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Wong CPS, Yeung JTK, Fong DYT, Smith RD, Ngan AHY, Lam YYL, Chan KSS, Leung HHY, Wang MP, Wong JYH. Effectiveness of group cognitive behavioral therapy for depression in adults: a systematic review and meta-analysis of delivery by different healthcare professionals. Cogn Behav Ther 2024; 53:302-323. [PMID: 38372166 DOI: 10.1080/16506073.2024.2313741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/14/2024] [Indexed: 02/20/2024]
Abstract
This study addresses the gap in understanding the varied effectiveness of group cognitive behavioral therapy (gCBT) delivered by different professionals. This study aims to address this gap by conducting a systematic review of randomized controlled trials (RCTs) that evaluate gCBT and compare it to inactive controls in adults with a clinical diagnosis of depression. A total of 33 RCTs were included for analysis. In the overall analysis, 'profession of gCBT deliverer' was not a significant moderator in the meta-regression model (p = 0.57). For people without comorbidity, the overall effect size estimate was -0.69 (95% CI, -1.01. to -0.37, p = 0.03). Among gCBT deliverers, psychologists and nurses/psychiatric nurses demonstrated significant effectiveness, with psychologists showing a large effect size of -0.78 (95% CI, -1.25 to -0.30, p < 0.01) and nurses/psychiatric nurses showing a medium effect size of -0.45 (95% CI, -0.85 to -0.05, p = 0.03). The certainty of evidence for both professionals was moderate. These results have significant implications for the delivery of mental healthcare, as nurses/psychiatric nurses may be more accessible and cost-effective than psychologists in some settings. However, further research is necessary to determine the effectiveness of gCBT delivered by a broader range of healthcare professionals for patients with depression and other comorbidities.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Man Ping Wang
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
| | - Janet Yuen Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
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2
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Li J, Fong DYT, Lok KYW, Wong JYH, Man Ho M, Choi EPH, Pandian V, Davidson PM, Duan W, Tarrant M, Lee JJ, Lin CC, Akingbade O, Alabdulwahhab KM, Ahmad MS, Alboraie M, Alzahrani MA, Bilimale AS, Boonpatcharanon S, Byiringiro S, Hasan MKC, Schettini LC, Corzo W, De Leon JM, De Leon AS, Deek H, Efficace F, El Nayal MA, El-Raey F, Ensaldo-Carrasco E, Escotorin P, Fadodun OA, Fawole IO, Goh YSS, Irawan D, Khan NE, Koirala B, Krishna A, Kwok C, Le TT, Leal DG, Lezana-Fernández MÁ, Manirambona E, Mantoani LC, Meneses-González F, Mohamed IE, Mukeshimana M, Nguyen CTM, Nguyen HTT, Nguyen KT, Nguyen ST, Nurumal MS, Nzabonimana A, Omer NAMA, Ogungbe O, Poon ACY, Reséndiz-Rodriguez A, Puang-Ngern B, Sagun CG, Shaik RA, Shankar NG, Sommer K, Toro E, Tran HTH, Urgel EL, Uwiringiyimana E, Vanichbuncha T, Youssef N. Key lifestyles and health outcomes across 16 prevalent chronic diseases: A network analysis of an international observational study. J Glob Health 2024; 14:04068. [PMID: 38606605 PMCID: PMC11010581 DOI: 10.7189/jogh-14-04068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
Background Central and bridge nodes can drive significant overall improvements within their respective networks. We aimed to identify them in 16 prevalent chronic diseases during the coronavirus disease 2019 (COVID-19) pandemic to guide effective intervention strategies and appropriate resource allocation for most significant holistic lifestyle and health improvements. Methods We surveyed 16 512 adults from July 2020 to August 2021 in 30 territories. Participants self-reported their medical histories and the perceived impact of COVID-19 on 18 lifestyle factors and 13 health outcomes. For each disease subgroup, we generated lifestyle, health outcome, and bridge networks. Variables with the highest centrality indices in each were identified central or bridge. We validated these networks using nonparametric and case-dropping subset bootstrapping and confirmed central and bridge variables' significantly higher indices through a centrality difference test. Findings Among the 48 networks, 44 were validated (all correlation-stability coefficients >0.25). Six central lifestyle factors were identified: less consumption of snacks (for the chronic disease: anxiety), less sugary drinks (cancer, gastric ulcer, hypertension, insomnia, and pre-diabetes), less smoking tobacco (chronic obstructive pulmonary disease), frequency of exercise (depression and fatty liver disease), duration of exercise (irritable bowel syndrome), and overall amount of exercise (autoimmune disease, diabetes, eczema, heart attack, and high cholesterol). Two central health outcomes emerged: less emotional distress (chronic obstructive pulmonary disease, eczema, fatty liver disease, gastric ulcer, heart attack, high cholesterol, hypertension, insomnia, and pre-diabetes) and quality of life (anxiety, autoimmune disease, cancer, depression, diabetes, and irritable bowel syndrome). Four bridge lifestyles were identified: consumption of fruits and vegetables (diabetes, high cholesterol, hypertension, and insomnia), less duration of sitting (eczema, fatty liver disease, and heart attack), frequency of exercise (autoimmune disease, depression, and heart attack), and overall amount of exercise (anxiety, gastric ulcer, and insomnia). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05). Conclusion To effectively manage chronic diseases during the COVID-19 pandemic, enhanced interventions and optimised resource allocation toward central lifestyle factors, health outcomes, and bridge lifestyles are paramount. The key variables shared across chronic diseases emphasise the importance of coordinated intervention strategies.
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Affiliation(s)
- Jiaying Li
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Janet Yuen Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong SAR, China
| | - Mandy Man Ho
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Vinciya Pandian
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Patricia M Davidson
- Vice-Chancellor and Principal, University of Wollongong, Wollongong, Australia
| | - Wenjie Duan
- Department of Social Work, East China University of Science and Technology, Shanghai, China
| | - Marie Tarrant
- School of Nursing, The University of British Columbia, Kelowna, British Columbia, Canada
| | - Jung Jae Lee
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Oluwadamilare Akingbade
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China
- Institute of Nursing Research, Osogbo, Osun State, Nigeria
| | | | - Mohammad Shakil Ahmad
- Department of Family & Community Medicine, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Mohamed Alboraie
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Meshari A Alzahrani
- Department of Urology, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Anil S Bilimale
- School of Public Health, JSS Medical College, JSS AHER, Mysuru, India
| | | | - Samuel Byiringiro
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | | | | | | | - Hiba Deek
- Nursing Department, Faculty of Health Science, Beirut Arab University, Beirut, Lebanon
| | - Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | | | - Fathiya El-Raey
- Department of hepatogastroenterology and infectious diseases, Damietta faculty of medicine, Al-Azhar University, Cairo, Egypt
| | | | - Pilar Escotorin
- Laboratory of Applied Prosocial Research, Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Barcelona, Spain
| | | | | | - Yong-Shian Shawn Goh
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore
| | - Devi Irawan
- School of Nursing, Wijaya Husada Health Institute, Bogor, Indonesia
| | | | - Binu Koirala
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Cannas Kwok
- School of Nursing, Paramedicine and Health Care Science, Charles Sturt University, New South Wales, Australia
| | | | | | | | - Emery Manirambona
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Leandro Cruz Mantoani
- Department of Physiotherapy, Faculty of Science and Technology, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | | | - Iman Elmahdi Mohamed
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Benghazi University, Benghazi, Libya
| | - Madeleine Mukeshimana
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | | | | | | | - Mohd Said Nurumal
- Kulliyyah of Nursing, International Islamic University, Kuantan, Malaysia
| | - Aimable Nzabonimana
- Center for Language Enhancement, College of Arts and Social Sciences, University of Rwanda, Huye, Rwanda
| | | | | | | | | | | | - Ceryl G Sagun
- School of Nursing, Centro Escolar University, Manila, Philippines
| | - Riyaz Ahmed Shaik
- Department of Family & Community Medicine, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Nikhil Gauri Shankar
- Mental Health and Learning division, Wrexham Maelor Hospital, Wrexham, Wales, UK
| | - Kathrin Sommer
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Edgardo Toro
- Pontificia Universidad Católica de Valparaíso, School of Social Work, Valparaíso, Chile
| | | | - Elvira L Urgel
- School of Nursing, Centro Escolar University, Manila, Philippines
| | | | - Tita Vanichbuncha
- Department of Statistics, Chulalongkorn Business School, Bangkok, Thailand
| | - Naglaa Youssef
- Medical-surgical Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt
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Chen N, Fong DYT, Wong JYH. Health and economic burden of low back pain and rheumatoid arthritis attributable to smoking in 192 countries and territories in 2019. Addiction 2024; 119:677-685. [PMID: 38105035 DOI: 10.1111/add.16404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 10/30/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND AND AIMS Smoking is a risk factor for low back pain (LBP) and rheumatoid arthritis (RA). We aimed to estimate the global health and economic burden of LBP and RA attributable to smoking. DESIGN This was a cross-sectional study. SETTING The study was conducted in 192 countries and territories. CASES Prevalent cases of LBP and RA were used, extracted from the Global Burden of Diseases, Injuries and Risk Factors Study 2019 data repositories. MEASUREMENTS Smoking-attributable health and economic burden was estimated with the population-attributable fraction method. Smoking-attributable prevalence of LBP and RA and health-care costs were estimated for patients of all ages, whereas years lived with disability (YLDs) and productivity losses due to morbidity were estimated for patients aged 15-84 years. Uncertainty intervals (UIs) of the results were obtained by repeating the analysis with the lower and upper bounds of all input variables. FINDINGS Globally, smoking accounted for 84.5 million (UI = 56.7-120.2 million) prevalent cases of LBP, 1.8 million (UI = 0.5-3.4 million) prevalent cases of RA and 11.3 million (UI = 6.2-18.5 million) YLDs, which represented 1.5% of all-cause YLDs in the working-age population aged 15-84 years in 2019. Health-care costs and productivity losses of smoking-attributable LBP and RA cost the global economy purchasing-power parity $326.0 billion (UI = $184.0-521.4 billion), representing 0.2% of the global gross domestic product. Specifically, smoking accounted for $65.8 billion (UI = $38.0-101.2 billion) in health-care costs world-wide, with more than half [$39.8 billion (UI = $23.1-61.3 billion), 60.6%] borne by the public sector. Smoking also contributed to $260.3 billion (UI = $146.0-420.3 billion) in productivity losses globally. Approximately 60.0% of the global YLDs were observed in middle-income countries, whereas 84.4% of health-care costs and 72.7% of productivity losses were borne by high-income countries. CONCLUSIONS Globally, in 2019, smoking accounted for more than 11.0 million years lived with disability and purchasing-power parity $326.0 billion in economic losses due to low back pain and rheumatoid arthritis. Middle-income countries suffered more morbidity, whereas high-income countries experienced larger economic losses.
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Affiliation(s)
- Ningjing Chen
- School of Nursing, Putian University, Putian, China
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Janet Yuen Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
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Pak SHL, Wang MP, Teitelman AM, Wong JYH, Fong DYT, Choi EPH. Nurse-Led Brief Intervention for Enhancing Safe Sex Practice Among Emerging Adults in Hong Kong Using Instant Messaging: Feasibility Study. JMIR Form Res 2024; 8:e52695. [PMID: 38506897 PMCID: PMC10993122 DOI: 10.2196/52695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/24/2024] [Accepted: 01/31/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND The incidence of sexually transmitted infections has been increasing throughout the world. Additionally, substantial changes in emerging adults' attitudes toward sex and the popularization of premarital sex could further affect the diagnosis and treatment of sexually transmitted infections. With the high acceptability and effectiveness of instant messaging (IM) interventions for health promotion, there is potential for such interventions to improve condom use knowledge and promote safer sex practice. OBJECTIVE The study evaluates the feasibility of a nurse-led IM intervention to promote safer sex practices in emerging adults. METHODS A 30-minute adaptive IM intervention and a 5-day booster dose of daily messages after 2 weeks through WhatsApp (Meta Platforms, Inc) were conducted with emerging adults in local universities in Hong Kong aged between 18 and 29 years with previous sexual experience. A questionnaire was distributed 1 week after the intervention that measured the consistency in condom use, the change in condom use knowledge and attitudes, and the acceptability of the intervention. The feasibility of the intervention was assessed by Bowen's feasibility framework. RESULTS A total of 20 participants completed the intervention and questionnaire. Results showed (1) high satisfaction level (mean satisfaction score: 9.10/10), (2) high demand of the intervention (retention rate: 95%), (3) smooth implementation of the intervention, (4) high practicality (13/20, 65% of the participants viewed IM to be an effective means of intervention), (5) potential integration of the intervention, and (6) significant mean increase in condom use knowledge and attitudes (mean increase 9.05; t19=3.727; 95% CI 3.97-14.13; P=.001). CONCLUSIONS The IM intervention was feasible, acceptable, and had potential impacts on improving safer sex practices. These findings will support the future development of IM interventions in the arena of sexual health promotion.
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Affiliation(s)
- Sharon Hoi Lam Pak
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Man Ping Wang
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Anne M Teitelman
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
- College of Nursing, Thomas Jefferson University, Philadelphia, PA, United States
| | - Janet Yuen Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China (Hong Kong)
| | - Daniel Yee Tak Fong
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Edmond Pui Hang Choi
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
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Takemura N, Cheung DST, Fong DYT, Lee AWM, Lam TC, Ho JCM, Kam TY, Chik JYK, Lin CC. Effectiveness of Aerobic Exercise and Tai Chi Interventions on Sleep Quality in Patients With Advanced Lung Cancer: A Randomized Clinical Trial. JAMA Oncol 2024; 10:176-184. [PMID: 38060250 PMCID: PMC10704344 DOI: 10.1001/jamaoncol.2023.5248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/05/2023] [Indexed: 12/08/2023]
Abstract
Importance Sleep disturbances prevalent among patients with advanced lung cancer can aggravate physical and psychological symptoms, contributing to decreased quality of life and survival. Objective To compare the effectiveness of 2 physical activities of different modalities and intensities, namely aerobic exercise (AE) and tai chi (TC), on subjective sleep quality, physical and psychological outcomes, and survival in patients with advanced lung cancer. Design, Setting, and Participants This assessor-blinded, randomized clinical trial was conducted in 3 public hospitals in Hong Kong between December 19, 2018, and September 7, 2022. A total of 226 patients with advanced lung cancer were recruited and randomized 1:1:1 to AE, TC, or the control group. Interventions For 16 weeks, the AE group received two 60-minute supervised group exercise sessions and home-based exercises per month, and the TC group received 60-minute group sessions twice weekly. The control group received physical activity guidelines. Main Outcomes and Measures The primary outcome was subjective sleep quality. Secondary outcomes included objective sleep measures, anxiety, depression, fatigue, quality of life, physical function, circadian rhythm, and 1-year survival. Assessments were conducted at baseline, 16 weeks (T1), and 1 year (T2). Results The 226 participants had a mean (SD) age of 61.41 (8.73) years, and 122 (54.0%) were female. Compared with the control group, participants in the AE and TC groups showed statistically significant improvements in subjective sleep quality from baseline to T1 (AE: between-group difference, -2.72; 95% CI, -3.97 to -1.46; P < .001; TC: between-group difference, -4.21; 95% CI, -5.48 to -2.94; P < .001) and T2 (AE: between-group difference, -1.75; 95% CI, -3.24 to -0.26; P = .02; TC: between-group difference, -3.95; 95% CI, -5.41 to -2.49; P < .001), psychological distress, physical function, step count, and circadian rhythm. The TC group had a statistically significant greater improvement in sleep than the AE group at T1 (between-group difference, -1.49; 95% CI, -2.77 to -0.22; P = .02) and T2 (between-group difference, -2.20; 95% CI, -3.57 to -0.83; P < .001). Participants in the TC group showed statistically significant improvement in survival compared with the control group. Conclusions and Relevance In this randomized clinical trial, AE and TC improved sleep, psychological distress, physical function, and circadian rhythm, with TC demonstrating greater benefits on sleep and survival. Both exercises, but particularly TC, can be incorporated into lung cancer survivorship care. Trial Registration ClinicalTrials.gov Identifier: NCT04119778.
