Yim Wah Mak

Spouses' experience of caregiving for cancer patients: a literature review.

Background The spouse is generally the primary informal caregiver for cancer patients. Many studies have explored the experience of caregiving for cancer patients, but it is unclear whether there are gender differences in the spousal caring experience for cancer patients. Aim This review describes the recent published research on the stress process of spousal caregiving experience for cancer patients, and aims to identify any gender differences in the caregiving experience. Methods Electronic, manual and authors searches were conducted. Articles included were published in English and Chinese, from January 2000 to March 2012. Study population is couples coping with cancer. Focus is on caregiving experience for spouse with cancer, and findings include both male and female spousal caregivers in quantitative studies. The databases searched included MEDLINE, CINAHL, Science Citation Index Expanded, Scopus, PsycINFO and the China Academic Journal Full-text Database. The key search terms used were ‘cancer’ or ‘oncology’ or ‘carcinoma’ AND ‘caregiver’ or ‘caregiving’ or ‘carer’ AND ‘gender differences’ or ‘gender’ AND ‘spouse’ or ‘couple’ or ‘partner’. Spousal caregiving experiences of cancer patients were explored by adopting the ‘stress process’ of the Cancer Family Caregiving Experience Model from the gender perspective. Results Twenty-five articles were identified and included in this review. It was revealed that female spousal caregivers perceived higher level negative experience in caregiving, such as lower mental health, lower physical health, poorer health-related quality of life, lower life satisfaction and decreased marital satisfaction than male spousal caregivers. However, female spousal caregivers are more likely to experience personal growth than male spousal caregivers. Conclusion This review identified that female spousal caregivers for cancer patients had higher levels of negative experience in caregiving. A better understanding of the spousal caregiving experience will provide healthcare professionals with the information needed to develop interventions to support and prepare spousal caregivers to care for their loved ones with cancer.

Association between Screen Viewing Duration and Sleep Duration, Sleep Quality, and Excessive Daytime Sleepiness among Adolescents in Hong Kong

Screen viewing is considered to have adverse impacts on the sleep of adolescents. Although there has been a considerable amount of research on the association between screen viewing and sleep, most studies have focused on specific types of screen viewing devices such as televisions and computers. The present study investigated the duration with which currently prevalent screen viewing devices (including televisions, personal computers, mobile phones, and portable video devices) are viewed in relation to sleep duration, sleep quality, and daytime sleepiness among Hong Kong adolescents (N = 762). Television and computer viewing remain prevalent, but were not correlated with sleep variables. Mobile phone viewing was correlated with all sleep variables, while portable video device viewing was shown to be correlated only with daytime sleepiness. The results demonstrated a trend of increase in the prevalence and types of screen viewing and their effects on the sleep patterns of adolescents.

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

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.

Occupational Stress, Mental Health Status and Stress Management Behaviors among Secondary School Teachers in Hong Kong.

Objective This study aimed to examine occupational stress and mental health among secondary school teachers in Hong Kong, and to identify the differences between those actively engaged in stress management behaviors and those who were not. Design Survey design was adopted using validated instruments including Occupational Stress Inventory (OSI-R), Depression Anxiety Stress Scale (DASS-21), and Health-Promoting Lifestyle Profile (HPLP) II. Setting The sample was 89 secondary school teachers who attended a professional development course offered by the University of Hong Kong in Hong Kong, People’s Republic of China. Method All 99 students who attended the professional development course were invited and 89 consented to participate and returned the completed questionnaires. Results The majority of participants (75.3 percent) reported fair to very low satisfaction with the teaching career, and 82 percent of them felt unaccountably tired or exhausted. Results of OSI-R showed that 38.6 percent had experienced strong maladaptive stress due to vocational strain but coping resource was limited with most deficits on rational and cognitive coping. Analysis of DASS-21 indicated that 30.3 percent had severe to extremely severe anxiety and 12.3 percent had severe to extremely severe depression. HPLP II revealed that participants paid little attention to their own health and the management of stress. Those who exhibited more stress management behaviors showed significantly less physical symptoms, higher satisfaction with teaching, and lower occupational stress. Conclusion Secondary teachers in Hong Kong have high occupational stress but insufficient stress coping resources. Cognitive-behavioral programs to enhance teachers’ stress management resources are recommended.

Secondhand smoke exposure and maternal action to protect children from secondhand smoke: Pre- and post-smokefree legislation in Hong Kong

Background Smokefree legislation may protect children from secondhand smoke (SHS) in the home from smoking parent(s). We examined the effect of the 2007 smokefree legislation on children’s exposure to SHS in the home and maternal action to protect children from SHS exposure in Hong Kong. Methods Families with a smoking father and a non-smoking mother were recruited from public clinics before (2005–2006, n = 333) and after the legislation (2007–2008, n = 742) which led to a major extension of smokefree places in Hong Kong. Main outcomes included children’s SHS exposure in the home, nicotine level in mothers’ and children’s hair and home environment, mothers’ action to protect children from SHS, and their support to the fathers to quit. Results Fewer mothers post-legislation reported children’s SHS exposure in the home (87.2% versus 29.3%, p<0.01), which was consistent with their hair nicotine levels (0.36ng/mg versus 0.04ng/mg, p<0.01). More mothers post-legislation in the last month took their children away from cigarette smoke (6.3% versus 92.2%; p<0.01) and advised fathers to quit over 3 times (8.3% versus 33.8%; p<0.01). No significant change was found in the content of smoking cessation advice and the proportion of mothers who took specific action to support the fathers to quit. Conclusions SHS exposure in the home decreased and maternal action to protect children from SHS increased after the 2007 smokefree legislation. Maternal support to fathers to quit showed moderate improvement. Cessation services for smokers and specific interventions for smoking families should be expanded together with smokefree legislation.

