Appraisal of influencing factors model outlook: a case of Chinese college students

. The negative views on life and frequent suicides among college students are urgent issues to be addressed. Based on grounded theory, the Influencing Factors Model of College Students’ Life Views (IFMCSLV) was constructed by open, axial, and selective coding. IFMCSLV revealed that 13 factors at four dimensions could influence college students’ views on life. Besides, several appropriate solutions were proposed based on IFMCSLV. We believe this study can provide references for establishing a positive outlook for college students.


Introduction
Scholars around the world address the life issues of college students, studying their life satisfaction [1], stressors [2], quality [3], spiritual life [4], stressful life events [5], academic stress [6], and more.Additionally, college students' suicides are studied through empirical research in many pieces of literature, such as college student suicides in the United States [7].In China, many researchers pay attention to the current situation of college students' view of life [8], connotations [9], problems [10], and more.As shown by the previous studies, academia has begun to place a premium on college students' life issues.The current research is primarily concerned with identifying the situation of college students' life views and searching for a method for reducing the suicides risk.
Ideation is a significant risk factor for future self-harmful behaviour [11].The life views provide a guideline for adopting life-related behaviours.Nevertheless, the current research lacks a comprehensive understanding of the impacting factors and their interactions on college students' life views.Therefore, it is challenging to systematically cultivate positive views on life among college students and change their life-related behaviours.
This research clarified the composition and interactions of factors influencing college students' views on life by Nvivo11 and finally obtained the Influencing Factors Model of College Students' Life Views (IFMCSLV).It is beneficial to systematically explore feasible measures to cultivate positive life views and change their life behaviours, thus providing a new research reference for suicide prevention among college students.Based on IFMCSLV, some preventive methods to cultivate positive life views and promote mental health protection among college students were recommended.

Research method
Grounded theory is a qualitative research technique used to develop a theory from empirical evidence [12].Based on the grounded theory, this research adopted the interview method, collected interview data, performed three-level coding, and finally constructed IFMCSLV.

Research subjects
The research subjects were chosen by purposeful sampling, following the knowledge and experience principles [13].Additionally, subjects' willingness to participate and ability to communicate articulately was considered.Finally, thirty-two college students (Age from 18-29, gender equality, 14 undergraduates, 14 master students, and 4 PhD students) in Wuhan who had rich life experiences and experienced life harming events were chosen.Table 1 summarizes the interviewees' basic information.Interviews lasted between 15 and 30 minutes and followed a pre-planned interview plan.With the interviewees' permission, the entire interview was recorded.

Interview questions
The Social-Ecological Suicide Prevention Model (SESPM) categorized suicide risk factors into four dimensions: individual, relational, community, and societal.Personal characteristics such as health status are in individual dimension.Relational dimension contains direct interactions between individuals, such as family support.Community dimension limits the impact within a specific area, such as schools, workplaces.Societal dimension includes factors that span society, such as policies, laws, social and cultural norms, etc. [14] Using the SESPM as a guide, this study delved deeper into the data collected about these four dimensions throughout the interview process.Additionally, great attention was paid to other information.

Data analysis
After transcribing the interview transcripts into text, the original interview data was analyzed in the order of open coding, axial coding, and selective coding by NVivo11.Before coding, two interview transcripts were randomly chosen as the test sample.

Open coding
Open coding aims to generate initial concepts and discover initial categories.The original interview data were deconstructed, and the most valuable original statements were conceptualized.The selected original statement served as an illustration of this initial concept.Accordingly, 91 useful original statements and 36 initial concepts were obtained.Subsequently, the initial concepts were categorized.Since there is some crossover, the initial concepts containing two or more repetitions were chosen, and those contradicting initial concepts were rejected.Finally, following filtering and categorization, 31 initial concepts and 19 initial categories were acquired.Table 2 contains the open coding results.

Axial coding
Axial coding aims to analyze potential logical links between initial categories, generates major groups and constructs various linkages between major categories and their corresponding initial categories.The initial categories were merged into the major categories according to their logical connections.Thus, 13 major categories were obtained.Axial coding results are shown in Table 3.

Life education course
Ignore life education courses Ignoring is a reflection of the life education courses.

Hope to improve the life course
Hope to improve is a reflection of the life education courses.

Psychological counselling institution
Counselling institution is one aspect of psychological assistance.

Psychological assistance services
Assistance services is one aspect of psychological assistance.

Media factor
Media impact Media impact is a media factor.

Social environment
Social environment Social environment is a social factor.

