Search

This study aims to understand the experiences of colorectal cancer (CRC) patients and their spousal caregivers during the COVID-19 pandemic, and to refine a self-efficacy (SE) intervention for these couples.A descriptive phenomenological approach was used in this study. Data were collected from 11 CRC couples. All interviews were recorded, transcribed, and analysed using the Colaizzi strategy.Three themes and eight subthemes emerged: (a) Get and contribute support, (b) Life's challenges, and (c) The Journey of Reconstruction. The CRC couples encountered escalating challenges in coping with cancer during COVID-19. At the same time, they have received considerable support and developed confidence in rebuilding themselves in the process. Healthcare providers are advised to focus on giving appropriate support to CRC couples, so they can go further.This study gave insights to healthcare providers on the experiences of CRC couples and the development of SE intervention programme to support these couples: (a) initially providing caregiving training for spousal caregivers and psychological support for patients, (b) encouraging self-care for CRC couples in the middle stage, (c) guiding them to view life positively in the later stage, and (d) assessing their situation in time to identify their needs and to provide support. Healthcare providers are recommended to increase flexibility in the SE intervention programme delivery format, to reduce the impact of COVID-19 on CRC couples.

The aim of this study was to test the validity and reliability of a tool for measuring the disaster resilience of healthcare disaster rescuers. A cross-sectional study involving 936 healthcare disaster rescuers of the Sichuan Disaster Response Team was conducted to establish the psychometric properties of the disaster resilience measuring tool (DRMT). Item analysis, exploratory factor analysis, confirmatory factor analysis, and correlation analysis were adopted to analyze the data. Item analysis showed that all but three items had the critical ratio over 3, which indicates adequate discriminability for inclusion in the measuring tool. The exploratory factor analysis showed that 65.93% of the total variance was explained by four factors—self-efficacy, social support, positive growth, and altruism. The confirmatory factor analysis showed goodness of fit for the four-factor model: CMIN/DF (2.846), GFI (0.916 ≥ 0.90), CFI (0.949 ≥ 0.90), AGFI (0.891 ≥ 0.80), and RMSEA (0.063 ≤ 0.08). Criterion validity demonstrated significant associations of the DRMT and the Connor-Davidson Resilience Scale (P< 0.01,r= 0.566). Convergent validity was established by correlation with stress (P< 0.05,r= − 0.095), depression (P< 0.01,r= − 0.127), posttraumatic stress disorder-PCL-C (P< 0.05, r = − 0.100), compassion satisfaction (P< 0.01,r= 0.536), and burnout (P< 0.01,r= − 0.330). The DRMT demonstrated adequate internal consistency (Cronbach’s alpha > 0.84) and stability over the two-week study period (intraclass correlation coefficient > 0.85), and a cut-off point of 61 was suggested. The disaster resilience measuring tool has satisfactory psychometric properties and is a valid, reliable, and valuable instrument for assessing disaster resilience in healthcare rescue workers. The scale needs to be tested further among other populations and those from other cultures.

Disasters can cause long-lasting damage to survivors and rescue workers. Some rescue workers suffer negative physical and psychological consequences, while others do not. Thus, it is of value to fully understand the characteristics of rescuers who have not been affected by rescue activities. Resilience refers to the ability or capacity to cope with adversity. The aim of this review is to explore and identify the characteristics of resilience among rescue workers. A systematic literature search was conducted of seven electronic databases from inception to May 2019, using keywords and medical subject heading terms related to the resilience of rescuers. Hand searches and searches of leading authors were also performed. A total of 31 articles were eligible for review. Six domains were identified to characterize the resilience of rescuers namely, demographic and physical characteristics, personality traits, coping strategies, perceived resources, being equipped with special skills for disaster rescue, and having less adverse consequences from exposure to disaster. Researchers and disaster managers can take note of these characteristics to comprehensively understand the ‘positive concept’ of resilience. This enhanced understanding of ‘positive resilience’ can in turn be used to develop a framework to assess and establish interventions, and consequently to improve the psychological wellbeing of rescuers after disaster rescue efforts.

