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Aim: To examine Chinese women's satisfaction with and the perceived effect of childbirth education class on their labour experience. Background: Attending childbirth education classes is a common activity for pregnant women. Nonetheless, evidence reveals that evaluation of the effects of childbirth education classes is inconsistent. Moreover, women's perceived effect of these classes has not been systematically examined. Methods: This two-phase study adopted a mixed-method design with Donadedian's model as the theoretical framework. In Phase One, a random sample of 40 Chinese women was invited to complete a questionnaire after attending a childbirth education class. The questionnaire was focused on their satisfaction with specific aspects of the class. Descriptive statistics were performed to summarize participants' response. In Phase Two, six of the original 40 women were purposively selected for a semi-structured interview pertaining to the perceived effect of the childbirth education class on their labour experience. Thematic analysis was conducted on the interview data. Findings: The participants expressed overall satisfaction with the class. The area that satisfied them the most was the performance of the midwife. The areas that satisfied them the least were the date, length, size and time of the class. Three themes emerged from the interview data, namely, 'learning about labour', 'contributing to a smooth labour process' and 'coping with uncertainty and handling anxiety. Conclusion: This study supports using a mixed-method approach to evaluate client education activity, and highlights the importance of cultivating positive coping measures among the Chinese women after attending childbirth education class when facing childbirth-related anxiety. [ABSTRACT FROM AUTHOR]

Aims. The aims of this study were to translate and evaluate the psychometric properties of the Chinese version of the Self-Control Schedule (C-SCS) in Chinese childbearing women. Background. The SCS was developed to measure learned resourcefulness, which facilitates people's coping under adversity. Promoting learned resourcefulness in childbearing women facilitates positive adaptation to motherhood, which is essential to both maternal and child health. Thus, a reliable and valid C-SCS is crucial for the development of interventions to promote learned resourcefulness in Chinese childbearing women. Design and methods. In phase one, the SCS was translated into Chinese using the technique of translation and back-translation and was reviewed by an expert panel for cultural equivalence. In phase two, psychometric testing of the C-SCS was conducted by using a convenience sample of 360 childbearing women recruited from an antenatal clinic of a regional hospital. Four instruments including the C-SCS, General Self-Efficacy Scale (GSE), Rosenberg's Self-Esteem Scale (RSES) and Edinburgh's Postnatal Depression Scale (EPDS) were administered to the participants. Ninety-two women participated in the four-week retest. Results. The C-SCS demonstrated good internal consistency (Cronbach's alpha = 0.83) and test-retest reliability (ICC = 0.91). Factor analysis revealed the presence of three factors supporting the conceptual dimension of the original instrument. Significant correlations with GSE (r = 0.48, p < 0.01), RSES (r = 0.41, p < 0.01) and EPDS (r = -0.46, p < 0.01) demonstrated good construct validity. Conclusion. The findings suggest that the C-SCS is a reliable and valid instrument for measuring learned resourcefulness in Chinese childbearing women. Relevance to clinical practice. The C-SCS provides midwives with a useful tool in the evaluation of interventions designed to strengthen Chinese women's learned resourcefulness and promote maternal well-being during childbearing. [ABSTRACT FROM AUTHOR]

This article addresses the dilemmas of elderly Chinese women as spousal caregivers in Hong Kong in the 1990s. An in-depth ethnographic approach was used to draw on a convenience sample of 20 elderly wives who were caregivers from Hong Kong. At the conceptual level, the discussion highlights how caregiving is rooted in complex, culturally-based models of contemporary practices, sociohistoric patterns, and gender-specific obligations. The key themes identified were marital duty-bound roles and responsibilities, reciprocity and burden, public guidelines and upholding reputations as Chinese wives, monetary restrictions, affection as an emotional force to sustain caregiving, effects of the caregiving role, and the creation of self-identity through caregiving. The model proposed for interpreting elderly Chinese wives' caregiving obligations highlights the tension-filled links between Confucianism and government guidelines, early and ongoing socializing experiences, and self-identity. [ABSTRACT FROM AUTHOR]

It is well recognized that individual health behavior is embedded in cultural patterns of exchange. This study sought to identify Chinese women's cultural beliefs and behaviors related 'doing the month' and suggest how these are modified in the light of contemporary realties and experiences within the context of rapid social change. Ethnographic interview data was gathered by means of a telephone interviews (postnatally) with 100 eligible primiparous women who had attended hospital based antenatal programmes.. The analysis highlighted a range of issues for these predominately middle class women which included special post partum dietary beliefs and behaviours including the avoidance of hot and cold food, the restorative powers of food, wind and water prohibitions, food proscriptions and prohibitions during breast feeding, the cultural imperative of timing and contemporary autonomy of women versus conforming to female centered kinship obligations. It is concluded that health professionals working with Chinese women need further awareness of the cultural significance of adherence to post natal practices and their fundamental links to the health status of post partum women, and family relationships. [ABSTRACT FROM AUTHOR]

