Cecilia L. W. Chan

Association between sleeping hours, working hours and obesity in Hong Kong Chinese: the ‘better health for better Hong Kong’ health promotion campaign

Objective:To study the inter-relationships between sleeping hours, working hours and obesity in subjects from a working population.Research design:A cross-sectional observation study under the ‘Better Health for Better Hong Kong’ Campaign, which is a territory-wide health awareness and promotion program.Subjects:4793 subjects (2353 (49.1%) men and 2440 (50.9%) women). Their mean age (±s.d.) was 42.4±8.9 years (range 17–83 years, median 43.0 years). Subjects were randomly selected using computer-generated codes in accordance to the distribution of occupational groups in Hong Kong.Results:The mean daily sleeping time was 7.06±1.03 h (women vs men: 7.14±1.08 h vs 6.98±0.96 h, P<0.001). Increasing body mass index (BMI) was associated with reducing number of sleeping hours and increasing number of working hours reaching significance in the whole group as well as among male subjects. Those with short sleeping hour (6 h or less) and long working hours (>9 h) had the highest BMI and waist in both men and women. Based on multiple regression analysis with age, smoking, alcohol drinking, systolic and diastolic blood pressure, mean daily sleeping hours and working hours as independent variables, BMI was independently associated with age, systolic and diastolic blood pressure in women, whereas waist was associated with age, smoking and blood pressure. In men, blood pressure, sleeping hours and working hours were independently associated with BMI, whereas waist was independently associated with age, smoking, blood pressure, sleeping hours and working hours in men.Conclusion:Obesity is associated with reduced sleeping hours and long working hours in men among Hong Kong Chinese working population. Further studies are needed to investigate the underlying mechanisms of this relationship and its potential implication on prevention and management of obesity.

Optimism, positive affectivity, and salivary cortisol

OBJECTIVES Research on stress and salivary cortisol has focused almost exclusively on the effects of negative psychological conditions or emotional states. Little attention has been drawn to the impact associated with positive psychological conditions, which have been shown recently to have significant influences on neuroendocrine regulation. The aim of this study is to examine the impact of optimism and positive affect on salivary cortisol with the effects of their negative counterparts controlled for. DESIGN Optimism and pessimism, and positive and negative affectivity were studied in relation to the diurnal rhythm of salivary cortisol in a group of 80 Hong Kong Chinese, who provided six saliva samples over the course of a day on two consecutive days. The separate effects of optimism and positive affect on two dynamic components of cortisol secretion, awakening response, and diurnal decline were examined. METHODS Optimism and pessimism were measured using the Chinese version of the revised Life Orientation Test while generalized affects and mood states were assessed by the Chinese Affect Scale. An enzyme-linked immunoabsorbent assay kit (EIA) developed for use in saliva was adopted for the biochemical analysis of cortisol. Testing of major group differences associated with positive psychological conditions was carried out using two-way (group by saliva collection time) ANOVAs for repeated measures with negative psychological conditions and mood states as covariates. RESULTS Participants having higher optimism scores exhibited less cortisol secretion in the awakening period when the effect of pessimism and mood were controlled. This effect was more apparent in men than in women who had higher cortisol levels in the awakening period. Optimism did not have similar effect on cortisol levels during the underlying period of diurnal decline. On the other hand, higher generalized positive affect was associated with lower cortisol levels during the underlying period of diurnal decline after the effects of negative affect and mood states had been controlled. Generalized positive affect did not significantly influence cortisol secretion during the awakening period. CONCLUSIONS These findings suggest that positive psychological resources including optimism and generalized positive affect had higher impact on cortisol secretion than their negative counterparts, and point to the need for increased attention to the potential contribution of positive mental states to well-being.

Posttraumatic stress disorder symptoms among adult survivors of the 2008 Sichuan earthquake in China

This study examined the estimated prevalence rate of posttraumatic stress disorder (PTSD) symptoms and associated risk factors among Chinese adult survivors 7 to 8 months after the 2008 Sichuan earthquake. The sample was recruited from 2 areas close to the epicenter but of different distances. The estimated rate of PTSD symptoms was 55.6% and 26.4% respectively in the two areas. Loss of a child was a strong predictive factor for PTSD symptoms for the parents. Other predictive factors included female gender, loss of a parent, loss of friends or neighbors, residential house damage or collapse, and proximity to the epicenter. Effective and sustainable mental health services are needed and should be directed particularly to bereaved survivors.

The Measurement of Body-Mind-Spirit Well-Being: Toward Multidimensionality and Transcultural Applicability

Abstract The Body-Mind-Spirit model of health promotion (Chan, Ho, & Chow, 2002) guided the construction of a multidimensional inventory for assessing holistic health. Named Body-Mind-Spirit Well-Being Inventory (BMSWBI), it comprises four scales: Physical Distress, Daily Functioning, Affect, and Spirituality (differentiated from religiosity and conceived as ecumenical). Respondents (674 Chinese adults from Hong Kong) completed the BMSWBI via the Internet. Results indicate that all four scales have high reliability, with alpha coefficients ranging from .87 to .92, and concurrent validity. Factor analysis indicates that (a) positive and negative affect form two distinct factors, and (b) spirituality comprises three distinct aspects: tranquility, resistance to disorientation, and resilience. Spirituality is positively associated with mental well-being, positive affect, satisfaction with life, and hope; but negatively associated with negative affect and perceived stress. These results suggest that the inventory may be used to assess different dimensions of health satisfactorily.

