients with pulmonary tuberculosis（PTB），so as to provide evidence for developing effective prevention and control strategies. Methods Derived the information from PTB management information system in 2010-2019 of the tuberculosis patients who were aged 60 years or older in Huai'an City, described and analyzed the influencing factors of patient delay. Results The median time of PTB patients delay in Huaian was 21 day, while the rate was 65.91%. Multivariate logistic regression analysis results showed that compared with permanent residents, city dwellers, the first diagnosis unit specialized hospital, and the patient source referral, the patient delay risks of the floating residents（OR = 2.942 , 95% CI: 2.461-3.518）, the country dwellers（OR = 1.528,95% CI :1.377-1.697）, the first diagnosis unit general hospital（OR = 1.203,95% CI: 1.087-1.333）, and the patient source recommendation （OR = 2.395,95% CI: 1.960-2.928）were higher, Compared with the peasants（OR = 0.315 , 95% CI : 0.213-0.512）, new patients（OR = 0.812 , 95% CI : 0.689-0.974） and sputum smear positive patients（OR = 0.866 , 95% CI : 0.780-0.962）, the patient delay risks of the non-peasants, recurrent patients, and sputum negative patients were lower. Conclusion The patient delay of the elderly patients with pulmonary tuberculosis（PTB）in Huaian was serious, the influencing factors of patient delay were type of household registration, current residence, occupation, type of first-time unit, source of patient , classification of treatment, and the sputum test results.