Sophia Sc Chan

Three versions of Perceived Stress Scale: validation in a sample of Chinese cardiac patients who smoke

BackgroundSmoking causes heart disease, the major cause of death in China and Hong Kong. Stress is one major trigger of smoking and relapse, and understanding stress among smoking cardiac patients can therefore help in designing effective interventions to motivate them to quit. The objective of this study was to examine the psychometric properties of the Perceived Stress Scale (PSS), and to compare the appropriateness of the three versions of the scale (PSS-14, PSS-10, and PSS-4) among Chinese cardiac patients who were also smokers.MethodsFrom March 2002 to December 2004, 1860 cardiac patients who smoked were recruited at the cardiac outpatient clinics of ten acute hospitals in Hong Kong, and 1800 questionnaires were analysed. Participants completed a questionnaire including the PSS, nicotine dependence and certain demographic variables. The psychometric properties of the PSS were investigated: construct validity using confirmatory factor analysis, reliability using Cronbachs alpha and concurrent validity by examining the relationship with smoking- and health-related variables.ResultsFor all the three versions of the PSS, confirmatory factor analyses corroborated the 2-factor structure of the scale, with the positive and negative factors correlating significantly and negatively to a moderate extent (r < -0.5), and high Cronbachs alpha values for the two subscales (alpha > 0.5). All the correlations of the two subscales and the smoking- and health-related variables were statistically significant and in the expected directions although of small magnitudes, except daily cigarette consumption.ConclusionsThe findings confirmed the satisfactory psychometric properties of all three Chinese versions of PSS. We recommend the use of PSS-10 for research which focuses on the two components of perceived stress, as it shows a higher reliability; and the use of PSS-4 if such partition is not essential and space for multiple measures is limited.

Transmission of methicillin-resistant staphylococcus aureus in the long term care facilities in Hong Kong

BackgroundThe relative contribution of long term care facilities (LTCFs) and hospitals in the transmission of methicillin-resistant Staphylococcus aureus (MRSA) is unknown.MethodsConcurrent MRSA screening and spa type analysis was performed in LTCFs and their network hospitals to estimate the rate of MRSA acquisition among residents during their stay in LTCFs and hospitals, by colonization pressure and MRSA transmission calculations.ResultsIn 40 LTCFs, 436 (21.6%) of 2020 residents were identified as ‘MRSA-positive’. The incidence of MRSA transmission per 1000-colonization-days among the residents during their stay in LTCFs and hospitals were 309 and 113 respectively, while the colonization pressure in LTCFs and hospitals were 210 and 185 per 1000-patient-days respectively. MRSA spa type t1081 was the most commonly isolated linage in both LTCF residents (76/121, 62.8%) and hospitalized patients (51/87, 58.6%), while type t4677 was significantly associated with LTCF residents (24/121, 19.8%) compared with hospitalized patients (3/87, 3.4%) (p < 0.001). This suggested continuous transmission of MRSA t4677 among LTCF residents. Also, an inverse linear relationship between MRSA prevalence in LTCFs and the average living area per LTCF resident was observed (Pearson correlation −0.443, p = 0.004), with the odds of patients acquiring MRSA reduced by a factor of 0.90 for each 10 square feet increase in living area.ConclusionsOur data suggest that MRSA transmission was more serious in LTCFs than in hospitals. Infection control should be focused on LTCFs in order to reduce the burden of MRSA carriers in healthcare settings.

Effectiveness of a mobile smoking cessation service in reaching elderly smokers and predictors of quitting.

BackgroundDifferent smoking cessation programmes have been developed in the last decade but utilization by the elderly is low. We evaluated a pilot mobile smoking cessation service for the Chinese elderly in Hong Kong and identified predictors of quitting.MethodsThe Mobile Smoking Cessation Programme (MSCP) targeted elderly smokers (aged 60 or above) and provided service in a place that was convenient to the elderly. Trained counsellors provided individual counselling and 4 weeks free supply of nicotine replacement therapy (NRT). Follow up was arranged at 1 month by face-to-face and at 3 and 6 months by telephone plus urinary cotinine validation. A structured record sheet was used for data collection. The service was evaluated in terms of process, outcome and cost.Results102 governmental and non-governmental social service units and private residential homes for the elderly participated in the MSCP. We held 90 health talks with 3266 elderly (1140 smokers and 2126 non-smokers) attended. Of the 1140 smokers, 365 (32%) received intensive smoking cessation service. By intention-to-treat, the validated 7 day point prevalence quit rate was 20.3% (95% confidence interval: 16.2%–24.8%). Smoking less than 11 cigarettes per day and being adherent to NRT for 4 weeks or more were significant predictors of quitting. The average cost per contact was US