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Affiliation(s)
- Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Anne Wing Mui Lee
- Department of Clinical Oncology, University of Hong Kong–Shenzhen Hospital, Guangdong, China
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Tai-Chung Lam
- Department of Clinical Oncology, University of Hong Kong–Shenzhen Hospital, Guangdong, China
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
- Rosemere Cancer Center, Royal Preston Hospital, Lancashire, England, United Kingdom
| | - James Chung-Man Ho
- Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Tsz Yeung Kam
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | | | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
- Alice Ho Miu Ling Nethersole Charity Foundation, Tai Po, Hong Kong
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Fan Y, Li J, Wong JYH, Fong DYT, Wang KMP, Lok KYW. Text messaging interventions for breastfeeding outcomes: A systematic review and meta-analysis. Int J Nurs Stud 2024; 150:104647. [PMID: 38056353 DOI: 10.1016/j.ijnurstu.2023.104647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/31/2023] [Accepted: 11/15/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Given the health benefits of breastfeeding for infants and mothers, breastfeeding has become a significant public health issue. The global growth of mobile phone usage has created new options for breastfeeding promotion, including text messaging. OBJECTIVE We aimed to evaluate the efficacy of text messaging interventions on breastfeeding outcomes and to identify the efficacy moderators of such interventions. METHODS Ten electronic databases were searched from the inception of the databases to 5 July 2023. Studies were included if they used randomized controlled trials or quasi-experimental designs to evaluate the effect of text messaging interventions on breastfeeding outcomes. Two reviewers screened the included studies, assessed the risk of bias, and extracted the data. Pooled results were obtained by the random-effects model, and subgroup analyses were conducted on intervention characteristics to identify potential moderators. The protocol of this study was registered on PROSPERO (ID: CRD42022371311). RESULTS Sixteen studies were included. Text messaging interventions could improve the exclusive breastfeeding rate (at <3 months: OR = 2.04; 95 % CI: 1.60-2.60, P < 0.001; at 3-6 months: OR = 1.66; 95 % CI: 1.18-2.33, P = 0.004; at ≥6 months: OR = 2.13; 95 % CI: 1.47-3.08, P < 0.001), and the breastfeeding self-efficacy (SMD = 0.30, 95 % CI: 0.14-0.45, P < 0.001). Text messaging interventions that covered antenatal and postnatal periods, delivered weekly were most effective in improving the exclusive breastfeeding rate. CONCLUSIONS Text messaging interventions may improve breastfeeding practice compared with no or general health information. We suggest text messaging conducted from the pre- to postnatal periods in a weekly manner can effectively increase exclusive breastfeeding rates and breastfeeding self-efficacy. Further studies should investigate the relation between new theories (such as the health action process approach and the theory of message-framing) and efficacy of breastfeeding interventions, using text components.
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Affiliation(s)
- Yingwei Fan
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Junyan Li
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Janet Yuen Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan, Hong Kong, China
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Nam S, Wong JYH, Wang T, An B, Fong DYT. Psychological distress as a mediator between workplace violence and turnover intention with caring for patients with COVID-19. Front Psychol 2024; 14:1321957. [PMID: 38259558 PMCID: PMC10801077 DOI: 10.3389/fpsyg.2023.1321957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024] Open
Abstract
The Coronavirus Disease 2019 (COVID-19) outbreak exacerbated workplace violence and turnover intention among nurses, particularly affecting greater levels of psychological distress. This study aimed to examine psychological distress as a mediator of the relationship between workplace violence and turnover intention among clinical nurses, and to investigate whether caring for patients with COVID-19 moderates this relationship through the lens of the affective events theory. We conducted an online survey of 325 Korean registered nurses (mean age = 30.75; female = 92.6%) who work in clinical settings between August and October 2021 using the convenience sampling method. Psychological distress was measured using the 21-item Depression Anxiety Stress Scale and workplace violence using one dichotomous item adopted from the Workplace violence questionnaire. We measured turnover intention using the six-item Anticipated Turnover Scale. Caring for patients with COVID-19 was determined using one dichotomous item. The research hypotheses assume that the relationship between workplace violence and turnover intention could be mediated by psychological distress and moderated by caring for patients with COVID-19 among Korean nurses. We performed a moderated mediation analysis with workplace violence as the independent variable, turnover intention as the dependent variable, psychological distress as a potential mediator, and caring for patients with COVID-19 as a potential moderator. The analysis revealed that nurses' psychological distress among 308 nurses had a statistically significant mediating effect on the relationship between workplace violence and turnover intention. Furthermore, caring for patients with COVID-19 had a significant further moderating effect on this relationship. These findings highlight the need for psychological support services for clinical nurses at institutional and organizational levels amidst the ongoing COVID-19 pandemic. It is hoped that these findings can contribute to the development of tailored interventions for nurses caring for patients with COVID-19 to attenuate their psychological distress in a timely and effective manner.
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Affiliation(s)
- Sujin Nam
- School of Health and Environmental Science, College of Health Science, Korea University, Seoul, Republic of Korea
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Janet Yuen Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, Hong Kong SAR, China
| | - Tingxuan Wang
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Bomi An
- College of Nursing, Hannam University, Daejeon, Republic of Korea
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Yang N, Ma H, Huang M, Lau EYY, Fong DYT, Wang M, Wang P, Xu S, Xu J, Jiang C, Luo Y, Meng R. Measurement Properties and Optimal Cutoff Point of the WHO-5 Among Chinese Healthcare Students. Psychol Res Behav Manag 2023; 16:5141-5158. [PMID: 38148776 PMCID: PMC10750781 DOI: 10.2147/prbm.s437219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/26/2023] [Indexed: 12/28/2023] Open
Abstract
Purpose The World Health Organization-Five Well-Being Index (WHO-5) is widely used to assess subjective well-being. Nevertheless, measurement invariance and optimal cutoff point of the WHO-5 have not been examined in Chinese samples. We aimed to assess measurement properties of the Chinese version of the WHO-5 (WHO-5-C) among healthcare students. Patients and Methods A two-wave longitudinal assessment was conducted among 343 Chinese healthcare students from September to November 2022. Measurement properties of the WHO-5-C were assessed through structural validity using confirmatory factor analysis (CFA), measurement invariance using multigroup CFA (MGCFA) and longitudinal CFA (LCFA), convergent validity using correlation analysis with the Self-Rated Health Questionnaire (SRHQ) and Patient Health Questionnaire-4 (PHQ-4), reliability using internal consistency and test-retest reliability, and optimal cutoff point using receiver operating characteristic (ROC) analysis. Results The WHO-5-C demonstrated satisfactory structural validity with comparative fit index (CFI) of 0.968 at baseline and 0.980 at follow-up, and adequate measurement invariance in different sociodemographic variables at baseline (gender, age, major, home location, being only child, monthly household income, part-time job, physical exercise, hobby, frequency of visiting home, and stress coping strategy) (CFI changes [ΔCFI] = -0.009-0.003) and over a week (ΔCFI = -0.006-0.000). The WHO-5-C also had good internal consistency (Cronbach's α = 0.907-0.934; McDonald's ω = 0.908-0.935) and test-retest reliability (intraclass correlation coefficient [ICC] = 0.803). Convergent validity was supported by moderate correlations of the WHO-5-C with the SRHQ and PHQ-4. The optimal cutoff point of the WHO-5-C was found to be 50, with an area under the ROC curve of 0.882 at baseline data, with sensitivity of 0.803 and specificity of 0.762 at follow-up. Conclusion The WHO-5-C demonstrated adequate measurement properties, especially concerning cross-sectional and longitudinal measurement invariance, with a recommended optimal cutoff point of ≥ 50 for assessing adequate level of psychological well-being in healthcare students.
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Affiliation(s)
- Nongnong Yang
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China
| | - Haiyan Ma
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China
- Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou, Zhejiang, People’s Republic of China
| | - Mengyi Huang
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China
| | - Esther Yuet Ying Lau
- Sleep Laboratory, Department of Psychology, The Education University of Hong Kong, Hong Kong, People’s Republic of China
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong, People’s Republic of China
- Centre for Religious and Spirituality Education, The Education University of Hong Kong, Hong Kong, People’s Republic of China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People’s Republic of China
| | - Meng Wang
- Ophthalmology Center, Ningbo Yinzhou No.2 Hospital, Ningbo, Zhejiang, People’s Republic of China
| | - Pengqiao Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China
| | - Siyi Xu
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China
| | - Jiale Xu
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China
| | - Chen Jiang
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China
| | - Yi Luo
- School of Nursing, Ningbo College of Health Sciences, Ningbo, Zhejiang, People’s Republic of China
| | - Runtang Meng
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, People’s Republic of China
- Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou, Zhejiang, People’s Republic of China
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9
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Fan HSL, Fong DYT, Lok KYW, Tarrant M. Experiences of expressed human milk feeding: A qualitative study. Sex Reprod Healthc 2023; 38:100903. [PMID: 37657300 DOI: 10.1016/j.srhc.2023.100903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/28/2023] [Accepted: 08/22/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE The objective of this study was to understand and describe the breastfeeding experiences of Chinese women with a high proportion of expressed human milk feeding. METHODS A qualitative descriptive design was used to describe the usual practices of expressed human milk feeding among breastfeeding women. We conducted semi-structured, in-depth, one-to-one interviews with participants (N = 25) who had a high proportion of expressed human milk feeding. Thematic analysis was used to analyze the data. RESULTS We identified three main themes: a sense of control, a sense of security, and milk expression challenges. Participants described that expressed human milk feeding provided a greater sense of control over their time and provided more freedom as they were no longer restricted by their infant's feeding schedule. Furthermore, knowing the amount of milk and having a stored milk supply provided a sense of security. However, providing expressed human milk can be time-consuming and has a lower intimacy level when compared with direct breastfeeding. CONCLUSION Expressed human milk feeding can provide a greater sense of control and was used as an immediate solution to direct breastfeeding problems. However, some participants experienced challenges in expressed human milk feeding, and some preferred breastfeed directly. Therefore, it is crucial to strengthen the breastfeeding support provided in the early postpartum period to ensure that all breastfeeding persons can breastfeed directly.
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Affiliation(s)
- Heidi Sze Lok Fan
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada.
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR
| | - Marie Tarrant
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
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10
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Li J, Fong DYT, Lok KYW, Wong JYH, Ho MM, Choi EPH, Pandian V, Davidson PM, Duan W, Tarrant M, Lee JJ, Lin CC, Akingbade O, Alabdulwahhab KM, Ahmad MS, Alboraie M, Alzahrani MA, Bilimale AS, Boonpatcharanon S, Byiringiro S, Hasan MKC, Schettini LC, Corzo W, De Leon JM, De Leon AS, Deek H, Efficace F, El Nayal MA, El-Raey F, Ensaldo-Carrasco E, Escotorin P, Fadodun OA, Fawole IO, Goh YSS, Irawan D, Khan NE, Koirala B, Krishna A, Kwok C, Le TT, Leal DG, Lezana-Fernández MÁ, Manirambona E, Mantoani LC, Meneses-González F, Mohamed IE, Mukeshimana M, Nguyen CTM, Nguyen HTT, Nguyen KT, Nguyen ST, Nurumal MS, Nzabonimana A, Omer NAMA, Ogungbe O, Poon ACY, Reséndiz-Rodriguez A, Puang-Ngern B, Sagun CG, Shaik RA, Shankar NG, Sommer K, Toro E, Tran HTH, Urgel EL, Uwiringiyimana E, Vanichbuncha T, Youssef N. Key lifestyles and interim health outcomes for effective interventions in general populations: A network analysis of a large international observational study. J Glob Health 2023; 13:04125. [PMID: 37861130 PMCID: PMC10588292 DOI: 10.7189/jogh.13.04125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Background The interconnected nature of lifestyles and interim health outcomes implies the presence of the central lifestyle, central interim health outcome and bridge lifestyle, which are yet to be determined. Modifying these factors holds immense potential for substantial positive changes across all aspects of health and lifestyles. We aimed to identify these factors from a pool of 18 lifestyle factors and 13 interim health outcomes while investigating potential gender and occupation differences. Methods An international cross-sectional study was conducted in 30 countries across six World Health Organization regions from July 2020 to August 2021, with 16 512 adults self-reporting changes in 18 lifestyle factors and 13 interim health outcomes since the pandemic. Results Three networks were computed and tested. The central variables decided by the expected influence centrality were consumption of fruits and vegetables (centrality = 0.98) jointly with less sugary drinks (centrality = 0.93) in the lifestyles network; and quality of life (centrality = 1.00) co-dominant (centrality = 1.00) with less emotional distress in the interim health outcomes network. The overall amount of exercise had the highest bridge expected influence centrality in the bridge network (centrality = 0.51). No significant differences were found in the network global strength or the centrality of the aforementioned key variables within each network between males and females or health workers and non-health workers (all P-values >0.05 after Holm-Bonferroni correction). Conclusions Consumption of fruits and vegetables, sugary drinks, quality of life, emotional distress, and the overall amount of exercise are key intervention components for improving overall lifestyle, overall health and overall health via lifestyle in the general population, respectively. Although modifications are needed for all aspects of lifestyle and interim health outcomes, a larger allocation of resources and more intensive interventions were recommended for these key variables to produce the most cost-effective improvements in lifestyles and health, regardless of gender or occupation.
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Affiliation(s)
- Jiaying Li
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Janet Yuen Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong SAR, China
| | - Mandy Man Ho
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Vinciya Pandian
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Patricia M Davidson
- Vice-Chancellor and Principal, University of Wollongong, Wollongong, Australia
| | - Wenjie Duan
- Department of Social Work, East China University of Science and Technology, Shanghai, China
| | - Marie Tarrant
- School of Nursing, The University of British Columbia, Kelowna British Columbia, Canada
| | - Jung Jae Lee
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Oluwadamilare Akingbade
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong
- Institute of Nursing Research, Osogbo, Osun State, Nigeria
| | | | - Mohammad Shakil Ahmad
- Department of Family & Community Medicine, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Mohamed Alboraie
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Meshari A Alzahrani
- Department of Urology, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Anil S Bilimale
- School of Public Health, JSS Medical College, JSS AHER, Mysuru, India
| | | | - Samuel Byiringiro
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | | | | | | | - Hiba Deek
- Nursing Department, Faculty of Health Science, Beirut Arab University, Lebanon
| | - Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | | | - Fathiya El-Raey
- Department of hepatogastroenterology and infectious diseases, Damietta faculty of medicine, Al-Azher University, Egypt
| | | | - Pilar Escotorin
- Laboratory of Applied Prosocial Research, Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Spain
| | | | | | - Yong-Shian Shawn Goh
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore
| | - Devi Irawan
- School of Nursing, Wijaya Husada Health Institute, Bogor, Indonesia
| | | | - Binu Koirala
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Cannas Kwok
- School of Nursing, Paramedicine and Health Care Science, Charles Sturt University, New South Wales, Australia
| | | | | | | | - Emery Manirambona
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Leandro Cruz Mantoani
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), Londrina, Brazil
| | | | - Iman Elmahdi Mohamed
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Benghazi University, Libya
| | - Madeleine Mukeshimana
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | | | | | | | - Mohd Said Nurumal
- Kulliyyah of Nursing, International Islamic University, Kuantan, Malaysia
| | - Aimable Nzabonimana
- Center for Language Enhancement, College of Arts and Social Sciences, University of Rwanda, Huye, Rwanda
| | | | | | | | | | | | - Ceryl G Sagun
- School of Nursing, Centro Escolar University, Manila, Philippines
| | - Riyaz Ahmed Shaik
- Department of Family & Community Medicine, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Nikhil Gauri Shankar
- Mental Health and Learning division, Wrexham Maelor Hospital, Wrexham, United Kingdom
| | - Kathrin Sommer
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Edgardo Toro
- Pontificia Universidad Católica de Valparaíso, School of Social Work, Valparaíso, Chile
| | | | - Elvira L Urgel
- School of Nursing, Centro Escolar University, Manila, Philippines
| | | | - Tita Vanichbuncha
- Department of Statistics, Chulalongkorn Business School, Bangkok, Thailand
| | - Naglaa Youssef
- Medical-surgical Nursing Department, Faculty of Nursing, Cairo University, Egypt
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11
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Chen N, Fong DYT, Wong JYH. The global health and economic impact of low-back pain attributable to occupational ergonomic factors in the working-age population by age, sex, geography in 2019. Scand J Work Environ Health 2023; 49:487-495. [PMID: 37634250 PMCID: PMC10838400 DOI: 10.5271/sjweh.4116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE Occupational ergonomic factors (OEF) include physical exertion, demanding posture, repetitive work, hand-arm vibration, kneeling or squatting, rising, and climbing, which are risk factors for low-back pain (LBP). This study aimed to examine the prevalence, years lived with disability (YLD), healthcare costs, and productivity losses of LBP attributable to OEF by age, sex, World Health Organization region, and country in 2019. METHODS In this cross-sectional study, prevalence and YLD were extracted from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. Employment statistics were obtained from the International Labor Organization websites. Health and economic impact was estimated for 192 countries and territories using the population attributable fraction method. RESULTS Globally, OEF were responsible for 126.1 million prevalent cases of LBP and 15.1 million YLD in the working-age population (aged 15-84 years) in 2019, with the Western Pacific region suffering most. OEF-attributable LBP led to $216.1 billion of economic losses worldwide. Of these, $47.0 billion were paid in healthcare costs, with the public sector serving as the largest contributor (59.2%). High-income countries bore >70% of global economic burden, whereas middle-income countries experienced >70% of global YLD. Generally, more prevalent cases and healthcare costs were found among females, whereas more YLD, productivity losses, and total costs were found among males. CONCLUSIONS Globally, OEF-attributable LBP presented a heavy burden on health and economic systems. Exercise together with education, active monitoring, evidence-based medical practices, alternative cost-effective solutions, and prioritizing health policies are needed.
