K.C. Choi

Colorectal cancer screening behaviour and associated factors among Chinese aged 50 and above in Hong Kong – A population-based survey

PURPOSE This study reports the uptake rate of colorectal cancer screening among Chinese people aged 50 or above and the identified factors associated with the likelihood of undergoing such screening. METHODS A cross-sectional population-based telephone survey was conducted in Hong Kong during the period 2 to 28 May 2007. The survey covered demographics, perceived health status and susceptibility to cancer, utilisation of complementary medicine, family history of cancer and cancer screening behaviour. RESULTS The survey was completed by 2004 Hong Kong Chinese residents aged 50 or older (response rate = 66.6%). The uptake rate of a fecal occult blood test and a colonoscopy was 12% and 19% respectively. Factors associated with colorectal cancer screening behaviour included: male participants, ex-smokers, with cancer or other serious disease, a family history of cancer, perceived health status fair or poor, regular visits to a doctor to look after health, and utilisation of complementary medicine. CONCLUSIONS The uptake rate of this study population was low though an increasing trend did appear. Heath education and promotion programmes may focus on these identified factors to facilitate colorectal cancer screening in a Chinese population.

Associations of uric acid and gamma-glutamyltransferase (GGT) with obesity and components of metabolic syndrome in children and adolescents.

Associations between concentrations of uric acid and cardiovascular risk factors are known. The associations between gamma‐glutamyltransferase (GGT) levels and cardiovascular disease are also known. But no study has ever investigated the combined effects of both GGT and uric acid in cardiovascular risk factors in adolescents.

A feasibility study of a psychoeducational intervention program for gynecological cancer patients

PURPOSE OF THE RESEARCH This study aimed to test the feasibility of implementing a psychoeducational intervention program for gynecological cancer patients. METHODS AND SAMPLE A single-blinded randomized controlled trial and mixed-method design were used. Study subjects were newly diagnosed gynecological cancer patients with surgery as the first-line treatment. They were randomly assigned to the intervention group, in which a psychoeducational intervention program based on a thematic counseling model was offered, or to the attention control group. Quantitative data on sexual functioning, quality of life, uncertainty, anxiety, depression and social support were collected at recruitment, post-operative and during the in-hospital period, and eight weeks after the operation. Participants in the intervention group and three nurses working in the clinical setting were invited to have semi-structured interviews. KEY RESULTS Of the 30 eligible subjects, 26 were successfully recruited into the study. Following the psychoeducational intervention program, there was significant improvement in the level of inconsistent information about the illness within the category of uncertainty among participants in the intervention group. In addition, trends towards improvement were demonstrated in quality of life, uncertainty, depression and perceived social support with the provision of the interventions. Qualitative data indicated the interventions were desired and appreciated by the participants, as well as being feasible and practical to implement in Hong Kong clinical settings. CONCLUSIONS The findings suggest that it is feasible to deliver the psychoeducational intervention program and it may have beneficial effects in gynecological cancer patients. A full-scale study is warranted to confirm the results.

A Review of Psychoeducational Interventions to Improve Sexual Functioning, Quality of Life, and Psychological Outcomes in Gynecological Cancer Patients.

Background: Psychoeducational interventions are recommended for use with clinical gynecological cancer patients to improve their patient care outcomes. However, the evidence of their effectiveness is far from conclusive. Objective: The objective of this study was to identify the best available research evidence related to the effects of psychoeducational interventions on sexual functioning, quality of life, and psychological outcomes in gynecological cancer patients. Methods: A systematic search was conducted to identify English and Chinese articles from the inception of the databases to April 2012 and included 13 English databases and 7 Chinese databases. Gray literature or unpublished studies were also searched. Results: A total of 11 studies involving 975 gynecological cancer patients were included in the review. Meta-analysis results for 4 comparable studies indicated that psychoeducational interventions were effective in treating depressive symptoms among gynecological cancer patients (standardized mean difference = −0.80; 95% confidence interval, −1.05 to −0.54), whereas information provision significantly improved the mental aspect of quality of life (standardized mean difference = −0.41; 95% confidence interval, −0.74 to −0.08). With regard to sexual functioning, psychoeducational interventions appeared to have benefits in improving the sexual life of patients. Conclusions: Findings confirm the effectiveness of psychoeducational interventions on depressive symptoms and mental aspect of the quality of life in gynecological cancer patients. Implications for Practice: The authors discuss the implications of review findings for the effective design of psychoeducational interventions including components, provider, provision time frame, and duration for clinical practice, as well as psychoeducational intervention research.

