Search

In this paper, we examine discourses about border and scale in the context of Hong Kong's relationship with mainland China. We argue that, as the physical and political borders between Hong Kong and the mainland are eroding, other forms of bordering practices – such as linguistic borders – become more salient and contested. We draw on selected thematic analyses of a corpus of 70 articles from Hong Kong English media, as well as socio-historical analyses that have widely circulated since Hong Kong's handover from Britain to China, in order to examine how the construction of "Cantonese" and "Mandarin" is managed against anxieties about Hong Kong's potential loss of distinction and fears of becoming "just another Chinese city". In this process, both borders and scales become key terrains of negotiation and function themselves as ideological resources in debates about Hong Kong's identity and future, as certain distinctions take on reduced or pronounced meaning from particular scalar perspectives. Amid an ongoing reframing of what it means to be "Chinese", examining language ideologies in Hong Kong contributes to our understanding of how national and linguistic categories achieve or reframe their social meanings. [ABSTRACT FROM AUTHOR]

Although translation may be considered the sine qua non of bilingual legislation, the perceived authenticity and equivalence of different language versions of the same law are contingent on the disavowal of translation. Yet precisely because of such disavowal, translated versions of law are paradoxically valorized as equal in meaning and status to their originals, notwithstanding possible infelicities in the translation, so as not to compromise the precepts of legal bilingualism. This paper theorizes such a situation in relation to Hong Kong's bilingual jurisdiction. On the basis of relevant legislation, official guidelines on statutory interpretation, and court cases in Hong Kong, the paper proposes the terms Translatophobia and Translatophilia to highlight the double bind that entraps translation in institutional discourses on legal bilingualism. More specifically, it reveals the language ideology generating anxieties over translation, and observes how such anxieties may be channelled into a fetishization of translation. [ABSTRACT FROM AUTHOR]

China's new National Security Law, enacted in Hong Kong on 30 June 2020, has amplified widespread concerns among the city's population regarding the implications of this law. These concerns have at root anxieties related to Hong Kong's resinicisation, referring to anxieties over Hong Kong's political and economic dependence on mainland China, including loyalty and patriotism towards the motherland. This paper explores these developments in relation to the ongoing legacy of localism, argued to be instilled as a colonial project to help secure the populations' identification with Hong Kong. Seen as 'criminals' from the perspective of mainland Chinese authorities, many of those involved in today's protests (many of whom include young people) see themselves as engaging in legitimate forms of civil disobedience. First explicating the context of Hong Kong's colonial history in order to help make sense of present-day turmoil, we turn to recent trends in arrests related to the protests, as well as evidence of rapidly declining trust in the Hong Kong Police Force, seen by some as increasingly beholden to the interests of mainland China. Implications for these trends going forward are considered, with a discussion of the need for greater attention to colonial histories and post-colonial ramifications. [ABSTRACT FROM AUTHOR]

This paper reports on significant gender differences in psychological distress and perceived social support (PSS) among a clinical sample of Hong Kong Chinese depressed parents (Nmen = 17, Nwomen = 94; 73.8% belonging to 30−50 age group). Men's mental health and PSS were found to relate to their employment status, while women's to family income and family origin. PSS had positive effects on psychological wellbeing of both genders, while gender-specific effects were found for some subtypes of PSS. The results of our study contributed a gendered perspective and validated the importance of PSS to understanding and helping depressed parents' recovery. [ABSTRACT FROM AUTHOR]

Background: Psychiatric patients are susceptible to adverse mental health outcome during COVID-19 pandemic, but its associated factors are understudied. This observational cross-sectional study aimed to comprehensively examine prevalence and correlates of psychological distress, in terms of depression, anxiety and post-traumatic-stress-disorder (PTSD)-like symptoms, among Chinese adult psychiatric outpatients amidst the peak of fifth COVID-19 wave in Hong-Kong. Methods: A total of 415 patients (comprising 246 patients with common-mental-disorders [CMD] and 169 with severe-mental-disorders [SMD]) and 399 demographically-matched controls without mental disorders were assessed with self-rated questionnaires between 28-March and 8-April-2022, encompassing illness profile, mental health symptoms, psychosocial measures (loneliness, resilience, coping styles) and COVID-19 related factors. Univariate and multivariable logistic regression analyses were conducted to determine variables associated with moderate-to-severe depressive, anxiety and PTSD-like symptoms among psychiatric patients. Results: Our results showed that CMD patients had the greatest psychological distress relative to SMD patients and controls. Approximately 40–55% CMD patients and 25% SMD patients exhibited moderate-to-severe depression, anxiety and PTSD-like symptoms. Multivariable regression analyses revealed that female gender, lower educational attainment, single marital status, being housewife, more severe insomnia, psychotic-like symptoms and cognitive complaints, self-harm behavior, lower resilience, avoidance coping, never contracting COVID-19 infection, greater fear of contagion, and longer exposure to pandemic-related information were independently associated with depression, anxiety and/or PTSD-like symptoms in psychiatric patients. Conclusions: Our results affirm increased vulnerability of psychiatric patients toward psychological distress during pandemic. An array of identified correlates facilitates early detection of high-risk psychiatric patients for targeted strategies to minimize pandemic-related negative psychological impact. [ABSTRACT FROM AUTHOR]

Background: Psychiatric patients are susceptible to adverse mental health impacts during COVID-19, but complex interplays between psychopathology and pandemic-related variables remain elusive. This study aimed to investigate concomitant associations between psychopathological symptoms, psychological measures and COVID-19 related variables in Chinese psychiatric patients during the peak of fifth pandemic wave in Hong Kong. Methods: We employed network analysis to investigate inter-relationships among psychopathological symptoms (including depression, anxiety, post-traumatic stress disorder-like [PTSD-like] symptoms, insomnia, psychotic symptoms), cognitive complaints, health-related quality of life, loneliness, resilience and selected pandemic-related factors in 415 psychiatric outpatients between 28 March and 8 April, 2022. Network comparisons between genders, diagnosis (common mental disorders [CMD] vs. severe mental disorders [SMD]), and history of contracting COVID-19 at fifth wave were performed as exploratory analyses. Results: Our results showed that anxiety represented the most central node in the network, as indicated by its highest node strength and expected influence, followed by depression and quality of life. Three comparatively strong connections between COVID-19 and psychopathological variables were observed including: fear of contagion and PTSD-like symptoms, COVID-19 stressor burden and PTSD-like symptoms, and COVID-19 stressor burden and insomnia. Network comparison tests revealed significant network structural difference between participants with history of contracting COVID-19 and those without, but showed no significant difference between genders as well as between CMD and SMD patients. Conclusions: Our findings suggest the pivotal role of anxiety in psychopathology network of psychiatric patients amidst COVID-19. Pandemic-related variables are critically associated with trauma/stress and insomnia symptoms. Future research is required to elucidate potential network structural changes between pandemic and post-COVID periods. [ABSTRACT FROM AUTHOR]