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Affiliation(s)
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
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12
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Yu HJ, Ho M, Chau PH, Fong DYT. Trajectories of fasting glucose and glycated haemoglobin in obese and non-obese incident diabetes: Results from two large cohort studies. Diabetes Obes Metab 2023; 25:2835-2845. [PMID: 37336785 DOI: 10.1111/dom.15173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/22/2023] [Accepted: 05/30/2023] [Indexed: 06/21/2023]
Abstract
AIMS Diabetes development mechanisms vary by weight status. We aimed to compare cardiometabolic risk and characterize fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c) trajectories before diagnosing type 2 diabetes in individuals with/without obesity. METHODS Data from the China Health and Retirement Longitudinal Study (CHARLS) and English Longitudinal Study of Ageing (ELSA) were analysed. Participants without diabetes and with a body mass index of 18.5-40 kg/m2 at baseline were included. Incident diabetes was ascertained by self-reported physician diagnosis and/or antidiabetic drug use, FPG ≥126 mg/dl and/or HbA1c ≥6.5%. The difference in the FPG/HbA1c trajectory before the diabetes diagnosis in participants with/without obesity was examined using mixed-effects models. RESULTS Among 11 925 eligible participants, 1361 incident diabetes cases (mean age: 61.4 years; male: 46.2%) were identified within 15 years of follow-up. Obese diabetes showed higher levels of diastolic blood pressure and C-reactive protein at diagnosis than non-obese diabetes. Mixed-effects models indicated the difference in the FPG trajectory before diagnosis by weight status was non-significant with a slope difference of 0.149 mg/dl (SE = 0.642, p = .816, CHARLS) and 0.013 mg/dl (SE = 0.013, p = .337, ELSA). However, obese diabetes showed a steep increase in HbA1c before diagnosis with a slope difference of 0.036% (SE = 0.016, p = .021) in the CHARLS and 0.032% (SE = 0.014, p = .027) in the ELSA, respectively. Sex-stratified analyses showed that the difference in HbA1c trajectory before the diabetes diagnosis by weight status was only significant in males. CONCLUSIONS Obese and non-obese diabetes developments may share a similar FPG but distinct HbA1c trajectory. Obese diabetes interventions require more attention to cardiometabolic risks. Moreover, studies addressing weight/sex-related differences in diabetes aetiologies and treatments are warranted.
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Affiliation(s)
- Hong-Jie Yu
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
| | - Mandy Ho
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
| | - Pui Hing Chau
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
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13
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Chen S, Liu Y, Fong DYT, Zhou J, Chen H, Wan C. Health-related quality of life and its influencing factors in patients with breast cancer based on the scale QLICP-BR. Sci Rep 2023; 13:15176. [PMID: 37704676 PMCID: PMC10499782 DOI: 10.1038/s41598-023-41809-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/31/2023] [Indexed: 09/15/2023] Open
Abstract
Breast cancer is the most common cancer and the leading cause of cancer death among females worldwide. During the past 15 years, quality of life (QOL) has become an important aspect of breast cancer treatment. The purpose of this study was to evaluate QOL of breast cancer patients in China, and investigate its associations with sociodemographic and clinical variables. A cross-sectional study was conducted in 246 breast cancer patients in China. Recruited patients were surveyed for QOL using the QOL instruments for cancer patients-breast cancer QLICP-BR (V2.0). We assessed the associations between potential influencing factors and QOL using multiple linear regression models. The general mean QOL score for our population was 70.24 with SD = 8.70. Results indicated that medical insurance, drinking history, alkaline phosphatase, serum chloride ion level, serum calcium ion level, serum phosphorus ion level, mean corpuscular volume, mean corpuscular hemoglobin, red cell volume distribution width and platelet had significant associations with QOL of breast cancer patients. Our results emphasized that many factors are affecting QOL of breast cancer patients, which may provide a reference for targeted management or intervention strategies of breast cancer patients to improve their QOL.
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Affiliation(s)
- Shu Chen
- The First Dongguan Affiliated Hospital of Guangdong Medical University, Dongguan, China
- Key Laboratory for Quality of Life and Psychological Assessment and Intervention, Research Center for Quality of Life and Applied Psychology, Guangdong Medical University, Dongguan, China
| | - Yuxi Liu
- The First Dongguan Affiliated Hospital of Guangdong Medical University, Dongguan, China
| | | | - Jiali Zhou
- Key Laboratory for Quality of Life and Psychological Assessment and Intervention, Research Center for Quality of Life and Applied Psychology, Guangdong Medical University, Dongguan, China
| | - Huanwei Chen
- Central Hospital of Guangdong Nongken, Zhanjiang, China
| | - Chonghua Wan
- The First Dongguan Affiliated Hospital of Guangdong Medical University, Dongguan, China.
- Key Laboratory for Quality of Life and Psychological Assessment and Intervention, Research Center for Quality of Life and Applied Psychology, Guangdong Medical University, Dongguan, China.
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Yu HJ, Ho M, Liu X, Yang J, Chau PH, Fong DYT. Incidence and temporal trends in type 2 diabetes by weight status: A systematic review and meta-analysis of prospective cohort studies. J Glob Health 2023; 13:04088. [PMID: 37651631 PMCID: PMC10471153 DOI: 10.7189/jogh.13.04088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Background Diabetes is more prevalent among overweight/obese individuals, but has become a significant public health challenge among normal weight populations. In this meta-analysis, we aimed to estimate diabetes/prediabetes incidence and its temporal trends by weight status. Methods PubMed, Embase, Web of Science, and Cochrane Library were searched until 8 December 2021. Prospective cohort studies reporting diabetes incidence by baseline body mass index (BMI) categories in adults were included. The median year of data collection was used to assess the temporal trends. Subgroup analyses and meta-regression were also performed. Results We included 94 studies involving 3.4 million adults from 22 countries. The pooled diabetes incidence in underweight, normal-weight, and overweight/obese adults was 4.5 (95% confidence interval (CI) = 2.8-7.3), 2.7 (95% CI = 2.2-3.3), and 10.5 (95% CI = 9.3-11.8) per 1000 person-years, respectively. The diabetes incidence in low- and middle-income countries (LMICs) was higher than in high-income countries among normal-weight (5.8 vs 2.0 per 1000 person-years) or overweight/obese (15.9 vs 8.9 per 1000 person-years) adults. European and American regions had a higher diabetes incidence than the non-Western areas, regardless of weight status. Underweight diabetes incidence decreased significantly from 1995-2000 to 2005-2010. Diabetes incidence in normal-weight populations has increased continuously since 1985 by an estimated 36% every five years. In overweight/obese adults, diabetes incidence increased between 1985-1990 and 1995-2000, stabilised between 2000 and 2010, and spiked suddenly after 2010. Conclusions Diabetes incidence and its temporal trends differed by weight status. The continuous upward trend of diabetes incidence among overweight/obese individuals requires urgent attention, particularly in LMICs. Furthermore, diabetes among normal-weight individuals is becoming a significant public health problem. Registration PROSPERO (CRD42020215957).
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Affiliation(s)
- Hong-jie Yu
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Mandy Ho
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Xiangxiang Liu
- National Clinical Research Center for Infectious Diseases, The Third People’s Hospital of Shenzhen, Shenzhen, China
| | - Jundi Yang
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Pui Hing Chau
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
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Jiang C, Ma H, Luo Y, Fong DYT, Umucu E, Zheng H, Zhang Q, Liu X, Liu X, Spruyt K, Meng R. Validation of the Chinese version of the Perceived Stress Scale-10 integrating exploratory graph analysis and confirmatory factor analysis. Gen Hosp Psychiatry 2023; 84:194-202. [PMID: 37572467 DOI: 10.1016/j.genhosppsych.2023.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/02/2023] [Accepted: 07/28/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVE The study aimed to initially assess the measurement properties of the 10-item simplified Chinese version of the Perceived Stress Scale (PSS-C-10) and as a first, assess a longitudinal measurement invariance (LMI). METHODS A longitudinal survey was conducted with a convenient sample of healthcare students using the PSS-C-10. We assessed the PSS-C-10 mainly using composite analytical approaches, including exploratory graph analysis (EGA) and confirmatory factor analysis (CFA) to suggest the best-fit factor structure and assess measurement invariance. RESULTS The EGA identified a two-factor structural solution with an accuracy of 98.6% at baseline and 100% at a 7-day follow-up. The CFA subsequently confirmed this structure, with a comparative fit index of 0.963 at baseline and 0.987 at follow-up, Tucker-Lewis index of 0.951 at baseline and 0.982 at follow-up, and root mean square error of approximation of 0.111 at baseline and 0.089 at follow-up. The LMI was supported by the goodness-of-fit indices, and their changes fell within the recommended cut-off range. Additionally, Cronbach's alpha (0.885 at baseline and 0.904 at follow-up), McDonald's omega (0.885 at baseline and 0.902 at follow-up), and an ICC value of 0.816 for 7 days demonstrated the robust reliability of the PSS-C-10. CONCLUSION The PSS-C-10 exhibited a stable two-factor structure with promising LMI and measurement properties.
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Affiliation(s)
- Chen Jiang
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Haiyan Ma
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China; Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou 311121, Zhejiang, China.
| | - Yi Luo
- School of Nursing, Ningbo College of Health Sciences, Ningbo 315100, Zhejiang, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
| | - Emre Umucu
- College of Health Sciences, University of Texas at El Paso, El Paso, Texas TX 79968, USA
| | - Huiqiu Zheng
- Department of Child and Adolescent Health and Health Education, School of Public Health, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia, China
| | - Qiran Zhang
- School of Medicine, Xiangyang Polytechnic, Xiangyang 441021, Hubei, China
| | - Xiao Liu
- School of Medicine, Xiangyang Polytechnic, Xiangyang 441021, Hubei, China
| | - Xiaoxue Liu
- Global Health Research Division, Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi 214122, Jiangsu, China
| | - Karen Spruyt
- Université de Paris, NeuroDiderot, INSERM, Paris 75019, France
| | - Runtang Meng
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China; Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou 311121, Zhejiang, China.
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16
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Li J, Fong DYT, Lok KYW, Wong JYH, Man Ho M, Choi EPH, Pandian V, Davidson PM, Duan W, Tarrant M, Lee JJ, Lin CC, Akingbade O, Alabdulwahhab KM, Ahmad MS, Alboraie M, Alzahrani MA, Bilimale AS, Boonpatcharanon S, Byiringiro S, Hasan MKC, Schettini LC, Corzo W, De Leon JM, De Leon AS, Deek H, Efficace F, El Nayal MA, El-Raey F, Ensaldo-Carrasco E, Escotorin P, Fadodun OA, Fawole IO, Goh YSS, Irawan D, Khan NE, Koirala B, Krishna A, Kwok C, Le TT, Leal DG, Lezana-Fernández MÁ, Manirambona E, Mantoani LC, Meneses-González F, Mohamed IE, Mukeshimana M, Nguyen CTM, Nguyen HTT, Nguyen KT, Nguyen ST, Nurumal MS, Nzabonimana A, Omer NAMA, Ogungbe O, Poon ACY, Reséndiz-Rodriguez A, Puang-Ngern B, Sagun CG, Shaik RA, Shankar NG, Sommer K, Toro E, Tran HTH, Urgel EL, Uwiringiyimana E, Vanichbuncha T, Youssef N. Global impacts of COVID-19 on lifestyles and health and preparation preferences: An international survey of 30 countries. J Glob Health 2023; 13:06031. [PMID: 37565394 PMCID: PMC10416140 DOI: 10.7189/jogh.13.06031] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023] Open
Abstract
Background The health area being greatest impacted by coronavirus disease 2019 (COVID-19) and residents' perspective to better prepare for future pandemic remain unknown. We aimed to assess and make cross-country and cross-region comparisons of the global impacts of COVID-19 and preparation preferences of pandemic. Methods We recruited adults in 30 countries covering all World Health Organization (WHO) regions from July 2020 to August 2021. 5 Likert-point scales were used to measure their perceived change in 32 aspects due to COVID-19 (-2 = substantially reduced to 2 = substantially increased) and perceived importance of 13 preparations (1 = not important to 5 = extremely important). Samples were stratified by age and gender in the corresponding countries. Multidimensional preference analysis displays disparities between 30 countries, WHO regions, economic development levels, and COVID-19 severity levels. Results 16 512 adults participated, with 10 351 females. Among 32 aspects of impact, the most affected were having a meal at home (mean (m) = 0.84, standard error (SE) = 0.01), cooking at home (m = 0.78, SE = 0.01), social activities (m = -0.68, SE = 0.01), duration of screen time (m = 0.67, SE = 0.01), and duration of sitting (m = 0.59, SE = 0.01). Alcohol (m = -0.36, SE = 0.01) and tobacco (m = -0.38, SE = 0.01) consumption declined moderately. Among 13 preparations, respondents rated medicine delivery (m = 3.50, SE = 0.01), getting prescribed medicine in a hospital visit / follow-up in a community pharmacy (m = 3.37, SE = 0.01), and online shopping (m = 3.33, SE = 0.02) as the most important. The multidimensional preference analysis showed the European Region, Region of the Americas, Western Pacific Region and countries with a high-income level or medium to high COVID-19 severity were more adversely impacted on sitting and screen time duration and social activities, whereas other regions and countries experienced more cooking and eating at home. Countries with a high-income level or medium to high COVID-19 severity reported higher perceived mental burden and emotional distress. Except for low- and lower-middle-income countries, medicine delivery was always prioritised. Conclusions Global increasing sitting and screen time and limiting social activities deserve as much attention as mental health. Besides, the pandemic has ushered in a notable enhancement in lifestyle of home cooking and eating, while simultaneously reducing the consumption of tobacco and alcohol. A health care system and technological infrastructure that facilitate medicine delivery, medicine prescription, and online shopping are priorities for coping with future pandemics.