Background The aim of this study was to examine the effectiveness of delivering an individual Acceptance and Commitment Therapy (ACT) for smoking cessation among a Chinese population. Methods Participants were recruited from six primary health care centers. A total of 144 were eligible to take part in the study and agreed to be randomized to the intervention (ACT) group (n = 70) and control group (n = 74), respectively. Both groups received self-help materials on smoking cessation. The ACT group also underwent an initial face-to-face session and two telephone ACT sessions at 1 week and 1 month following the first session. They were re-contacted through telephone follow-ups at 3, 6, and 12 months by research assistants. The primary outcome was self-reported 7-day point-prevalence abstinence at the 12-month follow-up session. Other outcomes included biochemically validated quitting, quitting attempts, the intention to quit, the self-perception of quitting, and psychological flexibility. Results There was no significant difference in the self-reported 7-day point prevalence quit rate at the 12-month follow-up between the intervention group (24.3%) and the control group (21.6%) (risk ratio = 1.12; 95%CI = (0.62, 2.05); p = 0.704). Greater improvements in secondary outcomes from baseline to the 12-month follow-up were observed in the ACT group than in the control group, including a forward progression in the participants’ readiness to quit smoking (p = 0.014) and increased psychological flexibility (p = 0.022). Conclusions This study is the first evidence of a randomized-controlled trial on the adoption of an individual ACT for smoking cessation, delivered initially in primary health care settings and subsequently by telephone within a Chinese population. The present study found that the brief ACT intervention could not produce a significant quit rate but was promising in terms of bringing about cognitive changes, including greater psychological flexibility, and more confidence about quitting, when compared to the use of self-help materials only among the general population. Trial registration This trial was registered prospectively with the U.S. National Library of Medicine: (NCT01652508) on 26th July 2012.

Background:Stigma is considered a major barrier to accessing healthcare services by female sex workers. Current knowledge of nurses’ attitudes appears to imply a stigma toward female sex workers. But in-depth understanding of their perceptions is scarce. Furthermore, factors that inform a conceptual understanding of how this occurs are lacking.Objectives:The study aimed to explore nurses’ attitudes toward female sex workers and factors affecting caring for female sex workers.Research design:This was a qualitative study. A content analysis approach was adopted in analyzing the data.Participants and research context:Thirty-three practicing nurses participated in seven semi-structured focus group interviews and three key informants participated in three individual interviews in Hong Kong.Ethical considerations:This study was approved by the Ethics Committee of one university in Hong Kong.Findings:The findings revealed three themes: (1) accept, stigmatize, or against sex work; (2) reluctance, hesitation, or willingness to care for female sex workers; and (3) factors affecting the care of female sex workers.Discussion and conclusion:This study found that nurses held different attitudes toward female sex workers, and they experienced feelings of reluctance, hesitation, or willingness to care for female sex workers. Multi-level factors could affect their level of comfort of caring for female sex workers. Intervention should be developed to encourage health professionals to examine their personal views toward female sex workers introspectively, how their attitude may have affected the provision of quality services, and to enhance the provision of sensitive non-discriminative services to female sex workers.

Objective: To review HIV/AIDS-related stigma-reduction interventions for professionals and students from health-related disciplines. Methods: A scoping review was conducted to identify the key char...

Background In China, the prevalence of exclusive breastfeeding at 6 months was only 20.8%. In promoting breastfeeding for newborns, a number of strategies have been initiated by Chinese government. These actions facilitated a high breastfeeding initiation of 77 to 99.9% in different regions. However, the exclusive breastfeeding rates remained low at 6 months resulting from a high rate of perceived insufficient breast milk and complementary feeding during the early days after childbirth. The aim of this study was to understand the experiences of women in Shenzhen with regard to breastfeeding in the first 6 weeks after giving birth, to identify the facilitators and barriers impacting their breastfeeding decisions and to identify their perceived support needs that might facilitate breastfeeding in the future. Methods This was a qualitative exploratory study. Data were collected in November 2018 through semi-structured, face-to-face, in-depth interviews. A purposive sample of early postpartum women was recruited from a postpartum clinic of a tertiary maternal hospital in Shenzhen, China. The dataset was analysed using inductive content analysis. Results A total of 22women were interviewed within the first 6 weeks after delivery. Three themes related to breastfeeding were identified from the transcribed interviews: “breastfeeding facilitators,” “breastfeeding barriers,” and “recommendations for breastfeeding promotion.” Conclusions Women experienced both joy and suffering in their journey of breastfeeding. Insufficient knowledge of breastfeeding, discomfort, intergenerational disagreements regarding nutritional supplements, and a lack of professional support contributed to difficulties and the threat of discontinuation. A supportive environment for breastfeeding is crucial for women’s decision on exclusive breastfeeding and the psychological wellbeing of breastfeeding women. Interventions that target to promote exclusive breastfeeding should include both new mothers and significant family members. Future studies could test the effectiveness of breastfeeding training for home visit nurses to promote exclusive breastfeeding in the early postpartum.