Aims: To explore the impact of the coronavirus disease 2019 pandemic on the healthrelated quality of life (HRQoL) of breast cancer survivors. Design: We utilized a qualitative descriptive approach to facilitate interviews among 25 participants, all of whom are survivors of breast cancer and have received treatment in Hong Kong within the preceding 3 years. Methods: Content analysis was performed to understand how patients' HRQoL views and experiences changed during coronavirus disease 2019 pandemic. Results: The results included six themes delineating the impact of the coronavirus disease 2019 pandemic: (i) survivor sensitivities in pandemic times, (ii) coping and conditioning in pandemic times, (iii) transforming work and home dynamics in pandemic times, (iv) cognitive resilience and adaptation to the COVID-19 protective measures, (v) social resilience in pandemic times and (vi) healthcare adaptation and coping in pandemic times. Conclusion: This study provides insights into the experiences and challenges of breast cancer survivors during the coronavirus disease 2019 pandemic. Some survivors had new physical and psychological symptoms, including fear and anxiety, isolation, pain, lymphoedema and burnout, which potentially have long-term impact upon HRQoL. Implications for the profession and/or patient care: This study highlights the unique challenges faced by breast cancer survivors during the coronavirus disease 2019 pandemic, including accessing healthcare services and the impact of social isolation. Healthcare providers should consider the holistic needs of breast cancer survivors in the provision of health care and develop supportive interventions, including telehealth services and online support groups, to address these challenges and improve their HRQoL. Impact: Surgery aimed at treating breast cancer or reducing its risk generally influences the appearance of breast areas and donor sites. The continuing effects of these changes on body image and HRQoL are well-reported, although studies have ineffectively examined the initial experiences of women regarding their postoperative appearance, particularly during the pandemic. Reporting method: The checklist of consolidated criteria for reporting qualitative research (COREQ) was utilized. [ABSTRACT FROM AUTHOR]

This study investigated the cross-sectional relationships between reading-related affective and cognitive factors and reading skills among adolescents with and without dyslexia. Participants were 120 Chinese-speaking eighth graders, including 60 adolescents with dyslexia and 60 typically developing adolescents from Hong Kong, China. Adolescents completed questionnaires on general anxiety, reading anxiety, and reading self-concept. They were also assessed on measures of rapid digit naming, verbal working memory, word reading, reading fluency, and reading comprehension. The results showed that readers with dyslexia reported higher levels of general anxiety and reading anxiety and lower levels of reading self-concept than typical readers. They also showed difficulties in rapid digit naming and verbal working memory. Importantly, controlling for rapid digit naming and verbal working memory, reading self-concept was uniquely associated with word reading and reading fluency for readers with and without dyslexia. Furthermore, reading anxiety and reading self-concept were uniquely associated with reading comprehension for the two groups of readers. The findings point to the importance of considering affective factors when examining the reading skills of Chinese readers and the utility of targeting these factors when supporting the learning of adolescents with and without dyslexia. [ABSTRACT FROM AUTHOR]

Introduction: Previous coronavirus, 2019 (COVID-19) research has applied network analysis to examine relationships between psychopathological symptoms but rarely extended to potential risk and protective factors or the influence of COVID-19 infection history. This study examined complex interrelationships between psychopathological symptoms, COVID-19-related stressors, perceived social support, and COVID-19 infection history among Chinese university/college students during the peak of fifth pandemic wave using a network analysis approach. Methods: A Least Absolute Shrinkage and Selection Operator-regularized partial correlation network using Gaussian graphical model was constructed in 1,395 Chinese university/college students in Hong Kong who completed a survey between 15 March and 3 April, 2022. Depressive, anxiety, and acute/traumatic stress symptoms were measured by Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Impact of Event Scale-6, respectively. COVID-19-related stressors and perceived social support were measured. Network differences by COVID-19 infection history (COVID-network vs. no_COVIDnetwork) and network communities were examined. Results: Our results showed that the most influential nodes were depressed mood, uncontrollable worries, and uncontrollable thoughts about COVID-19. The main bridging symptoms were concentration problems and psychomotor problems. The COVID-network, comprising participants with a history of COVID-19 infection only, was significantly stronger than the no_COVIDnetwork. Perceived social support and stress from conflicts with family/friends formed a unique community with negative cognition and suicidal idea in the COVID-network only. Conclusion: Our findings indicate that specific interventions targeting interpersonal conflicts and concentration problems as well as facilitating stress buffering effects of social support may represent effective strategies to reduce psychological distress in university/college students during COVID-19 and should be considered for future pandemic preparedness. [ABSTRACT FROM AUTHOR]

Background: Female migrant domestic workers (MDW), approximately 8.5 million globally, often live in their employer's home under vulnerable conditions. In Hong Kong, MDWs currently comprise 5% of the population. This study was conducted to assess the association between employment conditions and mental health, and the mediating roles stress and job satisfaction have, among female MDWs in Hong Kong. Methods: Participants completed an online cross-sectional survey. A total of 1,965 survey were collected between August 2020 and August 2021. Questions in the survey were related to MDWs background information, employment conditions, stress, job satisfaction, and two mental health outcomes: anxiety and depression. An employment conditions score was created to assess the cumulative effect poor employment conditions had on mental health. A multicategorical parallel mediation analysis was used to assess the direct effect employment conditions have on mental health and the indirect effects through stress and job satisfaction. Results: Overall, 17.7% of MDWs were reported to be suffering from anxiety and 30.8% from depression. An increase in poor employment conditions was statistically associated with an increase in both outcomes, while stress levels and job satisfaction mediated this association. Conclusions: The findings call for increased scrutiny of employment conditions and mental well-being of MDWs. [ABSTRACT FROM AUTHOR]

The music-with-movement intervention is particularly suitable for people with dementia because their gross motor ability is preserved until the later stage of dementia. This study examines the effect of music-with-movement on reducing anxiety, sleep disturbances, and improving the wellbeing of people with dementia. This paper reports the first stage of the study - developing the intervention protocol that staff can use to teach family caregivers. A registered music therapist developed a music-with-movement protocol and taught staff of two social service centers over five weekly 1.5 h sessions, with center-in-charges (social workers and occupational therapists) and our research team joining these sessions to provide comments from their professional perspective. Each discipline had different expectations about the content; therefore, numerous meetings and discussions were held to bridge these differences and fine-tune the protocol. Few healthcare professionals doubt the merits of interdisciplinary collaboration at all levels of health promotion. In practice, interdisciplinary collaboration is complex and requires commitment. Openness and persistence is required from all stakeholders to achieve a successful intervention for consumers. [ABSTRACT FROM AUTHOR]

The present study explored the determinants of registration to facilitate the promotion of posthumous organ donation based on the theory of reasoned actions. A total of 211 university students participated in the study. Logistic regression, multiple regressions, and path analysis were conducted. The logistic regression model correctly predicted nearly 80% of registration status, and a good fit model of registration for posthumous organ donation (MRPOD) was proposed. Findings suggested that affective attitude, subjective norm of family, self-rated knowledge, distance from death, and age were predictors of registration. Worries about organ removal and postmortem mutilation anxiety were also mediated through bodily integrity, which had an indirect effect on the registration through affective attitude. Policymakers are suggested to address the negative emotions associated with challenges towards bodily integrity, encourage parents to initiate discussions with children, instill correct knowledge of brain death, and intervene the bystander effect on organ donation. [ABSTRACT FROM AUTHOR]