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Affiliation(s)
- Jiaying Li
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Janet Yuen Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong SAR, China
| | - Mandy Man Ho
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Vinciya Pandian
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Patricia M Davidson
- Vice-Chancellor and Principal, University of Wollongong, Wollongong, Australia
| | - Wenjie Duan
- Department of Social Work, East China University of Science and Technology, Shanghai, China
| | - Marie Tarrant
- School of Nursing, The University of British Columbia, Kelowna British Columbia, Canada
| | - Jung Jae Lee
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Oluwadamilare Akingbade
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong
- Institute of Nursing Research, Osogbo, Osun State, Nigeria
| | | | - Mohammad Shakil Ahmad
- Department of Family & Community Medicine, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Mohamed Alboraie
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Meshari A Alzahrani
- Department of Urology, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Anil S Bilimale
- School of Public Health, JSS Medical College, JSS AHER, Mysuru, India
| | | | - Samuel Byiringiro
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | | | | | | | | | | | - Hiba Deek
- Nursing Department, Faculty of Health Science, Beirut Arab University, Lebanon
| | - Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | | | - Fathiya El-Raey
- Department of hepatogastroenterology and infectious diseases, Damietta faculty of medicine, Al-Azher University, Egypt
| | | | - Pilar Escotorin
- Laboratory of Applied Prosocial Research, Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Spain
| | | | | | - Yong-Shian Shawn Goh
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore
| | - Devi Irawan
- School of Nursing, Wijaya Husada Health Institute, Bogor, Indonesia
| | | | - Binu Koirala
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Cannas Kwok
- School of Nursing, Paramedicine and Health Care Science, Charles Sturt University, New South Wales, Australia
| | | | | | | | - Emery Manirambona
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Leandro Cruz Mantoani
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL) – Londrina, Brazil
| | | | - Iman Elmahdi Mohamed
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Benghazi University, Libya
| | - Madeleine Mukeshimana
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | | | | | | | - Mohd Said Nurumal
- Kulliyyah of Nursing, International Islamic University, Kuantan, Malaysia
| | - Aimable Nzabonimana
- Center for Language Enhancement, College of Arts and Social Sciences, University of Rwanda, Huye, Rwanda
| | | | | | | | | | | | - Ceryl G Sagun
- School of Nursing, Centro Escolar University, Manila, Philippines
| | - Riyaz Ahmed Shaik
- Department of Family & Community Medicine, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Nikhil Gauri Shankar
- Mental Health and Learning division, Wrexham Maelor Hospital, Wrexham, United Kingdom
| | - Kathrin Sommer
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Edgardo Toro
- Pontificia Universidad Católica de Valparaíso, School of Social Work, Valparaíso, Chile
| | | | - Elvira L Urgel
- School of Nursing, Centro Escolar University, Manila, Philippines
| | | | - Tita Vanichbuncha
- Department of Statistics, Chulalongkorn Business School, Bangkok, Thailand
| | - Naglaa Youssef
- Medical-surgical Nursing Department, Faculty of Nursing, Cairo University, Egypt
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Takemura N, Cheung DST, Fong DYT, Ho MH, Lin CC. Relationship Between Cortisol Rhythm and Psychoneurological Symptom Cluster in Patients With Advanced Lung Cancer. Cancer Nurs 2023:00002820-990000000-00165. [PMID: 37552217 DOI: 10.1097/ncc.0000000000001268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
BACKGROUND Patients with advanced lung cancer commonly experience a high prevalence of physical and psychological symptoms, which tend to co-occur as a symptom cluster. Cortisol rhythm has the potential to influence psychoneurological symptom cluster based on neuroendocrine-immune models; however, little is known about the relationship between them. OBJECTIVE To examine the intercorrelation among symptoms in psychoneurological symptom cluster and the factors influencing the severity of psychoneurological symptom cluster. METHODS One hundred sixty-one patients with advanced lung cancer were recruited from 2018 to 2020 as part of a large study. Data on sleep disturbances, fatigue, and psychological distress were collected via self-report questionnaires, and the diurnal cortisol slope was analyzed using saliva samples. Linear regression analyses were adopted to examine the association between cortisol rhythm and demographic and clinical variables with psychoneurological symptom cluster. RESULTS Psychoneurological symptoms (including sleep disturbances, fatigue, anxiety, and depression) were significantly correlated. Poor physical performance status (β = -0.061, P < .001), increased number of comorbidities (β = 0.533, P < .001), and flatter cortisol rhythm (β = 545.092, P < .001) were significantly associated with higher-severity psychoneurological symptom cluster. Diurnal cortisol slope (β = 328.829, P = .025) was identified as the most critical factor influencing the psychoneurological symptom cluster in multiple linear regression model after adjusting for covariates. CONCLUSIONS Patients with flatter diurnal cortisol slopes were found to experience more severe psychoneurological symptom cluster, after controlling for demographic and clinical factors. IMPLICATIONS FOR PRACTICE Interventions targeting the improvement of associated factors, such as comorbidities and physical performance status, could potentially alleviate the severity of the psychoneurological symptom cluster.
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Affiliation(s)
- Naomi Takemura
- Authors' Affiliation: School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
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18
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Takemura N, Cheung DST, Fong DYT, Lin CC. Impact of adherence to exercise interventions on effectiveness in a randomized controlled trial in improving sleep in advanced lung cancer patients: A comparison between aerobic exercise and Tai Chi. Palliat Support Care 2023:1-9. [PMID: 37503844 DOI: 10.1017/s1478951523000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
OBJECTIVES Adherence plays a vital role in the effectiveness of non-pharmacological interventions. The disappearance of interventions' effects at follow-up was caused by inadequate self-practice beyond intervention period. The purpose of this study is to examine the factors associated with adherence to aerobic exercise and Tai Chi and the impact of adherence on the short- and long-term effectiveness in improving sleep in patients with advanced lung cancer. METHODS This study analyzed data collected in a clinical trial that evaluated the effects of aerobic exercise and Tai Chi in patients with advanced lung cancer. Two types of exercises were maintained at the same intensity but with different dosage. A total of 99 patients with advanced lung cancer who were recruited between 2018 and 2020 were included. Data were collected using self-report questionnaires. RESULTS Fifty participants were randomly assigned to aerobic exercise and 49 to Tai Chi intervention. Higher levels of satisfaction and lower levels of depression were significantly associated with higher attendance and compliance in both groups. Low fatigue levels contributed to higher attendance in Tai Chi. Both attendance and compliance were significantly associated with long-term sleep improvement. SIGNIFICANCE OF RESULTS Higher levels of satisfaction and lower levels of depression were important characteristics of attendance and compliance with home-based practice in both groups, whereas lower levels of fatigue uniquely contributed to higher attendance in Tai Chi. Better exercise adherence improves long-term effectiveness of sleep in patients with advanced lung cancer. Adopting strategies is imperative to promote exercise adherence in patients with greater levels of depression and fatigue.
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Affiliation(s)
- Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
- Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Hong Kong, Hong Kong
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19
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Kwok JYY, Auyeung M, Pang SYY, Ho PWL, Yu DSF, Fong DYT, Lin CC, Walker R, Wong SYS, Ho RTH. A randomized controlled trial on the effects and acceptability of individual mindfulness techniques - meditation and yoga - on anxiety and depression in people with Parkinson's disease: a study protocol. BMC Complement Med Ther 2023; 23:241. [PMID: 37461018 PMCID: PMC10351114 DOI: 10.1186/s12906-023-04049-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 06/21/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Between 40 and 50% of patients with Parkinson's disease (PD) experience anxiety and depression, associated with impaired physical function, high care dependency and mortality. Recently, the United States National Institutes of Health has urged the implementation of mindfulness practices in chronic illness care. Most research to date has examined the effects on chronically ill patients of complex interventions using a combination of mindfulness techniques. In PD patients, however, such complex modalities appear to hinder the technique mastery. Hence, the aim of this trial is to investigate the effects and underlying mechanism of individual mindfulness techniques among PD patients, as well as exploring participants' experience in using individual mindfulness techniques as a lifestyle intervention for stress and symptom management. METHODS We will conduct an assessor-blind three-arm randomized waitlist-controlled trial with a descriptive qualitative evaluation. Up to 168 PD patients will be recruited from community settings and out-patient clinics, and randomized to meditation, yoga, or usual care group. Meditation and yoga sessions of 90-minute are held weekly for 8 weeks. Primary outcomes include anxiety and depression. Secondary outcomes include PD-related motor and non-motor symptoms and quality-of-life; and level of mindfulness and biomarkers of stress and inflammatory responses will be measured as mediating variables. All outcome evaluations will be assessed at baseline, 8 weeks, and 24 weeks. Following the intention-to-treat principle, generalized estimating equation models and path analysis will be used to identify the treatment effects and the mediating mechanisms. A subsample of 30 participants from each intervention group will be invited for qualitative interviews. DISCUSSION The study would also generate important insights to enhance the patients' adaptation to debilitating disease. More specifically, symptom management and stress adaptation are highly prioritized healthcare agenda in managing PD. The research evidence will further inform the development of community-based, nurse-led compassionate care models for neurodegenerative conditions, which is complementary to existing health services. TRIAL REGISTRATION WHO Primary Registry - Chinese Clinical Trials Registry number: ChiCTR2100045939; registered on 2021/04/29 ( https://www.chictr.org.cn/showproj.html?proj=125878 ).
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Affiliation(s)
- Jojo Yan Yan Kwok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Man Auyeung
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR
| | | | - Philip Wing Lok Ho
- Division of Neurology, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR
- The State Key Laboratory of Marine Pollution, City University of Hong Kong, Kowloon Tong, Hong Kong SAR
| | - Doris Sau Fung Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Chia-chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Richard Walker
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Newcastle, UK
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Samuel Yeung-shan Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
- CUHK Thomas Jing Centre for Mindfulness Research and Training, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Rainbow Tin Hung Ho
- Centre on Behavioral Health, The University of Hong Kong, Pokfulam, Hong Kong SAR
- Department of Social Work & Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR
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20
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Yeung CY, Men VY, So WWY, Fong DYT, Lam MWC, Cheung DYT, Yip PSF. Correction: Risk and protective factors related to changes in mental health among adolescents since COVID-19 in Hong Kong: a cross-sectional study. Child Adolesc Psychiatry Ment Health 2023; 17:84. [PMID: 37391831 DOI: 10.1186/s13034-023-00634-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2023] Open
Affiliation(s)
- Cheuk Yui Yeung
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China
| | - Vera Yu Men
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, SAR, China
| | - Wendy W Y So
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, SAR, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | | | - Derek Yee Tak Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China.
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, SAR, China.
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21
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Akingbade O, Adeleye K, Fadodun OA, Fawole IO, Li J, Choi EPH, Ho M, Lok KYW, Wong JYH, Fong DYT, Ogungbe O. eHealth literacy was associated with anxiety and depression during the COVID-19 pandemic in Nigeria: a cross-sectional study. Front Public Health 2023; 11:1194908. [PMID: 37427252 PMCID: PMC10323132 DOI: 10.3389/fpubh.2023.1194908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Background Electronic health (eHealth) literacy may play an important role in individuals' engagement with online mental health-related information. Aim To examine associations between eHealth literacy and psychological outcomes among Nigerians during the Coronavirus disease-2019 (COVID-19) pandemic. Methods This was a cross-sectional study among Nigerians conducted using the 'COVID-19's impAct on feaR and hEalth (CARE) questionnaire. The exposure: eHealth literacy, was assessed using the eHealth literacy scale, and psychological outcomes were assessed using the PHQ-4 scale, which measured anxiety and depression; and the fear scale to measure fear of COVID-19. We fitted logistic regression models to assess the association of eHealth literacy with anxiety, depression, and fear, adjusting for covariates. We included interaction terms to assess for age, gender, and regional differences. We also assessed participants' endorsement of strategies for future pandemic preparedness. Results This study involved 590 participants, of which 56% were female, and 38% were 30 years or older. About 83% reported high eHealth literacy, and 55% reported anxiety or depression. High eHealth literacy was associated with a 66% lower likelihood of anxiety (adjusted odds ratio aOR, 0·34; 95% confidence interval, 0·20-0·54) and depression (aOR: 0·34; 95% CI, 0·21-0·56). There were age, gender, and regional differences in the associations between eHealth literacy and psychological outcomes. eHealth-related strategies such as medicine delivery, receiving health information through text messaging, and online courses were highlighted as important for future pandemic preparedness. Conclusion Considering that mental health and psychological care services are severely lacking in Nigeria, digital health information sources present an opportunity to improve access and delivery of mental health services. The different associations of e-health literacy with psychological well-being between age, gender, and geographic region highlight the urgent need for targeted interventions for vulnerable populations. Policymakers must prioritize digitally backed interventions, such as medicine delivery and health information dissemination through text messaging, to address these disparities and promote equitable mental well-being.
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Affiliation(s)
- Oluwadamilare Akingbade
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Institute of Nursing Research, Osogbo, Osun, Nigeria
| | | | | | - Israel Opeyemi Fawole
- Institute of Nursing Research, Osogbo, Osun, Nigeria
- Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Jiaying Li
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | | | - Mandy Ho
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kris Yuet Wan Lok
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Janet Yuen Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, Hong Kong SAR, China
| | - Daniel Yee Tak Fong
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Oluwabunmi Ogungbe
- Johns Hopkins University School of Nursing, Baltimore, MD, United States
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22
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Yeung CY, Men VY, So WWY, Fong DYT, Lam MWC, Cheung DYT, Yip PSF. Risk and protective factors related to changes in mental health among adolescents since COVID-19 in Hong Kong: a cross-sectional study. Child Adolesc Psychiatry Ment Health 2023; 17:68. [PMID: 37308933 DOI: 10.1186/s13034-023-00622-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 05/23/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Most research has suggested that children and adolescents had poorer mental health than pre-COVID-19 pandemic status. There have been few investigations into factors associated with pre-peri pandemic differences in young people's mental health status. Our study aimed to investigate the association between sociodemographic factors, attitudes, and daily life experiences and these differences. METHODS We used self-reported cross-sectional data from the Youth Sexuality Survey (YSS) by the Family Planning Association of Hong Kong, collected from secondary school students aged 10-16 between the fourth and fifth waves of the pandemic. The study outcome was pre-peri pandemic differences in mental health (better, unchanged, or poorer). Associations between the study outcome with age, sex, satisfaction with academic performance, school life, relationship with classmates and family life, and average sleeping and exercising time in the past month, were assessed through multinomial logistic regression, controlling for depressive/anxiety symptoms and change in physical health status since the pandemic. RESULTS There were 6,665 respondents. Compared with pre-pandemic, approximately 30% reported poorer mental health, whilst 20% reported better mental health. Females (OR = 1.355, 95% CI = 1.159-1.585) and those dissatisfied with their academic performance (OR = 1.468, 95% CI = 1.233-1.748) were significantly more likely to report poorer mental health with reference to unchanged status, while those satisfied with family life had improved mental health with reference to unchanged (OR = 1.261, 95% CI = 1.006-1.579) and poorer status (OR = 1.369, 95% CI = 1.085-1.728). CONCLUSION Policy and community strategies that promote good family relationships are thus essential for young people's mental health during societal challenges such as the COVID-19 pandemic.
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Affiliation(s)
- Cheuk Yui Yeung
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Vera Yu Men
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China
| | - Wendy W Y So
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | | | - Derek Yee Tak Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China.
