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The development of efficient and reliable online assessments has become increasingly important in the digital era. We developed a 10-min online word reading assessment of global English based on the existing paper-and-pencil version of our English silent word reading test. The test includes two parts, namely, random word recognition and contextual word reading. A total of 889 participants (437 children and 392 adults; 62.7% female) took part in the study. They were from various regions including mainland China, Hong Kong SAR, Macau SAR, Poland, the United States, and the Philippines. Reliability and validity analyses on various demographics samples (by age and country/region of origin) demonstrated that the WordSword Test is highly reliable and valid (e.g., the correlation of this test with other English reading measures were above.80). Education level was positively correlated with test performance, while the correlations between age and test performance were not consistent. Ninety-seven children participants also took the paper-and-pencil version of the WordSword Test. The correlation between performances on the online and paper-and-pencil versions of the test was.879, one year apart. With more children and adults taking the WordSword Test, we ultimately hope to establish norms by area, grade level, and age. [ABSTRACT FROM AUTHOR]

Harsh levels of social inequality stunt social mobility and progress towards equality of opportunity in Hong Kong. There are also strong connections between levels of social inequality and educational attainment in this “global city”. This paper seeks to contribute to the important body of work on equality studies and attainment research by examining two inter-connected aspects of educational inequality in higher education in Hong Kong: first, the relative shortage of degree places available for local students at local universities, and second, the relatively strong correlation between income and educational attainment across the districts in Hong Kong. It adopts a discursive sociocultural approach in examining, and commenting on, both the context and statistical trajectory of post-secondary education in Hong Kong. The paper also assesses government initiatives that claim to encourage higher levels of post-secondary participation, in particular through the rapid development of self-financed sub-degree programmes. A secondary argument discusses how university rankings criteria have a deleterious effect on the commitment to promote mass higher education, especially in terms of participation rates at publicly-funded full-time degree programmes. [ABSTRACT FROM AUTHOR]

This paper analyzes the determinants of the age at first marriage among women using an integrated approach incorporating social, familial, and economic factors. Hazard analysis was applied to an original data set for Hong Kong containing 1,024 observations compiled on the basis of a household survey with respondents selected by random sampling. Our findings support the human capital hypothesis, which predicts that women with higher educational attainment and stronger career commitment tend to marry later. In addition, we find that social and family background characteristics are also important determinants of the age at first marriage, including how strongly traditional values and ties to the natal family are held by the women. [ABSTRACT FROM AUTHOR]

The trends and determinants of young adults' living arrangements across a wide range of societies have been a hot topic in multi–disciplinary literature on contemporary youth transitions and urban and housing studies. Extant literature has identified both macro–structural and micro–individual factors to explain the living arrangements of young adults in developed and developing societies. Empirical studies to assess their relative contribution to the spatial and temporal heterogeneity in young people's transition to adulthood, however, remain scarce. This paper attempts to fill this research gap by conducting a case study of Hong Kong young adults. Through descriptive and regression analyses of the population census data in 1991, 2001, and 2011, the paper identifies a declining trend in independent living arrangements in Hong Kong over the past two decades. Such change has been found to be associated with a compositional shift of young adults in their socio-economic characteristics in terms of place of birth, ethnicity, educational attainment, and income and employment status. Further decomposition analysis revealed that over 80% of the change could be attributed to urban institutional and policy contexts beyond the control of young individuals. The pursuit of residential independence among young adults has become an increasingly challenging task in this Asian's world city because of the worsening structural and institutional environments in the 2000s. The case study highlighted the selective nature of Hong Kong's welfare regime, which prioritizes the extension of assistance and benefits to the elderly at the relative neglect of the demand of young adults. [ABSTRACT FROM AUTHOR]

Aims This paper tests the mediating effect of institutional peer support on the relationship between physical declines and depressive symptoms among nursing home residents. Background As the number of older adults living in nursing homes increases, peer support received from other residents in the institutions is critical to the psychological well-being of residents who face physical declines and reduction in family support. This study tested whether institutional peer support would account for the detrimental effect of physical declines on depressive symptoms of Chinese older people residing in nursing homes. Design A cross-sectional design was used. Method The study was conducted between January-March 2009 by convenience sampling. The sample consisted of 187 nursing home residents, with 54 men and 133 women. Interviews were conducted by an experienced research assistant, and responses on physical abilities and institutional peer support were collected. Geriatric Depression Scale was used to assess depressive symptoms of each participant. Results Participants with poor physical abilities reported more depressive symptoms. Institutional peer support was negatively correlated with physical declines and depressive symptoms. Results of the regression analysis showed that the effect of physical declines on depressive symptoms was no longer significant when the influence of institutional peer support was statistically controlled, indicating a full mediation of institutional peer support on depression of older people. Conclusion Findings of this study reveal that institutional peer support positively contributes to the psychological well-being of nursing home residents. [ABSTRACT FROM AUTHOR]

INTRODUCTION Never smokers' responses to tobacco control policy are often overshadowed by the opposition from smokers and tobacco industry during policy advocacy and legislation. Very few studies have examined never smokers' exposure to point-of-sale (POS) tobacco displays and their effects. Therefore, we investigated the exposure, pro-smoking responses due to and attitudes towards such displays in never smokers in Hong Kong. METHODS We conducted two-stage, randomized cross-sectional telephone-based surveys in 2015 and 2016 of 1833 never-smoking adults. They were asked how often they noticed POS displays in the past 30 days (often, sometimes, never), whether they found POS displays attractive, felt encouraged to smoke, perceived POS displays as advertisements, and if they supported banning them. The distributions of the outcomes were analyzed by descriptive statistics with weighting to the general population. Risk ratios (RR) from Poisson regression models adjusted for sociodemographic characteristics were used to analyze the associations. RESULTS Our results showed that, in never smokers, the younger were more likely to often notice POS displays (RR=0.80, 95% CI: 0.72-0.89, p<0.01). Finding POS displays attractive was associated with primary (RR=2.52, 95% CI: 1.51-4.22, p<0.01) and secondary education (RR=1.68, 95% CI: 1.16-2.44, p=0.01) versus tertiary education. Often noticing displays was associated with perceived attractiveness (RR=1.90, 95% CI: 1.32-2.75, p<0.01). The positive association between often noticing displays and being encouraged to smoke was marginally significant (RR=4.05, 95% CI: 0.98-16.85, p=0.054). Respondents who often noticed POS displays (RR=0.87, 95% CI: 0.77-0.98, p=0.02) and did not perceive them as advertisements (RR=0.70, 95% CI: 0.61-0.98, p<0.01) showed less support on banning them than those who did not notice them. CONCLUSIONS Frequent exposure to POS displays was associated with greater perceived attractiveness and lower support for banning them. A total ban on POS displays is needed to eliminate the advertising and normalization effect of POS displays. [ABSTRACT FROM AUTHOR]