Objective: This survey examined and compared the disaster perception and preparedness of 2421 residents with and without chronic disease in Shenzhen, China. Methods: The participants were recruited and were asked to complete a survey in 2018. Results: Three types of disasters considered most likely to happen in Shenzhen were: typhoons (73.5% vs 74.9%), major transport accidents (61.5% vs 64.7%), and major fires (60.8% vs 63.0%). Only 5.9% and 5% of them, respectively, considered infectious diseases pandemics to be likely. There were significant differences between those with and without chronic disease in disaster preparedness, only a small percentage could be considered to have prepared for disaster (20.7% vs 14.5%). Logistic regression analyses showed that those aged 65 or older (odds ratio [OR] = 2.76), who had attained a Master’s degree or higher (OR = 2.0), and with chronic disease (OR = 1.38) were more prepared for disasters. Conclusions: Although participants with chronic disease were better prepared than those without, overall, Shenzhen residents were inadequately prepared for disasters and in need of public education.

Case-control survey.To explore intrapersonal factors associated with decision of patients with degenerative back pain for surgery.From September 2018 to May 2019 patients were invited to complete a questionnaire. Patients who decided on (case) and declined surgery (control) were later confirmed from medical records.Seventy-five patients were recruited. Male patients (75.0%, p = 0.019), those who were married (78.7%, p = 0.0045), and had spousal care-givers (89.2%, p 0.0001) were more likely to decide for surgery. All patients who decided on surgery expressed need for information on "the severity of their spine conditions" (p = 0.039). Those who decided on surgery did not have as the high expectation on "to sleep more comfortably" as those who declined (4.71 vs. 4.91, p = 0.022). The predictive factors for surgery decision by logistic regression analysis were: male gender (OR = 3.23, 95% CI: 1.19-8.77, p = 0.021); married (OR = 5.231, 95% CI: 1.87-14.61, p = 0.002); with available spousal care-giver (OR = 1.85, 95% CI: 0.198-3.89, p = 0.031); and those who preferred to treat/cure the spine disorder by pharmacological treatment (OR = 2.77, 95% CI: 1.02-7.50, p = 0.045).Patients who decided on surgery were likely to indicate need of medical information related to their condition. Patients were in hope of better relief of physical symptoms, especially related to sleep comfort. Patients would escalate their treatment from conservative to surgery when conservative treatments were no longer effective.

Aim To summarize evidence on the poststroke coping experiences of stroke patients and spousal caregivers living at home in the community. Design A scoping review. Methods Extensive searches were conducted in credible databases. Articles published in the English language were retrieved. Data were extracted based on study location, aims, study design, sample size, time after stroke and key findings. Results Out of 53 identified articles, 17 studies were included in the review. Five key themes were as follows: (a) emotional challenges; (b) role conflicts; (c) lack of strategies in coping; (d) decreased life satisfaction of the couples; and (e) marriage relationship: at a point of change. Couples were not sufficiently prepared to cope and manage with stroke at home on discharge from the hospital. This review emphasized the need for hospitals to implement policies to address the inadequate preparation of couples in coping with stroke.

Objective:The term disaster resilience has not been well defined. The purpose of this article is to scrutinize the concept of disaster resilience in rescue workers.Methods:A systematic search was conducted of the PsychInfo, PubMed, ISI Web of Science, MEDLINE, CINAHL, Embase, and Scopus databases using the key terms. The framework from Walker and Avant was used to analyze the concept of disaster resilience.Results:A total of 26 papers was included in this analysis. The attributes of disaster resilience have been identified from the literature as including personality, perceived control, self-efficacy, coping strategies, and social support. The antecedents of disaster resilience are disastrous events and preparedness for disaster. The consequences of disaster resilience are psychological well-being, posttraumatic growth, and enhanced work engagement.Conclusion:This concept analysis presents a definition of the concept of disaster resilience that could contribute to the development of a standardized screening or assessment tool and tailored training programs to strengthen disaster resilience among those who are willing to be deployed to engage in disaster rescue work and those who have been involved in such work.