BACKGROUND: Compared with other countries, Hong Kong has a relatively high rate of cervical cancer. Much of this morbidity should be avoidable with cervical screening, but uptake rates for screening in Hong Kong are low. In programmes to promote cervical screening attendance, it is essential that aspects of the socio-cultural system be taken into account to provide appropriate preventive health strategies. AIM: This paper outlines an investigation of the cultural and social factors contributing to Chinese women's attendance for cervical screening. METHOD: A mixed methods design was employed, combining and comparing two data sets. The initial data set was drawn from 10 focus groups involving both screened and unscreened Chinese women (n = 54). The second data set was drawn from a total population of Hong Kong doctors, and involved face-to-face semi-structured interviews (n = 28). RESULTS: Thematic analysis of the data from women indicated that the social factors of cost, educational base, knowledge of risk, the social value of early detection and cultural issues such as modesty and embarrassment contributed to screening attendance. The doctors perceived a cultural tendency towards fatalism, as well as seeing the gender, interpersonal and interprofessional skills of the practitioner to be important in influencing levels of Chinese women's shyness and discomfort, and hence affecting attendance. The lay and practitioner data sets varied in the perceptions of women's pain, embarrassment and risk factors. CONCLUSION: Programmes providing services for Chinese women need to ensure that the philosophy of the staff and the approach and materials used are culturally relevant. Recommendations are that nurses equipped with relevant social and cultural knowledge of population groups should have a central role in health promotion and screening services. [ABSTRACT FROM AUTHOR]

Aim of the Study. This was an exploratory descriptive study using mixed methodology to investigate Hong Kong Chinese women's perceptions of the effectiveness of antenatal education in their preparation for motherhood. Design. In the first phase, the structure and process of five antenatal classes on the topic of motherhood were observed using an observation guide. In the second phase 11 women who had attended the antenatal classes were interviewed in two focus groups, using a semi-structured interview guide. Findings. In respect to the structure of the classes women revealed that large class sizes and the didactic mode of teaching inhibited learning. While they were satisfied with the date and time of antenatal classes, and the information about self and baby care being provided, they felt unprepared for the demands of motherhood. Further themes identified from the analysis were: anticipating personal needs for antenatal preparation for motherhood, unrealistic preparation for breastfeeding problems, inadequate preparation for baby care, unfulfilled informational needs and conflicting advice from antenatal educators. Conclusion. The conclusion highlights Chinese culturally specific changes needed in the content and mode of antenatal education. In addition, recommendations are made for antenatal educators to work within a framework of adult Chinese learning styles in order to meet the educational needs of Chinese women. [ABSTRACT FROM AUTHOR]

This paper, based on a study carried out in Hong Kong, outlines the caregiving obligations of Hong Kong Chinese daughters towards their frail elderly parents. A cultural model approach drawn from cognitive anthropology is taken to focus on how Chinese caregiving daughters develop a sense of what is right and emotionally fulfilling and acquire the motivation to care for their parents. An ethnographic approach was used in the study and techniques included guided and open-ended interviews and non-participatory observations. A total of 20 co-residential caregiving daughters were interviewed in their homes on average twice over the course of one year. All interviews were conducted in Cantonese. Although the sample was small, daughters' accounts are structured by reference to cultural models and this structure provides the common basis for generalisability of results. Concepts of Confucian antecedents, reciprocity and personhood and other modern ideas of filial duty are explored. Conclusions are drawn about the shifting rights and obligations of Chinese caregiving daughters within the contemporary urban realities of Hong Kong. The findings of this study have relevance for the development of welfare policy for older Chinese persons and the chronically ill, and to all services involving women. The findings will also serve to inform family caregiver education programs. [ABSTRACT FROM AUTHOR]

AIM OF THE STUDY: The purpose of this exploratory study was to describe the type and nature of psychosocial nursing interventions provided for cardiac clients in Hong Kong's Community Rehabilitation Centres (CRNs). DESIGN/METHODS: Using a two-phase case study design data were collected from nurses, cardiac clients and their caregivers. The initial phase focused on identifying the types of psychosocial interventions provided. These data were obtained by observing nursing activities and the keeping of daily journals by the nurses. The second phase acquired data from structured telephone interviews, that reviewed clients' perceptions of the psychosocial interventions provided by the nurses and face-to-face interviews with clients and their caregivers. FINDINGS: These findings revealed that the nurses' interpersonal skills of information giving, social support and counselling were highly valued by cardiac clients and their caregivers. Both clients and caregivers outlined a concern about the lack of individual care and this was reflected in the focus of the CRN on group processes. CONCLUSION: Recommendations for psychosocial cardiac care are made for public health nurses and nurses working in community settings. [ABSTRACT FROM AUTHOR]