Evidence has accumulated to suggest that the mean IQs of Orientals in the United States and in the countries of the Pacific Basin are higher than those of Whites (Caucasoids) in the United States and Britain. This paper presents evidence from IQ tests on 4858 6-year-old Chinese children in Hong Kong. On the Coloured Progressive Matrices these children obtained a mean IQ of 116. Samples from Australia, Czechoslovakia, Germany, Romania, the UK and the US obtain IQs in the range 95–102. It is suggested that these results pose difficulties for the environmentalist explanations commonly advanced to explain the low mean IQs obtained by some ethnic minorities in the United States. [ABSTRACT FROM PUBLISHER]

Previous studies documented inconsistent findings of cohort differences in attitudes toward migrants. Some research has shown that younger people tend to be more welcoming toward migrants compared to older people; however, other research has shown the opposite. This suggests that the way different generations perceive migrants may depend on the specific local contexts in which they live. In this paper, we compared attitudes toward migrants in Hong Kong and Shanghai under the "one country, two systems" framework, using comparable data from the Hong Kong Panel Study of Social Dynamics and Shanghai Urban Neighborhood Survey. We found a sharp contrast in the attitudes toward migrants between Hong Kong and Shanghai. Compared to older people, young people in Shanghai were more friendly to migrants, yet young people in Hong Kong were more resistant to migrants. Our study identified disparities of generational gaps in attitudes toward migrants of the same ethnicity within one country. The relatively more positive attitudes toward migrants of younger cohorts (compared to people born before 1960) in Shanghai could be explained by educational level and life satisfaction. The relatively more negative attitudes toward migrants in Hong Kong could be explained by identity. Our empirical analyses suggest that local contexts matter in explaining generational gaps in attitudes toward migrants. [ABSTRACT FROM AUTHOR]

Background: Youth with mental illness face many challenges in educational attainment, including a high school dropout rate. Objectives: This study aims to explore the feasibility of a supported education program for youth with mental illness in Hong Kong. Research Method : Mixed research method was conducted. The quantitative study adopted one group pre- and posttest design involving 34 participants, while the qualitative study involved conducting in-depth semistructured individual interviews for seven participants who completed all training courses. Results: A dropout rate of 23.5% was reported, and more than one-third of participants achieved open employment or educational attainment during the 24-month follow-up period. Qualitative content analysis revealed that all participants benefited from the supported education by enjoying a positive learning environment and achieving personal growth. Conclusion. The results of both quantitative and qualitative studies support the feasibility and efficacy of the supported education for youth with mental illness in Hong Kong. [ABSTRACT FROM AUTHOR]

This study examines the extent to which poverty is passed from parents to children in Hong Kong based on the social investment thesis. Through tracking the educational and career trajectories of the second generation (aged 23–25) of 77 families, this study suggests that adolescents with poor parents have a 202 percent higher chance of being poor in young adulthood. This poverty-continuation probability increases dramatically to 681 percent if parental poverty is defined in terms of homeownership rather than income. Another important factor that also affects intergenerational poverty is the mother's educational level. Implications for social workers and policy makers are discussed. [ABSTRACT FROM AUTHOR]

The sociodemographic and career-related characteristics of two types of youth who are not in education, employment or training (NEETs) in Hong Kong were examined and compared: longer-term (≥5 months, n = 787) and transitional (<5 months, n = 3,939). After controlling for sociodemographic variables, multivariate logistic regression analyses showed that longer-term NEETs are more likely to be associated with risk factors such as taking a carer role, seclusion at home, involvement in deviant activities, having addiction or health problems; whereas higher educational attainment, identification of career interest and plans for future work/study/ training, and higher career adaptability appeared to be protective factors for NEETs and identifiers of transitional NEETs. Implications are drawn for research and career support services for NEETs. [ABSTRACT FROM AUTHOR]

With the growing research interest in work–family enrichment, this study explores how negative workplace phenomenon affects store managers' experience of work‐to‐family enrichment. Using two‐wave survey data collected from 156 retail store managers who had frequent interactions with customers, we found that customer misbehavior had a negative effect on their work‐to‐family enrichment through work meaningfulness. Furthermore, store managers' organizational affective commitment acted as an effective buffer on such negative relationship. Our findings thus fill in one missing piece in the current work–family enrichment literature and carry important implications for organizations to help retail store managers attain work meaningfulness and enrich their family life. [ABSTRACT FROM AUTHOR]

This study aims to investigate the relationships between perceived discrimination, institutional trust, and settlement intention among highly educated domestic migrants by accounting for their structural (educational and economic) positions. Theoretically, this study of Hong Kong and Macao explores the integration paradox, a well-documented perspective on skilled migrants in transnational contexts, and expands it to internal migrant populations. Using respondent-driven sampling, the data include 2,951 highly educated migrants from mainland China to Hong Kong and Macao. The results indicate that a higher educational position in terms of tertiary educational attainment is associated with lower settlement intention among domestic migrants, a finding that tallies with the integration paradox. However, economic position in terms of income bolsters, rather than weakens, settlement intention. Perceived discrimination and institutional trust are evident in mediating the negative effect of tertiary educational attainment on the settlement intention of domestic migrants. [ABSTRACT FROM AUTHOR]

Loneliness (inclusive social loneliness and emotional loneliness) of older adults is a prominent public health issue internationally. Factors consistently associated with loneliness are age, gender, education, living arrangements, social network, and functional status. Intergenerational co‐living with spouse and adult children is important for the exchange of social, emotional, practical, and financial support provided to older adults. Co‐living with migrant domestic workers (MDWs) to care for older adults became an emergent phenomenon internationally, particularly in Asian countries. According to the convoy model of social relations, the effect of co‐living with MDWs on older adults' loneliness is unknown. This study examined (1) the prevalence of loneliness among community‐dwelling older adults; and (2) the association between co‐living with MDWs and older adult loneliness. Using the Chinese version of the 6‐item De Jong Gierveld Loneliness Scale on loneliness, 380 older adults were interviewed at busy points in Hong Kong, including subway stations. 35.3% of older adults experienced moderate‐to‐severe loneliness. Linear regression was performed to examine the association between co‐living with MDWs and loneliness. The results showed that co‐living with MDWs was significantly associated with lower levels of overall loneliness (β = −0.636; p =.022) and emotional loneliness (β = −0.298, p =.039), but not for social loneliness (β = −0.337, p =.084). While MDWs could be an attachment figure for older adults, they might not be effective in promoting the social integration of older adults. There is a need to investigate the barriers of social integration faced by older adults co‐living with MDWs. [ABSTRACT FROM AUTHOR]

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Lee YM, Hung YK, Mo FKF, Ho WM. International Journal of Nursing Practice 2010; 16: 508-516 Comparison between ambulatory infusion mode and inpatient infusion mode from the perspective of quality of life among colorectal cancer patients receiving chemotherapy Folfox and Folfiri are active chemotherapy treatments used in advanced colorectal cancer. The total admission for these treatments has been significantly increasing in the study hospital. An ambulatory infusion programme was launched to address the problems of long waiting list and bed shortage. The study objective was to compare the quality of life between patients receiving the chemotherapy treatments in the ambulatory infusion group and the inpatient infusion group. The results showed that some demographic variables of education level, family role and employment status were determinants of the treatment mode. Patients in the ambulatory infusion group of social and global domains performed better than the inpatient group. However, the inpatient group had better quality of life of nauseated symptom at different stages. Some nursing educations should be reinforced to address the symptom management for patients receiving ambulatory infusion at home. The ambulatory infusion programme offered considerable quality of life benefits to colorectal cancer patients receiving chemotherapy. [ABSTRACT FROM AUTHOR]