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23
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Wang Y, Ho M, Chau PH, Schembre SM, Fong DYT. Emotional Eating as a Mediator in the Relationship between Dietary Restraint and Body Weight. Nutrients 2023; 15:nu15081983. [PMID: 37111204 PMCID: PMC10141227 DOI: 10.3390/nu15081983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/15/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
This study aimed to assess the relationships between routine and compensatory restraints and body mass index (BMI), as well as to explore the mediating role of emotional and external eating in the relationships between routine and compensatory restraints and BMI. Chinese adults aged ≥18 years with different weight statuses were invited to fill out an online questionnaire. Routine and compensatory restraints and emotional and external eating were assessed using the validated 13-item Chinese version of the Weight-Related Eating Questionnaire. Mediation analyses tested the mediation effects of emotional and external eating on the relationship between routine and compensatory restraints and BMI. In total, 949 participants (26.4% male) responded to the survey (mean age = 33 years, standard deviation (SD) = 14, mean BMI = 22.0 kg/m2, SD = 3.8). The mean routine restraint score was higher in the overweight/obese group (mean ± SD = 2.13 ± 0.76, p < 0.001) than in the normal weight (2.08 ± 0.89) and underweight (1.72 ± 0.94) groups. However, the normal weight group scored higher in compensatory restraint (2.88 ± 1.03, p = 0.021) than the overweight/obese (2.75 ± 0.93) and underweight (2.62 ± 1.04) groups. Routine restraint was related to higher BMI both directly (β = 0.07, p = 0.02) and indirectly through emotional eating (β = 0.04, 95% confidence interval (CI) = 0.03, 0.07). Compensatory restraint was only indirectly related to higher BMI through emotional eating (β = 0.04, 95% CI = 0.03, 0.07).
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Affiliation(s)
- Yaqi Wang
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Mandy Ho
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Pui-Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Susan M Schembre
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20007, USA
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Choi EPH, Kwok JYY, Choi KWY, Lee JJ, Lok KYW, Wong JYH, Fong DYT, Wan EYF, Wong WCW, Chow EPF. Perceptions and experiences of sexual violence among Chinese men who have sex with men in Hong Kong. J Adv Nurs 2023; 79:1385-1398. [PMID: 35909096 PMCID: PMC10952851 DOI: 10.1111/jan.15391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/08/2022] [Accepted: 07/17/2022] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to understand the perceptions and experiences of sexual violence among Chinese men who have sex with men (MSM) in Hong Kong. DESIGN The study adopted a qualitative descriptive design with thematic analysis. METHODS Thirty-one Chinese MSM were recruited in Hong Kong from May to June 2019 using purposive sampling. Individual semi-structured interviews were conducted with the participants. The interview data were transcribed verbatim from the recordings and analysed using Braun and Clarke's thematic analysis approach. RESULTS Four themes were identified: (1) different forms of sexual violence, from physical to virtual; (2) inner struggles with fears and worry; (3) low awareness and perceived risk of sexual violence - 'it has nothing to do with me' and (4) dilemma towards sexual violence prevention. CONCLUSION The study provided qualitative evidence regarding the experiences and perceptions of sexual violence among Chinese MSM in Hong Kong. Physical and image-based forms of sexual violence were identified, which led the participants to experience psychological distress, fear of contracting human immunodeficiency virus/other sexually transmitted infections, notoriety within the gay community, and discrimination and stigmatization within their family and workplace. To reduce the risk of sexual violence, some participants were cautious about the venue in which they engaged in sex and the habit of sharing sexually explicit photos with others. However, some participants had low awareness and perceived risk of sexual violence. IMPACTS This study was the first to fill the research gap on sexual violence issues among Chinese MSM using dating apps in Hong Kong. The qualitative findings enhanced the scholarly understanding of Chinese MSM's perceptions and experiences of sexual violence. The study findings can help nursing staff and other healthcare professionals to develop tailored primary, secondary and tertiary sexual violence prevention programmes for MSM or beyond.
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Affiliation(s)
| | | | - Kitty Wai Ying Choi
- School of NursingThe University of Hong KongPok Fu LamHong Kong
- Sticky Rice LoveHong Kong
| | - Jung Jae Lee
- School of NursingThe University of Hong KongPok Fu LamHong Kong
| | | | | | | | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, School of Clinical MedicineThe University of Hong KongPok Fu LamHong Kong
- Department of Pharmacology and PharmacyThe University of Hong KongPok Fu LamHong Kong
| | - William Chi Wai Wong
- Department of Family Medicine and Primary Care, School of Clinical MedicineThe University of Hong KongPok Fu LamHong Kong
| | - Eric Pui Fung Chow
- Melbourne Sexual Health CentreAlfred HealthMelbourneVictoriaAustralia
- Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
- Melbourne School of Population and Global HealthThe University of MelbourneMelbourneVictoriaAustralia
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Li J, Li S, Fong DYT. Short form development of the Chinese work readiness scale for graduate nurse: An optimal test assembly approach. J Adv Nurs 2023. [PMID: 36932038 DOI: 10.1111/jan.15648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 02/13/2023] [Accepted: 03/08/2023] [Indexed: 03/19/2023]
Abstract
AIM To develop and psychometrically test shortened 37-item Chinese Work Readiness Scale for Graduate Nurse without compromising its reliability and validity. DESIGN Two cross-sectional studies. METHODS Data were obtained from two cross-sectional online surveys on the same target group of newly graduated nurses in China. The two periods of data collection were from June to August 2018 and from June and July 2021, with 1348 respondents completing the 37-item Chinese Work Readiness Scale for Graduate Nurse. The optimal test assembly procedure based on a generalized partial credit model was adopted to shorten the scale. RESULTS The mean age of the 1348 nurses was 22.3 years (standard deviation = 1.5), with 1257 (93.2%) being female. The category characteristic curve showed that a 5-point Likert scale was adequate in lieu of the original 10-point Likert scale. The optimal test assembly procedure identified a 17-item version that maintained at least 0.9 correlation with the full scale, a Cronbach's alpha of at least 0.9, and at least 70% of the test information retained. Its discrimination parameters ranged from 1.68 to 2.84, whereas the difficulty parameters were monotonic and ranged from -4.50 to 1.56. When retaining only 50% of test information, a 9-item version was obtained. Its discrimination parameters ranged from 1.84 to 4.55, and difficulty parameters ranged from -3.37 to 1.15. The Cronbach's alphas for the 17-item and 9-item versions were 0.97 and 0.95 respectively. CONCLUSIONS Both the 17-item and 9-item versions are appropriate for assessing registered nurses' work readiness, with the 9-item version demanding more subjects to compensate for the reduced information. Optimal test assembly approach is appropriate in shortening self-reported scales in the nursing field, while retaining satisfactory levels of reliability, validity, test information and conceptual adequacy. PATIENT OR PUBLIC CONTRIBUTION This study involved graduate nurses who provided responses to the test scale and experts who contributed to the content validation.
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Affiliation(s)
- Jiaying Li
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Sha Li
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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Lu F, Wong CKH, Tse ETY, Ng APP, Li L, Lam JSM, Bedford L, Fong DYT, Ip P, Lam CLK. The Impact of a Health Empowerment Program on Self-Care Enablement and Mental Health among Low-Income Families: Evidence from a 5 Year Cohort Study in Hong Kong. Int J Environ Res Public Health 2023; 20:5168. [PMID: 36982089 PMCID: PMC10049337 DOI: 10.3390/ijerph20065168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
Health empowerment can be an effective way to reduce health inequities. This prospective cohort study evaluated the 5 year impact of a health empowerment program (HEP) on health outcomes among adults from low-income families. The Patient Enablement Instrument version 2 (PEI-2), Depression, Anxiety and Stress Scale 21 (DASS-21), and 12 item Short-Form Health Survey version 2 (SF-12v2) were administered at baseline and follow-up for both intervention and comparison groups. A total of 289 participants (n = 162 for intervention group, n = 127 for comparison group) were included in the analysis. Most of the participants were female (72.32%), and aged from 26 to 66 years old (M = 41.63, SD = 6.91). Linear regressions weighted by inverse probability weighting using the propensity score showed that, after follow-up of 5 years, the intervention group demonstrated significantly greater increases in all items and total scores for the PEI-2 (all B > 0.59, p < 0.001), greater decreases in the DASS depression score (B = -1.98 p = 0.001), and greater increases in the Mental Component Summary score of the SF-12v2 (B = 2.99, p = 0.027) than the comparison group. The HEP may be an effective intervention enabling adults from low-income families to manage their health-related issues and improve their mental health, as evidenced by our study.
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Affiliation(s)
- Fangcao Lu
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
| | - Carlos King Ho Wong
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong 999077, China
| | - Emily Tsui Yee Tse
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China
| | - Amy Pui Pui Ng
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China
| | - Lanlan Li
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
| | - Joyce Sau Mei Lam
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
| | - Laura Bedford
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong 999077, China
| | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China
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Li J, Zeng Q, Huang H, Song Y, Guo W, Fong DYT. "Finding the Way in the Dark"- Working experience of specific-duty-post nurses in a nurse-led in-hospital pulmonary rehabilitation program: A qualitative study. Heart Lung 2023; 58:39-46. [PMID: 36375396 DOI: 10.1016/j.hrtlng.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 10/28/2022] [Accepted: 11/06/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND The globally low access to pulmonary rehabilitation can be attributed to the shortage of competent professionals. Setting up specific-duty-post nurses in pulmonary rehabilitation is a novel attempt to solve it. However, their work experience in this position has not been examined. OBJECTIVES To describe the working experience of special-duty-post pulmonary rehabilitation nurses to improve the efficiency of this mode and provide guidance for management hospitals contemplating setting up and optimizing this position. METHODS A descriptive phenomenology qualitative approach with semi-structured in-depth interviews was adopted. RESULTS Fourteen special-duty-post pulmonary rehabilitation nurses were recruited by purposive and snowball sampling from May to July 2021. Four main themes emerged: finding the way in the dark, meeting qualifications and requirements, seeking independence, and anticipating better development. The lack of relevant standards, inadequate support, and variation in chronic respiratory diseases had made them felt like they were finding their way in the dark. As a result of meeting new requirements and qualifications, they experienced role transition shock. Moreover, they were seeking a clear role boundary and independence to foster their sense of belonging. They suggested ways that future management and policies could nurture them to invest more in pulmonary rehabilitation development. CONCLUSION Developing detailed working standards before work begins and providing adequate support, especially from pulmonologists was key. Compared to a clinical position, this position requires a high level of specialty knowledge, communication skills, self-learning, innovative ability, decision-making, and resilience. Special-duty-post pulmonary rehabilitation nurses suggested ways that tailored management based on the identified factors could counteract their transition shock. A clear role boundary and independence help foster belongingness. To maximize effectiveness and overcome challenges requires identifying obstacles to success, initiating strategies to overcome these and ongoing efforts to promote interdisciplinary support of the role.
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Affiliation(s)
- Jiaying Li
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR
| | - Qiuxuan Zeng
- The First Affiliated Hospital of Guangzhou Medicine University, Guangzhou, China
| | - Huixin Huang
- The First Affiliated Hospital of Guangzhou Medicine University, Guangzhou, China
| | - Yang Song
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wenwei Guo
- The First Affiliated Hospital of Guangzhou Medicine University, Guangzhou, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR.
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Yu HJ, Ho M, Chau PH, Geng L, Fong DYT. Salivary telomere length and the risks of prediabetes and diabetes among middle-aged and older adults: findings from the Health and Retirement Study. Acta Diabetol 2023; 60:273-283. [PMID: 36371747 DOI: 10.1007/s00592-022-02004-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 11/03/2022] [Indexed: 11/14/2022]
Abstract
AIM To assess the association of telomere length (TL) with prediabetes/diabetes and to explore the potential factors affecting TL among individuals with prediabetes/diabetes by weight status. METHODS This study included 3,379 eligible adults (aged 45-85 years, males: 42%) from the US Health and Retirement Study in 2008. TL was assayed using quantitative PCR of saliva (T/S ratio). Linear and nonlinear associations between TL and prediabetes/diabetes were assessed using the logistic regression and restricted cubic spline model, respectively, adjusting for TL-plate numbers, age, sex, race, body mass index, lifestyles, diabetes medications, and cardiometabolic parameters (blood pressure, C-reactive protein, and total cholesterol). Multiple linear regression was used for testing any factors associated with TL. RESULTS Among 3,379 participants, 868 (25.7%) had prediabetes with a mean TL of 1.34 ± 0.37 (T/S ratio) and 858 (25.4%) had diabetes with a mean TL of 1.36 ± 0.43 (T/S ratio). Neither linear nor nonlinear association of TL with prediabetes/diabetes was significant by weight status. Age was negatively associated with TL in both normal-weight (β = - 0.002, p = 0.025) and overweight/obese (β = - 0.002, p = 0.006) prediabetes, but non-significant in normal-weight and overweight/obese diabetes. BMI and cardiometabolic parameters were not associated with TL in prediabetes/diabetes by weight status. CONCLUSIONS Salivary TL was not associated with prediabetes/diabetes among the US middle-aged and older adults. Further longitudinal studies are required to establish the link between TL and diabetes development and to identify potential factors affecting TL shortening, particularly in normal-weight diabetic patients.
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Affiliation(s)
- Hong-Jie Yu
- School of Nursing, The University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong SAR, China
| | - Mandy Ho
- School of Nursing, The University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong SAR, China.
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong SAR, China
| | - Leiluo Geng
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong SAR, China
- Department of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Daniel Yee Tak Fong
- School of Nursing, The University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong SAR, China
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Ho M, Smith R, Chau PH, Chung CY, Fong DYT. Chinese version Weight-Related Eating Questionnaire to assess psychological aspects of eating behaviours in Chinese adults: abridged secondary publication. Hong Kong Med J 2023; 29 Suppl 2:29-32. [PMID: 36951003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Affiliation(s)
- M Ho
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
| | - R Smith
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
| | - P H Chau
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
| | - C Y Chung
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
| | - D Y T Fong
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
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30
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Fan HSL, Fong DYT, Lok KYW, Tarrant M. A Qualitative Exploration of the Reasons for Expressed Human Milk Feeding Informed by the Breastfeeding Self-Efficacy Theory. J Hum Lact 2023; 39:146-156. [PMID: 35414281 DOI: 10.1177/08903344221084629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is an increasing prevalence of expressed human milk feeding. The reasons for expressed human milk feeding of healthy term infants may differ from those for preterm infants. The process of adopting expressed human milk feeding for healthy full-term infants has not been well-described in the existing literature. RESEARCH AIM To describe the reasons for, and antecedents to, expressed human milk feeding among Chinese women who used a high proportion of expressed human milk for feeding. METHODS A descriptive, prospective cross-sectional qualitative design was used. Participants (N = 25) who used a high proportion of expressed human milk feeding were recruited from a larger perspective cohort study in two public hospitals in Hong Kong. Semi-structured, in-depth, one-to-one interviews were conducted 2017-2018. Data collection and thematic analysis were guided by the Breastfeeding Self-Efficacy Theory. RESULTS The authors conducted thematic analysis and identified six core themes: (1) perceived maternal roles; (2) breastfeeding role models; (3) negative feedback from social networks; (4) negative direct breastfeeding experiences; (5) expressed human milk feeding as a solution to a problem; and (6) advice from health care professionals to express human milk. These themes were consistent with the four antecedents of the Breastfeeding Self-Efficacy Theory (e.g., physiological and affective state, vicarious experiences, performance accomplishments, and verbal persuasion). CONCLUSIONS The main reason for participants to feed expressed human milk was experiencing difficulties with direct breastfeeding. Expressed human milk feeding was used as an immediate solution for breastfeeding problems. Strengthening breastfeeding support in the early postpartum period may decrease the perceived need for human milk expression.