Background: Self-discrepancy is associated with poorer mental health, yet its mechanism is understudied. A recent study found that resilience plays a moderating role in the relationship between self-discrepancy and depressive symptoms in adults. The current study investigated whether there were any similar relationships among young people aged 15 to 24 years. Methods: As part of the ongoing Hong Kong Epidemiological Study of Mental Health (HK-YES) project, the current study analysed data from 1,144 participants who provided complete data on ideal-actual selfdiscrepancy, psychiatric conditions, resilience level and recent stressful life events (SLEs). Results: Ideal-actual self-discrepancies were associated with increased depressive and anxiety symptoms, as well as odds of 12-month major depressive episodes (MDEs) and generalised anxiety disorder (GAD). All these associations became nonsignificant after adjusting for resilience. Separate models found resilience mediating rather than moderating the relationship. According to four-way decomposition, the pure indirect effect explained most of the total effects of self-discrepancy on mental health conditions. The mediation effects on symptom severity were recently revealed to be more prominent among individuals with substantial exposure to SLE. Conclusions: Resilience functions mainly as a mediator in the relationship between self-discrepancy and mental health conditions, and its effect is weakened by the exposure of SLEs. Important implications are discussed regarding the use of resilience-focused interventions and the consideration of recent adversity. [ABSTRACT FROM AUTHOR]

Emerging efficacy and safety data have led to the authorization of COVID-19 vaccines worldwide, but most trials excluded patients with active malignancies. This study evaluates the intended acceptance of COVID-19 vaccination in cancer patients in Hong Kong. Methods: 660 adult cancer patients received a survey, in paper or electronic format, between 31 January 2021 and 15 February 2021. The survey included patient's clinical characteristics, perceptions of COVID-19 and vaccination, vaccine knowledge, cancer health literacy, and Hospital Anxiety and Depression scale (HADS). The primary outcome was the intended acceptance of COVID-19 vaccine in cancer patients. Multivariable analysis was performed to identify factors associated with intended acceptance. Results: The intended acceptance of COVID-19 vaccination was 17.9%. A total of 487 (73.8%) believed that vaccination could prevent them from infection. Over 70% worried about vaccine negative effects on cancer and its side effects. Factors associated with intended acceptance included higher level of "belief in vaccine on preventing them from getting COVID-19", less worry about long-term side effects of vaccine, lower level of cancer health literacy, and normal HADS (Depression scale). Conclusions: To improve vaccine acceptance rate, public education campaigns specific to cancer patients to gain their trust in efficacy and relieve their worries are needed. [ABSTRACT FROM AUTHOR]

On January 15,1857, as the Second Opium War raged, bread distributed by the Esing bakery to Hong Kong's Western community was doctored with a prodigious amount of arsenic. Few were seriously harmed, but the American trader Augustine Heard Jr. noted that the poisoning marked a great change in the Sino-American relationship. Although Americans were not involved in the Second Opium War, Heard's comments suggest that, influenced by rumors and panic, the Sino-American relationship deteriorated as Americans increasingly saw themselves as members of a besieged white community. The Heards' Hong Kong house is a reflection of this feeling of besiegement. This article places the 1857 Hong Kong poison panic within a broader atmosphere of colonial anxiety that increasingly led Americans in China to identify with the British at the expense of amicable Sino-American relations. It argues that the poison panic was one of a series of confrontations and minor panics between Hong Kong's Chinese and Western communities that recalibrated how Americans in China perceived the Chinese and that such panics entrenched racial barriers between white and non-white colonial communities. [ABSTRACT FROM AUTHOR]

Introduction: It remains unknown what factors may account for the link between self-stigma and increased anxiety among men who have sex with men (MSM). This study aims to extend previous research by examining the serial mediation of perceived stress and negative affect in the effect of MSM-related self-stigma on anxiety, which is reflected by generalized anxiety disorder (GAD) symptoms. Methods: In a 6-month longitudinal study design, self-stigma, perceived stress, negative affect, and GAD symptoms were measured in a sample of 407 men who have sex with men (Mage = 31.27 ± 7.83) in Hong Kong, China, from April 2018 to July 2019. Results: The prevalence of probable GAD (GAD-7 scores ≥ 5) was 42.3% and 40.8% at T1 and T2, respectively. Regression analyses revealed that self-stigma at baseline (T1) positively predicted GAD symptoms at 6-month follow-up (T2). Mediation analyses showed a significant indirect effect of baseline self-stigma on follow-up GAD symptoms (c = 0.096, p = 0.031; ab = 0.032, SE = 0.015, CI = 0.0076 to 0.0625). Two paths of the self-stigma at T1 — GAD symptoms at T2 relationship — were found. Self-stigma at T1 predicted GAD symptoms at T2 indirectly via perceived stress and negative affect at T1, and directly via perceived stress at T1. Conclusions: Findings underscore the need for health care policies that address self-stigma, perceived stress, and negative affect to manage anxiety in MSM. Policy Implications: More attention should be paid to the mental health issues among MSM. To prevent anxiety, policies on health promotions need to reduce self-stigma, perceived stress, and negative affect in MSM. [ABSTRACT FROM AUTHOR]

Social unrest has a significant impact on all citizens but for university students, little is known about how they thrived through this period with certain disconnection to social support while living in residential halls. Therefore, this study focused on the lived experiences of a group of university students and explored how the social unrest had affected them. Focus group interviews were conducted with 20 university students in Hong Kong. Using thematic analysis, the transcriptions were categorized into four themes: disruptions to daily routines, impact on psychological wellbeing, relationships, and coping strategies. It was revealed that reduced social connections during the unrest impacted their coping strategies and relationships, and emotional distress. This sheds implications on policymaking in residential halls and for university counselling services [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has imposed a profound negative impact on the mental health and wellbeing of societies and individuals worldwide. Older adults may be more vulnerable to the mental health effects of the pandemic, either directly from the infection itself or indirectly through the preventive measures. However, the existing literature on mental health in the older age groups has not been consistent so far. The aim of this study was therefore to assess the prevalence of common mental disorders (CMD; including depression and anxiety disorders) given their association with dementia risk, and to further examine age-related differences between older (≥60 years old) and younger (18-59 years old) adult's psychological status during the COVID-19 pandemic. Method: This was a secondary analysis of a cross-sectional survey-study conducted during the second wave of COVID-19 pandemic in Hong Kong. The survey was disseminated through different social media platforms to the general population and included sociodemographic questions, self-reported physical health, and previous encounter with SARS or COVID-19. CMD was the primary outcome and was assessed using the 6-item Kessler Scale. A total of 1030 adults fulfilled inclusion criteria. Results: The prevalence of CMD during the pandemic was 16.1%. Compared to younger adults, older adults were significantly less likely to have a CMD (unadjusted OR = 0.07, 95% CI = 0.02-0.30, p < 0.001), with 18.1% of younger adults having CMD compared to 1.6% in the older cohort. Age differences remained significant after controlling for sociodemographic factors, physical health, and previous encounter with SARS or COVID-19 (adjusted OR = 0.12, 95% CI = 0.02-0.57, p = 0.008). Conclusion: Common mental disorders are highly prevalent during the COVID-19 pandemic in Hong Kong, though older adults appeared to be less affected mentally. Present findings highlight the urgent need to implement measures and strategies tomitigate themental health problems, with particular Frontiers in attention to the younger cohort. Given their association with higher dementia risk, early detection and treatment of depression and anxiety disorders will be of critical importance in providing some relief to the already pressurized dementia burden in the longer term. [ABSTRACT FROM AUTHOR]