Health inequality creates conditions for the transmission of infectious diseases, and existing health disparities can contribute to unequal burdens of morbidity and mortality. In Hong Kong, low socioeconomic districts were the epicentres of third‐wave outbreak of COVID‐19 in July and August 2020, suggesting that people from low socioeconomic class are vulnerable groups. Socially disadvantaged people are relatively more vulnerable to the physical, mental, and social impacts of infectious diseases. To achieve more effective infection control, the social determinants of health and existing health inequalities should be identified, and understanding the experiences of socially disadvantaged groups in the COVID‐19 outbreak will be beneficial to health authorities in formulating a responsive infection control policy targeting the needs of the socially disadvantaged. This article investigates the experiences of economically disadvantaged groups during the COVID‐19 outbreak and examines how they were further disadvantaged in the outbreak by delineating how health inequality intersected with social inequality. In‐depth, semistructured interviews were conducted from February to April 2020 with 35 participants from the poverty class in Hong Kong. The high prices of surgical face masks and disinfecting products as well as the economic impacts induced by COVID‐19‐related social distancing policies imposed severe economic burden on the participants. In addition to economic and housing deprivation, social inequality was closely associated with health inequality, which made the participants more vulnerable to infection. Social inequality is associated with and can worsen health inequality. Here, the participants, who were of low socioeconomic status were more disadvantaged in health and in the attainment of social resources such as employment, education, face masks, disinfection products and right to use public facilities, during the COVID‐19 outbreak. All these elements may have interrelated effects and in turn limit accessibility to healthcare and lead to less positive health outcomes and consequently to health inequality. [ABSTRACT FROM AUTHOR]

Most studies highlighted the association between psychological distress and socioeconomic status (SES). There were weaker explanations for distress found in the middle classes, especially in Asian countries. We conducted a questionnaire survey with 1626 adult Chinese primary-care attenders from 13 private and 6 public clinics in different districts of Hong Kong. Their demographic background and distress level measured by GHQ-12 were analysed. We found that respondents with younger age, better education, and lower income were more likely to be distressed. In a multiple logistic regression model, age and income, but not education, were significant predictors for distress. Highest rates of distress were found among the unemployed (45.5%) and the students (37.1%), followed by service workers and shop sales workers (33.0%), associate professionals (32.0%), and clerks (29.2%). Craftworkers (9.1%), plant and machine operators (11.5%), and retired people (12.8%) were least likely to be distressed, followed by professionals (21.0%). Apart from SES, the findings suggest that young age, academic and job stressors, and low self-esteem are significant factors for distress. These factors may be intensified in a Chinese context by peer comparison resulting in a state of relative deprivation. [ABSTRACT FROM AUTHOR]

This study aimed to examine three major issues: (a) The extent to which registered donors have communicated with family about body donation; (b) The differences in demographics, life and death attitudes, and quality of relationship with family members between those who communicated their body donation decision and those who did not; (c) The factors associated with the act of communicating with family about body donation. A survey was conducted of people who registered in a body donation programme in Hong Kong. A total of 1,070 registered donors completed an online questionnaire between August and September 2016. The majority of participants (80.1%) reported that they communicated with family members about body donation. About one‐third only informed family members of their decisions after registration, and around 15.6% did not communicate with family members. Those who communicated with family were significantly older and married; they also indicated more positive life and death attitudes and a better quality of relationship with family members. Three factors were found to have significant associations with the act of communicating with family members about the decision to donate the body: (a) Age, (b) Quality of life, (c) Quality of relationship with family members. Communication with family members about body donation is still inadequate. Future body donation programmes may focus more on the way body donation decisions can be better communicated with family members. Special attention can be given to younger registered donors who find it difficult to communicate with the older generation, those who indicate more negative life and death attitudes, and who experienced a poorer quality of relationship with family members. [ABSTRACT FROM AUTHOR]

Mass media and previous research tend to label Asian parents as "academic-obsessive" in their parenting, which can be reflected in the primary-school choice for their children. While some extant Hong Kong studies conducted a decade ago corroborated the above contention, we aim to provide an updated account of the general criteria considered by parents in Hong Kong while selecting primary schools, and how parental income and educational level influence the selection criteria. Using a survey design, a total of 99 kindergartens (N = 3429 parents) participated in this study. Findings show parents emphasized both child-centered factors (e.g., child happiness) and academic-centered factors in their decision-making. In general, parents with higher income attached higher importance to academic-centered factors and were also less concerned about practical and cost-related aspects. Child-centered criteria were found to be less important for parents with higher income and educational level. [ABSTRACT FROM AUTHOR]

Background: Difference of perspective between patients and physicians over integrative medicine (IM) research and service provision remains unclear despite significant use worldwide. We observed an exceptionally low utilisation of IM and potential underreporting in diabetes. We aimed to explore the barriers and recommendations regarding service delivery and research of IM service among diabetes patients and physicians. Methods: A 10-group, 50-participant semi-structured focus group interview series was conducted. Twenty-one patients with diverse severity of disease, comorbidities and education levels; and 29 physicians (14 conventional medicine (ConM) and 15 Chinese medicine (CM)) with diverse clinical experience, academic background and affiliation were purposively sampled from private and public clinics. Their perspectives were qualitatively analysed by constant comparative method. Results: Seven subthemes regarding barriers towards IM service were identified including finance, service access, advice from medical professionals, uncertainty of service quality, uncertainty of CM effect, difficulty in understanding CM epistemology and access to medical records. Patients underreported the use of CM due to the concern over neutrality of medical advice among physicians. Inconvenience of service access, frequent follow-up, use of decoction and long-term financial burden were identified as key obstacles among patients. Regarding research design, ConM physicians emphasised standardisation and reproducibility while CM physicians emphasised personalisation. Some CM-related outcome measurements were suggested as non-communicable. Both physicians acknowledged the discordance in epistemology should be addressed by pragmatic approach. Conclusion: Key obstacles of CAM clinical utilisation are different between patients. Further assessment on IM should be pragmatic to balance between standardisation, reproducibility and real-world practice. Evidence-based IM programs and research should merge with existing infrastructure. [ABSTRACT FROM AUTHOR]

Mental health service disengagement can have devastating consequences for people in need of mental health services. This study explored parental factors in mental health service engagement among Chinese young adult mental health service users. Seventy-two Chinese young adults, aged from 18 to 26 years, were recruited from a Hong Kong community mental health service center. Nearly three-fifths (58.3%) of participants were female and over two-fifths (44.2%) attended college. Results of logistic regression analysis showed that Chinese young adult mental health service users with high levels of perceived need for services and low levels of perceived parental involvement in mental health services were more likely to engage in mental health services. However, concerns about the parent–child relationship, perceived parental encouragement and perceived parental demand for mental health service use were not associated with mental health service engagement. The practice implications of these results are discussed in light of the Chinese context. [ABSTRACT FROM AUTHOR]

