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Aims: This study aimed to investigate the trajectory and predictors of family function in caregivers of stroke survivors during the first 6 months after the first episode of stroke. Design: Longitudinal study. Methods: A total of 288 primary caregivers of patients with first‐time stroke were recruited from seven tertiary hospitals in China between July 2020 and March 2021. The following characteristics were assessed by caregivers at hospitalization (T0) and at 1 month (T1), 3 months (T2) and 6 months (T3) after the stroke: family function, general self‐efficacy, social support, coping style, caregiver burden, and sociodemographic and clinical data. Results: Family function scores among caregivers of stroke survivors were highest in the resolve dimension and lowest in the growth and adaptation dimensions within the first 6 months. The percentages of families with low functioning were 34.7%, 33.3%, 24.8% and 17.7% at T0, T1, T2 and T3, respectively. The generalized estimating equation model revealed that family function in caregivers increased over the first 6 months (Exp(B) = 1.415–2.689, p <.05). The following factors were identified as predictors of family functioning: caregiver's age, education, residential district, self‐efficacy, social support utilization and caregiver burden. Conclusions: Family function of caregivers of stroke survivors gradually increased during the first 6 months after stroke. However, some families demonstrated poor functioning. Caregivers' age, education, caregiver burden, self‐efficacy and social support utilization could predict family function over time. Impact: Empirical data on family function in families of stroke survivors are important for developing psychosocial interventions that can help families adapt to stroke. This study found that families of stroke survivors were likely to be dysfunctional in the first 6 months after stroke, particularly in family growth and adaptation. Therefore, reducing caregiver burden and promoting self‐efficacy and social support utilization can help restore family functioning early after stroke. Patient or Public Contribution: Stroke caregivers from seven hospitals in China were involved in this study and had the right to be informed of the main findings. A few patients were informed of the research results, who contributed to the dissemination. [ABSTRACT FROM AUTHOR]

The formation of peer attachment is vitally important for the mental health of adolescents. Additionally, converging evidences show that childhood emotional trauma leads to poor peer attachment during adolescence. However, little is known about the underlying mechanism accounting for the link between early emotional trauma and adolescent peer attachment. Therefore, the present study is intended to examine the relationship between childhood psychological maltreatment (CPM) and peer attachment among Chinese adolescents and reveal its underlying mechanism. In total, we collected data from 670 adolescents (36.5% males and 63.5% females, M age = 16.44 years, SD = 0.78) attending two Chinese high schools. These participants completed measurement scales for CPM (emotional abuse and neglect), peer attachment, and emotion regulation strategies, including cognitive reappraisal (CR) and expressive suppression (ES). The multiple mediation models showed that emotional neglect negatively predicted adolescent peer attachment but that emotional abuse did not. Furthermore, the two emotion regulation strategies, CR and ES, completely mediated the relationship between emotional abuse and peer attachment and partially mediated the relationship between emotional neglect and peer attachment. These findings extend the existing studies on adolescent peer attachment and elucidate how childhood emotional trauma negatively influences adolescent peer attachment. In addition, the present results provide implications for improving the peer attachment of adolescents. On one hand, appropriate family intervention should be implemented to reduce CPM. On the other hand, schools can focus on improving the peer attachment of adolescents by enhancing their emotion regulation. Specifically, adolescents should be taught how to use adaptive strategies, such as CR, to regulate negative emotions. [ABSTRACT FROM AUTHOR]

Aim: Cancer patients have long been found to have multiple types of unmet needs during their survivorship. Composite psychological instruments are essential for measuring the unmet needs of cancer patients. The objective of this study was to evaluate the psychometric properties of the Short‐Form Survivor Unmet Needs Survey (SF‐SUNS)‐Chinese version. Design: A cross‐sectional survey. Methods: The Chinese version was developed using the standard Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology and 428 Chinese cancer patients participated in the survey between 2016‐2017. Inter‐rater reliability, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were calculated. Results: Confirmatory factor analysis supported the four‐factor structure with good model fit. Cronbach's alpha of 0.894 for the overall scale and intra‐class correlation coefficients (0.869–0.884) indicated that reliability was satisfactory. The EFA extracted four factors with eigenvalues greater than 1 and these factors explained 50.68% of the total variance. The Chinese version of SF‐SUNS was confirmed to have the potential to become a useful and valid instrument. It could contribute to the assessment of unmet needs among Chinese cancer patients with accuracy and with respect to Chinese culture and context. This measurement of unmet needs may help promote cancer management and nursing quality. Clinical nurses and researchers could use the simple assessment tool to target the individual needs of Chinese cancer patients and then provide more personalized care efficiently. [ABSTRACT FROM AUTHOR]

