Ho Cheung William Li

Effectiveness and appropriateness of therapeutic play intervention in preparing children for surgery: a randomized controlled trial study.

PURPOSE This paper aims to examine the effectiveness and appropriateness of using therapeutic play in preparing children for surgery. DESIGN/METHOD A randomized controlled trial was employed. Children (7-12 years of age; n = 203) admitted for surgery during a 13-month period were recruited. RESULTS The results support the effectiveness and appropriateness of using therapeutic play in preparing children for surgery. PRACTICE IMPLICATIONS The study results promote awareness in nurses and parents that play is a very important part of childrens lives, and heighten the importance of integrating therapeutic play as an essential component of holistic and quality nursing care to prepare children for surgery.

Relationships among Mental Health, Self-esteem and Physical Health in Chinese Adolescents An exploratory study

This study explored the relationships among mental health, self-esteem and physical health in Hong Kong Chinese adolescents. Chinese students (N = 1945) between the ages of 12 and 19 from four secondary schools of different regions were invited to participate in the study. This study revealed that a significant number of adolescents in Hong Kong are experiencing depressive symptoms. The overall results indicated that self-esteem of adolescents was correlated to and a predictor of their physical and mental health. Health care professionals should take a more assertive role in promoting relevant health education to the community with emphasis on helping adolescents develop positive self-esteem.

The impact of cancer on children's physical, emotional, and psychosocial well-being.

The diagnosis and treatment of cancer are a stressful and threatening experience, which can be emotionally devastating to children. Despite the improved prognosis, the course of cancer treatment has tremendous impact on children. This article aims to examine the impact of cancer on physical, emotional, and psychosocial well-being of Hong Kong Chinese children, an area of research that has been underrepresented in the literature. Ninety-eight Hong Kong Chinese children aged 7 to 15 years, admitted for treatment of cancer in 2 pediatric oncology units of 2 different hospitals, were invited to participate in the study. Findings from this study indicated that the children scored considerably high state anxiety on admission, and more than half of the participants presented some depressive symptoms during their stay in the hospital. Moreover, semistructured interviews indicated that nearly all children expressed different degrees of sadness and worry. The findings suggested that there is a room for improvement in existing nursing intervention regarding preparing children for hospitalization and treatment of cancer. There is an imperative need for nurses to evaluate appropriate nursing interventions that can help children resume their normal growth and development, in particular, to help them ease the physical, emotional, and psychological burden of life-threatening disease.

Center for Epidemiologic Studies Depression Scale for Children: psychometric testing of the Chinese version

AIM This paper is a report of psychometric testing of the Chinese version of the Center for Epidemiologic Studies Depression Scale for Children. BACKGROUND The availability of a valid and reliable instrument that accurately detects depressive symptoms in children is crucial before any psychological intervention can be appropriately planned and evaluated. There is no such an instrument for Chinese children. METHODS A test-retest, within-subjects design was used. A total of 313 primary school students between the ages of 8 and 12 years were invited to participate in the study in 2009. Participants were asked to respond to the Chinese version of the Center for Epidemiologic Studies Depression Scale for Children, short form of the State Anxiety Scale for Children and Rosenbergs Self-Esteem Scale. The internal consistency, content validity and construct validity and test-retest reliability of the Chinese version of the Center for Epidemiologic Studies Depression Scale for Children 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 detecting depressive symptoms of Chinese children aged between 8 and 12 years.

The Relationship Between Children's Locus of Control and Their Anticipatory Anxiety

OBJECTIVES This study investigated the relationship between childrens locus of control and their state anxiety scores, and determined whether childrens locus of control could predict their state anxiety scores before academic examinations. DESIGN A test-retest within subjects design was used. SAMPLE 519 school children were invited to participate in the study. MEASUREMENTS Participants were asked to respond to the Chinese version of the Nowicki-Strickland locus of control scale and state anxiety scale for children in stressful and nonstressful situations. The data were collected in 2005. RESULTS There were significant strong positive correlations between the state anxiety and locus of control scores in the period before academic examinations. Multiple regression analysis showed that the Nowicki-Strickland locus of control score was a good predictor of childrens state anxiety in a stressful situation. CONCLUSIONS This study supports the use of the Nowicki-Strickland locus of control scale as a screening tool to identify school children who are most likely to exhibit high levels of anxiety before academic examinations. Understanding childrens locus of control in advance is a necessary step toward designing appropriate interventions to reduce their stress and bolster their coping mechanisms.