Data are reported from a survey of 49 South Asian women who self-identified as having experienced domestic violence from an intimate partner within the past 12 months. Logistic regression analysis reveals that perceived social support and having children emerged as the strongest predictors for seeking help. This study also demonstrates that women's approach to help-seeking is shaped and embedded by a combination of individual and structural factors. The findings of this study may be used to help enhance efforts to promote and provide resources and support for victims of domestic violence from an intimate partner. [ABSTRACT FROM AUTHOR]

Births outside marriage (BoM) account for around 15% of all births globally. However, the distribution around the world is very uneven, as are cultural and political attitudes towards them. Studies from East Asia have shown that the percentage of such births is very low, with only modest increases in recent years. The orthodox demographic view holds that the maintenance of conservative views around the relationship between marriage and childbearing can play a role in keeping fertility low. Prenuptial pregnancies (PNP) (where births occur within eight months of marriage) have been identified as a growing phenomenon in Japan, possibly being an ‘alternative’ Asian pathway to family formation. As yet, no comprehensive statistical analysis of the trends of BoM or PNP has been performed for Hong Kong. Using a comprehensive microdata set of birth registration in Hong Kong from 1984–2015 (N = 1,680,831) we provide evidence of recent trends in such ‘alternative pathways’ to family formation and examine predictors through regression analysis. Our results indicate, in common with elsewhere in East Asia, low overall period rates of either BoM or PNP (although the latter has risen notably in recent years). While more recent birth cohorts exhibit higher prevalence of such births, their incomplete nature and higher expected propensity suggests that the figures are exaggerated. In our regression analysis, we find that lower educational attainment is a strong predictor of both BoM and PNP, suggesting that a bifurcation of experience may be occurring. This adds further evidence to the theory that the maintenance of traditional family formation systems in the context of revolutionised educational and work opportunities for women mean that the opportunity costs of the ‘marriage package’ become too high. Current disparities in rights and privileges between married and unmarried parents–and especially their children–means that targeted family planning services and support for vulnerable families are policy priorities. [ABSTRACT FROM AUTHOR]

Background: there is little evidence to suggest that older people today are living in better health than their predecessors did at the same age. Only a few studies have evaluated whether there are birth cohort effects on frailty, an indicator of health in older people, encompassing physical, functional and mental health dimensions. Objectives: this study examined longitudinal trajectories of frailty among Chinese older people in Hong Kong. Methods: this study utilised data from the 18 Elderly Health Centres of the Department of Health comprising a total of 417,949 observations from 94,550 community-dwelling Chinese people aged ≥65 years in one early birth cohort (1901-23) and four later birth cohorts (1924-29, 1930-35, 1936-41, 1942-47) collected between 2001 and 2012, to examine trajectories of the frailty index and how birth cohorts may have contributed to the trends using an age-period-cohort analysis. Results: more recent cohorts had higher levels of frailty than did earlier cohorts at the same age, controlling for period, gender, marital status, educational levels, socioeconomic status, lifestyle and social factors. Older age, being female, widow-hood, lower education and smoking were associated with higher levels of frailty. Conclusion: more recent cohorts had higher levels of frailty than did earlier cohorts. Frailty interventions, coupled with early detection, should be developed to combat the increasing rates of frailty in Hong Kong Chinese. [ABSTRACT FROM AUTHOR]

Purpose: The risk behaviors of Hong Kong ethnic minority students are understudied. This exploratory qualitative study aimed to explore culturally nuanced factors for the development and prevention of risk behaviors among Pakistani and Indian students in Hong Kong. Method: Twenty-three students participated in four focus groups. All interviews were transcribed verbatim and analyzed using thematic analysis. Results: The participants reported bullying, delinquency, gambling, alcohol, cigarette, and drug uses as risk behaviors. Four themes emerged in the development and prevention of risk behaviors: (a) Parental and peer influence, (b) An unsafe community environment were perceived by the participants as essential factors for the development of risk behaviors, (c) Parental monitoring, and (d) Strong religious beliefs were believed as protective factors for the prevention of risk behaviors. Conclusion: Further research and practice may investigate and focus on the factors embedded in the Hong Kong ethnic minorities’ sociocultural contexts to prevent risk behaviors. [ABSTRACT FROM AUTHOR]

Background: To more accurately quantify the potential impact of the neighbourhood environment on adults' physical activity (PA), it is important to compare environment-PA associations between periods of the day or week when adults are more versus less likely to be in their neighbourhood and utilise its PA resources. We examined whether, among adults from 10 countries, associations between objectively-assessed neighbourhood environment attributes and moderate-to-vigorous physical activity (MVPA) varied by time of the day and day of the week. The secondary aim was to examine whether such associations varied by employment status, gender and city. Methods: This cross-sectional study included 6,712 adults from 14 cities across 10 countries with ≥1 day of valid accelerometer-assessed MVPA and complete information on socio-demographic and objectively-assessed environmental characteristics within 0.5 and 1 km street-network buffers around the home. Accelerometer measures (MVPA min/h) were created for six time periods from early morning until late evening/night, for weekdays and weekend days separately. Associations were estimated using generalized additive mixed models. Results: Time of the day, day of week, gender and employment status were significant moderators of environment-MVPA associations. Land use mix was positively associated with MVPA in women who were employed and in men irrespective of their employment status. The positive associations between MVPA and net residential density, intersection density and land use mix were stronger in the mornings of weekdays and the afternoon/evening periods of both weekdays and weekend days. Associations between number of parks and MVPA were stronger in the mornings and afternoon/evenings irrespective of day of the week. Public transport density showed consistent positive associations with MVPA during weekends, while stronger effects on weekdays were observed in the morning and early evenings. Conclusions: This study suggests that space and time constraints in adults' daily activities are important factors that determine the impact of neighbourhood attributes on PA. Consideration of time-specific associations is important to better characterise the magnitude of the effects of the neighbourhood environment on PA. Future research will need to examine the contribution of built environment characteristics of areas surrounding other types of daily life centres (e.g., workplaces) to explaining adults' PA at specific times of the day. [ABSTRACT FROM AUTHOR]

Authoritative parenting provided by the parent and received by the child offers support and demand to socialize the child, possibly in terms of the performance of taking others' perspectives and self-esteem. Nevertheless, when the child receives less authoritative parenting than the parent claims to provide, a discrepancy in authoritative parenting between the parent-child pair happens and would be likely to reduce the performance. Such impacts on the performance are the focus of this study. Based on cross-sectional data collected from 223 children (aged 14-21 years) and their parents through self-administered questionnaires, results analyzed from structural equation modeling show that (1) authoritative parents, based on the reports of both the parent and child, engendered a positive direct effect on the child's perspective taking, which in turn sustained a positive effect on the child's self-esteem; (2) discrepancy in authoritative parenting between the parent-child pair indicated negative direct effects on both the child's perspective taking and self-esteem; and (3) the child's perspective taking significantly mediated, although not totally, the effects of authoritative parenting and its discrepancy on the child's self-esteem. The present study supports the propositions of symbolic-interactionist theory in explanation of the importance of authoritative parenting and its discrepancy in relation to the child's development of perspective taking and self-esteem. Implications and future research directions are discussed. [ABSTRACT FROM AUTHOR]