Aims: To explore the level and associated factors of perceived participation and autonomy among stroke survivors in Shanghai, China. Design: Cross‐sectional explorative study. Methods: From January to December 2018, 431 patients presenting at the neurology departments of three hospitals with a confirmed diagnosis of stroke were recruited. Impact on Participation and Autonomy Questionnaire, modified Rankin Scale, Self‐efficacy for Managing Chronic Disease six‐item Scale, Medical Coping Modes Questionnaire and Multidimensional Scale of Perceived Social Support were applied to measure their participation, physical function, self‐efficacy, coping styles, and social support. Results: The average score of perceived participation and autonomy was 41.30 (SD 21.22); and 54.3%, 46.9%, 21.6%, and 7.7% of the participants reported poor participation in social relations, family role, autonomy indoors, and autonomy outdoors. Age, physical function, self‐efficacy, friend support, and knowledge of stroke were predictors of post‐stroke participation. Physical function and self‐efficacy were the most relevant factors of nearly all domains of participation except autonomy outdoors, while predictors of autonomy outdoors were social support, resignation coping style, and knowledge of stroke. Conclusion: The stroke patients experienced insufficient participation compared with previous studies in western countries. Patients' physical function and self‐efficacy were particularly important and contributed to their participation, while the patient's age, perceived social support, coping styles, and knowledge of stroke also played a role in formulating participation. Impact: The results may be used to provide nurses with a better understanding of the participation among stroke patients and assist them in promoting the post‐stroke participation. Nurses should pay special attention to those with older age, worse physical function, lower self‐efficacy, less support, little stroke‐related knowledge, or who applied resignation coping style since those patients might experience lower participation in their daily life. It needs further studies to explore the causal effects of self‐efficacy, coping styles, and social support on post‐stroke participation. [ABSTRACT FROM AUTHOR]

Aim: The objective of this study is to identify the role of factors influencing women's breast cancer screening (BCS) intentions in Changchun city based on the health belief model (HBM) and the theory of planned behavior (TPB). Methods: A cross‐sectional study of 422 women aged 17–75 years was conducted in Changchun, northern China, in 2018. Data were collected using a questionnaire that included three parts. We used descriptive analysis, correlation analysis and multiple regressions to analyze data in spss version 23.0. Results: Career (P = 0.004), clinical examination (P = 0.002), X‐ray examination (P = 0.026), screening costs accepted (100–300 RMB) (P = 0.001), perceived behavioral benefit (P = 0.000), self‐efficacy (P = 0.000), subjective norms (P = 0.000), behavioral attitudes (P = 0.000) and perceived behavioral control (P = 0.000) had significant associations with BCS intentions. This study tested the applicability of the HBM (adjusted R2 = 4.7%, ΔR2 = 5.6%) and the TPB (adjusted R2 = 8.3%, ΔR2 = 3.8%) in the prediction of BCS intentions. It was found that the predictive power of the integrated model (adjusted R2 = 39%, ΔR2 = 30.8%) is better than that of each of the single models. Therefore, the integrated model has better predictive power. Conclusion: An exploration of the factors affecting BCS intentions based on the HBM and the TPB is beneficial for reduced mortality and the development of measures to increase women's BCS awareness, thus providing a basis for future research on the factors affecting BCS intentions. [ABSTRACT FROM AUTHOR]

With the development of Web 2.0 technologies, an increasing number of websites are providing online healthcare services, and they have potential to alleviate problems of overloaded medical resources in China. However, some patients are reluctant to trust and continue using online healthcare services, partly due to the immature development of healthcare websites. Previous research has argued that online trust is significantly associated with the risk or benefit perceived by users. This study aims to extend prior research and examine how perceptual factors influence patients' online trust and intention to continue using online healthcare services. We developed a model with the moderating role of purpose of use and tested it with data collected from 283 participants. The results support the validity of the model and most hypotheses. The moderating role of purpose of use between the perceived benefits/risks and patients' online trust is also highlighted. Theoretical and practical implications are also discussed. [ABSTRACT FROM AUTHOR]