Effectiveness of a play-integrated primary one preparatory programme to enhance a smooth transition for children

54 (smokers only); per smoker with counselling: US

Smoking among Hong Kong Chinese women: behavior, attitudes and experience

168; per self-reported quitter: US

Effectiveness of a parental training programme in enhancing the parent–child relationship and reducing harsh parenting practices and parental stress in preparing children for their transition to primary school: a randomised controlled trial

594; and per cotinine validated quitter: US

Development and validation of Chinese Health Literacy Scale for Diabetes

827.ConclusionThis mobile smoking cessation programme was acceptable to elderly Chinese smokers, with quit rate comparable to other comprehensive programmes in the West. A mobile clinic is a promising model to reach the elderly and probably other hard to reach smokers.

Cohort Profile: FAMILY Cohort

This study tested the effectiveness of a play-integrated preparatory programme to enhance a smooth transition for children from kindergarten to primary one. A randomized controlled trial was employed and 142 families were recruited. Children in the experimental group experienced greater happiness, fewer worries and lesser difficulty in psychological adjustment than children in the control group, providing evidence that the play-integrated preparatory programme is effective in enhancing a smooth transition for children. Findings from this study promote the awareness in parents and teachers that play is an important part of children’s lives, which is essential for their normal growth and development.

Psychometric properties of the Big Five Inventory in a Chinese sample of smokers receiving cessation treatment: A validation study

BackgroundThe numbers of women smoking have risen 72.5% since 1990 with the increasing population – from 56,100 to 96,800 in 2012, reflecting an alarming situation in Hong Kong. The study aimed to describe the smoking behaviour, attitudes and associated factors among women in Hong Kong.MethodsA qualitative cross-sectional study involving semi-structured interview was conducted with Chinese women from five community centres in different districts in Hong Kong in 2010. A purposive sample of 73 female participants (24 current smokers, 20 ex-smokers and 29 never-smokers) were recruited. The 73 women were classified by their smoking status and age to form 15 focus groups.ResultsMost informants knew about the general health hazards of smoking, such as cancer and heart or respiratory diseases, but not about the female-specific health consequences of smoking. A few smokers considered smoking to be a weight control strategy, fearing a gain in weight if they gave up. Moreover, a few relied on smoking as a coping strategy to relieve negative emotions and stress. Additionally, a few smokers had misconceptions about giving up: that a loss of concentration would result, that continued smoking would not further affect their health as they had become desensitised to the chemicals in tobacco smoke or that quitting would harm their health.ConclusionsThis study generates new knowledge about the behavior, attitudes, and experiences related to smoking of current female smokers, ex-smokers and non-smokers in Hong Kong, which is unique as a Chinese but highly westernized community but with a very low female smoking prevalence.

Passive smoking exposure of sick children in Hong Kong

BackgroundEntering primary school is an important childhood milestone, marking the beginning of a child’s formal education. Yet the change creates a time of vulnerability for the child, the parents and the parent–child relationship. Failure to adjust to the transition may place the family in a psychologically devastating position. The aims of this study were to test the effectiveness of a parental training programme in enhancing the parent–child relationship and decreasing parental stress by reducing harsh parenting in preparing children for the transition to primary school.MethodsA randomised controlled trial incorporating a two-group pre-test and repeated post-test was conducted in one of the largest public housing estates in Hong Kong. A total of 142 parents were recruited, with 72 parents randomly assigned to the experimental group and 70 to the control group. Harsh parenting practices, parent–child relationships and parental stress were assessed.ResultsIn comparison to parents in the control group, those in the experimental group engaged in less harsh parenting practices and reported better parent–child relationships. However, parental stress scores did not differ significantly between the two groups.ConclusionThis study addressed a gap in the literature by examining the effectiveness of the training programme for enhancing parent–child relationship and decreasing parental stress at the time of a child’s transition to primary school. The findings from this study provide empirical evidence of the effectiveness of the parental training programme and highlight the significance of parenting in promoting a smooth transition for children from kindergarten to primary 1.Trial registrationClinicalTrials.gov: NCT01845948.