This is a cross-sectional study with the objective to examine the relationships between infertility-related stress, family sense of coherence and quality of life of Chinese couples with infertility in Hong Kong. A convenience sample of 135 Chinese couples were recruited at the subfertility clinics of the Family Planning Association of Hong Kong. Data were collected using the Fertility Problem Inventory, Family Sense of Coherence Scale and Fertility Quality of Life. Path analysis was used for data analysis. The results showed that infertility-related stress had a negative association with the quality of life of infertile couples and family sense of coherence mediated the effect of infertility-related stress on quality of life for both partners. The infertility-related stress of women had a negative association with their husbands' quality of life. Infertile women had more infertility-related stress and a lower quality of life than their husbands. The findings provide new insights into the importance of family sense of coherence in facilitating couples' adjustment to infertility. Culturally competent heath care interventions should be developed to strengthen family sense of coherence among Chinese couples with infertility and help them reduce their infertility-related stress, thus improving their quality of life.

Most studies conducted in the West on the role played by intergenerational families in co-parenting have focused mostly on families with a single mother or those in difficult circumstances, while little is known about the experiences of members of intergenerational intact families during the early postpartum period. This study aimed to explore the intergenerational co-parenting experiences of young parents and grandmothers in China, focusing on how they shared the responsibility of caring for the new mother and infant during the postpartum period. A total of 16 eligible intergenerational intact families, including 16 mothers, 15 fathers and 12 grandmothers, were interviewed. The data set was analysed using the approach of directed content analysis guided by Feinberg's Ecological Model of Co-parenting. The data were categorized into four themes: 'division of labour', 'postpartum and infant care agreement', 'support-undermining' and 'joint family management'. An additional theme, 'expressed a need for family support', emerged from the data on these intergenerational families. The findings emphasize the importance of intergenerational co-parenting relationships in families where two generations co-parent the newborn together.

Diaphragmatic breathing, a deep breathing technique, has been reported to improve autonomic function by reducing sympathetic activity and increasing baroreflex sensitivity. This literature review aimed to (1) examine the effects of diaphragmatic breathing on physiological and psychological measures in prehypertensive or hypertensive adults and to (2) determine the appropriate length, frequency, and duration of an effective diaphragmatic breathing exercise in the management of prehypertension and hypertension. Relevant studies were searched using electronic databases, and 13 studies that met the inclusion criteria were included. The synthesis of the findings revealed that voluntary diaphragmatic deep breathing resulted in decreased of systolic and diastolic blood pressures, reduced heart rate, a relaxing effect, and reduced anxiety in hypertensive or prehypertensive individuals. It is concluded that voluntary diaphragmatic breathing at10 or 6 breaths per minute for 10 min twice a day for 4 weeks was effective in producing positive outcomes. The results of this review provide directions for related interventions and future research.

The aim in this literature review was (1) to explore the physiologically and psychologically therapeutic benefits of forest bathing on adults suffering from pre-hypertension or hypertension, and (2) to identify the type, duration, and frequency of an effective forest bathing intervention in the management of pre-hypertension and hypertension, so as to provide directions for future interventions or research. The electronic databases PubMed, Cochrane Library, CINAHL, PsyINFO, and the China Academic Journals (CAJ) offered through the Full-text Database (CNKI) were searched for relevant studies published from the inception of the databases to April 2019. Of the 364 articles that were identified, 14 met the criteria for inclusion in this review. The synthesis of the findings in the included studies revealed that forest bathing interventions were effective at reducing blood pressure, lowering pulse rate, increasing the power of heart rate variability (HRV), improving cardiac-pulmonary parameters, and metabolic function, inducing a positive mood, reducing anxiety levels, and improving the quality of life of pre-hypertensive or hypertensive participants. Forest walking and forest therapy programs were the two most effective forest bathing interventions. Studies reported that practicing a single forest walking or forest therapy program can produce short-term physiological and psychological benefits. It is concluded that forest bathing, particularly forest walking and therapy, has physiologically and psychologically relaxing effects on middle-aged and elderly people with pre-hypertension and hypertension.