The acceptance and commitment therapy for smoking cessation in the primary health care setting: a study protocol

BackgroundAccess to effective smoking cessation programs is crucial to reducing smoking-related morbidity and mortality. Several studies have shown promising results for the application of Acceptance and Commitment Therapy (ACT) in managing psychological or behavioral health problems. However, to date, only one study has examined the feasibility of a telephone-based ACT for smoking cessation and it was conducted among a Western population, in the United States. This study reports a protocol for a randomized controlled trial (RCT) examining the feasibility and potential efficacy of an individual, telephone-delivered ACT for smoking cessation in primary healthcare settings among a Chinese population.MethodsA randomized, two-group design was chosen, with assessment at baseline (before intervention) and via telephone follow-ups at three and six months. Subjects will be proactively recruited from primary healthcare centers. Eligible participants will be randomized to either the intervention (ACT) or control group following the baseline assessment. Both groups will receive self-help materials on smoking cessation. Those in the ACT group will undergo an initial face-to-face session and two telephone ACT sessions at one week and one month following the first session, to be delivered by a counselor based on the treatment protocol. All of the participants will be contacted by telephone for follow-up assessments at three and six months. Treatment fidelity will be assessed by reviewing around one-fifth of audio-recorded telephone calls.DiscussionTo the best of our knowledge, this protocol describes the first RCT of a telephone-based ACT for smoking cessation. It is also the first RCT of ACT for smoking cessation on a Chinese population. The study will provide us with information about the feasibility of a telephone-delivered ACT within a Chinese sample. If effective, this trial will support the development of ACT treatment protocols that could be made available for use by a greater range of clinicians, and offer an evidence base to support alternative treatments for smoking cessation.Trial registrationClinicalTrials.gov ID NCT01652508. Registered on 26th July 2012.

Association between Psychological Flexibility and Health Beliefs in the Uptake of Influenza Vaccination among People with Chronic Respiratory Diseases in Hong Kong

It is common for elderly people and those with such chronic disorders as respiratory diseases to suffer severe complications from influenza, a viral infection. The voluntary uptake of vaccination is vital to the effectiveness of influenza prevention efforts. The Health Belief Model (HBM) is the most commonly used framework in the field of vaccination behavior to explain the decision that people make to accept or refuse vaccination. In addition, psychological flexibility is considered helpful in causing people to be open to adopting new practices that are consistent with their values. This study examined the role of psychological flexibility and health beliefs in predicting the uptake of influenza vaccination among people in Hong Kong. Eligible participants were Hong Kong permanent residents aged 18 years or above with a history of chronic respiratory diseases (CRD). A convenience sample of 255 patients was recruited to participate in a cross-sectional survey in which HBM components and factors of psychological flexibility were assessed. The following variables were found to be significant predictors of vaccination: age, smoking status, comorbidity, previous hospitalization, perceived susceptibility, perceived severity, and psychological flexibility. Enhancing psychological flexibility might be a potential new direction for motivating people to accept influenza vaccination.

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

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.

Nursing Intervention Practices for Smoking Cessation: A Large Survey in Hong Kong

Previous studies have shown that nursing interventions are effective in helping people to stop smoking, but that the participation of nurses in tobacco control activities has been far from satisfactory. The primary objective of this study is to identify factors that encourage or discourage nurses from participating in providing smoking-cessation interventions to their clients, based on the 5 A’s (ask, advise, assess, assist, arrange) framework. A cross-sectional survey was conducted among 4413 nurses in Hong Kong from different clinical specialties. A logistics regression analysis found that predictors for the practicing of all of the 5 A’s are nurses who want to receive training in smoking-cessation interventions, those who have received such training, and those who are primarily working in a medical unit or in ambulatory/outpatient settings. The regression model also showed that attitude towards smoking cessation was positively associated with all of the 5 A’s. The results indicate a need to encourage and provide nurses with opportunities to receive training on smoking-cessation interventions. Strategies to persuade nurses to provide smoking-cessation interventions are also important, since nurses are motivated to perform smoking-cessation interventions when they feel a stronger sense of mission to control tobacco use.

Psycho-Physiological Associates of Dyspnea in Hospitalized Patients with Interstitial Lung Diseases: A Cross-Sectional Study

Dyspnea has been found to be an independent predictor of mortality among patients with respiratory diseases and is often regarded as a difficult symptom to control in patients with interstitial lung diseases (ILDs). Previous studies have found an association of psychological and physiological factors with dyspnea among patients with chronic obstructive airway diseases. However, symptom management of hospitalized patients with ILDs has been hampered by difficulty in priority, since they are often admitted with multiple psycho-physiological needs. This study examined the prevalence of dyspnea and the psycho-physiological factors associated with it among hospitalized Chinese patients with ILDs. We studied 165 hospitalized patients with ILDs recruited consecutively over three months in a public hospital in Guangzhou, China. Dyspnea and common psycho-physiological factors, including cough symptoms, activity capacity, lung function, physical and mental health status, and anxiety and depression symptoms, were measured. By ordered logistic regression, level of dyspnea statistically significantly affected performance in a six-minute walk test and physical functioning in work or other regular daily activities in hospitalized patients with ILDs. Respiratory rehabilitation with an appropriate intensity of exercise training or other strategies for enhancing the physical functioning of this population with moderate and severe levels of dyspnea should be prioritized.