Selective coding
Selective coding aims at the core category.This research highlighted the core category of "factors and mechanisms impacting pupils' view on life."Then, studied the interrelationships and connections between the core and major categories through several inquiries and analyses of the original interview data.Eventually, IFMCSLV was created referring to the SESPM.As shown in Figure 1, the factors influencing college students' outlook on life are influenced by four dimensions and thirteen influencing factors.The specific mechanism of action is as follows: The five influencing factors at individual dimensions are endogenous factors.They directly influence college students' attitudes toward life and play a decisive role in their behaviour about life safety.D6 mentioned that bipolar disorder played a direct role in selfharm.In addition, M24 notes that the college student who committed suicide was in a poor mental state.M4 says that loneliness led to tragic suicide.The four influencing factors at the relational dimension, two influencing factors at the community dimension, and two influencing factors at the societal dimension are all exogenous elements that might affect college students' attitudes on life directly or indirectly.In terms of direct influence, those above can determine their direct impact on college students' outlook on life by being filtered into major categories.In terms of indirect effect, the analysis is as follows.First, the TSR affects college students' view of life by influencing their learning.M20 mentioned that the master student is particular because of the tutorial system.The heavy course load and the tutor's neglect or indifference to the student's emotions can expose the student to high pressure in academic.Second, life education courses influence how people perceive death indirectly.U14 says how a well-planned life course can provide her with the time and space to reflect on the meaning of life and death.Thirdly, the media indirectly affects college students' life views by affecting their psychological health.U13 stated that the information circulated through Sina Weibo during the COVID-19 made her apprehensive about life to the point where she couldn't take it anymore and unloaded it.Additionally, some evidence can be found in many pieces of literature to support the IFMCSLV theoretically.For example, the ability of positive TSR can change a life [15] , life education can help students correct life views and realize life's value and meaning [16], rumors spread by media and social networks in COVID-19 cause serious psychological impacts such as anxiety [17], mental health care needs to be highly regarded during COVID-19 [18], etc.Evidence of direct and indirect influence can also be found in the interview transcripts.This excerpt demonstrates the complexity and diversity of influences: "My view of life, ah, first is the people around me, second is the news media, and third is what I've learned." After the IFMCSLV was constructed, the two randomly selected test samples were subjected to a theoretical saturation test.The test showed no new main categories emerged.
Moreover, no other significant relationships were included among the 13 main categories.The above indicates that the theoretical model has reached saturation.

Conclusions
This study described the composition and interaction of the influencing factors on college students' life views through grounded theory.Finally, IFMCSLV was created.According to IFMCSLV, 13 factors influence college students' outlook on life from four dimensions.It is difficult to change at individual dimension technically.However, many measures have feasibility in the other three sizes.Currently, the scope of international suicide prevention efforts consists of four levels: primary, secondary, tertiary prevention and postvention [14].In terms of ex-ante prevention, the first three levels are worth considering.Referring to them and IFMCSLV, this research proposes the following entry points for college students' mental health protection and suicide prevention in universities.
In primary prevention, great attention should be paid to life education practice.The IFMCSLV shows that life education can directly influence college students' views on life.It can also indirectly influence them by influencing death cognition.Thus, life education is a significant breakthrough point.Several interviewees mentioned that their universities do not have reasonable and interactive life education.Therefore, universities should combine theory and practice in life education, such as the Life Education Experience Hall established in Yuhang and the Life Education Practice Base in Shanghai Normal University.
In secondary prevention, focus on TSR and imply gate-keeper training.TSR is a fundamental ethical relationship in educational practice.Many scholars studied TSR, such as communication skills in TSR [19], quality of TSR [20], TSR's effect on academic press [21], motivation to learn [22], emotional and behavioural adjustment [23], etc. Hagenauer (2014) notes that TSR affects students' studies at universities [24].According to IFMCSLV, tutors' indifference can negatively influence one's academic stress and indirectly impact their life views.College years prove to be a vulnerable time for students and a critical period for suicide prevention [25].The gate-keeper training program is a suicide prevention effort widely used in many populations.It trains people who regularly contact those in psychological distress to reduce the suicide rate [26].The tutor is the first person responsible for postgraduate training in China.Instructors need to acquire mental health knowledge and become powerful "gate-keepers" through professional mental health seminars.
In tertiary prevention, further establish a psychological assistance system.According to IFMCSLV, psychological assistance can directly impact students' views on life.Universities should further build an on-campus psychological assistance system.Additionally, relying on the mental health resources in the region deepens medical-school cooperation.As Zhongchun Liu in Renmin Hospital of Wuhan University said, the late intervention of psychotherapy needs to integrate social forces.
In general, regarding the international scope of suicide prevention efforts and IFMCSLV, the breakthrough points proposed above were summarized based on the research.More supportive measures are expected to ensure that the psychological assistance system in universities is fully utilized and develop a positive outlook on life to reduce the likelihood of suicide and self-injurious conduct in college students effectively.In future studies, more samples can be expanded to remove geographic and statistical bias.

Table 1 .
Basic information of interviewees.

Table 2 .
Open coding results.
There are three graduate students around me who committed suicide.They are under too much pressure to study.WorkingFrustrated at work 7.The essence is the frustration caused by not getting the due return for their work, so as to be disappointed in life.