Background The increasing frequency and magnitude of disasters call for enhancing the preparation of nurses with advanced knowledge and skills in disaster management. Objectives With the release in December 2019 of the updated version 2.0 of the ICN's Core Competencies in Disaster Nursing (ICN CCDN V2.0), the aims of this study were to examine the extent to which the selected disaster nursing postgraduate program curriculum and the dissertation projects address the updated core competencies and to determine whether the syllabus requires revision. Methods A data mapping analysis approach was used to review the syllabus of the studied program for coverage of the ICN V2.0 core competencies for general professional (Level I) and advanced/specialized nurses (Level II). The dissertation projects of the students were also included in the mapping analysis. Results It found that 83% of the core competencies were addressed at Level I for general professional nurses and 69% at Level II for advanced/specialized nurses in the curriculum. Out of the 35 core competencies at Level I under the eight domains, six items (17.1%) were not covered under the domains of Intervention and Recovery. Out of the 32 core competencies at Level II, ten items (31.3%) were not covered under the domains of Communication, Incident Management, Safety and Security, Assessment, Intervention, and Law and Ethics. Students' dissertations could complement some of the competencies not covered in the syllabus. Conclusions The studied curriculum covered the majority of the core competencies proposed by ICN CCDN V2.0, but subjects were required to be revised to address the competencies missing from the syllabus. Moreover, it is critically important for educators to review their curriculum to prepare nurses for disasters, to ensure that they are equipped with the competencies required to meet the demands arising from the increasingly frequent occurrences of global disaster.

Background: The aim of this cross-sectional study was to assess the dementia literacy of community-dwelling adults in four cities (Hong Kong, Guangzhou, Macau, and Zhuhai) of the Greater Bay Area of China, and to determine their mass media preferences for receiving dementia information. Methods: The survey was completed by 787 community-dwelling adults. Dementia literacy was indirectly measured using two validated scales—the 30-item Alzheimer’s Disease Knowledge Scale and the 20-item Dementia Attitude Scale (DAS). Participants were also asked to indicate whether they wanted to receive dementia information via digital or traditional media. Chi-square tests, logistic regressions, and MANOVA analyses were conducted. Results: Unemployed or retired people had poor attitudes towards dementia and lower levels of knowledge about dementia. Single, cohabiting, or divorced people in Hong Kong and Macau had lower DAS scores than married people. Young people and those with a secondary education preferred to get their dementia information from social media. People with a tertiary education and employed people enjoyed searching government or hospital websites for information. Middle-aged, unemployed, or retired people tended to learn about dementia from television or radio. Conclusion: It is worth educating the public about dementia and developing strategies consistent with their preferences for types of mass media.

Background: There were inconsistent results in the relationship between poor sleep quality and obesity among different population in previous studies. Our study evaluated the association between sleep quality and obesity in a representative adult population of Chinese subjects living in the Macao Special Administrative Region, China. Methods: This cross-sectional study was an analysis of 1426 participants aged 18 to 90 years from a community-based health needs assessment study titled “Healthy Living, Longer Lives”. Recruitment was conducted in seven districts of Macao from 2017 to 2018. Stratified sampling by age and gender strata was adopted. The Chinese version of Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality. Higher score of PSQI indicates worse sleep quality. Height, weight, and other covariates were collected by self-administered questionnaire. Obesity was defined as body mass index (BMI) ≥ 25 kg/m 2 according to the WHO standard. Results: Of all participants, 263 (18.4%) were obese and 285 (20.0%) were overweight. The average BMI and global score of PSQI were 22.9±3.0 kg/m 2 and 4.48±2.58 for men, 22.1±3.3 kg/m 2 and 5.05±2.92 for women, respectively. After adjustment of age, sex, income, marital status, education, smoking, and drinking, a significant negative relationship was found between sleep quality and BMI: higher PSQI global score was associated with higher BMI (β = 0.09, 95% CI: 0.03 - 0.15; P < 0.01). Within the 7 domains of PSQI, higher sleep disturbance score (β = 0.63, 95% CI: 0.34 - 0.93) and daytime dysfunction score (β = 0.41, 95% CI: 0.13 - 0.68) predicted higher BMI (both P < 0.01). The poor sleep status (global PSQI score > 5) was associated with 39.2% greater odds of being obese (95% CI: 1.04-1.87; P < 0.05). Conclusions: In a population of young to older adult Macao residents, we found an inverse linear association between sleep quality and BMI. People with sleep disturbance and daytime dysfunction were more likely to be fat. Poor sleep quality was strongly associated with greater obesity.