Gender Selection in China: Its Meanings and Implications

With the advancement of assisted reproduction technologies, people are offered wider choices to choose the gender of their offspring and to construct ‘ideal-typed’ families with specific gender structure. Gender selection is welcomed by many societies with gender-specific preference, especially those patriarchal societies such as Chinese communities. It is not only a medical procedure but also a social orientation, which reveals much of the underlying preference towards gender. This paper explores the cultural dimensions to gender selection and its psychosocial meanings and implications in Chinese societies, especially after the establishment of One Child Policy in China. Problems associated with son preference in the culture with strong gender stereotyping are addressed. We believe that gender selection for social reasons should not be allowed since undesirable outcomes will be resulted under such strict population control program.

Symptoms of posttraumatic stress disorder and depression among bereaved and non-bereaved survivors following the 2008 Sichuan earthquake

Many studies have suggested that unexpected death of a loved one is an important risk factor of posttraumatic stress disorder (PTSD) and depression among disaster survivors, but few have examined the magnitude of psychiatric morbidities among bereaved survivors. This study examined the prevalence rates of clinically significant PTSD and depressive symptoms and their associated risk factors among Chinese adult survivors following the 2008 Sichuan earthquake. Two hundred and fifty-one bereaved adults were compared with 1474 non-bereaved adult survivors. The estimated rates of PTSD and depressive symptoms were 65.6% and 64.8% for those who lost first-degree family members, 34.1% and 45.5% for those who lost second-degree relatives, and 27.1% and 37.5% for non-bereaved survivors respectively. Loss of a child was a significant predictor of psychopathological symptoms. The results suggested that effective and sustainable mental health services were required, especially for bereaved single-child parents.

The Experience of Chinese Bereaved Persons: A Preliminary Study of Meaning Making and Continuing Bonds

ABSTRACT This study explores the bereavement process of Chinese persons in Hong Kong, with the focus on how they make meaning of the death as well as how they maintain a bond with the deceased. A review of video- and audiotapes of 52 bereaved persons in bereavement counseling pointed to how these concepts are reflected in key themes that appeared throughout these interviews. The way this bereaved population found meaning in the death was reflected in how they understood the cause of death, their observations at the death moment, their understanding of the life of the deceased after the death, the life of the bereaved after the death, and the burial and mourning rituals that were followed. The continuing bond the bereaved felt with the deceased was experienced by the bereaved as either initiated by the deceased, for example by the deceased appearing in dreams or initiated by the bereaved themselves in their talking with the deceased. These 2 aspects of the bereavement process seem to be similar to those found in other societies, but the ways in which they were manifested were unique to the Chinese culture. Based on these findings, the authors conclude with implications for intervention with this bereaved population.

A Randomized Controlled Trial of Qigong Exercise on Fatigue Symptoms, Functioning, and Telomerase Activity in Persons with Chronic Fatigue or Chronic Fatigue Syndrome

BackgroundChronic fatigue is common in the general population. Complementary therapies are often used by patients with chronic fatigue or chronic fatigue syndrome to manage their symptoms.PurposeThis study aimed to assess the effect of a 4-month qigong intervention program among patients with chronic fatigue or chronic fatigue syndrome.MethodsSixty-four participants were randomly assigned to either an intervention group or a wait list control group. Outcome measures included fatigue symptoms, physical functioning, mental functioning, and telomerase activity.ResultsFatigue symptoms and mental functioning were significantly improved in the qigong group compared to controls. Telomerase activity increased in the qigong group from 0.102 to 0.178 arbitrary units (p < 0.05). The change was statistically significant when compared to the control group (p < 0.05).ConclusionQigong exercise may be used as an alternative and complementary therapy or rehabilitative program for chronic fatigue and chronic fatigue syndrome.

A randomized controlled trial of psychosocial interventions using the psychophysiological framework for Chinese breast cancer patients.

Abstract This study aimed to investigate the psychophysiological outcomes of different psychosocial interventions for breast cancer patients. Participants were randomly assigned into 3 intervention groups, namely, Body-Mind-Spirit (BMS), Supportive-Expressive (SE), and Social Support Self-Help (SS) groups; a no-intervention group was used as control. Salivary cortisol was used as the physiological stress marker. Distress level, mental adjustment, emotional control, and social support were measured. Data were collected at baseline, 4 month, and 8 month. Preliminary results indicated that BMS intervention produced the greatest and the most sustained effects. It enhanced positive social support, reduced psychological distress, emotional control, and negative mental adjustment. Total salivary cortisol was lowered after 8 months. Most participants in SE groups indicated the treatment helpful, but changes in psychophysiological outcomes were not statistically significant. Participants in SS groups seemed less likely to benefit from the intervention. The no intervention control group indicated a reduction in social support. These outcomes suggest that active professional intervention is more likely to yield therapeutic effects. In particular, psychosocial intervention attending to the spiritual dimension contributes to positive outcomes.

The Protective Function of Meaning of Life on Life Satisfaction among Chinese Students in Australia and Hong Kong: A Cross-Cultural Comparative Study.

Objective: The authors compared the predictive effects of acculturative stressors and meaning of life on life satisfaction between Chinese students in Australia and in Hong Kong. Participants: In 2006, the researchers recruited 606 Chinese students studying abroad at the University of Melbourne in Australia and at 6 universities in Hong Kong. Methods: Participants completed a questionnaire that included measures of acculturative stressors, meaning of life, life satisfaction, and demographic information. Results: The Australian sample experienced a significantly higher level of acculturative stressors than did the Hong Kong sample, but life satisfaction did not differ significantly between the 2 samples. Meaning of life had a strong positive contribution and acculturative stressors had a negative contribution in predicting life satisfaction in both samples. Meaning of life partially mediated the relationship between acculturative stressors and life satisfaction in both samples. Conclusions: The authors discuss the theoretical and practical implications for Chinese students studying abroad.