This study aimed to explore the caregiving experiences of primary caregivers, mothers of children with high-functioning autism, during the transition of leaving school and sometimes starting work. In-depth interviews were conducted with nine caregiving mothers with high-functioning children with autism aged 16–27 years. Results revealed that caring for a high-functioning child with autism during their life transition includes three roles: social advocacy, caregiving life coach, and personal selfhood reexamination. Thus, a theoretical model of empowering these caregivers during the child's school-to-work life transition can be established. With the empowerment strategies of strengthening multiple roles, findings allow practitioners and policymakers to reflect on the interventions supporting families in transitioning planning at different systematic levels, including the individual, the family, and the larger community. [ABSTRACT FROM AUTHOR]

Sexual self-concept (SSC) is an important component of health that is closely associated with the well-being of survivors of child sexual abuse (CSA). Compared with non-CSA respondents, SSC of CSA survivors was deleteriously affected, resulting in ineffective psychological functioning (negative self-evaluation, psychological ill-health, and difficulties in interpersonal relationships). Negative SSC (sexual anxiety, sexual depression, and sexual fear) played a significant role in mediating the adverse effects of CSA on psychological functioning. Future studies may recruit a sample with greater variation in CSA characteristics and use externalizing problems as outcome measures to cross-validate findings of this study. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic disrupts the daily routine and increases the caregiving load of the family carers of older adults. This study examined how the pandemic may impact mental health and investigated the prevalence of anxiety and depressive symptoms in family carers of older people.Methods: Two hundred and thirty-six family carers of older adults participated in this cross-sectional survey study. Outcome measures included their symptoms of anxiety and depression, pandemic-related psychosocial factors, external factors, and the practice of preventive behaviours.Results: Caseness prevalence of anxiety and depression among family carers was 25 and 56% respectively. Working carers were more depressed than non-working, while younger carers reported more anxiety and depression symptoms than older. Hand hygiene and getting drugs from the hospital positively predicted depression while healthy lifestyle negatively predicted depression. These variables, together with perceived risk and severity and the worry of getting infected, predicted anxiety.Conclusions: The prevalence of mental health symptoms was alarming. Telemedicine practice, including online pharmaceutical services and the Internet Hospital plus Drug Delivery platform, could be a solution in alleviating the burden and worry of infection of family carers. Tailored-made interventions by age and working status of the family carers are recommended. [ABSTRACT FROM AUTHOR]

Importance: Patients with long-term neurological conditions, such as Parkinson's disease (PD), are particularly vulnerable to the public health measures taken to combat the COVID-19 pandemic. The inaccessibility of center-based rehabilitation further aggravated their motor dysfunctions as well as mental distress, leading to exacerbation of motor and non-motor symptoms, high healthcare utilization and worsened health-related quality of life (HRQOL). Objective: This study aimed to evaluate the feasibility, safety, and preliminary effects of the mHealth-delivered home-based mindfulness yoga program on functional balance, motor symptoms, mental health and HRQOL in patients with PD. Design, setting and participants: This prospective, single-arm, non-randomized feasibility study adopted a sequential explanatory mixed-method design. Adults (aged ≥ 18) with a clinical diagnosis of idiopathic Parkinson's disease (Hoehn and Yahr stage I to III) who were able to stand unaided and walk with or without an assistive device were enrolled via convenience sampling. Intervention: Home-based mindfulness yoga training were delivered via video-conferencing software (Zoom) in eight bi-weekly 90-min sessions. Main outcomes and measures: This current study measured functional balance, motor symptoms, perceived balance confidence, perceived freezing of gait symptoms, anxiety and depression, mindfulness and HRQOL using a tele-assessment approach at baseline and 1-week post-intervention. All participants were invited to attend qualitative individual interviews to explore their experience of using online mindfulness yoga program as a lifestyle intervention for PD rehabilitation. Results: Among the ten patients, 80% completed the program with an adherence rate of 98.4%. All participants were able to learn and practice mindfulness yoga following the eight bi-weekly online mindfulness yoga training sessions, without any significant adverse events. Tele-assessment of outcomes were feasible and uneventful. Qualitative feedback revealed participants had a high preference of using the tele-rehabilitation approach to stay mindful and being active, both physically and socially, while confronting the changes brought by COVID-19 pandemic. Conclusions and relevance: The mHealth-delivered home-based mindfulness yoga intervention was feasible, safe, and well-accepted among people with PD to relieve the burden brought by COVID-19 pandemic. Future studies should adopt a design with enhanced rigor, a comparison group, and enlarged sample size to evaluate the efficacy of the program in patients with long-term neurological conditions and/or physical impairments. We recommend a longer intervention duration of at least 8 weeks to enhance the psychophysiological effects. [ABSTRACT FROM AUTHOR]

Limited studies exist on women's mild traumatic brain injury received from episode of intimate partner violence. This study aims to identify the occurrence of intimate partner violence‐related mild traumatic brain injury in Chinese women admitted to emergency units; and examine the physical, mental, and cognitive functioning of abused women with mild traumatic brain injury related to violent episodes. Eighty‐six Chinese abused women presenting at emergency units in four major local hospitals in Hong Kong between January 2014 and December 2016 were recruited. They were admitted for the treatment of intimate partner violence‐related physical injuries and were screened for traumatic brain injury by the emergency unit nurses at triage. Participants were assessed for traumatic brain injury based on the definition from US Center for Disease Control and Prevention, post‐concussion physical symptoms, anxiety and depression, health‐related quality of life, and cognitive functioning. Structured multiphase regression was used to examine the impact of intimate partner violence‐related mild traumatic brain injury on physical, mental, and cognitive functioning of participants. We found that 24.4% of participants had intimate partner violence‐related mild traumatic brain injury. There were significantly more severe post‐concussion physical symptoms in abused women with intimate partner violence‐related mild traumatic brain injury than those without mild traumatic brain injury (estimate = 18.7, 95% CI = 10.9 to 26.6, p < 0.001). The Mental Component Summary was also significantly associated with intimate partner violence‐related mild traumatic brain injury (estimate = ‐7.9, 95% CI = ‐13.8 to ‐2.1, p = 0.009). Regarding cognitive functioning, the mean total test scores indicated that both groups were cognitively abnormal and there was no significant impact from mild traumatic brain injury. This study provides evidence on the impact of mild traumatic brain injury and implications in screening for mild traumatic brain injury and early intervention for improving quality of life in abused women. [ABSTRACT FROM AUTHOR]

Although extracurricular music activities are common in Hong Kong, private music teachers' perceptions of children with autism spectrum disorder (ASD) are underexplored in research in this context. This study examined private music teachers' knowledge of ASD and their attitudes toward students with ASD in Hong Kong, and the relationship between these two factors. The study collected data from a questionnaire survey (n = 200) and eleven individual interviews. Unexpectedly, the findings showed that the teachers had a good understanding and a marginally positive perception of ASD, despite some anxiety about teaching students with ASD. Furthermore, knowledge of and attitude toward ASD were positively correlated. Teachers with previous training in special education needs had a better understanding of ASD and a more positive attitude toward ASD than those without related training. These results imply that further formal and public education could promote acceptance of and equal learning opportunities for students with ASD. [ABSTRACT FROM AUTHOR]