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Affiliation(s)
- Heidi Sze Lok Fan
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR
| | - Marie Tarrant
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
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Meng R, Kato T, Mastrotheodoros S, Dong L, Fong DYT, Wang F, Cao M, Liu X, Yao C, Cao J, Yu Y, Luo Y, Yu C, Gozal D. Adaptation and validation of the Chinese version of the Sleep Quality Questionnaire. Qual Life Res 2023; 32:569-582. [PMID: 36125602 DOI: 10.1007/s11136-022-03241-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2022] [Indexed: 11/24/2022]
Abstract
STUDY OBJECTIVES Sleep quality is essential to health. The current study aimed to adapt and validate the Sleep Quality Questionnaire (SQQ) into Chinese language. METHODS The Chinese version of the SQQ (SQQ-C) was created following the guidelines for cross-cultural adaptation. Compliant with the COSMIN methodology, baseline data (N = 13,325) examined three validity domains and internal consistency, including content validity using the content validity index (CVI) and the cognitive debriefing and focus group (relevance, comprehensiveness and comprehensibility), construct validity using structural validity and cross‑sectional measurement invariance, and criterion validity using concurrent/convergent validity. Follow-up data (N = 3410) gathered within a mean of 168 (167-207) h interval were used to additionally assess longitudinal measurement invariance and test-retest reliability using intraclass correlation coefficient (ICC). RESULTS Scale-level CVI/Average was equal to 0.922; Item-level CVIs ranged from 0.889 to 1.000 (excellent), except for item 2 (0.556-fair). A panel of local experts and local participants during cognitive debriefing and focus group stated that it had sufficient relevance and comprehensibility but a slight deficiency in comprehensiveness. Confirmatory factor analysis indicated a stable two-factor structure encompassing Daytime Sleepiness Subscale and Sleep Difficulty Subscale from baseline to follow-up data. The SQQ-C-9 (without item 2) outperformed the SQQ-C-10 (full form). The SQQ-C-9 provided evidence of measurement invariance (strict) across subgroups (cohorts, gender, and age) and across time. The SQQ-C was negatively correlated with the Chinese Nonrestorative Sleep Scale and the Chinese Sleep Condition Indicator. Cronbach's alpha (α), McDonald's Omega (ω), and ICC, respectively, ranged from 0.712 to 0.838, 0.723 to 0.840, and 0.738 to 0.764 for total scale and each subscale. CONCLUSION The SQQ-C exhibits adequate psychometric properties and a stable two-factor structure, and should enable valuable assessments of sleep quality in clinical and research settings.
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Affiliation(s)
- Runtang Meng
- School of Public Health, Hangzhou Normal University, No. 2318, Yuhangtang Rd, Yuhang District, Hangzhou, 311121, Zhejiang, China. .,School of Public Health, Wuhan University, Wuhan, Hubei, China.
| | - Tsukasa Kato
- Department of Social Psychology, Toyo University, Tokyo, Japan
| | - Stefanos Mastrotheodoros
- Department of Psychology, University of Crete, Rethymno, Crete, Greece.,Department of Youth and Family, Utrecht University, Utrecht, the Netherlands
| | - Lu Dong
- Department of Behavioral & Policy Sciences, RAND Corporation, Santa Monica, CA, USA
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Fang Wang
- School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Menglu Cao
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Xinliang Liu
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Chenmin Yao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education (KLOBM), School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Jinhong Cao
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Yong Yu
- School of Public Health, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yi Luo
- School of Nursing, Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Chuanhua Yu
- School of Public Health, Wuhan University, Wuhan, Hubei, China.,Global Health Institute, Wuhan University, Wuhan, Hubei, China
| | - David Gozal
- Department of Child Health, University of Missouri School of Medicine, Columbia, MO, USA
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Chen N, Fong DYT, Wong JYH. Health and Economic Outcomes Associated With Musculoskeletal Disorders Attributable to High Body Mass Index in 192 Countries and Territories in 2019. JAMA Netw Open 2023; 6:e2250674. [PMID: 36662529 PMCID: PMC9860530 DOI: 10.1001/jamanetworkopen.2022.50674] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/20/2022] [Indexed: 01/21/2023] Open
Abstract
Importance The degree to which health and economic outcomes of musculoskeletal disorders are attributable to high body mass index (BMI) has not been quantified on a global scale. Objective To estimate global health and economic outcomes associated with musculoskeletal disorders-low back pain (LBP), gout, and osteoarthritis attributable to high BMI in 2019. Design, Setting, and Participants This cross-sectional study used data of 192 countries and territories from the Global Burden of Diseases, Injuries, and Risk Factors Study, World Health Organization Global Health Expenditure, World Bank, and International Labour Organization databases. Data analyses were conducted from February 24 to June 16, 2022. Main Outcomes and Measures Prevalence, years lived with disability (YLDs), health care costs, and productivity losses due to morbidity from LBP, gout, and osteoarthritis attributable to high BMI by region and country. Prevalence and YLDs were calculated with the population attributable fraction approach. The economic burden, including health care costs and productivity losses due to morbidity, was also quantified. Health care costs borne by the public, private, and out-of-pocket sectors were estimated based on their corresponding payment shares. Productivity losses were estimated based on the output per worker. A sensitivity analysis was conducted to arrive at the base, minimum, and maximum estimates (ie, uncertainty interval [UI]) by using the mean, lower, and upper bounds of all input variables. Results High BMI was estimated to be responsible for 36.3 million (UI, 18.4-61.0 million), 16.9 million (UI, 7.5-32.5 million), and 73.0 million (UI, 32.4-131.1 million) prevalent cases of LBP, gout, and osteoarthritis, respectively, which accounted for 7.3 million (UI, 3.0-15.0 million) YLDs across 192 countries and territories in 2019. Globally, the YLDs of musculoskeletal disorders attributable to high BMI accounted for 1.0% of all-cause YLDs in the working-age population aged 15 to 84 years. The global total costs of musculoskeletal disorders attributable to high BMI reached $180.7 billion (UI, $83.8-$333.1 billion), including $60.5 billion (UI, $30.7-$100.5 billion) in health care costs and $120.2 billion (UI, $53.1-$232.7 billion) in productivity losses. In terms of the global health care costs, 58.9% ($35.6 billion; UI, $17.8-$59.6 billion) was borne by the public sector, 24.0% ($14.5 billion; UI, $7.8-$23.2 billion) by the private sector, and 17.1% ($10.3 billion; UI, $5.1-$17.6 billion) by the out-of-pocket sector. On average, the total costs accounted for 0.2% of global gross domestic product. Great inequalities in the disease and economic burden existed across regions and countries. Nearly 80% of global health care (82.4%) and morbidity-related costs (82.9%) were paid by high-income countries, whereas more than 60% (61.4%) of global YLDs occurred in middle-income countries. Conclusions and Relevance In this cross-sectional study of 192 countries and territories, a substantial amount of the health and economic impact of musculoskeletal disorders was attributable to high BMI. Developing effective policies and active participation from health professionals to prevent excessive weight gain are needed. More available estimates are also needed to facilitate a global analysis.
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Affiliation(s)
- Ningjing Chen
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Janet Yuen Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
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Chung KCW, Nam S, Li S, Fan HSL, Wong JYH, Kwok JYY, Davies H, Huang L, Annunziata MA, Fong DYT. Psychometric properties of the Cognitive Functioning Self-Assessment Scale in community-dwelling adults: A cross-sectional online survey. Front Psychol 2023; 14:1122198. [PMID: 36910776 PMCID: PMC9995380 DOI: 10.3389/fpsyg.2023.1122198] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/03/2023] [Indexed: 02/25/2023] Open
Abstract
Background The Cognitive Functioning Self-Assessment Scale (CFSS) was developed to allow the self-assessment of perceived cognitive functioning. It has been tested with satisfactory reliability and validity but was not available for the Chinese population. This study aimed to adapt and validate the Chinese version of the CFSS for community-dwelling adults. Methods A cross-sectional study of a sample of 1,002 Chinese adults from the general population was conducted online (July-August 2022). The Chinese version of the CFSS with 18 items was created through translation, cognitive debriefing, and psychometric evaluation. Exploratory factor analysis (EFA) was performed on the first half of the randomly split sample. A model derived from EFA was confirmed by confirmatory factor analysis (CFA) in the second half of the sample. The model fits were further evaluated with and without subgrouping by age, gender, and education level. Internal consistency was assessed using Cronbach's alpha (α) and McDonald's omega hierarchical coefficients (ωH). Results EFA (n = 460) revealed a three-factor solution, including spatio-temporal orientation, attention, and memory, which explained 51% of the total variance. The second-order CFA (n = 510) demonstrated a good fit: CFI = 0.951, TLI = 0.944, RMSEA = 0.054, SRMR = 0.040. A second-order multiple-group analysis showed that the structure was invariant by age, gender, and education level. The total CFSS score was significantly associated with the Chinese version of the nine-item Patient Health Questionnaire (r = 0.56, p< 0.001) and the Chinese version of the seven-item General Anxiety Disorder (r = 0.53, p<0.001). The internal consistency reliability was satisfactory, with α = 0.94 and ωH = 0.84. The item-total correlation coefficients ranged from 0.58 to 0.72. Conclusion The Chinese version of the CFSS possesses good item characteristics, satisfactory validity, and reliability for assessing self-reported cognitive functioning among community-dwelling adults. It is a feasible and appropriate self-assessment instrument to examine cognitive functioning in the Hong Kong Chinese population, which contributes to monitoring and developing strategies to prevent and manage cognitive impairment and disorders for the public's cognitive health and well-being.
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Affiliation(s)
- Krista Ching Wai Chung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Sujin Nam
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Sha Li
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Heidi Sze Lok Fan
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
| | - Janet Yuen Ha Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Kowloon, Hong Kong SAR, China
| | - Jojo Yan Yan Kwok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Hugh Davies
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Lixi Huang
- Department of Mechanical Engineering, Faculty of Engineering, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Maria Antonietta Annunziata
- Unit of Oncological Psychology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Pordenone, Italy
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Guo N, Tsun Luk T, Wu Y, Lai AYK, Li Y, Cheung DYT, Wong JYH, Fong DYT, Wang MP. Between- and within-person associations of mobile gaming time and total screen time with sleep problems in young adults: Daily assessment study. Addict Behav 2022; 134:107408. [PMID: 35717890 DOI: 10.1016/j.addbeh.2022.107408] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/27/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To explore associations of screen time (total, mobile gaming) with sleep problems in Chinese young adults. METHODS This was a 4-week daily morning (completion rate = 82.1%, 909/1107) and evening (completion rate = 92.4%, 1061/1148) assessment study in 41 university students (22 female, mean age = 22.3 [SD 4.2] years). Short sleep duration < 7 h, difficulty initiating sleep, difficulty maintaining sleep, early morning awakening, and any of these three insomnia symptoms were self-reported in the morning. Mobile gaming time was self-reported in the evening, whilst total screen time was objectively tracked. Bayesian multilevel mixed-effects modeling disaggregated between- and within-person associations. RESULTS Between person, longer mobile gaming time predicted short sleep duration (adjusted odds ratio [AOR] = 1.90, 95% CI 1.39, 2.69), any insomnia symptoms (AOR = 1.59, 95% CI 1.20, 2.11), difficulty initiating sleep (AOR = 3.05, 95% CI 1.51, 6.24), and difficulty maintaining sleep (AOR = 2.19, 95% CI 1.18, 3.74). Short sleep duration (adjusted b = 0.99, 95% CI 0.05, 1.95), any insomnia symptoms (adjusted b = 1.19, 95% CI 0.24, 1.94), and difficulty initiating sleep (adjusted b = 1.72, 95% CI 0.11, 3.19) reversely increased mobile gaming time. Within person, any insomnia symptoms (adjusted b = 0.17, 95% CI 0.04, 0.31) and early morning awakening (adjusted b = 0.28, 95% CI 0.08, 0.48) increased next-day mobile gaming time. Total screen time was not associated with sleep problems both between and within person. CONCLUSIONS Bidirectional between-person associations of mobile gaming time with short sleep duration and insomnia symptoms informed multiple-health-behavior-change interventions. Unidirectional within-person associations of insomnia symptoms with next-day mobile gaming time informed just-in-time adaptive interventions addressing daily variations in insomnia symptoms. [250/250 word limits].
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Affiliation(s)
- Ningyuan Guo
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China; School of Nursing, University of Hong Kong, Hong Kong, China
| | - Tzu Tsun Luk
- School of Nursing, University of Hong Kong, Hong Kong, China
| | - Yongda Wu
- School of Nursing, University of Hong Kong, Hong Kong, China
| | | | - Yajie Li
- School of Nursing, University of Hong Kong, Hong Kong, China
| | | | | | | | - Man Ping Wang
- School of Nursing, University of Hong Kong, Hong Kong, China.
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Takemura N, Fong DYT, Lin CC. Evaluating end-of-life care capacity building training for home care nurses. Nurse Educ Today 2022; 117:105478. [PMID: 35841686 DOI: 10.1016/j.nedt.2022.105478] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 06/22/2022] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND With the rapidly aging population, the quality of end-of-life (EOL) care has become a significant issue. As the majority of deaths in Hong Kong (HK) currently occur in public hospitals, promoting palliative home care can relieve hospital burden and provide good deaths. There is a practical need to properly educate and train nurses on the skills to provide EOL care in home care settings. OBJECTIVES To evaluate the effect of the first EOL care training program for nurses working in home care settings or nursing homes on quality of life at work, orientation toward dying and death, and self-competence in death work. DESIGN A pre-experimental research design was utilized to conduct this study using a one-group pretest and posttest approach. SETTINGS AND PARTICIPANTS A convenience sample of 153 nurses working in home care settings or nursing homes in HK was selected. METHODS Participating nurses attended two-day entry-level and seven-day advanced-level courses. Quality of life at work, multidimensional orientation toward dying and death, and self-competence in death work were assessed using questionnaires at baseline and immediately after entry- and advanced-level training. RESULTS The results revealed that nurses reported a higher level of compassion satisfaction (d = 2.52, p < 0.001), less burnout at work (d = -3.25, p = 0.045), less fear about their own death (d = -1.33, p = 0.019), and more acceptance of others' deaths (d = 1.07, p = 0.004) in post-advanced-level courses. In general, participants were satisfied with the delivery method, duration, and logistical arrangement of the courses. CONCLUSIONS Nurses reported improved professional quality of life, less fear, and more acceptance toward death and dying after the training program. More educational strategies, such as role-play and case study discussions, are needed to improve the overall learning experience and effectiveness of the program. Future studies could add a qualitative component to yield deeper insights through the findings. As training programs allow nurses to cultivate their skills in clinical situations, there is an undeniable need to continue implementing standardized education and training for palliative care nurses to improve EOL care quality.
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Affiliation(s)
- Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong; Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Hong Kong.
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Wang T, Wong JYH, Fong DYT. Subjective socioeconomic status: An indicator of intimate partner violence in middle-aged adults in Hong Kong. Health Soc Care Community 2022; 30:e3150-e3157. [PMID: 35194868 DOI: 10.1111/hsc.13760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 01/04/2022] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
Intimate partner violence (IPV) has recently been recognised as a global public health issue that can cause various kinds of long-lasting physical, sexual and psychological health problems. Limited studies are available concerning the relationship between objective and subjective socioeconomic status (SES) and IPV, and the impact of experiencing IPV on health consequences. This is a cross-sectional study aiming to examine the association between objective and subjective SES as risk factors of IPV, and further investigate how they affect health status in adults who experienced IPV. A total of 400 participants were recruited from June to September 2016 among 18 districts in Hong Kong. Results from multiple linear regression showed that having a higher education (adjusted B [aB] = 0.22, 95% CI = 0.01, 0.45), having lower levels of subjective SES (aB = -0.08, 95% CI = -0.15, -0.01), experiencing childhood stress (aB = 0.58, 95% CI = 0.27, 0.89) and being married (aB = 0.60, 95% CI = 0.01, 1.19) were significantly associated with IPV. While employment and household income were not associated with IPV. Participants with higher levels of subjective SES were more likely to report somatic symptom (aB = -0.44, 95% CI = -0.87, -0.02), anxiety (aB = -0.38, 95% CI = -0.72, -0.04) and depressive symptom (aB = -0.52, 95% CI = -0.94, -0.10). Low subjective SES, instead of low objective SES, was found associated with IPV in Chinese adults. A priority for future studies is the confirmation and expansion of subjective SES and its function in clinical measures. Programmes instilling hope and optimism will be helpful to enhance subjective SES and boost physical and mental well-being in IPV survivors.