This study carried out in Hong Kong, identified 29 Chinese patients' perceptions of the importance of nursing care behaviours in an acute setting using a Chinese language translated version of the CARE-Q instrument. Patients ranked items concerned with 'giving the patients' treatments and medication on time' as the most important and 'sits down with the patient' as the least important. Comparisons are made with the results from other cultures and specific Chinese cultural interpretations are drawn to provide direction for nursing care of Chinese patients in Hong Kong and worldwide. [ABSTRACT FROM AUTHOR]

The validity of studies using translated instruments may be questioned when there is a lack of attention to and/or minimal explanation of the procedures used for determining the equivalence between the primary and secondary language tool. Ensuring equivalence of a translated Chinese version of the Menstrual Distress Questionnaire is an important prerequisite for identifying culturally specific expressions of concepts under investigation and for cross-cultural comparisons. This paper examines the principles and procedures for determining equivalence of translated tools and their application to the development of an equivalent Chinese version of the Menstrual Distress Questionnaire. Translation and back-translation were used to develop a Chinese version of the Menstrual Distress Questionnaire. Bilingual university students completed both versions of the Menstrual Distress Questionnaire. Most of the Menstrual Distress Questionnaire items had an acceptable Kappa of >0.4. Intraclass correlation coefficients indicated moderate to high levels of equivalence for total scores and all scales. Improvement in the translation of some items is needed to further enhance the equivalence of the Chinese version of the Menstrual Distress Questionnaire. [ABSTRACT FROM AUTHOR]

Tertiary education for nurses in Hong Kong is in its early development. With many overseas universities competing to secure Asian students, the need for locally developed programmes to meet Hong Kong's needs can be overlooked. In this survey 705 nurses with degree level qualifications working for the major public and private employing agencies completed a questionnaire designed to obtain details of postgraduate study plans and preferences for the type, focus and mode of postgraduate programmes. Analysis of responses showed 50% of the graduates surveyed intended to pursue further study in the next two years with a clear preference for course work masters, degree programmes (55%), studies with a specialist (71%) rather than a generalist focus, and programmes offered locally (85%) on a part-time basis (86%). Future educational needs were also found to vary according to gender, marital status, place of employment and nursing post. The findings from this survey have considerable implications for educational and professional nursing developments and planning to meet the future health care needs of Hong Kong. In addition, the information may inform the planning of other countries newly embarked on tertiary education for nurses. [ABSTRACT FROM AUTHOR]

An ethnographic approach was used to explore the cultural practices of Hong Kong Chinese women during the postpartum period. Seven multiparous women were interviewed and asked to reflect on their self-care practices within the family home during the month after the birth of their first child. Content analysis was applied to the interviews and major categories identified: good food and bad blood, poisonous sex, dirt and prohibitions, rest and appeasing the placenta god, and competing loyalties. The indication is that these Chinese mothers had attempted to follow their personally constructed interpretations of traditional customary practices, being influenced by close family members, neighbors, and historical precedent. These women further outlined a number of personal variations to traditional practices in the face of increasingly Western influences. We provide insights into the complexity of issues modern Hong Kong Chinese women face in the first postpartum month and on a more global level highlight the importance of culturally sensitive and congruent nursing practice. [ABSTRACT FROM AUTHOR]

Premenstrual syndrome (PMS) has been studied in many countries, but few studies have been reported internationally on the experience of Chinese women. Because culture and employment are important factors in the perception of health status, in this study we sought to determine the existence and features of PMS in Chinese clerical women in Hong Kong. We used a cross-sectional, retrospective approach to collect data with a translation of an established questionnaire (the Menstrual Distress Questionnaire). Fatigue was found to be the most prevalent symptom, and the Pain, Water Retention, Behavioral Change, and Negative Affect scales had more than 64% frequency. The main difference between these findings and those of other studies is that negative affect featured most prominently in Western samples, whereas pain featured most highly in this sample of Chinese women. [ABSTRACT FROM AUTHOR]

Presents letter to the editor on the statistics of the linear car following model.