This study aimed to examine the association between working hours and anxiety of a working population in Hong Kong. We used a cross sectional data from a population-based household survey of Hong Kong Chinese adults. Key measures included employment status, skill level, working hours, length of stay at current job and anxiety level. Symptoms of anxiety were assessed using the Depression Anxiety Stress Scale (DASS-21). The data were analysed using logistic regression. Chinese adults who had long working hours (≥ 72 h per week) had higher odds of developing symptoms of anxiety than those who worked for ≤ 36 h per week (odds ratio [OR] 5.94, 95% confidence interval [CI]: 1.82‒19.41). Compared with short period (< 1 year), long period of stay at current job (≥ 5 years) was found as a protective factor from anxiety (OR 0.38, 95% CI: 0.20‒0.73). We found that a working period of 72 h per week was a significant threshold to cause anxiety to workers. Stable job arrangement was a protective factor to workers from anxiety. Implementation of labour market regulations, such as standard working hour policy and stable job arrangement, was also significant to mitigate risk of anxiety for working people in Hong Kong. [ABSTRACT FROM AUTHOR]

This study aimed to establish a new COVID‐19 Fear (Higher Education) scale to investigate the relationship between fear and generalised anxiety symptoms among Chinese students in mainland China, Hong Kong, and other countries. 219 Chinese university students studying in universities in mainland China (n = 76, 34.7%), Hong Kong (n = 66, 30.1%), and overseas (i.e., outside of China as international students, n = 77, 35.2%) participated in an online study from March 31, 2020 to April 4. Participants completed a newly developed COVID‐19 Fear (Higher Education) scale to measure three domains of fear including fear of infection, fear of instability and fear of insecurity related to the COVID‐19 pandemic. They also completed the Generalized Anxiety Disorder 7‐item scale (GAD‐7) on the severity of anxiety symptoms. About 9.6% of the participants could be classified as exhibiting high anxiety level according to the GAD‐7. More students studying overseas (about 15%) were classified into the high GAD group when compared to students studying in both mainland China (6.6%) and Hong Kong (6.1%). MANOVA results showed that students studying in Hong Kong and overseas had more concerns related to preventive measures related to COVID‐19 than their mainland counterparts did. We concluded that international students studying away from their home country would have higher risk to develop anxiety problems during a collective trauma such as the COVID‐19 pandemic. Education institutions should provide support services including online support groups, social media groups for mutual support to alleviate the fear and anxiety of international students. [ABSTRACT FROM AUTHOR]

Background: Apart from depressive disorders, there are great interests in adopting mindfulness based interventions (MBIs) for other mental health conditions. Depression and anxiety are common in people with neurocognitive disorders (NCD). The potential of MBIs as an adjuvant treatment in this cognitively at-risk group should be further explored. Objectives: The current study explored the association between depression and anxiety symptoms with dispositional mindfulness in older adults, and if same association stays in the context of cognitive impairment. Methods: The Hong Kong Mental Morbidity Survey for Older People (MMSOP) is an ongoing epidemiology study of the prevalence of neurocognitive and mental disorders in adults aged 60 years or over in Hong Kong. MMSOP evaluated cognitive function, psychiatric symptoms (Clinical Interview Schedule-revised, CIS-R), chronic physical disease burden, psychosocial support, and resilience factors, including dispositional mindfulness as measured by the Mindful Attention Awareness Scale (MAAS). We analyzed the impact of MAAS on CIS-R and potential moderation effects of mindfulness. Results: In March 2021, 1,218 community dwelling participants completed assessments. The mean age of the sample is 69.0 (SD 6.9) years. Eight hundred and two participants (65.7%) were not demented (CDR 0) and 391 (32%) and 25 (2%) were categorized as having mild NCD (CDR 0.5) and major NCD (CDR 1 or more), respectively. One hundred forty-three (11.7%) satisfied ICD-10 criteria for anxiety or depressive disorder as measured by CIS-R. Linear regression analysis showed that female gender, CIRS, and MAAS scores were significant factors associated with CIS-R scores. MAAS scores moderated and attenuated the impact CIRS on CIS-R (adjusted R 2 = 0.447, p < 0.001). MAAS scores remained as significant moderator for CIRS in patients with NCD (CDR ≥ 0.5) (adjusted R 2 = 0.33, p < 0.001). Conclusion: Interim findings of the MMSOP suggested that dispositional mindfulness is associated with lower level of mood symptoms in community dwelling older adults in Hong Kong. The interaction effects further suggested that high mindful awareness may reduce the adverse effects of chronic physical morbidity on mental health. The observation stayed in the participants with cognitive impairment. We should further explore MBIs as a non-pharmacological treatment for in older adults at-risk of physical morbidity and cognitive decline. [ABSTRACT FROM AUTHOR]

While primary care physicians (PCPs) have opportunities to recognize patients who encounter domestic violence (DV) by intimate partners, warning symptoms such as unexplained physical injury, bruising, anxiety, and depression are often missed during clinic visits. This study investigated the barriers of Hong Kong PCPs toward managing DV, including recognition, management, and referrals of these patients. Four focus group interviews were conducted to explore the in-depth opinions of PCPs on managing DV in Hong Kong. The themes identified were investigated in a questionnaire survey with data from 504 PCPs working in public and private sectors. Factor analysis of the survey data suggested four major barrier factors: (a) worries about the potential harms of intervening in patients' domestic affairs and DV issues, (b) lack of guidelines and support services, (c) limited skills and time in managing DV, and (d) patients' reluctance in disclosing DV issues. PCPs with more years of practice had more worries about intervening in domestic issues (Factor 1), while the younger PCPs tended to perceive limited skills and time in managing DV cases as barriers (Factor 3). PCPs working in the public setting were more likely to ask patients about DV (M = 5.4 vs. 2.9), suspected DV (M = 3.8 vs. 2.3), and managed DV (M = 1.7 vs. 1.0) in the past 5 years compared with the private PCPs. Some PCPs in the focus groups expressed the view that DV cases should be handled by social workers instead of doctors. Survey respondents who held such views about doctors' limited role in DV management also scored higher in all of the barrier factors. The findings suggest that there are boundaries between domestic and medical realms, especially in a Chinese context. Resolving PCPs' worries by training, provision of DV management guidelines, and referral pathway to social workers may be good starting points to bridge the gaps. [ABSTRACT FROM AUTHOR]

This study aims to enrich the comprehension of the effect of living density on anxiety and stress among adults in a global city. A random sample of 1,978 Hong Kong adults was interviewed in a cross‐sectional population study in 2014–2015. Descriptive statistics and logistic regressions were used to investigate the association between housing variables and mental health indicators, namely, anxiety and stress. Logistic regression analysis results have shown that by controlling the confounding effect of demographic variables, income poverty, housing ownership and housing cost, the living density was significantly associated with anxiety and stress of residents. Compared with those living in high density of <7 m2, living in medium density of ≥7 and <13 m2 was significantly associated with lower risk of anxiety (adjusted OR 0.52, 95% CI 0.30–0.88), and the risk was less for those living in low density of ≥13 m2 (adjusted OR 0.41, 95% CI 0.23–0.72). Meanwhile, living in low density of ≥13 m2 was significantly associated with a lower risk of stress (adjusted OR 0.44, 95% CI 0.20–0.97). These results highlighted the significant impact of living density on personal anxiety and stress. Moreover, female, younger adults or those living in income poverty were also at risk of anxiety and stress. In conclusion, our findings implied that improving housing policies, such as building public housing with adequate living areas and market regulation of living density of private housing, would help enhance the mental well‐being of residents. [ABSTRACT FROM AUTHOR]