Introduction The nine‐item Patient Health Questionnaire (PHQ‐9) is widely used to determine the severity of depression in adult populations, but its psychometric properties with regard to adolescents has been poorly explored. The present study aims to identify the factor structure and examine the measurement invariance of this instrument across genders and age groups in a Chinese adolescent sample. Methods A large sample of Chinese schoolchildren completed the PHQ‐9 in a cross‐sectional survey in Hong Kong (N = 10 933). A confirmatory factor analysis (CFA) to test the factor structure and a multiple group CFA to test the gender and age invariances of the PHQ‐9 in adolescents were conducted. Cronbach alpha was used to assess the reliability of the questionnaire, and Pearson correlations with anxiety, self‐esteem, and perceived control were used to assess its construct validity. Results The CFA results indicate that a one‐factor model with three pairs of item correlations fitted the PHQ‐9 data well, and measurement invariances by age and gender were supported. The PHQ‐9 also possesses adequate internal consistency (>.84) and is strongly correlated with anxiety (>.77), self‐esteem (

With the increasing involvement of women in the workforce, the involvement of grandparents in infant care is a phenomenon that is climbing worldwide. Studies on intergenerational co-parenting are still in their infancy, and no consensus has been reached on the concept.The aim here is to explore the antecedents, attributes, and consequences of intergenerational co-parenting and clarify the concept of intergenerational co-parenting specifically during the postpartum period.The Rodgers' evolutionary framework (2000) for concept analysis was adopted to guide the process of developing, clarifying, and refining the concept of "intergenerational co-parenting."A total of 14 original articles on intergenerational co-parenting covering the postpartum period were included. Six attributes were identified from the literature: division of labor on infant care between parents and grandparents, generational boundaries, intergenerational transmission, reciprocal support between parents and grandparents in infant care, commitment on parenting decisions between parents and grandparents, and intergenerational communication. Sharing the responsibility of childrearing with grandparents, the development stage of the family, family structure, and cultural origins were antecedents of intergenerational co-parenting that emerged from the literature. The consequences of intergenerational co-parenting included the mother's parenting self-efficacy, the psychological health of both the grandparents and parents, the co-parenting relationship between the couple, and the intergenerational relationship.Based on the identified antecedents, attributes, and consequences of intergenerational co-parenting, and a definition of the concept of intergenerational co-parenting during the postpartum period of first-time parents, a conceptual framework was proposed. The conceptual framework will serve as a platform for developing a supportive program for intergenerational co-parenting in the postpartum period and for related research. To improve the intergenerational co-parenting relationship, postpartum interventions should involve both generations who are involved in infant care. In addition, the components of division of labor, generational boundaries, mutual support between the generations on infant care, the commitment on parenting decision-making within two generations, and skills of intergenerational communication should be considered in intergenerational co-parenting interventions.

To explore the infertility-related sexual and relationship concerns, sexual satisfaction and perceived intimacy of infertile couples.Infertility is known to affect the psychosocial well-being of couples. Fertility treatment and the scheduled regime of sexual activities places further pressure on infertile couples.This was a cross-sectional study. Infertile couples who attended fertility clinics for treatment between November 2015 and March 2016 were invited. A total of 113 pairs of infertile women and men participated in the study as couples.A significantly higher proportion of women than men reported that their partner did not understand how the problem of fertility affected them and had worries that they were drifting apart in their relationship. Significantly more men than women considered their sex life to be lacking in quality. In terms of perceived intimacy, more women than men reported that they had disclosed their feelings and negative emotions to their partner. The correlation analysis revealed significant positive correlations between sexual (dis)satisfaction and infertility-related sexual and relationship concerns in couples.The results show that infertile couples suffer from infertility-related sexual and relationship concerns. An intervention study should be conducted to help these couples overcome such concerns.