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Affiliation(s)
- Tingxuan Wang
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Janet Yuen Ha Wong
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Daniel Yee Tak Fong
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR
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Takemura N, Cheung DST, Fong DYT, Lin CC. Promoting moderate-to-vigorous physical activities in patients with advanced lung cancer: preferences and social cognitive factors, and the mediating roles. Support Care Cancer 2022; 30:7419-7429. [PMID: 35622150 PMCID: PMC9136819 DOI: 10.1007/s00520-022-07149-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/13/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study is to assess the prevalence and preferences of moderate-to-vigorous physical activities (MVPA) in patients with advanced lung cancer, explore the social cognitive factors that were associated with MVPA and interest in PA counseling and program, and examine the mediating role of social cognitive factors. METHODS This was a cross-sectional study. Questionnaires on PA levels, PA counseling and programming preferences, and social cognitive variables (social support and self-efficacy) were administered to 105 patients with advanced lung cancer. Linear regression model was used to explore the social cognitive factors associated with MVPA, and logistic regression model was used to explore the factors associated with interest in PA counseling and program. Mediation analysis was used to examine the mediating role of self-efficacy on social support and MVPA. RESULTS Merely 30.5% of patients met the recommended level of MVPA; however, the majority of patients (89.5%) were interested in PA program. Social support (β = 0.60; p = 0.007) and self-efficacy (β = 1.06; p = 0.027) were positively associated with MVPA. Specifically, self-efficacy mediated the relationship between social support and MVPA (β = 0.63, p = 0.004). CONCLUSION The majority of the patients with advanced lung cancer did not meet the recommended level of MVPA; however, they are interested in receiving PA counseling and joining PA programs. Social support was key to promoting higher levels of MVPA, and the association was mediated by self-efficacy. The established mediating model provides insights into designing PA programs and targeting the mediating variable, self-efficacy, to enhance the level of MVPA.
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Affiliation(s)
- Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
- Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Hong Kong, Hong Kong.
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Abstract
Introduction: It is well established that low breastfeeding self-efficacy is associated with early breastfeeding cessation. Over the past several decades, expressed human milk feeding has increased among parents of healthy infants. Researchers have hypothesized an association between maternal breastfeeding confidence and expressed human milk feeding, but it has not been empirically examined. Therefore, the primary objective of this study was to assess the associations between breastfeeding self-efficacy and human milk expression practices. The secondary objective was to assess the effect of breastfeeding self-efficacy on breastfeeding duration and exclusivity. Methods: This study used a prospective cohort design. From 2017 to 2018, we recruited 821 healthy mothers with term births in two public hospitals in Hong Kong. Participants completed a self-administered questionnaire in the immediate postpartum period, which gathered information about sociodemographic characteristics and Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). Participants were followed up for 6 months or until infants were weaned. The proportion and type of infant feeding were assessed at telephone follow-up. Results: The overall mean BSES-SF score in our sample was 46.5 (standard deviation = 10.1). Every one-point increase in the BSES-SF score was associated with 4-5% lower risk of any expressed human milk feeding and 4-7% higher odds of breastfeeding continuation across the first 6 months postpartum. Conclusion: Higher breastfeeding self-efficacy is associated with a lower risk of expressed human milk feeding and a longer duration of any and exclusive breastfeeding. Further studies should explore how improving breastfeeding self-efficacy may affect the mode of human milk feeding.
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Affiliation(s)
- Heidi Sze Lok Fan
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Marie Tarrant
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, British Columbia, Canada
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Chen N, Fong DYT, Wong JYH. Trends in Musculoskeletal Rehabilitation Needs in China From 1990 to 2030: A Bayesian Age-Period-Cohort Modeling Study. Front Public Health 2022; 10:869239. [PMID: 35784203 PMCID: PMC9240767 DOI: 10.3389/fpubh.2022.869239] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/29/2022] [Indexed: 01/07/2023] Open
Abstract
Background Disability and medical expenses caused by musculoskeletal disorders in China had a great impact on the global health and economy. Rehabilitation is essential for dealing with musculoskeletal disorders. However, China's musculoskeletal rehabilitation needs remain unknown. This study aimed to examine the secular trends for musculoskeletal rehabilitation needs in China from 1990 to 2030. Methods Data on musculoskeletal rehabilitation needs were extracted from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) repository. Estimated annual percentage changes (EAPCs) were calculated to reflect fluctuations in the age-standardized rates. The Bayesian age-period-cohort models were used to project rehabilitation needs. Results The number of prevalent cases and years lived with disability (YLD) counts in need of musculoskeletal rehabilitation increased greatly in China from 1990 to 2019. There will be 465.9 million Chinese people in need of rehabilitation, with the age-standardized prevalence rate increasing to 21,151.0 [2.5–97.5% predictive interval (95% PI) 14,872.6–27,429.3] per 100,000 persons in 2030. Similarly, the YLD counts will increase to 40.1 million, with the age-standardized YLD rate increasing to 1,811.2 (95% PI 1,232.5–2,390.0) per 100,000 persons in 2030. Conclusions Increasing trends in musculoskeletal rehabilitation needs were found from 1990 to 2019, which will be anticipated through 2030. Rehabilitation is suggested to be integrated into primary care settings.
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Nam S, Hong S, Kim H, Wong JYH, Fong DYT. Reliability and validity of the Korean 12-item Perception of Aggression Scale. J Psychiatr Ment Health Nurs 2022; 29:442-450. [PMID: 33780587 DOI: 10.1111/jpm.12759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 01/13/2021] [Accepted: 03/23/2021] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: The importance of and interest in nurses' attitudes towards and subjective experience with workplace violence in clinical settings is increasing. The prevalence of patient-perpetrated violence against Korean nurses in hospital settings is highly prevalent. Only few instruments are available to measure the nurses' perception of patient aggression in Korea. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to assess the linguistic and psychometric reliability and validity of an instrument that evaluates the attitude of Korean nursing staff towards patient-perpetrated workplace violence. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This valid and reliable instrument could be used to assess and monitor the nurses' attitudes towards aggressive tendencies in the workplace. The results could contribute to the development of relevant interventions for coping with violence by patients towards nursing staff and the implementation of practical training to cultivate healthy perceptions towards patients to foster therapeutic nurse-patient relationships. ABSTRACT: Introduction Despite the high prevalence of patient-perpetrated violence against Korean nurses globally, reliable and valid measures of patient aggression are lacking in Korean. Aim We translated the 12-item Perception of Aggression Scale (POAS) into Korean and psychometrically assessed its utility in measuring nurses' attitudes towards aggression. Methods The 12-item Korean POAS was obtained through forward-backward translation and cognitive debriefing. It was administered online to 319 nurses (mean age = 32.64 years; females = 96.2%), of which 206 completed it again after two weeks. Confirmatory factor analysis validated the 3-factor structure as hypothesized in the original version. The intra-class correlation coefficient was used to assess the test-retest reliability. Results The originally hypothesized 3-factor structure showed a good fit. The 3 dimensions: aggression as a dysfunctional or undesirable phenomenon, aggression as a functional or comprehensible phenomenon, and aggression as a protective measure had internal consistencies of 0.74, 0.86 and 0.90 and corresponding ICCs of 0.70, 0.86 and 0.90, respectively. Discussion The 12-item Korean POAS is a valid and reliable scale that might aid investigating nurses' attitudes towards patient aggression. Implications for practice The 12-item Korean POAS can help Korean nurses adopt protective behaviours and develop interventions to cope with aggression.
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Affiliation(s)
- Sujin Nam
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Soyun Hong
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Republic of Korea
| | - Heejung Kim
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Janet Yuen Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
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Kwok JYY, Smith R, Chan LML, Lam LCC, Fong DYT, Choi EPH, Lok KYW, Lee JJ, Auyeung M, Bloem BR. Managing freezing of gait in Parkinson's disease: a systematic review and network meta-analysis. J Neurol 2022; 269:3310-3324. [PMID: 35244766 DOI: 10.1007/s00415-022-11031-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 02/07/2022] [Accepted: 02/11/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Freezing of gait (FOG) is one of the most disabling gait disorders affecting 80% of patients with Parkinson's disease (PD). Clinical guidelines recommend a behavioral approach for gait rehabilitation, but there is a wide diversity of behavioral modalities. OBJECTIVE The objective of this network meta-analysis was to compare the effectiveness of different behavioral interventions for FOG management in PD patients. METHODS Six databases were searched for randomized controlled trials of behavioral interventions for FOG management among PD patients from 1990 to December 2021. Bayesian network meta-analysis was used to combine both direct and indirect trial evidence on treatment effectiveness, while the surface under the cumulative ranking (SUCRA) score was used to estimate the ranked probability of intervention effectiveness. RESULTS Forty-six studies were included in the qualitative synthesis. Among, 36 studies (1454 patients) of 72 interventions or control conditions (12 classes) were included in the network meta-analysis, with a mean intervention period of 10.3 weeks. After adjusting for the moderating effect of baseline FOG severity, obstacle training [SMD -2.1; 95% credible interval (Crl): -3.3, -0.86], gait training with treadmill (SMD -1.2; 95% Crl: -2.0, -0.34), action observation training (SMD -1.0; 95% Crl: -1.9, -0.14), conventional physiotherapy (SMD -0.70; 95% Crl: -1.3, -0.12) and general exercise (SMD -0.64; 95% Crl: -1.2, -0.11) demonstrated significant improvement on immediate FOG severity compared to usual care. The SUCRA rankings suggest that obstacle training, gait training on treadmill and general exercises are most likely to reduce FOG severity. CONCLUSION Obstacle training, gait training on treadmill, general exercises, action observation training and conventional physiotherapy demonstrated immediate real-life benefits on FOG symptoms among patients with mild-moderate PD. With the promising findings, the sustained effects of high complexity motor training combined with attentional/cognitive strategy should be further explored. Future trials with rigorous research designs using both subjective and objective outcome measures, long-term follow-up and cost-effective analysis are warranted to establish effective behavioral strategies for FOG management.
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Affiliation(s)
- Jojo Yan Yan Kwok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China.
| | - Robert Smith
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Lily Man Lee Chan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Leo Chun Chung Lam
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Jung Jae Lee
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Man Auyeung
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR, People's Republic of China
| | - Bastiaan R Bloem
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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Li J, Huang Y, Fong DYT, Chen J, Song Y. Work Readiness: Its Determinants and Association with Work-related Outcomes among New Graduate Nurses. J Nurs Manag 2022; 30:2968-2981. [PMID: 35596059 DOI: 10.1111/jonm.13691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/06/2022] [Accepted: 05/18/2022] [Indexed: 11/27/2022]
Abstract
AIMS This study aimed to identify determinants of work readiness and to assess the influences of work readiness on work-related outcomes in graduate nurses. BACKGROUND Higher work readiness facilitates smoother role transitions of new graduate nurses. However, determinants of work readiness had not been fully examined. In addition, the relationships between work readiness and work-related outcomes, such as coping self-efficacy and occupational commitment, are also crucial but had not been assessed. METHODS We recruited 794 graduate nurses and assessed their work readiness before working as nurses. After they commenced their work, we assessed their occupational commitment, coping self-efficacy, and intention to remain. All assessments were conducted online. RESULTS There were 728 (92%) female respondents. The mean scores and standard deviation (SD) of work readiness, coping self-efficacy, occupational commitment, and intention to remain were 261.51 (SD: 45.40), 30.30 (SD: 6.13), 81.65 (SD: 11.56), and 11.01 (SD: 2.36), respectively. Based on a regression analysis, determinants of work readiness were positive school climate, student leadership experience, nursing as the primary choice of discipline, and perceived influences of COVID-19 on the honorability of being a nurse and the willingness to be a nurse (p < 0.001). Moreover, after adjusted by all demographics and characteristics variables, higher work readiness would result in higher coping self-efficacy (estimated coefficient = 0.06, p < 0.001), occupational commitment (estimated coefficient = 0.06, p < 0.001), and intention to remain (estimated coefficient = 0.01, p = 0.002). CONCLUSION Work readiness is a composite concept affected by psychosocial and environmental factors, which can predict new graduate nurses' future self-efficacy, occupational commitment, and intention to remain. IMPLICATIONS FOR NURSING MANAGEMENT The management of new graduate nurses when they begin to work could target their work readiness. Transition programs that consider our identified determinants can be provided to those who show lower work readiness.
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Affiliation(s)
- Jiaying Li
- The University of Hong Kong, Li Ka Shing Faculty of Medicine, School of Nursing
| | - Yanyi Huang
- Guangzhou University of Chinese Medicine, School of nursing
| | - Daniel Yee Tak Fong
- The University of Hong Kong, Li Ka Shing Faculty of Medicine, School of Nursing
| | - Jieya Chen
- Guangzhou Institute of Respiratory Health
| | - Yang Song
- Guangzhou University of Chinese Medicine, School of nursing
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Yu HJ, Ho M, Liu X, Yang J, Chau PH, Fong DYT. Association of weight status and the risks of diabetes in adults: a systematic review and meta-analysis of prospective cohort studies. Int J Obes (Lond) 2022; 46:1101-1113. [PMID: 35197569 DOI: 10.1038/s41366-022-01096-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/30/2022]
Abstract
Obesity is a known risk factor for type 2 diabetes mellitus (T2DM); however, the associations between underweight and T2DM and between weight status and prediabetes have not been systematically reviewed. We aimed to estimate the relative risks (RRs) of prediabetes/T2DM in underweight/overweight/obesity relative to normal weight. PubMed, Embase, Web of Science, and Cochrane Library were searched from inception to December 8, 2021. Prospective cohort studies with a minimum 12-month follow-up period reporting the association between baseline body mass index (BMI) categories and risk of prediabetes/T2DM in adults were included. Study quality was assessed using the Newcastle-Ottawa Scale. The main analyses of T2DM risk were performed using the ethnic-specific (Asian/non-Asian) BMI classification and additional analyses of prediabetes/T2DM risk by including all eligible studies. Random-effects models with inverse variance weighting were used. Subgroup analyses and meta-regression were conducted to explore the potential effects of pre-specified modifiers. The study protocol was registered with PROSPERO (CRD42020215957). Eighty-four articles involving over 2.69 million participants from 20 countries were included. The pooled RR of prediabetes risk was 1.24 (95% CI: 1.19-1.28, I2 = 9.7%, n = 5 studies) for overweight/obesity vs. normal weight. The pooled RRs of T2DM based on the ethnic-specific BMI categories were 0.93 (95% CI: 0.75-1.15, I2 = 55.5%, n = 12) for underweight, 2.24 (95% CI: 1.95-2.56, I2 = 92.0%, n = 47) for overweight, 4.56 (95% CI: 3.69-5.64, I2 = 96%, n = 43) for obesity, and 22.97 (95% CI: 13.58-38.86, I2 = 92.1%, n = 6) for severe obesity vs. normal weight. Subgroup analyses indicated that underweight is a protective factor against T2DM in non-Asians (RR = 0.68, 95% CI: 0.40-0.99, I2 = 56.1%, n = 6). The magnitude of the RR of T2DM in overweight/obesity decreased with age and varied by region and the assessment methods for weight and T2DM. Overweight/obesity was associated with an increased prediabetes/T2DM risk. Further studies are required to confirm the association between underweight and prediabetes/T2DM, particularly in Asian populations.