Based on the data of 337 female-headed divorced families living in poverty in Hong Kong, the relationships among maternal beliefs (Chinese cultural beliefs of familism, maternal expectations of children's future, maternal attribute of children's achievement to effort), adolescents' perceived maternal control and adolescent psychological competence (indexed by beliefs in the future, clear and positive identity, and resilience) were examined. Results indicated that adolescents' perceived maternal control mediated the influence between maternal beliefs and adolescent psychological competence in poor female-headed divorced families in Hong Kong. With the paucity of research on family beliefs and indigenous parenting practice, the present study underscores the importance of maternal beliefs and maternal control on nurturing adolescent psychological competence in Chinese divorced families facing adversity, which contributes to the development of Chinese familial model of resilience. Theoretical and practical implications of the findings are discussed. [ABSTRACT FROM AUTHOR]

Background: This study aims to assess evidence for any socioeconomic gradients in childhood obesity and hypertension in a population-representative sample in Hong Kong, China. Methods: The data of a stratified random sampled growth survey collected in 2005–2006 was matched with a population by-census. Obesity was defined using the International Obesity Task Force standard and hypertension was defined using the Hong Kong norm table. Family socioeconomic status (SES) was measured by maternal education level. Neighbourhood SES was measured by median household income of the neighbourhood. Multilevel Poisson regression models with robust standard error were used to test the association. Body mass indices of children’s parents were included as potential confounders. Intra-school/neighbourhood correlations were adjusted using random factors. Results: Totally 14842 children (age 6–19 years) included in the analysis, in which 16.6% of them were overweight or obese. Children whose mother only completed secondary school or below had higher risk of childhood obesity (RR 1.41, 95% CI 1.13–1.76, p = 0.003) and hypertension (RR 1.18, 95% CI 1.01–1.36, p = 0.03). Meanwhile, children in the lowest neighbourhood SES group had higher risk of childhood underweight (RR 1.61, 95% CI 1.04–2.49, p = 0.03), overweight (RR 1.35, 95% CI 1.05–1.72, p = 0.02), and obesity (RR 2.07, 95% CI 1.11–3.88, p = 0.02). Conclusions: Socioeconomic gradient in childhood obesity and hypertension existed in Hong Kong, one of the most developed cities in China. These results have implications for policymakers and public health experts and highlight the need to monitor trends in other parts of China. [ABSTRACT FROM AUTHOR]

Background: In recent years there has been a steady influx of immigrants into Hong Kong from Mainland China, where breastfeeding patterns differ. Studies in other regions have found substantial differences in breastfeeding rates between native-born and immigrant mothers. The purpose of this study was to examine factors associated with breastfeeding initiation in Hong Kong born and Mainland China born mothers living in Hong Kong.Methods: We used a multi-center cross-sectional study design and recruited 2761 new mothers from the postnatal wards of all eight public hospitals in Hong Kong that offer obstetric services. We assessed breastfeeding status as well as various socio-demographic, maternal and birth characteristics. Chi-square tests and multivariable logistic regression were used to identify the predictors of breastfeeding initiation in Hong Kong born and Mainland China born participants.Results: 80.3 % of Hong Kong and 81.1 % of Mainland Chinese born women initiated breastfeeding. In the fully adjusted models, multiparity (Odds Ratio [OR] 0.53, 95 % CI 0.43-0.66) and maternal smoking (OR 0.29, 95 % CI 0.18-0.45) were strongly associated with failure to initiate breastfeeding in both Hong Kong and Mainland China born participants. In Hong Kong born mothers, participants with lower maternal education and those who had a cesarean section were significantly less likely to breastfeed. For Mainland China born mothers, paternal smoking (OR 0.70, 95 % CI 0.49-0.99) and having a pregnancy-related health problem (OR 0.60, 95 % CI 0.38-0.94) were both additional risk factors for not breastfeeding.Conclusion: This study has identified predictors of breastfeeding initiation in Hong Kong and Mainland China born mothers. Given the current high breastfeeding initiation rates among both groups, antenatal breastfeeding education and promotion programmes need to specifically intervene with sub-groups of pregnant women at risk for not breastfeeding so that their efforts are more strategic and cost-effective. [ABSTRACT FROM AUTHOR]

Although the predominantly somatic presentation of distress has been used to explain low rates of emotional illnesses and health service use in Chinese communities, this concept of somatization has not been examined by concurrently studying the profile of somatically and psychologically distressed Chinese individuals. A random population-based sample of 3014 adults underwent a structured telephone interview that examined their sociodemographic characteristics, somatic distress (Patient Health Questionnaire-15, PHQ-15), non-specific psychological distress (Kessler Scale-6, K6), health service use, and functional impairment. Four groups of individuals identified by PHQ-15 and K6 cut-off scores were compared. Results showed that PHQ-15 and K6 scores were positively correlated. The large majority of respondents (85.9%) reported both somatic and psychological distress. The proportions of Low Distress Group, Somatically Distressed Group, Psychologically Distressed Group, and Mixed Distress Group were 69.2%, 5.0%, 15.8%, and 10.0%, respectively. Specific age range, male gender, greater family income, higher education level, and retirement were associated with decreased odds of somatic and/or psychological distress. Although psychological distress best predicted impairment, somatic distress best predicted health service use. Mixed distress predicted most impairment and health service use. Thus, psychological distress and somatic distress commonly coexist across Chinese sociodemographic groups. This speaks against the conventional notion of somatization and is consistent with recent findings of a higher prevalence of emotional illnesses in Chinese people. That psychologically distressed individuals are more impaired but less inclined to seek help than somatically distressed individuals may partly explain low levels of help-seeking for mental disorders found in epidemiological studies. [ABSTRACT FROM AUTHOR]

Using an interdisciplinary model of financial planning, we investigated the factors contributing to perceived adequacy of retirement savings among Hong Kong workers by replicating a previous study of American and Dutch workers. The model was also tested for age differences in the way in which the variables operated within the model. These questions were examined using data from a phone survey conducted with 999 Hong Kong workers in 2012. We examined three psychological factors (future time orientation, goal clarity and financial knowledge), three social support variables (early learning from parents, spousal support and friend support) and three institutional factors (quality of employer pensions, trust in banks and fund managers, and trust in the government), as well as retirement savings planning activity and perceived retirement savings adequacy. Path analyses were used to test the model for the whole sample and separately for younger (N=437) and older (N=562) workers. Although a few age differences were found in the path analyses, the model was found to be useful in explaining the factors contributing to retirement savings planning and practices. Finally, we discuss how our findings differ from those of prior studies, and we assess their theoretical and practical implications. [ABSTRACT FROM PUBLISHER]

