Healthcare
Depressive Symptoms, Insomnia-Related Difficulties and Self-Rated Health Among Community-Dwelling Adults Aged 40 Years and Older in Western China: A Cross-Sectional Structural Equation Modelling Study
By Yao L and Tham J.
Abstract
Background/objectives
This study examined the associations of depressive symptoms, medical help-seeking attitudes and perceived neighbourhood built environment with self-rated health, including statistical indirect associations through an Insomnia Severity Index (ISI)-derived sleep construct, among community-dwelling adults in western China.
Methods
This secondary cross-sectional analysis included 433 adults aged ≥40 years in Gaoping District, Nanchong, China. Self-rated health was assessed using the SF-36 General Health subscale. PHQ-9 and ISI indicators were reverse-coded so that higher values represented lower depressive symptom burden and fewer insomnia-related difficulties, respectively. Structural equation modelling estimated direct and indirect associations, with 5000 bootstrap resamples. Multi-group analysis compared the ISI-self-rated health path between family-functioning groups.