Abstract Background Under the "two countries, one system" policy implemented by China to manage the return of Hong Kong's sovereignty, Hong Kong has maintained a comparatively prosperous economy within the Asian region. This has resulted in an environment which fosters migration from the mainland to Hong Kong, due largely to proximity, higher earning potential, common language, and a relaxing of border control measures. However not all mainland China citizens are equally able to access these new migration schemes and indeed a number of women such as sex workers are either migrating and/or working illegally and without occupational, legal and health protection within Hong Kong. Discussion Female migrant sex workers are exposed to a number of significant threats to their health, however their illegal status contributes to even greater vulnerability. The prevailing discourses which view these women as either "trafficked women" or as "illegal immigrants" do not adequately account for the complex situations which result in such women's employment in Hong Kong's sex industry. Rather, their position can best be understood within the broader frameworks provided by migration literature and the concept of "structural violence". This allows for a greater understanding of the socio-political issues which are systematically denying migrant sex workers adequate access to health care and other opportunities for social advancement. When these issues are taken into account, it becomes clear that the current relevant legislation regarding both immigration and sex work is perpetuating the marginalised and vulnerable status of migrant sex workers. Unless changes are made, structural barriers will remain in place which impede the ability of migrant sex workers to manage their own health needs and status. Conclusion Female migrant sex workers in Hong Kong are extremely vulnerable to a number of occupational health and safety hazards which have significantly detrimental effects on their health. These risks can best be understood within a broad framework of socio-political factors contributing to their vulnerability. Ensuring that migrant sex workers have adequate support for their health and legal rights requires require structural interventions such as decriminalisation and providing open and inclusive access to health service to counteract such factors.

Loneliness has become a significant public health issue among community-dwelling older adults particularly those with multimorbidity. Family caregivers are crucial care resources for dependent older adults living in the community before transitioning to institutional services. However, understanding of their perceptions in supporting older adults with multimorbidity to cope with loneliness is limited. This qualitative study aimed to elucidate on the experiences of caring and explore the experiences and perceptions of family caregivers in supporting older community-dwelling adults with multimorbidity to cope with loneliness. Eleven family caregivers, aged 51-93 years old, with at least 2 years of caregiving experience were purposively recruited and interviewed individually. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was utilised to report the study. Three key themes were generated from the inductive analysis: (1) recognising older adults' loneliness through the expression of unusual emotions, behaviour/s, social network alteration and speech; (2) variations in perceptions and responses to loneliness among different family caregiving relationships; and (3) challenges in addressing loneliness. Positive feedback from cared-for older adults was appreciated by their family caregivers which in turn motivated further actions to alleviate loneliness. The findings emphasised the importance of developing specific patients and family caregivers centred interventions, such as communication skills training to enhance effective communications. Cultural values and norms of individuals should be respected in those interventions, ensuring that emotional expression is facilitated in a comfortable way for both older patients and family caregivers., (© 2024 The Author(s). International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)

The health system in Aotearoa New Zealand is predicated on equity in access to health services as a fundamental objective yet barriers to equitable access for migrant and refugees continue to exist. There is a paucity of studies that synthesise the experiences and realities of migrants, refugees and healthcare providers that hinder access to healthcare and provide recommendations to improve services. This review synthesised these barriers and recommendations, with an aim to improve equitable access to healthcare to migrants and refugees. An integrative review of 13 peer-reviewed research studies from EBSCOhost research databases published between January 2016 and September 2022. Studies included: (i) related to Aotearoa; (ii) had a focus on equitable delivery of healthcare to migrants and refugees; and (iii) had a full English text available. The PRISMA framework guided the reporting of the review. The findings were thematically analysed and presented using a narrative empirical synthesis. The findings were organised into three broad themes: attitudinal barriers, structural barriers, and recommendations. Attitudinal barriers included the lack of culturally competent healthcare providers, discrimination by healthcare providers, and personal, social, and cultural attributes. Structural barriers referred to policies and frameworks that regulated the accessibility of health services such as the cost of healthcare, accessibility and acceptability of interpreter services, length of allocated appointments and long waiting times for an appointment, difficulties navigating the health system, and logistical barriers. Recommendations focused on promoting a sense of belonging, enabling a whole-of-society approach that brings together all sectors involved in providing health care for collective impact, and advocating for government policies to create a system that addresses the core health service access needs. This review provides rich context-specific findings on the barriers to equitable access to healthcare and proposed interventions to enhance equitable health outcomes for migrants and refugees in Aotearoa. The review contributes to relevant policy decisions and has practical implications to build responsive health systems which are inclusive, equitable and best address the health needs of populations from diverse cultural backgrounds., (© 2023. The Author(s).)