Background and objectives: Stroke commonly results in physical dysfunction and seriously affects the quality of life. We aimed to estimate the prevalence and association of resilience with the quality of life among patients at hospitalization and whether the association was independent of physical function, anxiety, depression, and other population characteristics. Methods: A cross-sectional study at a tertiary hospital included 215 individuals. The Chinese version of the Connor-Davidson Resilience Scale was used to evaluate resilience. Stroke Scale Quality of life was used to measure the quality of life. Other validated questionnaires were used to assess physical function (Functional Independency Measure), anxiety, and depression (the Hospital Anxiety and Depression Scale). Hierarchical regression analysis was applied to determine the association between psychological factors and quality of life. Multiple linear regression was also used to examine whether resilience independently affects the quality of life. Results: The mean score of 215 participants' resilience was 62.36 ± 13.965. Resilience, anxiety, and depression were separately significantly associated with quality of life. Resilience was negatively associated with anxiety and depression. Subjects with high scores of resilience showed a higher quality of life at patients' hospitalization (Standardized Coefficients = 0.275) independent of physical function, anxiety, depression, disease-related characteristics, and sociodemographic characteristics. Discussion: Resilience was an independent predictor of quality of life beyond anxiety and depression in patients with ischemic stroke. Interventions aimed at improving resilience at acute hospitalization might be a worthwhile addition to improve quality of life early after stroke. [ABSTRACT FROM AUTHOR]

Objective: This paper aims to explore the determinants of the online health information seeking (OHIS) and usage (OHIU) behaviours of consumers based on the perceived benefits and costs of such activities. Methods: This study applies questionnaires and empirical research methods. A questionnaire is designed according to the hypothesis model. A total of 282 questionnaires are obtained from patients and their accompanying families in two large hospitals, and the SPSS 17.0 and AMOS 17.0 (IBM, Almond, NY, USA) software are used to analyse the sample data and to test the research models. Results: Three key findings are obtained from the analysis. Firstly, functional, learning, social and personal integrative benefits positively affect the OHIS intent of consumers. Secondly, cognitive costs negatively influence the OHIU behaviour of consumers. Thirdly, personal integrative benefits and OHIS behaviour significantly influence the OHIU behaviour of consumers. Conclusion: This paper highlights the differences between OHIS and OHIU based on their impact factors and applies social exchange theory to understand such factors. Online health information providers must improve the ease of use of their websites or applications, enhance the quality of their health information and focus on their functionality. [ABSTRACT FROM AUTHOR]

Aim: This investigation aimed to study the general self‐efficacy level and its influential factors of breast cancer screening for the female college students in Changchun city of China. Methods: A three‐part questionnaire was designed to investigate 220 female college students' general self‐efficacy for breast cancer screening and its associated factors and knowledge of breast cancer screening. The data were analyzed with spss 23.0 using descriptive statistics, independent sample t‐tests and multiple regression analysis. Results: The mean total score of general self‐efficacy for breast cancer screening was 22.2 ± 5.213 (average ± standard deviation [SD])). About 37.7% of participants had lower level of general self‐efficacy for breast cancer screening. The average score of knowledge about breast cancer and screening was 5.26 ± 3.974 (average ± SD). About half (48.6%) of the students had poor breast cancer screening knowledge. Multivariate logistic regression analysis demonstrated that the level of breast cancer knowledge (P = 0.011) and sleep satisfaction (P = 0.008) were two predictive factors of good general self‐efficacy for breast cancer screening in female college students. Conclusion: Female college students in Changchun did not have enough knowledge and self‐efficacy to cope with the breast cancer screening through this survey. Therefore, primary healthcare professionals have the responsibility to improve their awareness of breast cancer screening by delivering enough breast cancer knowledge and implementing effective health promotion strategies to keep better health status and have satisfied sleep. [ABSTRACT FROM AUTHOR]