Whereas the inclusion of children with special needs in regular classrooms has gained increasing advocacy, teachers' attitudes vary. Previous studies examining teacher attitudes have focused on primary and secondary schools in the Western world, and little is known about early childhood settings in Eastern countries. This study used MANOVA to examine preschool teachers' attitudes in Hong Kong (N = 410). Teachers reported only modest support for inclusion. Teachers with training in special education were stronger advocates of inclusion, irrespective of their professional roles (administrator or class teacher), for children with intellectual disability, or visual, hearing, and speech and language impairments. However, neither teacher training nor professional role made a significance difference to teachers' support of including children with physical disability, autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), specific learning difficulty, and the gifted and talented. Implications for practice and further research are explored. [ABSTRACT FROM AUTHOR]

Aim and objectives The aim of the study was to identify the predictors of functioning in Chinese people with serious mental illness. Background Mental healthcare services for people suffering from serious mental illness are delivered to not only minimise their psychiatric symptoms but also enhance their levels of functioning in the community. Yet, there is insufficient research directed towards the associated or predictive factors that may influence different aspects of functioning, particularly in terms of patients' psychosocial variables. Design A longitudinal, prospective cohort study design was adopted. Methods A clustered random sample of 395 of 611 outpatients with serious mental illness completed the same set of questionnaires at baseline and at 12 months. Changes in patients' functioning as measured by self-maintenance, social functioning and community living skills were recorded over 12 months. Potential relationships between their level of functioning and symptom severity, self-esteem, self-efficacy, perceived negative familial response, negative self-stigma towards mental illness, re-hospitalisation rate and socio-demographic characteristics were investigated. Results Most participants reported moderate to moderately high levels of overall functioning, self-efficacy, self-stigma and perceived negative familial response at baseline and there were significant observed correlations between these variables. Results of multiple regression models indicated that while symptom severity predicted functioning in patients with psychotic and affective disorders, a negatively perceived familial response only predicted negative changes in social functioning of the patients with psychotic disorders (β = −0·25). In addition, improvements in self-efficacy (β = 0·23) and reduction in self-stigma (β = −0·15) positively predicted changes in the community living skills of patients with affective disorders. Conclusion The findings indicate the significance of psychiatric patients' symptom management and factors such as self-efficacy and self-stigma to predict their functioning over a 12-month follow-up. Relevance to clinical practice Mental healthcare services should consider giving priority to self-stigma reduction and empowerment to manage illness especially in this population of patients and their families, thus effectively enhancing their self-care ability to cope with their illness and/or difficult life situations. [ABSTRACT FROM AUTHOR]

This article weighs the demographic evidence for either assimilation or separation among Hong Kong residents who were born in British Colonial Hong Kong or Mainland China. Using successive waves of Hong Kong census data from 1991 to 2011, we show the effects of nativity on four indicators of social distance and differentiation: residential segregation, linguistic assimilation, wage inequality and educational opportunity. On the one hand, there is some evidence of assimilation in terms of residential location and home language. On the other hand, in terms of wage inequality and access to postsecondary education, our findings suggest that Hong Kong's population could become more divided depending upon birthplace. [ABSTRACT FROM AUTHOR]

Objectives This study explored the views, barriers and facilitators of the poorly-educated elderly who were non-attendee of the nurse-led case manager clinic. The case managers provide assessment for diabetes complication screening and can refer to the appropriate multidisciplinary team in public outpatient primary care setting. Methods We adopted qualitative research method by individual semi-structured face to face interviews. Nineteen Chinese type 2 diabetes mellitus subjects aged ≥ 60 who failed to attend the nurse-led case manager clinic were interviewed. They all came from a socially deprived urban district in Hong Kong. Content and thematic analysis was performed. Results Seven men and twelve women aged 60 to 89 were interviewed. Nine of them received no formal education and ten of them attended up to primary school. The reasons for non- attendance included attitude and poor knowledge towards diabetes complication screening and confusion of the nurse-led clinic as an educational talk. Most respondents could not understand the reason for the screening of diabetic complications, the concept of multidisciplinary care and the procedure and outcomes of nurse assessment. Five respondents were unable to follow multiple appointments because they could not read. Other reasons included physical barriers and comorbidity, family and financial constraint. They either had a tight daily schedule because of the need to take care of family members, or the family members who brought them to clinic had difficulty in attending multiple appointments. Enhanced understanding of the importance and procedure of diabetes multidisciplinary management, a flexible appointment system and a single clear appointment sheet may facilitate their attendance. Conclusion Poorly-educated Chinese elderly with DM and their care givers faced physical, social and psychological barriers when attending the nurse-led case manager clinic. Strategies targeting on their low literacy include effective communication and education by health care professionals to arrive a shared understanding of care plan as well as a flexible appointment and schedule system. [ABSTRACT FROM AUTHOR]

The research reported is from the fourth round of a series of surveys carried out in 2004, 2007, 2010 and 2013 of Primary 4 Hong Kong students' reading attainment in Chinese, their first language, and in English, their second. Developmental trends in literacy proficiency in the two languages were monitored using attainment measures and demographic questionnaires developed as part of the 'Progress in International Reading Literacy Study (PIRLS)', a 5-yealy survey of trends in the reading proficiency of Grade 4 primary students in countries worldwide. The reading comprehension attainment of the 2,131 student cohort in 42 Hong Kong primary schools was examined in the 2013 round of testing. Statistical analyses revealed that their English reading performance was approximately 75% of that of the standard reached in Chinese. When faced with passages of a literary nature, their reading comprehension of Chinese text was superior to that of understanding English text at all levels in the PIRLS framework except at Level 1. It is suggested that the students' performance chiefly reflects differing patterns of classroom practice in Chinese and English language lessons. There was a decrease in the reading attainment standard from that reached in the preceding 2010 cycle, together with a drop in the number of highly competent bilingual readers. The evidence gives cause for concern about teachers' reading pedagogy and use of resources and procedures engaged to promote bilingual reading competence in an era witnessing a boom in children's processing of written information in computerised devices and technology in and outside school. [ABSTRACT FROM AUTHOR]

