Ying Lau

Influence of Intimate Partner Violence During Pregnancy and Early Postpartum Depressive Symptoms on Breastfeeding Among Chinese Women in Hong Kong

Numerous studies show that breastfeeding is beneficial to both mothers and babies. This study explores two understudied correlates that may influence breastfeeding initiation: intimate partner violence during pregnancy and early postnatal depressive symptoms. A cross-sectional comparative study design investigated the correlates of feeding modes of 1200 Chinese mother and infant pairs in a university-affiliated regional hospital in Hong Kong. The prevalence rates of breastfeeding and mixed feeding were 42.25% and 26.25%, respectively. Women who had no experience of intimate partner violence during pregnancy were significantly more likely to initiate breastfeeding (adjusted odds ratio = 1.84; 95% confidence interval, 1.16-2.91) after adjustment for demographic, socioeconomic, and obstetric variables. Early postnatal depressive symptoms were not significantly associated with feeding modes in a multinomial logistic regression model. Midwives are in a key position to identify and intervene to encourage more successful breastfeeding practice.

Health-related quality of life and social support among Chinese patients with coronary heart disease in mainland China

Aim: This study aimed to explore and identify the relationship between health-related quality of life (HRQoL) and perceived social support among Chinese patients with coronary heart disease (CHD) in mainland China. Methods: A descriptive correlational study was conducted with a convenience sample of 200 Chinese patients with CHD recruited from the cardiac outpatient departments of two university-affiliated hospitals in Xi’an, China. The Chinese Mandarin versions of the Short-form 36-item health survey (CM:SF-36) and the Medical Outcomes Study Social Support Survey (CM:MOS-SSS) were administered to assess HRQoL and perceived social support. Results: The results indicated that Chinese patients with CHD reported a poorer HRQoL and lower social support compared with their Western and Hong Kong counterparts. Multiple regression analyses identified four significant predictors of deteriorated physical health (increasing age, co-morbidity with heart failure or hypertension, and smoking status) and two significant predictors of poor mental health (co-morbidity with heart failure and perceived social support). Conclusions: Health status and social support in Chinese people with CHD should be routinely assessed and, where feasible, addressed through appropriate individually tailored interventions.

Effects of relaxation interventions on depression and anxiety among older adults: a systematic review

Objectives: This systematic review examined empirical evidence of the effects of relaxation interventions on anxiety and depression among older adults. Method: A comprehensive literature search identified studies that satisfied the pre-set inclusion and exclusion criteria. We focused on 15 published and non-published studies – 12 randomised controlled trials and three non-randomised controlled trials – undertaken in the past 20 years (1994–2014). Three reviewers selected studies, extracted data, and appraised the methodological quality. We then computed Hedges’ effect sizes and used these to represent the effects of intervention. Results: Our findings suggested that older adults who received relaxation interventions experienced greater reductions in depression and anxiety than controls in most studies. Progressive muscle relaxation training, music intervention, and yoga had the strongest intervention effects on depression. Music intervention, yoga, and combined relaxation training most effectively reduced anxiety symptoms among older adults. Furthermore, the impact of some relaxation interventions remained in effect for between 14 and 24 weeks after the interventions. Conclusion: This systematic review supported the positive effects of relaxation interventions on depression and anxiety among older adults. Health care providers may integrate relaxation interventions into standard care for older adults in community and hospital settings, taking into consideration the participants preference and health care policy.

Psychometric Properties of the Iowa Infant Feeding Attitude Scale among a Multiethnic Population during Pregnancy

Background: The Iowa Infant Feeding Attitude Scale (IIFAS) was developed to measure maternal attitudes toward infant feeding, but a number of validated studies on the IIFAS found that it was subject to methodological limitations. Objective: The purpose of this study was to evaluate the psychometric properties of the IIFAS among a multiethnic population in Singapore. Methods: A cross-sectional research design was used on a sample of 417 antenatal women. The internal consistency and stability of the IIFAS were evaluated using Cronbach’s α and test–retest reliability. Known-group comparisons discriminated certain group differences in a predictable way. A series of exploratory factor analyses (EFAs) was conducted to test the factor structure of the IIFAS using the maximum likelihood and principal axis factoring. The number of factors was selected according to theoretical and statistical considerations. A confirmatory factor analysis (CFA) was further performed to validate the factor structure constructed in the prior EFA. Results: The IIFAS had a Cronbach’s α and Pearson correlation of 0.79 and 0.85, respectively. The known-group comparisons among certain groups were supported. The EFA results showed that the 3-factor structure produced the most interpretable and theoretical sense. A second-order CFA was conducted to confirm the construct dimensionality of the 15-item IIFAS, with satisfactory fit indices found. Conclusion: The 15-item IIFAS is a psychometrically sound measurement tool that health care professionals can use to understand the diverse infant feeding attitudes and knowledge among different ethnic groups in order to provide breastfeeding interventions that are culturally sensitive.

The reliability and validity of the Chinese version of the Dysfunctional Attitudes Scale Form A (DAS-A) in a community sample.