This study examined whether child autistic symptoms would heighten parental affective symptoms through evoking enacted stigma from the community (i.e., public and courtesy stigma) and felt stigma within the parents (i.e., vicarious and self-stigma). Cross-sectional questionnaire data were collected from 441 parents of children with autism spectrum disorder. Path analyses showed that social communication and interaction deficits and restricted and repetitive behaviors in child autism were positively associated with public and courtesy stigma. While public stigma was positively associated with parental vicarious stigma, courtesy stigma was positively associated with parental self-stigma. Both vicarious and self-stigma were positively associated with depressive and anxiety symptoms among parents. Findings revealed how child autism could compromise parental well-being through exacerbating the family's stigmatizing experiences. [ABSTRACT FROM AUTHOR]

Purpose: This article documents accounts of the tactics parents and siblings of autistic persons in Hong Kong deploy to manage social encounters. This article aims to consider the impact of such tactics and their enmeshment with factors that combine to limit satisfactory outcomes and outlines a project intent upon contriving dialogue between persons. Design/methodology/approach: This qualitative project elicited stories and accounts (or narratives) produced by persons involved in encounters involving autistic persons. This project also intervened in these encounters. Findings: Persons involved in social encounters are de-fused, in the sense of being disconnected. The emotions persons experience through these encounters (e.g. and especially anxiety) remain hidden. Dialogue has the capacity to re-fuse, not only reconnecting but also rejecting unsatisfactory arrangements. Originality/value: The dialogue produced in the article may extend beyond the specific circumstances and persons considered, potentially reducing the barriers and distances between autistic persons and others. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has impacted the psychological health and health service utilisation of older adults with multimorbidity, who are particularly vulnerable.Aim: To describe changes in loneliness, mental health problems, and attendance to scheduled medical care before and after the onset of the COVID-19 pandemic.Design and Setting: Telephone survey on a pre-existing cohort of older adults with multimorbidity in primary care.Method: Mental health and health service utilisation outcomes were compared with the outcomes before the onset of the COVID-19 outbreak in Hong Kong using paired t-tests, Wilcoxon's signed-rank test, and McNemar's test. Loneliness was measured by the De Jong Gierveld Loneliness Scale. The secondary outcomes (anxiety, depression, and insomnia) were measured by the 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder tool, and the Insomnia Severity Index. Appointments attendance data were extracted from a computerised medical record system. Sociodemographic factors associated with outcome changes were examined by linear regression and generalised estimating equations.Results: Data were collected from 583 older (≥60 years) adults. There were significant increases in loneliness, anxiety, and insomnia, after the onset of the COVID-19 outbreak. Missed medical appointments over a 3-month period increased from 16.5% 1 year ago to 22.0% after the onset of the outbreak. In adjusted analysis, being female, living alone, and having >4 chronic conditions were independently associated with increased loneliness. Females were more likely to have increased anxiety and insomnia.Conclusion: Psychosocial health of older patients with multimorbidity markedly deteriorated and missed medical appointments substantially increased after the COVID-19 outbreak. [ABSTRACT FROM AUTHOR]

To facilitate the understanding of pregabalin and optimize its clinical usage in Hong Kong, an expert panel (11 psychiatrists, one family physician and one anesthesiologist) experienced in treating anxiety and somatic symptoms was invited to establish a set of consensus statements based on several discussion areas. A non‐systematic literature search for relevant articles was conducted. The panelists addressed the discussion areas by sharing their clinical experience and available literature in a couple of meetings. At the last meeting, consensus statements derived from the proceedings were discussed and finalized. A total of 11 statements were ultimately accepted by panel voting based on their practicability of recommendation in Hong Kong. These statements are aimed to act as a practical reference for local clinicians when they consider prescribing pregabalin in different clinical situations. [ABSTRACT FROM AUTHOR]

Anxieties about the effects of international property investment in world cities like London have mainly focused on super-rich investors and corporate vehicles that have generated price inflation of assets and accelerated exclusion from an already expensive market. In fact, many international investors in the city’s housing market are middle-class individuals, and focusing on Hong Kong as an emblematic example of such processes, we examine their motives and the products offered to them by important investment intermediaries. We find that an important rationale for these investments lies in local class-based uncertainties and existential anxieties concerning the future of Hong Kong itself. We focus on the cultural roots of these investor rationalities but also consider the role of investment intermediaries who have helped bolster confidence while shielding investors from the consequences of their aggregated market power – concerns in London over household displacement from foreign investment. We suggest that what may seem to be the predatory search to ‘fry’ property (炒樓), a Hongkonger colloquialism referring to the search for high performing investments, should also be understood as actions anchored in and generated by the habitus of the Hong Kong middle class whose lives have been moulded by historical geopolitical uncertainty and worries about its longer-term social positioning and security. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine the effects of the six-week music-with-movement (MM) intervention, as compared with music listening (ML) and social activity (SA), on the cognitive functions of people with moderate dementia over time. Methods: A multi-center randomized controlled trial was conducted on 165 nursing home residents with moderate dementia. The MM intervention protocol was developed based on a critical literature review, and tested in three rounds of pilot studies before undergoing testing in this study. The participants were randomly allocated into three groups. Intervention participants (n = 58) received a 12-week MM program led by a trained health care professional, while the participants in the comparison ML group (n = 54) listened to their preferred music, and those in the SA group (n = 53) engaged in social chatting. Cognitive functions, depressive symptoms, and anxiety were measured at baseline, the sixth week, and six weeks post-intervention. Results: Greater improvements in memory and depressive symptoms for the MM group were revealed in the univariate analysis and pairwise comparisons. The effects on memory could last for at least six weeks post-intervention. However, a mixed multivariate analysis of variance (MANOVA) analysis indicated that there were no significant interactions of group by time effect Conclusion: The findings revealed that the MM intervention may be useful for enhancing the cognitive functions of people with dementia. However, there is insufficient evidence to show that the effects of the MM intervention on outcome variables over time significantly different from those observed among the comparison groups. [ABSTRACT FROM AUTHOR]

Purpose: To test the psychometric properties of the International Prostate Symptom Score (Hong Kong Chinese version 2) (IPSS) in Chinese male patients with benign prostatic hyperplasia (BPH) under secondary care.Methods: A prospective longitudinal study was done by interviewing subjects at baseline, at 2 week after baseline for assessing test-retest reliability and at 26 week after baseline for assessing responsiveness. All subjects were interviewed to complete a structured questionnaire including IPSS, Short Form-12 Health Survey version 2 (SF-12v2) and Depression Anxiety Stress Scale (DASS).Results: The IPSS HRQOL score had weak correlations with SF-12v2 summary and DASS domain scores. For reliability analysis, Cronbach's alpha coefficient was 0.90 for the seven symptom-related items. The intraclass correlation coefficients of the IPSS total symptom score and HRQOL score were 0.90 and 0.86, respectively. For sensitivity, statistically significant differences were detected between the subjects with BPH and those without for IPSS total symptom score (effect size = 0.68) but not the IPSS HRQOL score. The areas under ROC curves for the IPSS total symptom and HRQOL scores were 0.67 and 0.60, respectively.Conclusions: The IPSS was valid, reliable instrument in Chinese patients with BPH. The IPSS total symptom score, but not the HRQOL score, is sensitive in differentiating subgroups. [ABSTRACT FROM AUTHOR]