Aim To explore nursing assistants' roles during the actual process of pain management (assessment, reporting, implementation of pain-relieving interventions and re-assessment) for cognitively impaired home residents with pain. Background Nursing assistants provide most of the direct care to residents and represent the major taskforce in nursing homes. They may develop specialized knowledge of residents' pain experience that enables them to play both a pivotal role in pain assessment and possibly a supporting role in pain treatment. Currently, there is a lack of research into nursing assistants' functions in pain management. Design This is a descriptive, exploratory qualitative study. Methods Forty-nine nursing assistants were recruited from 12 nursing homes, 12 of them participating in semi-structured individual interviews and 37 in 8 semi-structured focus groups. All interviews were carried out from May to September 2010. Data collected via both data collection methods were transcribed verbatim and analysed by content analysis. Results Nursing assistants were found to play four roles in the pain management process: (1) pain assessor; (2) reporter; (3) subordinate implementing prescribed medications; and (4) instigator implementing non-pharmacological interventions. Conclusions This study highlights the importance of nursing assistants in successful pain assessment and identifies their possible supporting roles in other aspects of pain management. However, nursing assistants' scope of practice resulted in their functions in pain management being continually undervalued by other healthcare professionals. Continuous in-service training, the use of a standardized pain management protocol and strategies for building coherent work teams in nursing homes are suggested to improve this situation. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the beliefs and attitudes towards menstruation of Chinese undergraduates in Hong Kong and to compare those of (1) male and female undergraduates with those of (2) undergraduates studying health-related vs. nonhealth-related programmes. Background Menstruation is typically viewed as a forbidden topic or a troublesome experience. These negative beliefs and attitudes result from existing myths and taboos associated with cultural factors and health education levels. Design A cross-sectional survey was conducted in all universities in Hong Kong. Undergraduates were invited through convenience sampling to complete a questionnaire assessing their attitudes and beliefs towards menstruation. Methods A questionnaire on 'beliefs about and attitudes towards menstruation' was adopted. Questionnaires were self-administered by the respondents. Results A total of 450 questionnaires were distributed, and a response rate of 96·6% was obtained; 416 completed questionnaires were collected and analysed. Many Chinese undergraduates agreed that menstruation is annoying, causes disability, involves prescription and proscription and is not pleasant. When comparing the beliefs and attitudes towards menstruation of Chinese male undergraduates with those of female undergraduates, females tended to disagree that menstruation should be maintained secret, but tended to agree that it was annoying. When comparing the beliefs and attitudes towards menstruation of Chinese undergraduates studying health-related programmes with those under nonhealth-related programmes, the latter group exhibited a higher level of belief in prescription and proscription for menstruation than the former group. Conclusion Chinese undergraduates in Hong Kong were influenced by the traditional Chinese culture and social environment, resulting in negative attitudes towards menstruation. This study recommends that sex education, especially reproductive health education, be extended to tertiary education. Relevance to clinical practice This study provides relevant information on planning the content of sex education or reproductive health education for Chinese undergraduates. [ABSTRACT FROM AUTHOR]

Aims and objectives To develop and to test the psychometric properties of the Chinese Health Literacy Scale for Diabetes. Background Patients with diabetes encounter many challenges when making health decisions in their daily lives, as they have access to many different kinds of health information. Health literacy issues are new topics in Chinese society. Without a valid and reliable instrument in Chinese, it is difficult to measure the level of health literacy and promote the concept of health literacy in Chinese societies. Design A methodological study with a sample of 137 patients with type 2 diabetes aged 65 years or older. Method Chinese Health Literacy Scale for Diabetes was developed with reference to the revised Bloom's taxonomy model. Psychometric tests (content validity, item analysis, construct validity, discriminative ability and test-retest reliability) were conducted. Correlations between Chinese Health Literacy Scale for Diabetes and four relevant measures were tested. Cronbach's alpha and alpha if item deleted were calculated to assess internal consistency. Results Cronbach's alpha for Chinese Health Literacy Scale for Diabetes and its four subscales (remembering, understanding, applying and analysing) were 0·884, 0·885, 0·667, 0·654 and 0·717, respectively. The Chinese Health Literacy Scale for Diabetes was significantly correlated with the Diabetic Knowledge Scale ( r = 0·398, p < 0·001), the Diabetic Management Self- Efficacy Scale ( r = 0·257, p < 0·001), the Preschool and Primary Chinese Literacy Scale ( r = 0·822, p < 0·001) and the Chinese Value of Learning Scale ( r = 0·303, p < 0·001). It took an average of seven minutes to complete this 34-item instrument. Conclusion The findings of this study support the Chinese Health Literacy Scale for Diabetes as a reliable and valid instrument for measuring the health literacy of Chinese patients with diabetes. Relevance to clinical practice We recommend that clinicians use this tool to assess patients' health literacy before conducting any kind of health promotion. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore nursing students' perception of the meanings and roles of non-verbal communication and sensitivity. It also attempts to understand how different factors influence their non-verbal communication style. Background The importance of non-verbal communication in the health arena lies in the need for good communication for efficient healthcare delivery. Understanding nursing students' non-verbal communication with patients and the influential factors is essential to prepare them for field work in the future. Design Qualitative approach based on 16 in-depth interviews. Methods Sixteen nursing students from the Master of Nursing and the Year 3 Bachelor of Nursing program were interviewed. Major points in the recorded interviews were marked down for content analysis. Results Three main themes were developed: (1) understanding students' non-verbal communication, which shows how nursing students value and experience non-verbal communication in the nursing context; (2) factors that influence the expression of non-verbal cues, which reveals the effect of patients' demographic background (gender, age, social status and educational level) and participants' characteristics (character, age, voice and appearance); and (3) metaphors of non-verbal communication, which is further divided into four subthemes: providing assistance, individualisation, dropping hints and promoting interaction. Conclusions Learning about students' non-verbal communication experiences in the clinical setting allowed us to understand their use of non-verbal communication and sensitivity, as well as to understand areas that may need further improvement. Relevance to clinical practice The experiences and perceptions revealed by the nursing students could provoke nurses to reconsider the effects of the different factors suggested in this study. The results might also help students and nurses to learn and ponder their missing gap, leading them to rethink, train and pay more attention to their non-verbal communication style and sensitivity. [ABSTRACT FROM AUTHOR]

Aim To explore the relationship between personal characteristics and smoking initiation among adolescents in Hong Kong. Background Adolescents have been initiating cigarette smoking at an increasing rate in recent years. Preventing tobacco use among young children has become one of the most effective strategies to reduce the harmful effects of tobacco use. Design A cross-sectional study. Methods Secondary students were recruited by convenience sampling from schools in the New Territories of Hong Kong in 2010. Questionnaires were used to collect information relating to their demographic and personal characteristics, including behavioural control, coping styles, sociability, locus of control, rebelliousness, self-esteem, emotional distress, and intention to smoke. Results A total of 644 secondary students were recruited. The prevalence of having ever tried smoking was 19·4% and that of regular smoking was 3·9% among these students. The results of this study show that secondary students who were living in public housing and had lower behavioural control and higher smoking intention were more likely to have tried smoking or to be regular smokers, indicating that these factors contribute to smoking initiation among secondary students. Conclusions The personal characteristics of secondary students do play a role in smoking initiation. Parents and school personnel should work together to help young people to improve their self-esteem and behavioural control and to overcome their rebelliousness. The causes of smoking intention should also be explored to stop young people from picking up their first cigarette. [ABSTRACT FROM AUTHOR]

cheung w.k.h. & lee r.l.t. (2012) Children and adolescents living with atopic eczema: an interpretive phenomenological study with Chinese mothers. Journal of Advanced Nursing 68(10), 2247-2255. Abstract Aim. This article is a report on a phenomenological study of Chinese mothers' experiences of caring for their children who were living with atopic eczema. Background. A mother's attitude and personality may have a direct influence on her child's adherence to treatment for atopic eczema. Thus, good communication between healthcare professionals and the mother is essential. Treatment and care should also be culturally appropriate. Methods. Using an interpretive phenomenological method, 14 interviews were conducted in Hong Kong, China from September 2007 to August 2008, with nine mothers caring for their children who were living with atopic eczema. Crist and Tanner's circular process of hermeneutic interpretive phenomenology was chosen to guide the data analysis. Findings. Mothers' coping patterns involved persistently dealing with enduring demands and seeking alternative therapies that were aimed at curing the disease. Four themes finally emerged from the data: (1) dealing with extra mothering, (2) giving up their life, (3) becoming an expert and (4) living with blame and worry. Mothers' coping patterns involved persistently finding ways to relieve their children's suffering with the aim of curing the disease and dealing with their own emotions related to the frustration resulting from giving up their life and living with blame and worry. Conclusion. The study findings provide nurses with an empathic insight into mothers' feelings and the enduring demands of caring for children with atopic eczema, and help nurses to develop culturally sensitive interventions, reinforce positive coping strategies, increase family function and improve health outcomes. [ABSTRACT FROM AUTHOR]