Background: The global population of women of menopausal age is quickly increasing. The COVID-19 pandemic has led to an accelerated increase in the use of telehealth services, especially technological solutions targeting women's health. Understanding the factors behind midlife women's help-seeking behaviors amidst the pandemic will assist in the development of person-centered holistic telehealth solutions targeting menopausal and postreproductive health., Objective: This study aimed to compare the factors underlying help-seeking for menopausal distress among midlife women in the United States and China., Methods: We conducted 2 web-based panel surveys in the United States using Amazon Mechanical Turk and in China using Credamo between July and October 2022. A total of 1002 American and 860 Chinese women aged between 40 and 65 years took part in the survey. The survey was designed based on the Health Belief Model with questions related to their menopausal knowledge, perceived severity of menopausal symptoms, perceived susceptibility to menopausal distress, perceived benefits of help-seeking, perceived COVID-19- and non-COVID-19-related barriers against help-seeking, self-efficacy, and motivation to seek help. Structural equations models were fitted for the data using full information maximum likelihood to manage missing data., Results: Knowledge was not directly related to help-seeking motivation in both samples. Among the Chinese sample, knowledge was negatively related to perceived severity but positively related to COVID-19-related barriers; in turn, higher perceived severity, benefits, COVID-19-related barriers, and self-efficacy and lower non-COVID-19-related barriers were related to more motivation to seek help. In the US sample, knowledge was negatively related to perceived severity, susceptibility, benefits, barriers (COVID-19- and non-COVID-19-related), and self-efficacy; in turn, higher self-efficacy, COVID-19-related barriers, and benefits were associated with more help-seeking motivation. The factors explained 53% and 45.3% of the variance of help-seeking motivation among the American and Chinese participants, respectively., Conclusions: This study revealed disparate pathways between knowledge, health beliefs, and the motivation for help-seeking among American and Chinese midlife women with respect to menopausal distress. Our findings show that knowledge may not directly influence help-seeking motivation. Instead, perceived benefits and self-efficacy consistently predicted help-seeking motivation. Interestingly, concern over COVID-19 infection was related to higher help-seeking motivation in both samples. Hence, our findings recommend the further development of telehealth services to (1) develop content beyond health education and symptom management that serves to enhance the perceived benefits of addressing women's multidimensional menopausal health needs, (2) facilitate patient-care provider communication with a focus on self-efficacy and a propensity to engage in help-seeking behaviors, and (3) target women who have greater midlife health concerns in the postpandemic era., (©Bobo Hi Po Lau, Catherine So Kum Tang, Eleanor Holroyd, William Chi Wai Wong. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 26.01.2024.)

Background: Antiretroviral therapy (ART) has played a crucial role in saving countless lives of patients with HIV/AIDS across the world. However, despite its effectiveness, ART adherence still falls short globally, and non-adherence remains the primary cause of treatment failure. In the rural areas of southern Thailand, where the population is predominantly conservative Muslims, there has been an observed increase in ART non-adherence., Objective: This study aimed to explore experiences of inconsistent ART adherence among Thai-Muslim patients with HIV/AIDS (PWHAs) in southern Thailand. In addition, the perspectives of healthcare providers were also sought., Methods: Data were collected by conducting semi-structured in-depth interviews with ten Thai-Muslim PWHAs and five healthcare providers at a Voluntary Counseling-and-Testing Clinic. A content analysis approach was utilized to analyze the data., Results: Inconsistent ART adherence was reported. Religion/spiritual imperatives, forgetfulness, inadequate knowledge (of drug side effects and drug regime), misunderstandings (about being symptom-free and feeling well), boredom from long-term drug-taking regimes, as well as poor transportation and lack of family support (arising from non-disclosure of one's HIV-serostatus due to HIV stigma) were emergent themes derived from the interviews with Thai-Muslim PWHAs. The healthcare providers' interview data revealed their need for the integration of Islamic beliefs to provide better care., Conclusion: It is essential for healthcare teams to work collaboratively with patients' religious beliefs to enhance ART adherence. Clinical nurses can contribute to the promotion of HIV-care services by integrating Islamic beliefs and Muslim culture into their practice, thus increasing patients' knowledge and motivation for ART adherence. This could entail utilizing Islamic prayer rituals as drug reminders, elaborating on Islamic moral beliefs concerning sickness and healing, and integrating the cultural imperatives of self-care in the Muslim community into ongoing care delivery. Cross-cultural nursing education and specialized training in HIV care should incorporate knowledge about Islamic and Muslim cultural beliefs., Competing Interests: None., (© The Author(s) 2023.)