Psychological flexibility (PF) refers to an individual's capacity to deal with the present moment non-judgmentally and to commit to value-based actions. This study evaluated how parental PF, psychological adjustment to a child's illness, and psychological symptoms including anxiety, depression, and stress in parents are associated with asthma morbidity in children. Three-hundred and twenty-four parents of children aged 3-12 years with asthma completed a self-administered questionnaire to measure their PF, psychological adjustment, and symptoms of anxiety, depression, and stress, their children's asthma symptoms and their use of bronchodilators. Structural equation modeling was used to explore the relationships among these constructs. The results showed that poor PF was significantly associated with poor psychological adjustment to the child's illness and increased psychological symptoms in parents. Parental PF was found to be the only latent construct possessing a significant association with the child's asthma morbidity ( β = 0.27, 95% CI [0.09, 0.42], p = .002). These results suggest that by fostering their PF parents may improve their own psychological well-being as well as their child's asthma condition. [ABSTRACT FROM AUTHOR]

The General Health Questionnaire-12 (GHQ-12) is a widely used instrument for measuring psychological strain, but the factor structure of the GHQ-12 is inconclusive. The present study examined one-factor, two- and three-factor models of the GHQ-12 using structural equations modelling in a longitudinal data-set of Hong Kong employees. The findings supported a two-factor model consisting of a ‘Social Dysfunction’ factor measured by three items, and an ‘Anxiety/Depression’ factor measured by four items. Implications and limitations are discussed. [ABSTRACT FROM PUBLISHER]

Childhood internalizing problems such as anxiety and depression can have serious personal, familial and societal repercussions, including drug and alcohol abuse, delinquency, unplanned pregnancy, and even suicide. There is little research on mindfulness interventions for children with clinical levels of internalizing problems, and school-based mindfulness research with children has focused on non-clinical groups. We employed a two-stage screening and intervention procedure to evaluate an in-school mindfulness-based cognitive intervention for Hong Kong children with subclinical internalizing difficulties. Ninety-three fourth to sixth graders were screened, and twenty students (age 9-13, median age 10) highest among their peers on internalizing problems, but lowest on externalizing problems, participated in a 9-week group mindfulness-based intervention. We employed a two-phase open trial design, with random assignment to an immediate intervention group or wait-list control group. In single-trial analysis, one-tailed dependent sample t-tests showed significant decreases in both worry and in symptoms of panic disorder, obsessive compulsive disorder, generalized anxiety and overall internalizing problems. In a randomized controlled trial analysis, the immediate intervention group evidenced larger but nonsignificant reductions on almost all measures. Eighty-five percent of the participants rated the program as helpful, and 65-80 % reported improvement in handling emotions and interpersonal relationships at post-treatment, with some treatment gains maintained at 3-month follow-up. These preliminary findings have encouraging implications for implementing time-limited school-based mindfulness interventions targeting elevated childhood internalizing difficulties. [ABSTRACT FROM AUTHOR]

Purpose: Stigma is a major factor causing delayed help-seeking and poor treatment adherence in patients with psychotic disorders. Previous research has mostly focused on chronic samples and the impact of culturally-relevant variables on both patients' and their caregivers' stigmatization is understudied. This study aimed to examine the relationships between various forms of stigma, "face concern", and clinical characteristics in a group of Chinese first-episode psychosis (FEP) patients and their caregivers.Methods: Forty-four Hong Kong Chinese aged 15-54 years presenting with FEP to psychiatric services and their caregivers were recruited. Assessments on self-stigma, affiliate stigma, perceived public stigma, "face concern", symptom severity and subjective quality of life (QoL) were conducted.Results: Self-stigma of FEP patients was correlated with perceived public stigma, "face concern", insight and psychological health of QoL. Multiple regression analysis revealed that perceived public stigma and "face concern" independently predicted self-stigma. Mediation analysis further suggested that "face concern" partially mediated the relationship between perceived public stigma and self-stigma. Caregivers' affiliate stigma was significantly associated with higher levels of stress, and symptoms of depression and anxiety. Affiliate stigma did not correlate with perceived public stigma and "face concern".Conclusion: Our results indicate a critical role of perceived public stigma and fear of losing face in determining self-stigma in Chinese patients with FEP. Caregivers with greater degree of affiliate stigma experience increased stress and emotional distress. Our findings highlight the importance to examine culturally specific factors that may contribute to the development of self-stigma in first-episode populations of different ethnicities. [ABSTRACT FROM AUTHOR]

Background: While Western academia has increasingly recognized the importance of studying existential anxiety among adolescents, psychometrically valid and reliable tools for measuring this construct remain unavailable in Chinese societies. Objective: This research investigated the empirical viability of the construct of existential anxiety in Chinese adolescents. Specifically, it examined if a similar factor structure and set of theoretical associations existed as found in previous western samples and provided initial psychometric data on the Chinese version of the Existential Anxiety Questionnaire (C-EAQ). Methods: A sample of 1205 Hong Kong Chinese high school students was recruited to complete a questionnaire comprising items of the C-EAQ and several validation measures. Results: An exploratory factor analysis on 621 randomly selected participants of the sample yielded a new threefold factor structure with 12 items. A confirmatory factor analysis on the remaining 584 participants demonstrated an acceptable model fit. These factors revealed three separate but related constructs of existential anxiety, namely, anxiety about the meaning of life and death, anxiety about condemnation and guilt, and non-acceptance of anxiety about the meaning of life and death. The construct validity of C-EAQ was supported by significant correlations with measures of fear of death, internal locus of control, presence of meaning, life satisfaction, and self-esteem. Conclusion: As the results suggest possible different interpretations of existential anxiety in Chinese culture, further studies should be undertaken to examine what constitutes the content areas or personal themes that generate existential anxiety among Chinese adolescents. Implications can also be drawn for youth work practice. [ABSTRACT FROM AUTHOR]

Aims The study estimates the prevalence and examines the socio-economic and psychological correlates of suicidality among professional nurses in Hong Kong. Background Suicide rates among middle-aged employed groups have been increasing over the past few decades. There is a concern that medical occupational groups worldwide are at elevated risk of suicide. Nonetheless there are few population-based studies of suicide dealing with working-age Asian nurses. Design The study uses a cross-sectional survey design. Method Data were collected in Hong Kong over 4 weeks from October-November 2013. Statistical methods including descriptive analysis and univariate and multivariate cumulative logit modelling were used to examine the weighted prevalence rates of past-year suicidality and its associated factors in nurses. Results A total of 850 nurses participated in the study; 14·9% of participants had contemplated suicide while 2·9% had attempted suicide once or more in the past year. Women report suicidal thoughts or attempts more often than men. Religion, poor health, deliberate self-harm, depressive symptoms and poor self-perceived physical and mental health were significantly associated with nurses' suicidality. Conclusions Nurse professionals are not immune from mental health issues. Hong Kong's local health authority should put in place a raft of suicide prevention initiatives to promote mental wellness in the profession. [ABSTRACT FROM AUTHOR]