Background A diagnosis of cancer and its treatment affect couples as a unit, and they must cope and give each other mutual support as dyads. Few studies have focused explicitly on understanding mutual support among couples coping with colorectal cancer (CRC). Objective The aim of this study was to explore the mutual support of couples in their journey of coping together with CRC. Methods This is a qualitative descriptive study with purposeful sampling. A total of 11 couples in which 1 partner has been diagnosed with CRC were recruited for in-depth interviews. Results Three themes and 8 subthemes emerged from a conventional content analysis. The 3 themes were mutual support and reciprocity, challenges confronted in the provision of support, and experiencing adjustments/outcomes. Conclusion The findings of this study provide insights to healthcare professionals on the process by which couples coping with CRC give each other mutual support and the related challenges. This will aid in the development of an intervention program to support such couples, through enhancing their mutual support, overcoming challenges, and improving their adjustment/outcomes. Implications for practice Healthcare professionals need to (1) include the spouse of the cancer patients in their care and provide them with support, (2) encourage the couples to share their concerns with each other, (3) encourage spousal caregivers to take good care of themselves while providing support to their loved ones with CRC, and (4) develop a couple-based intervention program in providing support to couples coping with cancer as dyads.

When a disaster strikes, rescue workers are deployed to the disaster site to provide immediate rescue support to victims. Given the unpredictable and overwhelming nature of disasters, rescue workers are at risk of suffering from negative psychological consequences. The goal of this review is to explore the psychological impact of a disaster on rescue workers. In this paper, a total of 55 articles – one qualitative study, 53 quantitative studies, and one mixed-methods study – were eligible for inclusion. The rescue workers identified in the literature included fire fighters, police officers, military personnel/soldiers, healthcare professionals, and volunteers. The literature revealed that these rescue workers who were deployed to disaster sites might suffer from acute stress disorder (ASD), anxiety and depression, post-traumatic stress disorder (PTSD), and other psychological disorders. Generally, of all rescuers and nurses among the healthcare professionals, the unaffiliated volunteers were most susceptible to negative psychological consequences. The findings of this review indicated that rescue workers are at a high risk of experiencing psychological problems after a disaster deployment. Interventions are needed to mitigate negative psychological consequences and foster resilience in rescue workers.

This is a feasibility study to examine the effects of a partnership and coping enhancement program (PCEP) on improving the psychological well-being and marital functions of couples undergoing in vitro fertilization treatment. A total of 100 couples were recruited consecutively and assigned to a PCEP intervention group or a routine care control group. The couples in the PCEP group received an additional face-to-face, couple-based, 90-minute session on enhancing partnership and coping on the day of the embryo transfer (ET). The outcome measures were assessed at baseline (T0), 10 days after the ET (T1), and one month after the ET (T2). The level of anxiety of the women was lower in the intervention than in the control group at T1. Significant improvements in partnership and dyadic coping were seen in women at T2. The men of infertile couples reported a significant improvement in the scores for partnership at T2. The PCEP had no significant effects on marital satisfaction and marital adjustment for both the females and males of the infertile couples. The findings indicated that the PCEP is feasible and acceptable. Before a larger simple-size randomized controlled trial with participants drawn from multiple reproductive medical centers is conducted to further confirm its effectiveness.

Background: The purpose of this review was to explore the uptake of the human papillomavirus (HPV) vaccination, its associated factors, and the facilitators of and barriers to HPV vaccination among adolescents. Methods: A comprehensive literature search was conducted through 5 electronic databases, including PubMed, CINAHL, Cochrane Library, Medline, and PsycInfo from January 2006 to March 2015 for studies examining the uptake, awareness, knowledge, acceptability, and intention of adolescents with regard to HPV vaccination. Results: Twenty-eight studies were identified and included. The HPV vaccination uptake rate (at least 1 dose) varied significantly among countries, ranging from 2.4% to 94.4%. Scotland achieved the highest uptake of all the studies included in this review, while Hong Kong had the lowest, at 2.4% to 9.1%. This review also showed that adolescents had limited awareness and knowledge of HPV infections and vaccines, even 10 years after the vaccine had become available. Conclusions: It is recommended that barriers to the uptake of the vaccine should be addressed, and that school-based sexual health education of HPV infection and vaccine promotion should be reinforced.

