AimTo assess the servant leadership behaviour of head nurse and its linkage with nurse work engagement in China.DesignA cross‐sectional study.MethodsA anonymous investigation with the stratified cluster randomized sampling of nurse was conducted in Hunan Province of China in December 2020. We administered the Perceived Head Nurse Service Leadership Behaviour Scale and the Chinese version of Utrecht work engagement scale to survey, and analyse its relationships by multiple linear regression.ResultsA number of 890 nurses participated in this study. The average score of the perceived servant leadership of head nurse reported by nurses was 78.90 ± 14.04, which was at a medium level. Among its six dimensions, the dimension of promote nurse development scored highest (16.04 ± 2.84), while the dimension of dedication scored lowest (11.39 ± 2.46). Official nurses reported higher perceived servant leadership scores of head nurses than those who were employed and temporary nurses (b = 1.727, 95% CI: 0.054–3.400); nurses in tertiary hospitals reported higher perceived servant leadership scores of head nurses than nurses in primary and secondary hospitals (b = 2.703, 95% CI: 0.305–5.100); and lower perceived servant leadership scores were associated with nurses' job overtime (b = −4.935, 95% CI: −6.891 to −2.978). Nurses' perceived servant leadership of head nurses were positively associated with nurses' work engagement (r = 0.336, p < .05). Multiple linear regression analysis indicated that the perceived servant leadership of head nurse affected nurses' work engagement strongly (b = 0.585, 95% CI: 0.479–0.691).ConclusionThe servant leadership behaviour of head nurse in China was at the medium level, which was positively associated with nurses' work engagement. Further research should improve the power of the servant leadership behaviour of head nurse by integrating additional training, policies and support.ImpactIt is time to consider the servant leadership behaviour of head nurses and its linkage with nurses' work engagement in China seriously, and address the policies, guidelines, curriculum, and practice culture.Patient or Public ContributionThe study was conducted to explore the situation of servant leadership behaviour of head nurses and its linkage with nurses' work engagement in China, which did not include input from the public or the intended participants.

Due to the growth of research on sleep, mental health, and learning burnout on healthy growth and its related public health significance of adolescents, this study aimed to provide a deeper understanding of the effect of mental health and learning burnout on sleep among primary school students. The sleep quality (subjective sleep quality, sleep time, sleep latency, sleep duration, sleep efficiency, sleep disturbance, and daytime dysfunction), mental health, and learning burnout (exhaustion, learning cynicism, and reduced efficacy) of 900 students of grades 3–6 in primary schools were assessed in 2020. The PSQI scores of participants were 4.19 ± 2.545, of which a number of 322 (39.03%) students had sleep disturbance (PSQI scores ≧ 5). Binary logistic regression analysis showed that screen time (OR = 1.518, 95% CI: 1.164–1.980), ranking status (OR = 0.659, 95% CI: 0.480–0.907), learning burnout (OR = 1.088, 95% CI: 1.067–1.108), and mental health (OR = 4.672, 95% CI: 1.954–11.173) were the influencing factors for sleep quality of grade 3–6 students. According to the mediation effect analyses, mental health played a mediating effect (58.73% of the total effect) on the relationship between learning burnout and sleep quality. In conclusion, primary school students in Hunan of China have prominent sleep problems, and the daytime dysfunction caused by sleep problems is the most serious. Learning burnout positively predicted poorer sleep quality, and mental health played a mediating effect on the relationship between learning burnout and sleep quality.

Health system responsiveness (HSR) measures the experience of health-system users in terms of the non-clinical domains of the health system, which has been regarded as the three major goals of health performance evaluation. Good HSR may promote the use of health services and ultimately the health of patients. However, the HSR has not been measured as the main goal of the Epilepsy Management Project (EMP) in rural China. This study aims to evaluate the levels and distributions of the patient-perceived HSR of the EMP in rural China during the period of COVID-19 and identify its relevant factors so as to provide advice on the improvement of further strategies. Based on the key informant survey (KIS) of responsiveness from the World Health Organization proposal, we conducted a cross-sectional survey of 420 epilepsy patients selected proportional randomly from seven rural areas in the Hunan province of China in 2021. Eight domains of patients-perceived HSR were assessed by face-to-face interview. The overall HSR scored at a fairly “good” level of 8.3 (8.3 out of a maximum of 10.0). During the COVID-19 period, the scores of responsiveness domains were highest at 8.66 to 8.93 in “confidentiality”, “dignity” and “choice of providers”, while lowest at 8.38 to 8.53 in “prompt attention”, “social support” and “basic amenities”. The representative responsiveness equality index (REI) was 0.732, indicating the moderately balanced distributions of responsiveness of the EMP in rural China. Female, old age, and low education were significantly related to the lower HSR scores of rural EMP (p < 0.05). The HSR of EMP in rural China was fairly good. However, measures to improve the patient-perceived HSR are still needed, especially including better service, higher social support, and more comfortable medical environments.

Objectives Mental health resources are an important basis for coping with mental health services. The equity is an important index of a reasonable allocation of health resources. This study aims to evaluate the mental health resources and its equity allocation in Hunan Province, which is one of the typical central south areas of China, so as to provide reference for the development of mental health in China and other areas. Methods Data related to mental health resources was obtained from the Project of Mental Health Resources in Hunan Province, which was conducted by the Department of Hunan Mental Health Center in 2019. The Gini coefficient, the Theil index and other indicators were employed to quantitatively evaluate the equity of mental health resources’ allocation. Results By the end of 2018, there were a total of 141 mental health institutions in Hunan Province of China, the bed density was 5.31 beds per 10,000 people, the ratio of doctors to nurses was 2.20, the number of outpatients of mental health institutions was 1288,047 per year. The mental health resources’ allocation in terms of demographic dimension were in a preferred status with the Gini values all less than 0.3, and the Gini values for mental health resources`allocation in terms of geographical dimension ranged from 0.24 to 0.35. The Theil index for mental health allocation in terms of demographic dimension was lower than 0.05, and the Theil index for mental health allocation in terms of geographical dimension ranged from 0.04 to 0.11. Conclusions The shortage of mental health resources is still the priority issue to be increased and optimized by policy-makers in Hunan in the future, especially the human resources. Moreover, the utilization of mental health resources was low though its equity was fair. Policy-makers need to consider the high utilization and geographical accessibility of health resources among different regions to ensure people in different regions could get access to available health services.

The aim of this study was to explore the compliance of epilepsy patients in the Phenobarbital Epilepsy Management Project in a rural area of China and its influencing factors, so as to provide the basis for further strategies. A retrospective study researching on the compliance of epilepsy patients in the Phenobarbital Epilepsy Management Project of Rural China was conducted. The Nan County, Hunan Province as a typical rural China was selected as the study site. We collected the compliance and other relative factors from 2017 to 2019 though the Phenobarbital Epilepsy Management Project data system. The good compliance patients in the Phenobarbital Epilepsy Management Project in a rural area of China were 98.99% (393/397); only 4 cases had poor compliance. The factors affecting the compliance of epilepsy patients were “adverse reactions of digestive tract symptoms,” “how the patient felt physically, mentally, or working and learning ability during this period," and “the ratio of the attack to the previous one.” The rate of good compliance among the epilepsy patients in the Phenobarbital Epilepsy Management Project in a rural area of China was high. More attention to education, patients’ psychology, and the curative effect of family members may improve the compliance of patients with epilepsy further.