Being the target of peer victimization contributes to alcohol and cigarette use during early adolescence. This 1-year longitudinal study extended the current literature by investigating the potential links between peer victimization and alcohol and cigarette initiation among a sample of 723 youths recruited from three middle schools in Southern China. We proposed a moderated mediation model to examine whether peer victimization is indirectly related to substance use via deviant peer affiliation, and whether the strength of this mediation is moderated by the level of parental knowledge for both genders. All participants self-reported using questionnaires to assess peer victimization, deviant peer affiliation, parental knowledge, and substance use. The results revealed that peer victimization was indirectly associated with increased alcohol use via deviant peer affiliation for both genders. However, deviant peer affiliation mediated the impact of peer victimization on trying cigarettes for only boys. Moreover, parental knowledge acted as a protective role for increases in alcohol use for girls, but not for boys. These findings highlight the potential role of deviant peer affiliation to explain the relationship between peer victimization and substance use, and provide important implications for addressing the adverse consequences of peer victimization. [ABSTRACT FROM AUTHOR]

China is experiencing one of the fastest growing human immunodeficiency virus (HIV) epidemics in the world. Condom use is consistently low among Chinese college students. The purpose of this study was to identify the predictors that determine the intention to use condoms among Chinese college students applying the theory of planned behavior (TPB). A non-probability convenience sample of 433 participants was drawn from three universities in Central, Eastern, and Southwestern China, respectively. An anonymous written questionnaire was self-administered. Data were collected and analyzed descriptively and statistically using Predictive Analytical Software 19.0. Multiple linear regression was performed to identify the predictors among 402 participants with non-missing data. Eighteen percent (78/433) of the participants reported being sexually active in the past 6 months. The percentage of times these individuals reported using condoms during intercourse was 38.19 %. Intention to use condoms was statistically significantly (R = 50.4 %) predicted by attitudes (β = 0.213), subjective norms (β = 0.259), and perceived behavior control (PBC) (β = 0.332). All predictors were statistically significant at the 0.001 level ( p < 0.001). PBC was the strongest predictor of intention to use condoms. The study findings indicated that the TPB could be used as a framework to determine the predictors of intention to use condoms among the Chinese college students. It is recommended that the HIV education programs should increase the intention to use condoms through promoting positive attitudes, subjective norms and PBC of condom use in Chinese college students. [ABSTRACT FROM AUTHOR]

Background: Traditional Chinese medicine (TCM) has been used to treat chronic obstructive pulmonary disease (COPD) for many years. This study aimed to evaluate the efficacy and safety of the comprehensive therapy based on the three common TCM patterns in stable COPD patients.Methods: A four-center, open-label randomized controlled method was conducted. A total of 352 patients were divided into the trial group (n = 176, treated with conventional Western medicine and Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules, and Yi-Qi Zi-Shen granules based on the TCM patterns respectively) and the control group (n = 176, treated with conventional Western medicine). The frequency and duration of acute exacerbation, lung function, clinical symptoms, 6-minute walking distance (6MWD), dyspnea scale and quality of life were observed during a 6-month treatment period and at a further 12-month follow-up. Results: A total of 306 patients completed the study fully. The full analysis set (FAS) population was 350 and the per-protocol analysis set (PPS) population was 306. After the 6-month treatment and 12-month follow-up, there were significant differences between the trial and control group in the following: frequency of acute exacerbation (FAS: P = 0.000; PPS: P = 0.000); duration of acute exacerbation (FAS: P = 0.000; PPS: P = 0.001); FEV1 (FAS: P = 0.007;PPS: P = 0.008); symptoms (FAS: P = 0.001; PPS: P = 0.001); 6MWD (FAS: P = 0.045; PPS: P = 0.042); dyspnea scale (FAS: P = 0.002; PPS: P = 0.004); and physical domain (FAS: P = 0.000; PPS: P = 0.000), psychological domain (FAS: P = 0.008; PPS: P = 0.011), social domain (FAS: P = 0.001; PPS: P = 0.000) and environment domain (FAS: P = 0.015; PPS: P = 0.009) of the WHOQOL-BREF questionnaire. There were no differences between the trial and control group in FVC, FEV1% and adverse events. Conclusions: Based on the TCM patterns, Bu-Fei Jian-Pi granules, Bu-Fei Yi-Shen granules and Yi-Qi Zi-Shen granules have beneficial effects on measured outcomes in stable COPD patients over the 6-month treatment and 12-month follow-up, with no relevant between-group differences in adverse events. Trial Registration: This trial was registered at Chinese Clinical Trial Register Center, ChiCTR-TRC-11001406. [ABSTRACT FROM AUTHOR]