Uptake of breast screening and associated factors among Hong Kong women aged ≥50 years: a population-based survey

OBJECTIVE To examine the uptake of breast screening and its associated factors among Hong Kong Chinese women aged ≥50 years. STUDY DESIGN Cross-sectional population-based survey. METHODS A sample of Hong Kong Chinese women was recruited through telephone random-digit dialling. The survey consisted of six sections: perceived health status, use of complementary medicine, uptake of breast screening, perceived susceptibility to cancer, family history of cancer and demographic data. The factors associated with uptake of breast screening were analysed using logistic regression analysis. RESULTS In total, 1002 women completed the (anonymous) telephone survey. The mean age was 63.5 (standard deviation 10.6) years. The uptake rate of breast screening among Hong Kong Chinese women aged ≥50 years was 34%. The primary reasons for undertaking breast screening were as part of a regular medical check-up (74%), prompted by local signs and symptoms (11%) and a physicians recommendation (7%). Higher educational level, married or cohabiting, family history of cancer, frequent use of complementary therapies, regular visits to a doctor or Chinese herbalist, and the recommendation of a health professional were all independently and significantly associated with increased odds of having had a mammogram. CONCLUSIONS This study provides community-based evidence of the need for public health policy to promote broader use of mammography services among this target population, with emphasis on the active involvement of health care professionals, through the development and implementation of appropriate evidence-based and resource-sensitive strategies.

Perceived unmet supportive care needs and determinants of quality of life among head and neck cancer survivors: a research protocol

AIM To describe a study protocol designed to explore the associations among the perceived unmet supportive care needs, quality of life and the demographic and clinical characteristics of head and neck cancer survivors. BACKGROUND The prognoses for people with head and neck cancer are improving with medical advances. However, studies have reported that such cancer survivors experience poor quality of life. Current studies mainly focus on Western populations and there is limited research investigating the needs of head and neck cancer survivors. DESIGN A mixed-design method is proposed, which will include two phases. Phase I will use a quantitative cross-sectional design and Phase II a qualitative descriptive approach. METHODS The participants will be recruited from the outpatient departments of three public hospitals in Hong Kong. In Phase I, a questionnaire will be used to collect demographic and clinical characteristics, supportive care needs, necessary access to various supportive services and quality of life. Semi-structured interviews will be conducted in Phase II. The study is supported by a grant from the Health and Health Services Research Fund, Hong Kong, September 2011. DISCUSSION The study will generate in-depth information on the needs of head and neck cancer survivors, to help healthcare professionals allocate resources better and develop new services, which can be more person-centred, to meet the needs of the these survivors.

Factors in the prioritization of information needs among Hong Kong Chinese breast cancer patients

Objective: The study aims to examine the prioritization of information needs in breast cancer patients, using the Information Needs Questionnaire (INQ); and to identify the demographic and clinical characteristics associated with that prioritization. Methods: A cross-sectional exploratory study was conducted, by means of consecutive sampling. The INQ was used to examine participants′ preferences on information needs. Their demographic and clinical characteristics were collected by means of a structured questionnaire and review of medical records. Backward multivariable logistic regression analysis was performed to examine the association between prioritization of patients′ information needs and their demographic and clinical characteristics. Results: A total of 275 breast cancer patients took part in the analysis. Of the nine INQ items, most participants ranked as their top four needs information about the likelihood of a cure (79%), extent of the disease (76%), treatment options (55%), and family risk of developing breast cancer (51%). Certain demographic and clinical characteristics-religious belief, whether living alone or not, household income, educational level, and time since cancer diagnosis-influenced patients′ prioritization of information needs. Conclusion: Understanding and meeting the information needs of breast cancer patients are crucial to improving their quality of care. Different patients are likely to have different priorities in information needs according to their demographic and clinical characteristics. An awareness of these associated factors will allow better tailor-made educational interventions to be provided to meet patients′ individual needs in a more adequate way.