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Affiliation(s)
- Hong-Jie Yu
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
| | - Mandy Ho
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China.
| | | | - Jundi Yang
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
| | - Pui Hing Chau
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
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Gong WJ, Fong DYT, Wang MP, Lam TH, Chung TWH, Ho SY. Worsening trends in self-rated health and correlates in Chinese adolescents in Hong Kong: a population-based panel study from 1999/2000 to 2014/15. BMJ Open 2022; 12:e055842. [PMID: 35165111 PMCID: PMC8845170 DOI: 10.1136/bmjopen-2021-055842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To examine the 15-year secular trends of self-rated health (SRH) and correlates in Chinese adolescents in Hong Kong. DESIGN A territory-wide population-based panel data study. SETTING Anonymised records of the annual health examination from the Student Health Service, Department of Health in Hong Kong. PARTICIPANTS 397 324 students in Secondary 2 (US grade 8), 335 902 in Secondary 4 and 113 892 in Secondary 6 during the academic year 1999/2000 and 2014/15. OUTCOME MEASURES SRH and lifestyles were self-reported using standardised questionnaires. Sex-standardised and age-standardised prevalence of very poor/poor SRH and its secular annual changes across sex, grade, weight status, breakfast habits, and frequency/duration of aerobic exercises were examined. Their disparities over time were examined by interactions with the academic year in generalised estimating equations. RESULTS The overall prevalence of very poor/poor SRH increased from 9.3% (95% CI: 8.9% to 9.7%) in 1999/2000 to 15.5% (15.1% to 15.8%) in 2014/15. Very poor/poor SRH was more prevalent in girls (adjusted OR: 1.02), in those having unemployed parents (1.29), being overweight (1.42) or obese (2.62), eating breakfast away from home (1.27) and skipping breakfast (1.49) or doing <1 time/week or ≤60 min/week aerobic exercises (1.78 and 1.88, respectively) than others. The corresponding disparities increased over time (ratios of OR: 1.006-1.042). CONCLUSIONS Increasing prevalence of very poor/poor SRH from 1999/2000 to 2014/15 was found among Hong Kong Chinese adolescents, which was greater in girls, adolescents being overweight/obese and those having unemployed parents or unhealthy lifestyles. Strategies to reduce health inequality should consider multiple factors, especially modifiable factors including lifestyles.
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Affiliation(s)
- Wei Jie Gong
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | | | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | | | - Sai Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
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Abstract
IMPORTANCE It is hard for policy makers and health professionals to develop musculoskeletal rehabilitation strategies because secular trends for musculoskeletal rehabilitation by region and country remain unknown. OBJECTIVE To evaluate the secular trends in global musculoskeletal rehabilitation needs by sex, age, region, country, and health condition. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included data from 191 countries and territories from the World Health Organization Rehabilitation Need Estimator between January 1, 1990, and December 31, 2019. Data analyses were performed from February to May 2021. MAIN OUTCOMES AND MEASURES Prevalence and years lived with disability (YLDs) of musculoskeletal disorders in need of rehabilitation, overall and by sex, age, region, country, and health condition. Trends in rehabilitation needs were evaluated by the estimated annual percentage changes (EAPCs) in age-standardized rates. Pearson correlation analysis was used to examine the associations between EAPCs and the age-standardized rates in 1990. The associations between the age-standardized rates and universal health coverage (UHC) effective coverage index were assessed by fitting a restricted cubic spline in a linear model. RESULTS From 1990 to 2019, the global number of prevalent cases of musculoskeletal disorders in need of rehabilitation increased from 1060.6 (95% uncertainty interval [UI], 1009.1-1116.4) million to 1713.6 (95% UI, 1632.4-1800.4) million, with a steady increase in the number of YLDs from 93.9 (95% UI, 67.7-123.6) million to 149.0 (95% UI, 107.5-198.6) million. Overall, 55 countries and territories (28.8%) had annual increase in age-standardized prevalence rates, and 18 countries and territories (9.4%) had annual increase in YLD rates. The global age-standardized prevalence and YLD rates of musculoskeletal disorders decreased annually with EAPCs of 0.34 (95% CI, -0.37 to -0.31) and 0.42 (95% CI, -0.51 to -0.32), respectively. Specifically, the global age-standardized prevalence and YLD rates decreased for low back pain (prevalence: EAPC, -0.52; 95% CI, -0.57 to -0.47; YLD: EAPC, -0.52; 95% CI, -0.66 to -0.37), fractures (prevalence: EAPC, -0.35; 95% CI, -0.41 to -0.30; YLD: EAPC, -0.42; 95% CI, -0.65 to -0.19), other injuries (prevalence: EAPC, -0.75; 95% CI, -0.82 to -0.68; YLD: EAPC, -1.04; 95% CI, -1.38 to -0.71), and amputation (prevalence: EAPC, -0.64; 95% CI, -0.73 to -0.55; YLD: EAPC, -1.13; 95% CI, -1.60 to -0.65). The age-standardized prevalence rate decreased for neck pain (EAPC, -0.10; 95% CI, -0.18 to -0.02) but increased for osteoarthritis (EAPC, 0.13; 95% CI, 0.06-0.19) and rheumatoid arthritis (EAPC, 0.37; 95% CI, 0.04-0.70). In contrast, the age-standardized YLD rates remained stable for neck pain (EAPC, -0.09; 95% CI, -0.35 to 0.16), osteoarthritis (EAPC, 0.14; 95% CI, -0.14 to 0.42), and rheumatoid arthritis (EAPC, 0.38; 95% CI, -0.40 to 1.16). The age-standardized prevalence rate of neck pain decreased faster in male individuals, with an EAPC of -0.10 (95% CI, -0.19 to -0.02), while the age-standardized prevalence rate of low back pain decreased faster in female individuals, with an EAPC of -0.55 (95% CI, -0.60 to -0.51). EAPCs were significantly associated with the baseline age-standardized rates (prevalence: ρ = -0.49; P < .001; YLD: ρ = -0.55; P < .001), except for those of neck pain and rheumatoid arthritis. Excess rehabilitation needs were observed in countries with both higher and lower UHC effective coverage indexes (prevalence: β = 749.04; SE, 288.52; P = .01; YLD: β = 49.70; SE, 22.89; P = .03). CONCLUSIONS AND RELEVANCE In this cross-sectional study, substantial increases in musculoskeletal rehabilitation needs were found across locations, suggesting rehabilitation needs have become a global health concern. Mitigating risk factors, strengthening rehabilitation in primary health care, and allocating sufficient funds are encouraged to satisfy rehabilitation needs.
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Affiliation(s)
- Ningjing Chen
- School of Nursing, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong, China
| | - Janet Yuen Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong, China
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Fan HSL, Choi EPH, Ko RWT, Kwok JYY, Wong JYH, Fong DYT, Shek NWM, Ngan HYS, Li J, Huang YY, Ouyang YQ, Lok KYW. COVID-19 related fear and depression of pregnant women and new mothers. Public Health Nurs 2021; 39:562-571. [PMID: 34902184 DOI: 10.1111/phn.13035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/15/2021] [Accepted: 11/28/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To explore factors associated with depression and COVID-19 related fear among pregnant women and new mothers. DESIGN A cross-sectional survey was conducted in China from July 2020 to July 2021. SAMPLE A total of 3027 pregnant and new mothers were recruited. MEASUREMENT Sociodemographic characteristics and the perceptions of the COVID-19 pandemic were collected. The Patient Health Questionnaire-9 (PHQ-9) and the Fear Scale was used to assess the depressive and fear level towards the COVID-19 pandemic, respectively. RESULTS Approximately 17.2% of the participants had depression (PHQ-9 ≥10). In Hong Kong, participants who perceived that they have increased knowledge to prevent infection were less likely to have depression (adjusted odds ratio [aOR] = 0.83; 95% confidence interval [CI] = 0.74-0.94). There was no association between perceived severity if infected and severity of spread and the depression level in our sample. An inverse relationship was found between the COVID-19 related fear level and perceived knowledge to prevent infection (Beta-coefficient [β] = -0.20; 95% CI = -0.38 to -0.02). CONCLUSION Public health nurses need to promote accurate and up to date COVID-19 related information at clinical and community settings and implement effective screening for depression and fear symptoms to identify these high-risk groups to improve women's psychological well-being.
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Affiliation(s)
- Heidi Sze Lok Fan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Rachel Wai Tung Ko
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Jojo Yan Yan Kwok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Janet Yuen Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Noel Wan Man Shek
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong
| | - Hextan Yuen Sheung Ngan
- Department of Obstetrics and Gynecology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Junyan Li
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Yi-Yan Huang
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Yan-Qiong Ouyang
- Department of Nursing, School of Health Sciences, Wuhan University, Wuhan, China
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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Chen N, Fong DYT, Li S, Wong JYH. Psychometric properties of the traditional Chinese version of the youth attitude to noise scale: a cross-sectional study in a large representative sample. BMJ Open 2021; 11:e049722. [PMID: 34753755 PMCID: PMC8578966 DOI: 10.1136/bmjopen-2021-049722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES This study aimed to examine the psychometric properties of the traditional Chinese version of the Youth Attitude to Noise Scale (YANS) in a large representative sample. DESIGN Cross-sectional study. SETTING 15 secondary schools in Hong Kong, China. PARTICIPANTS 2842 adolescents aged 12-20 years participated in this study between April and July 2016. METHODS The standard forward-backward validation procedures were followed to obtain the traditional Chinese version of the YANS. Prior to the formal investigation, the YANS was evaluated by cognitive debriefing. The sample was randomly divided into two halves for exploratory factor analyses (EFAs) and confirmatory factor analyses (CFAs), respectively. The number of factors was determined by comparison data approach using EFAs, and the factor structure was confirmed by CFAs using the one-factor, four-factor and bifactor models. The scale's internal reliability, dimensionality and measurement invariance across gender and age groups were also examined. RESULTS EFAs (n=1338) showed that four factors were extracted, and CFAs (n=1337) demonstrated the bifactor model fitted better to the sample than the other models. Additionally, the traditional Chinese version of the YANS showed high reliability (ω=0.84), a general factor, scale multidimensionality, and gender and age invariance. CONCLUSIONS The findings of the current study indicate that the traditional Chinese version of the YANS is a feasible instrument to assess attitude to noise in Chinese adolescents, regardless of their gender and age. Given the presence of a general factor, the YANS is not merely multidimensional, and whether to use the total or subscale scores is recommended to rely on research objectives.
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Affiliation(s)
- Ningjing Chen
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Sha Li
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Janet Yuen Ha Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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Li S, Fong DYT, Xu Y, Wilkinson K, Shapiro C, Wong JYH. Measurement properties of the simplified Chinese version of Nonrestorative Sleep Scale in adolescents. Health Soc Care Community 2021; 29:e299-e307. [PMID: 33756024 DOI: 10.1111/hsc.13354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/12/2020] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
Abstract
This study aimed to assess the measurement properties of a simplified Chinese version of the Nonrestorative Sleep Scale (NRSS) among adolescents. We obtained a simplified Chinese NRSS by the standard forward-backward translation procedures and administered it to 486 students who were attending Grade 7-11 in Nanjing, China. Furthermore, Pittsburgh Sleep Quality Index, Athens Insomnia Scale, Centre for Epidemiological Studies Depression Scale, and Toronto Hospital Alertness Test were also self-completed for measuring sleep quality, insomnia, depression and alertness respectively. The sample was randomly split into two halves, with the first half used to explore the scale structure by exploratory factor analysis (EFA), and the second half used to confirm the identified structure by confirmatory factor analysis (CFA). A total of 481 adolescents (49% male) with a mean age of 16 years (range: 13-18) completed this study. In the other half of 250 adolescents, the root mean square error of approximation (RMSEA), standardised root mean square residual, and comparative fit index (CFI) in CFA, which tested the four-factor structure obtained from EFA, were 0.062, 0.051 and 0.975, respectively. Convergent validity was demonstrated from a significant correlation of the simplified Chinese NRSS with sleep quality (r = -0.62), insomnia (r = -0.71), depression (r = -0.60) and alertness (r = 0.54). The internal consistency and test-retest reliability for the global scale were 0.83 and 0.86 respectively. Measurement invariance was established between males and females with the changes of both CFI and RMSEA < 0.01. The simplified Chinese NRSS is valid and reliable for measuring NRS among Chinese adolescents.
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Affiliation(s)
- Sha Li
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | | | - Yan Xu
- Jiangsu Luhe High School, Nanjing, China
| | - Kate Wilkinson
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Colin Shapiro
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Smith RD, Hung SC, Goh J, Ip HL, Fong DYT, Ali S, Wilson CA, Lok KYW. Protocol of a systematic review and network meta-analysis for the prevention and treatment of perinatal depression. BMJ Open 2021; 11:e048764. [PMID: 34635517 PMCID: PMC8506850 DOI: 10.1136/bmjopen-2021-048764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 10/01/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Perinatal depression is common and can often lead to adverse health outcomes for mother and child. Multiple pharmacological and non-pharmacological treatments have been evaluated against usual care or placebo controls in meta-analyses for preventing and treating perinatal depression compared. It is not yet established which of these candidate treatments might be the optimal approach for prevention or treatment. METHODS AND ANALYSIS A systematic review and Bayesian network meta-analyses will be conducted. Eight electronic databases shall be searched for randomised controlled trials that have evaluated the effectiveness of treatments for prevention and/or treatment of perinatal depression. Screening of articles shall be conducted by two reviewers independently. One network meta-analysis shall evaluate the effectiveness of interventions in preventing depression during the perinatal period. A second network meta-analysis shall compare the effectiveness of treatments for depression symptoms in women with perinatal depression. Bayesian 95% credible intervals shall be used to estimate the pooled mean effect size of each treatment, and surface under cumulative ranking area will be used to rank the treatments' effectiveness. ETHICS AND DISSEMINATION We shall report our findings so that healthcare providers can make informed decisions on what might be the optimal approach for addressing perinatal depression to prevent cases and improve outcomes in those suffering from depression through knowledge exchange workshops, international conference presentations and journal article publications. PROSPERO REGISTRATION NUMBER CRD42020200081.
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Affiliation(s)
- Robert David Smith
- School of Nursing, University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
| | - Sze Chai Hung
- School of Nursing, University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
| | - Joyce Goh
- School of Nursing, University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
| | - Hoi Lam Ip
- School of Nursing, University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
| | - Shehzad Ali
- Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada
| | | | - Kris Yuet-Wan Lok
- School of Nursing, University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
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Takemura N, Cheung DST, Fong DYT, Lee AWM, Lam TC, Ho JCM, Kam TY, Chik JYK, Lin CC. Relationship of subjective and objective sleep measures with physical performance in advanced-stage lung cancer patients. Sci Rep 2021; 11:17208. [PMID: 34446756 PMCID: PMC8390480 DOI: 10.1038/s41598-021-96481-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 08/11/2021] [Indexed: 11/25/2022] Open
Abstract
Advanced lung cancer patients suffer from deteriorated physical function, which negatively impacts physical and psychological health. As little is known about sleep and physical function in this population, this study aimed to examine the association between subjective and objective sleep parameters and physical function among them. 164 advanced lung cancer patients were included. Objective sleep was measured by actigraphy (measured on non-dominant wrist for 72 h), and subjective sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Performance-based physical function was measured by Timed Up and Go Test (TUGT), 6-Minute Walk Test (6MWT), Sit-to-Stand Test, and One-leg Standing Test. Univariable and multivariable regression analyses were employed to examine the association between sleep and physical function. Total sleep time (TST) was significantly associated with the 6MWT (β = 0.259; 95% CI 0.120, 0.398; P < 0.001), TUGT (β = - 0.012; 95% CI = - 0.017, - 0.008; P < 0.001) and Sit-to-Stand Test (β = 0.027; 95% CI = 0.018, 0.035; P < 0.001) after adjustment for multiple covariates. PSQI global score was only significantly associated with TUGT (β = 0.140; 95% CI = 0.000, 0.280; P = 0.050) after adjustment for multiple covariates. Shorter sleep duration significantly predicted poorer physical performance in advanced lung cancer patients, and more attention is required for those with less than 4.3 h of sleep on average.Trial registration: ClinicalTrials.gov, NCT03482323. Registered 29 March 2018, https://clinicaltrials.gov/ct2/show/NCT03482323 ; ClinicalTrials.gov, NCT04119778. Registered 8 October 2019, https://clinicaltrials.gov/ct2/show/NCT04119778 .
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Affiliation(s)
- Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Anne Wing Mui Lee
- Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Guangdong, China
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Tai-Chung Lam
- Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Guangdong, China
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - James Chung-Man Ho
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Tsz Yeung Kam
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | | | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
- Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Kowloon, Hong Kong.
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