197. The moderating effect of different cultural identities on the mental health level of patients in community care

Abstract Background As a core component of the public health service system, the correlation between the service quality of community nursing and the mental health level of patients is a research hotspot. Existing research has confirmed that factors such as social support and nursing intervention models can significantly affect the psychological state of patients receiving community care, but the exploration of the role of cultural factors is still relatively scarce. This study takes cultural identity as the core moderating variable to explore its mechanism of action in the mental health level of patients in community care, aiming to clarify the moderating effects of cultural identity in different dimensions on the mental health level of patients and provide empirical evidence for optimizing the psychological intervention strategies in community care. Methods This study adopted a cross-sectional survey method and selected community care patients from four communities with different cultural backgrounds in China (Han-inhabited communities, ethnic minority inhabited communities, multicultural integration communities, and communities with a high concentration of migrant population) from January 2023 to December 2023 as the research subjects. The research tools included the general information questionnaire, the Cultural Identity Scale (CIS), and the Symptom Checklist 90 (SCL-90). The investigation was conducted by uniformly trained investigators who guided patients to fill out the questionnaires on-site. For patients who are unable to fill in the form independently, one-on-one interviews will be conducted to complete the task. Results The total score of cultural identity of patients in community care is 68.32 ± 10.54 points, which is at an upper-middle level. The total score of SCL-90 was 156.78 ± 32.45 points. Among them, there were 234 patients with psychological problems, accounting for 29.77%. The results of relevant analysis indicated that the total score of cultural identity and the scores of each dimension were significantly negatively correlated with the total score of SCL-90 and the scores of each dimension (r = -0.326 to -0.518, p<.01). The results of the moderating effect test showed that cultural identity had a significant moderating effect between the satisfaction of community nursing services and the mental health level of patients (β = 0.214, p<.001). Discussion The research results have clarified the significant regulatory effect of different cultural identities on the mental health level of patients under community care, especially that a high cultural identity can enhance the positive impact of community care service satisfaction on mental health. Formulate differentiated nursing strategies for patients with different levels of cultural identity, and carry out cultural adaptation training and build cultural exchange platforms for patients with low cultural identity in communities with concentrated migrant populations. Further strengthen cultural adaptation nursing services in multicultural integration communities and give full play to the positive regulatory role of cultural identity. However, the study did not cover community-based care patients with special disease types. Future research can include patients with more disease types to deeply explore the dynamic association mechanism between cultural identity and the mental health level of community-based care patients.