Factorial structure of the Chinese version of the State Anxiety Scale for Children (short form)

AIM The present study aimed at examining the factorial structure of the Chinese version of the State Anxiety Scale (Short form), using exploratory and confirmatory analyses. BACKGROUND The factorial structure of the short form of the Chinese version of the State Anxiety Scale for Children has neither been examined by using exploratory factor analysis nor been examined by confirmatory factor analysis. Consequently, whether the factor structure of the short form is congruent with the hypothesised configuration of the factor structure of the full form cannot be confirmed. DESIGN Survey. METHOD A test-retest, within-subjects design was employed. Two hundred children (7-12 years of age) admitted for surgery in a day surgery unit was invited to participate in the study. They were asked to respond to the Chinese version of the State Anxiety Scale (short form) before surgery and upon discharge home. RESULTS The results of exploratory factor analysis showed that there are two factors underlying the short form, which is congruent with hypothesised configuration of the factor structure of the full form. Confirmatory factor analysis confirmed the construct validity, with a good fit between the factor structure of the short form and the observed data. CONCLUSION This study addressed a gap in the literature by examining the factorial structure of the short form. The results confirmed the factor structure of the short form is congruent with the hypothesised configuration of the factor structure of the full form. RELEVANCE TO CLINICAL PRACTICE The availability of a valid, reliable and convenient instrument is crucial in evaluating the effectiveness of nursing interventions. The findings also suggest that the short form is an objective assessment tool and can be used by clinical nurses as objective assessment tool in measuring anxiety level of Chinese children in busy clinical settings, where time constraints make the use of the full form unfeasible.

Herth hope index: psychometric testing of the Chinese version.

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 Rosenbergs 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.

A descriptive study of the psychosocial well-being and quality of life of childhood cancer survivors in Hong Kong

Background: Research indicates that increased survival rates are accompanied by an increase in associated psychosocial problems. Whereas much of the attention has focused on the physiological care of childhood cancer survivors, the consequences of cancer and its treatments on psychosocial well-being and quality of life remain relatively underexplored. Objective: The aim of this study was to describe the psychosocial well-being and quality of life of Hong Kong Chinese childhood cancer survivors. Methods: A cross-sectional study was used. A total of 137 childhood cancer survivors (9- to 16-year olds) who underwent medical follow-up in the outpatient clinic were invited to participate in the study. Results: A significant number of childhood cancer survivors had low self-esteem and experienced high levels of depression. The study also indicated that greater symptoms of depression in childhood cancer survivors were associated with higher state anxiety, lower self-esteem, and poor quality of life. Conclusions: Cancer and its treatments can have adverse effects on the psychosocial well-being and quality of life of survivors. Implications for Practice: It is essential for nurses to develop and evaluate interventions with the aim of promoting psychosocial well-being and quality of life for childhood cancer survivors. Knowing the self-esteem and coping behavior of survivors can help design appropriate and effective psychosocial interventions to promote their psychosocial well-being.

The impact of cancer and its treatment on physical activity levels and behavior in Hong Kong Chinese childhood cancer survivors

Background: Research indicates that regular physical activity is associated with numerous physiological and psychological health benefits for childhood cancer survivors. A review of the literature reveals that no study has so far examined the physical activity levels and behavior of Hong Kong Chinese childhood cancer survivors, and how the cancer and its treatment affect the physical activity and other behavior of these children remains unclear. Objective: The aims of this study were to assess the physical activity levels of Hong Kong Chinese childhood cancer survivors and to explore the factors that affect their adherence to and maintenance of regular physical activity. Methods: A cross-sectional study was used. A total of 128 childhood cancer survivors (9–16-year-olds) who underwent medical follow-up in the outpatient clinic were invited to participate in the study. Results: There was a significant decline in physical activity levels among childhood cancer survivors. Most of them did not take physical exercise regularly. Concern about academic performance, fatigue, and a decrease in physical strength and endurance after remission prevented them from engaging in regular physical activity. Conclusions: This study indicates that many childhood cancer survivors did not engage in regular physical activity and that they overlooked or underestimated its importance. Implications for Practice: It is essential for nurses to correct misconceptions about physical activity among childhood cancer survivors and their parents and, most importantly, to advocate the principle of regular physical activity for these children, with the aim of enhancing their physical and psychological well-being.

Coping behaviour checklist for Chinese children: development and psychometric testing

AIM This paper is a report of development and psychometric testing of the coping behaviour checklist for Chinese children. BACKGROUND An understanding of the coping behaviour of children is an essential prerequisite for the design of an appropriate psychological intervention to enhance childrens ability to cope with stressful medical procedures and hospitalization. Review of literature reveals that there is lack of child-sensitive measurement tools in the Chinese culture for assessing coping behaviours of children with good psychometric properties. METHODS An instrument development and validation study was conducted. Phase 1 was designed to develop a checklist of coping behaviour for Chinese children, while in phase 2 the psychometric properties of the new scale were tested. A total of 168 (phase 1) and 236 (phase 2) children between the ages of 7 and 12 years, were invited to participate in this study in 2008 and 2009, respectively; 228 completed both phases of data collection. RESULTS On the basis of the results of qualitative interview data, the coping behaviour checklist for Chinese children was developed. The newly developed scale had adequate internal consistency reliability and test-retest reliability, high content validity and appropriate construct validity. Confirmatory factor analysis further added evidence of the construct validity of the scale. CONCLUSION The instrument can be used to identify the coping behaviour of Hong Kong Chinese children aged between 7 and 12 years. Knowing the coping behaviour of children in advance can help nurses to shape and design appropriate psychological interventions that can help children better cope with stressful medical procedures and hospitalization.