chan k.s., li h.c.w., chan s. w.-c. & lopez v. (2012) Herth Hope Index: psychometric testing of the Chinese version. Journal of Advanced Nursing 68(9), 2079-2085. Abstract Aim. This article is a report on psychometric testing of the Chinese version of the Herth Hope Index. Background. The availability of a valid and reliable instrument that accurately measures the level of hope in patients with heart failure is crucial before any hope-enhancing interventions can be appropriately planned and evaluated. There is no such instrument for Chinese people. Methods. A test-retest, within-subjects design was used. A purposive sample of 120 Hong Kong Chinese patients with heart failure between the ages of 60 and 80 years admitted to two medical wards was recruited during an 8-month period in 2009. Participants were asked to respond to the Chinese version of the Herth Hope Index, Hamilton Depression Rating Scale and Rosenberg's Self-Esteem Scale. The internal consistency, content validity and construct validity and test-retest reliability of the Chinese version of the Herth Hope Index were assessed. Results. The newly translated scale demonstrated adequate internal consistency, good content validity and appropriate convergent and discriminant validity. Confirmatory factor analysis added further evidence of the construct validity of the scale. Conclusion. Results suggest that the newly translated scale can be used as a self-report assessment tool in assessing the level of hope in Hong Kong Chinese patients with heart failure. [ABSTRACT FROM AUTHOR]

shiu a.t.y., lee d.t.f. & chau j.p.c. (2011) Exploring the scope of expanding advanced nursing practice in nurse-led clinics: a multiple-case study. Journal of Advanced Nursing 68(6), 1780-1792. Abstract Aim. This article is a report on a study to explore the development of expanding advanced nursing practice in nurse-led clinics in Hong Kong. Background. Nurse-led clinics serviced by advanced practice nurses, a common international practice, have been adopted in Hong Kong since 1990s. Evaluations consistently show that this practice has good clinical outcomes and contributes to containing healthcare cost. However, similar to the international literature, it remains unclear as to what the elements of good advanced nursing practice are, and which directions Hong Kong should adopt for further development of such practice. Methods. A multiple-case study design was adopted with six nurse-led clinics representing three specialties as six case studies, and including two clinics each from continence, diabetes and wound care. Each case had four embedded units of analysis. They included non-participant observation of nursing activities (9 days), nurse interviews ( N = 6), doctor interviews ( N = 6) and client interviews ( N = 12). The data were collected in 2009. Within- and cross-case analyses were conducted. Results. The cross-case analysis demonstrated six elements of good advanced nursing practice in nurse-led clinics, and showed a great potential to expand the practice by reshaping four categories of current boundaries, including community-hospital, wellness-illness, public-private and professional-practice boundaries. From these findings, we suggest a model to advance the scope of advanced nursing practice in nurse-led clinics. Conclusion. The six elements may be applied as audit criteria for evaluation of advanced nursing practice in nurse-led clinics, and the proposed model provides directions for expanding such practice in Hong Kong and beyond. [ABSTRACT FROM AUTHOR]

Aims. The purpose of this study was (1) to explore postoperative pain experience among Chinese thoracotomy patients during hospitalisation; (2) to identify patient-related barriers to pain management; and (3) to explore how these barriers were related to patients' pain experience. Background. Major thoracotomy causes severe pain and extreme stress for patients. Unrelieved postoperative pain leads to high risks of postoperative complications and chronic post-thoracotomy pain syndrome, compromising the quality of life for those patients. Design. Cross-sectional design. Methods. A tertiary general hospital in mainland China was selected for this study. A total of 94 patients undergoing scheduled major thoracotomy operations participated in the study. All patients completed Brief Pain Inventory-Chinese version, the Barrier Questionnaire-Taiwan Form Surgical version and a demographic questionnaire. Results. Patients suffered moderate to severe pain and experienced extremely high interferences with daily activities after major thoracotomy operation. Patients reported the four highest barrier scores in the subscale of Barrier Questionnaire-Taiwan Form Surgical version were fear of tolerance, inhibition of wound healing, time intervals and distracting the physician from treating the disease. Patient's demographic data had no significant impact on their concerns about communicating pain and using of analgesics with exception of the subscale 'fatalism' of the Barrier Questionnaire-Taiwan Form Surgical version in patients with higher education levels or patients with 'non-farmer' occupation. However, there were no significant correlations indicated either between Barrier Questionnaire-Taiwan Form Surgical version score and pain severity or pain interference. Conclusions. Patients were underexposure of pain treatment after thoracotomy operation in the study, while patients' concerns about reporting pain and using analgesics had minimal impacts on their pain experience. Relevance to clinical practice. Education approach for patients is inadequate to improve the status of unrelieved postoperative pain. Appropriate pain management regime together with attentive nursing care should be provided to achieve better pain relief for Chinese patients. [ABSTRACT FROM AUTHOR]

The article discusses conceptual, policy and practical issues relevant to the participation of elders in lifelong learning in Hong Kong, China. It examines the role of government, providers and community agencies in developing policy and practice for elder learning in Hong Kong. It states that with respect to educational attainment, older people generally have a very low level of formal education and there is a wide difference between older and younger populations in terms of formal schooling.

Aim. This study aimed to explore the lived experience of sub-fertility among Chinese couples in Hong Kong. Background. In Chinese culture, the duty of young married couples is to bear children to carry on the family line. Married couples who are unable to bear children often experience personal psychological stress and social pressure. Design. Qualitative, exploratory study. Methods. Seven women and four men in Hong Kong were interviewed to explore their lived experiences of being involuntarily childless. Collaizi's phenomenological methods guided data collection and analysis. Results. Sub-fertile couples reported feelings of incompleteness, guilt, shame and isolation from the 'fertile' world. These couples acknowledged that sub-fertility had implications on their marital relationship and regretted not having treatment earlier. Some found ways to replace their 'loss' and to cope with their situation, and some rationalised by finding reasons that favoured being childless. Discussion. It is recommended that family planning should be incorporated into premarital screening and to provide timely support and counselling. Relevance to clinical practice. Family planning and fertility should be incorporated into premarital counselling. Sub-fertile couples should be encouraged to seek medical help, being provided with early referral for investigation and treatment and with support and counselling. Health care professionals should respect the decisions of sub-fertile couples with regard to investigations or assisted reproductive services. They should also assess how each partner interprets the situation if they encountered difficulty in dealing with the situation. [ABSTRACT FROM AUTHOR]