Background: There is emerging evidence of the significance of paternal mental health problems among the expectant fathers during the antenatal and postnatal period. The present study aims at determining the prevalence of paternal perinatal anxiety and identifying its risk factors among the fathers.Methods: A total of 622 expectant fathers were recruited in Hong Kong. The expectant fathers were assessed using standardized and validated psychological instruments on three time points including early pregnancy, late pregnancy and 6 week postnatal. Independent samples t-test, one way ANOVA, Pearson's correlation and multiple linear regression were used to examine the effect of hypothesized risk factors. Hierarchical multiple regression and mixed effect model were also conducted with potential confounding factors controlled for.Results: Results showed that a significant proportion of expectant fathers experienced anxiety during the perinatal period. Low self-esteem and poor social support were found to be risk factors of paternal anxiety across pregnancy to postnatal period. Work-family conflict could significantly predict paternal anxiety in the pregnancy period.Conclusions: The present study points to the need for greater research and clinical attention to paternal anxiety, given that it is a highly prevalent problem and could be detrimental to their partner's well-being and children development. The present findings contributes to the theoretical understanding of the prevalence and risk factors of paternal perinatal anxiety and have implications for the design of effective identification, prevention, and interventions of these clinical problems. [ABSTRACT FROM AUTHOR]

Cancer-related fatigue (CRF) is common in women with breast cancer, but little is known of its relationship with perceived stress. We conducted a cross-sectional study to explore the associations of CRF with perceived stress, anxiety, depression, pain and sleep quality in 133 Chinese women (aged 25-68 years) with early stage breast cancer. The majority of women had completed surgery and chemotherapy and were awaiting radiotherapy. Self-administered questionnaires consisting of the Brief Fatigue Inventory, Perceived Stress Scale-10, Hospital Anxiety and Depression Scale, Brief Pain Inventory, and Pittsburgh Sleep Quality Index were used to collect data. Forty-five per cent of the women were severely fatigued. Compared with local healthy women and US breast cancer patients, the group's mean perceived stress score was significantly higher (both p < 0.01). Higher perceived stress (β = 0.18, p = 0.032), higher anxiety (β = 0.30, p < 0.001) and higher pain severity (β = 0.38, p < 0.001) were associated with increased severity of CRF. The association of CRF with perceived stress was partially mediated by anxiety, suggesting a possible pathway from cancer and cancer treatment to CRF via stress appraisals and emotional distress. The findings indicate the importance of monitoring the psychological status of patients during treatment. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The literature has stipulated that stress causes somatic symptoms; however, the pathway has not been empirically examined. This study examines the relationship between stress, anxiety, depression, and somatic symptoms by investigating the mediating roles of anxiety and depression in the relationship between stress and somatic symptoms in the general Chinese population. Data were collected from 202 Chinese participants in a household survey conducted between August and September 2013 in Hong Kong. The measurements included a Patient Health Questionnaire, Perceived Stress Scale, Hospital Anxiety and Depression Scale, and Sociodemographics. By using structural equation modeling, anxiety was a significant mediator of the effect of stress on somatic symptoms (Z = 4.328,p < .001, 95% CI = .061, .152), even after adjusting for sociodemographic variables. The findings imply that clinical presentation of somatic symptoms will be helpful for general practitioners in primary care in diagnosing anxiety. [ABSTRACT FROM PUBLISHER]

In the United States, a distinction between proactive (deliberate aggressive behavior aimed at influencing others) and reactive (defensive response to provocation) aggression has been documented. Further, investigators have discovered an association between cognitive, social, and emotional variables and these two types of aggression. This study investigated this relationship with 251 (males = 170; females = 81) proactive and reactive aggressive Hong Kong secondary students ( M age = 13.07; SD = 1.38). Canonical analyses revealed proactive aggression was negatively related to transposing oneself into feelings and actions of fictional characters, feeling warmth and concern for others, and feeling discomfort in reaction to others' emotions. Reactive aggression, in contrast, was positively associated with experiencing and expressing anger without specific provocation, expressing anger when provoked, suppressing anger, expressing anger towards others or objects, and feeling anxiety-depression. Implications to address the aggression of students in Hong Kong and elsewhere are discussed. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify the prevalence and risk factors for fear of falling among robust community-dwelling older people. Background Different models including various risk factors emerged when previous studies attempted to explore the factors' multivariate associations with fear of falling. Attempting to detect fear of falling by a single question in some previous studies may not have been sufficiently sensitive, particularly in a robust population. Although some studies used a validated instrument to detect participants' fear of falling, their self-perceived efficacy in performing various activities was seldom reported. Information to provide an insight into the planning of well-targeted interventions to reduce fear of falling has been lacking. Design A cross-sectional study of 445 robust community-dwelling older people aged ≥65. Methods Besides their demographic and fall-related background, participants' fear of falling level was assessed using the Chinese Fall Efficacy Scale-International. Other instruments included the timed up and go test, the Chinese Geriatric Depression Scale-Short Form, the Chinese Anxiety Disorder Scale, the Chinese Lubben Social Network Scale and the Chinese Personal Wellbeing Index, which were used to assess different variables that may be associated with fear of falling. Results Of the 64·73% of participants who had fear of falling, 65·63% had no history of fall but still had fear of falling. This result was higher than in most previous studies. Participants' main concerns were walking on slippery/uneven surfaces, in crowded places and up/down a slope. Multivariate analyses showed that being female, suffering from poor vision and arthritis, poor performance in the timed up and go test, expressing more depressive and anxiety symptoms and low self-perceived well-being are multiply associated with fear of falling. Conclusion Fear of falling is prevalent among robust community-dwelling older people regardless of their fall history. They showed lack of self-perceived efficacy in performing various outdoor activities. Relevance to clinical practice The findings can assist in developing multidimensional strategies for reducing fear of falling in robust community-dwelling older people. [ABSTRACT FROM AUTHOR]

Aim To explore factors associated with health-related quality of life of patients with implantable cardioverter defibrillators. Background Substantial evidence indicates that implantable cardioverter defibrillator is proven to increase survival rate by terminating life-threatening arrhythmia. However, this device can negatively affect health-related quality of life. Little is known about factors associated with health-related quality of life of patients with implantable cardioverter defibrillators, particularly in Asian population. Design A transversal descriptive design was used. Methods Data were collected from a convenience sample of 139 adult patients with implantable cardioverter defibrillators from 4 January-30 April 2012 using the structured questionnaires administered by the researcher and medical record reviews. The Short Form-36 Health Survey version 2 was used to measure health-related quality of life. Results A total of 139 Chinese patients, including 107 (77·0%) males with a mean age of 63·0 (14·6) years, were selected. The physical component summary was relatively lower, whereas the mental component summary was relatively higher than that of the general Hong Kong Chinese population. Multivariable regression analysis revealed gender, self-care dependence, educational level, atrial fibrillation, diabetes mellitus, anxiety and depression significantly associated with physical or mental quality of life. Conclusions Depression was a common factor affecting physical and mental quality of life. Self-care dependence, atrial fibrillation, diabetes mellitus, depression and anxiety could be improved. Our findings expand existing knowledge on identifying at-risk patients for having lower quality of life, thus allowing development of appropriate interventions targeting risk factors for improving health-related quality of life of patients with implantable cardioverter defibrillator. [ABSTRACT FROM AUTHOR]