Background The aim of this study is to examine knowledge and attitude as facilitators and barriers to the acceptance of HPV vaccination for adolescent girls by mothers and adolescent girls. Methods A cross-sectional survey conducted in Hong Kong in January 2010. Adolescent girls aged 12–18, together with their mothers, were recruited to complete two separate questionnaires with similar questions. Results A total of 170 mother–adolescent girl dyads were recruited. When the daughters and mothers were compared, the mothers were found to be more aware of “the risk of becoming infected with HPV through early sexual intercourse,” while more daughters than mothers knew that “the HPV virus cannot be cured with antibiotics.” Significantly more daughters perceived that they had a “chance of being infected with HPV and getting cervical cancer without the vaccine,” while more mothers were concerned that “vaccinating for HPV will cause a girl to be stigmatized as promiscuous” and thought that their “adolescent daughters are too young to receive the HPV vaccine.” The major predictive factor for the acceptance of the HPV vaccine among mothers was “The HPV vaccine is safe” (OR = 10.126, 95% CI 2.47–41.54). Among daughters who accepted the vaccine, the predictive factor was “The HPV vaccine can prevent most HPV infections” (OR = 6.274, 95% CI 1.93–20.42). Conclusions The findings provide healthcare professionals with a better understanding of the differences between mothers and adolescent girls in knowledge, attitude, and potential factors associated with acceptance of the HPV vaccine. Health professionals should promote the early prevention of HPV infection and eliminate the stigma surrounding HPV vaccination to increase its acceptance. The government should provide financial support for adolescent girls to receive the vaccination in school.

The legal status of sex workers is correlated with their occupational health and safety. However, there is little consensus on the ideal legal framework for prostitution. Obtaining a good understanding of the opinions of different stakeholders will provide policymakers, health care professionals, and social workers with the necessary information to make decisions on how to protect the health and safety of sex workers and to propose laws on prostitution. This is a review of the literature on the attitudes of different stakeholders towards sex workers. A search of the literature identified a total of 49 studies that could ultimately be included in this review. The studies explored the attitudes towards prostitution among law enforcement officers, professionals in health and social services, clients of sex workers, the general public, and other multiple stakeholders. There was a lack of consensus among these stakeholders on accepting sex workers, and not everyone supported the decriminalization or legalization of prostitution in their countries. Although the debate over the legal status of prostitution seems unlikely to end in the foreseeable future, the findings of this review provide some indications that interventions among different professional groups are needed to improve the health and safety of sex workers.

AimIt is the aim of this study to explore the characteristics of influential peers identified by schoolmates, and the mechanism by which they exert their influence on their peers.BackgroundAdolescent crowds are a salient influence on the health-risk behaviors of peers, contributing to adolescent substance use such as drinking alcohol, smoking cigarettes, and taking drugs.MethodsA mixed method study. Three schools granted us access to students and those who had been nominated as influential by their peers. The students were asked to nominate and indicated the characteristics of peers whom they considered influential in a quantitative study. Those peers whom they considered influential were invited to take part in focus group interviews. A total of six focus group interviews were conducted, comprised of two groups from each school, with an average of seven participants in each group.FindingsStudents considered caring and friendliness (91.0%), being a buddy (88.5%), and entertaining/humor (86.8%) as the top three characteristics of influential peers. The interviews revealed that the students believed that they are influential because of their cheerfulness and humor, considerateness, ability to communicate, popularity and sociability, sincerity and trustworthiness, and because they possess the characteristics of a leader. They also believed that their power to influence came about through their helpfulness, accommodation, and the closeness of their relationships. Their influence was manifested in both positive and negative ways on the academic pursuits and health-risk behaviors of their peers. In order to engage at-risk students in health promotion programs, it is important to identify their influential peers, and to understand how adolescent friends may help one another to resist behaviors that pose a risk to their health.

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.

Study design A literature review. Objectives To identify the factors and concerns that influence the decision of patients to undergo spinal surgery. Methods Electronic databases MEDLINE, PsycINFO, CINAHL plus, and Embase were searched for relevant studies published from 2000 to 2015. The keywords for the search included: spine surgery OR spinal stenosis AND decision making OR consideration OR preference OR willingness OR concern. Seven quantitative studies met the criteria for inclusion and were included in this review. Results The findings showed that patients were more likely to decide on surgery when they were suffering from severe bodily pain, poor physical function, poor psychosocial health and a higher level of functional disability. Concerns that affected the patients' decision on whether or not to opt for surgery were: the benefits weighed against the perceived risks of different modalities of treatment, the effectiveness of medical treatments, their level of satisfaction with their symptoms and a preference for autonomy or a reliance on the opinion of medical professionals. The findings relating to patient characteristics and preference for surgery were inconsistent. Conclusion Patients go through a complex and a multi-factorial process in making the decision whether or not to undergo surgery, which calls for decision support interventions that will help them to make the decision.