Objective: This study investigated the reliability and validity of the DAS-A in a sample of 308 Chinese adults in Hong Kong. Method: The reliability of the DAS-A and its relevant sub-scales was measured using internal consistency (Cronbachs alpha) and Guttman split-half reliability. Principal components analysis was performed to assess construct validity. Discriminant validity of the DAS-A was performed by examining whether the DAS-A could discriminate between the depressed and the non-depressed subjects in this study. Results: The split-half reliability of the DAS-A was found to be r = 0.87; Cronbachs alpha was 0.945; and item-total correlations ranged between 0.36 and 0.75. Factor analysis revealed three factors that were similar to those that were found in other studies: Performance Evaluation, Need for Approval, and Anaclitic Self-Esteem. Discriminant validity suggested that the DAS-A discriminated successfully between the non-depressed and the depressed groups. Nevertheless, some differences were noticed in the relative strength of the factors and in the distribution of the scale items into the three factors. Conclusion: It was hoped that with this type of cross-cultural information, the universality of the constructs of the DAS-A could be reliably demonstrated.

Efficacy of Internet-Based Self-Monitoring Interventions on Maternal and Neonatal Outcomes in Perinatal Diabetic Women: A Systematic Review and Meta-Analysis

Background Self-monitoring using the Internet offers new opportunities to engage perinatal diabetic women in self-management to reduce maternal and neonatal complications. Objective This review aims to synthesize the best available evidence to evaluate the efficacy of Internet-based self-monitoring interventions in improving maternal and neonatal outcomes among perinatal diabetic women. Methods The review was conducted using Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsyINFO, Scopus, and ProQuest Dissertations and Theses to search for English-language research studies without any year limitation. A risk of bias table was used to assess methodological quality. Meta-analysis was performed with RevMan software. Cochran Q and I2 tests were used to assess heterogeneity. The overall effect was assessed using z tests at P<.05. Of the 438 studies identified through electronic searches and reference lists, nine experimental studies from 10 publications were selected. Results Half of the selected studies showed low risk of bias and comprised 852 perinatal diabetic women in six countries. The meta-analysis revealed that Internet-based self-monitoring interventions significantly decreased the level of maternal glycated hemoglobin A1c (z=2.23, P=.03) compared to usual care among perinatal diabetic women at postintervention. Moreover, Internet-based self-monitoring interventions significantly decreased the cesarean delivery rate (z=2.23, P=.03) compared to usual care among the mixed group at postintervention. Conclusions This review shows neonatal or other maternal outcomes are similar between Internet-based self-monitoring interventions and usual diabetes care among perinatal diabetic women. The long-term effects of the intervention must be confirmed in future studies using randomized controlled trials and follow-up data.

Physical fitness, health behaviour and health among nursing students: A descriptive correlational study.

BACKGROUND Health behaviour is of great importance for nursing students to achieve optimal health. Healthy students tend to complete their study and remain in the nursing workforce. They will also serve as a role model of for patients. However, there is limited research concerning physical fitness and health behaviour (such as sleep problems) in this population. OBJECTIVES This study aims to examine the relationships among health behaviour, personal variables, physical fitness, perceived physical health and psychological health. DESIGN A cross-sectional descriptive correlational study was used. PARTICIPANTS A total of 335 nursing students who were enrolled in a university in Thailand. METHODS Data were collected by self-administered questionnaires and physical fitness tests. Independent variables were personal variables and health behaviour. Outcome variables included physical fitness, perceived physical health and psychological health. Descriptive statistics and path analyses were used to analyse data. RESULTS Nursing students had poor to moderate levels of total physical fitness, with cardiovascular fitness and body flexibility components having the lowest scores. Students who exercised regularly tended to have better physical fitness, perceived physical health and psychological health. Those who did not have sleep problems had better psychological health. CONCLUSION Some personal variables and health behaviours were associated with health among nursing students. Appropriate interventions are required to promote positive health behaviour in this population.

Development and evaluation of a learner-centered training course on communication skills for baccalaureate nursing students

BACKGROUND There is no standardized or formal communication skills training in the current nursing curriculum in Macao, China. OBJECTIVES To develop and evaluate a learner-centered communication skills training course. DESIGN Both qualitative and quantitative designs were used in two separate stages. SETTINGS AND PARTICIPANTS A randomized sample and a convenience sample were taken from students on a four-year bachelors degree program at a public institute in Macao. METHODS Stage I consisted of developing a learner-centered communication skills training course using four focus groups (n=32). Stage II evaluated the trainings efficacy by comparing communication skills, clinical interaction, interpersonal dysfunction, and social problem-solving abilities using a quasi-experimental longitudinal pre-post design among 62 nursing students. A course evaluation form was also used. RESULTS Content analysis was used to evaluate the essential themes in order to develop the specific content and teaching strategies of the course. Paired t-tests and Wilcoxon signed-rank tests showed significant improvement in all post-training scores for communication ability, content of communication, and handling of communication barriers. According to the mean scores of the course evaluation form, students were generally very satisfied with the course: 6.11 to 6.74 on a scale of 1 to 7. CONCLUSIONS This study showed that the course was effective in improving communication skills, especially in terms of the content and the handling of communication barriers. The course filled an important gap in the training needs of nursing students in Macao. The importance of these findings and their implications for nursing education are discussed.

Perinatal depressive symptoms, sociodemographic correlates, and breast-feeding among Chinese women.

Objectives The objectives of the study were to (1) investigate the relationship between breast-feeding initiation and duration and patterns of perinatal depressive symptoms and (2) identify the sociodemographic correlates of such initiation and duration. Method A sample of 2365 women in their second and third trimesters and 6 weeks postdelivery was recruited via systematic sampling from 6 regional public hospitals in Hong Kong. The women were identified as having perinatal depressive symptoms, using the Edinburgh Postnatal Depression Scale. Their sociodemographic variables were investigated using the empirical evidence. Results A total of 285 (47.66%) of the participants were found to have initiated breast-feeding, of whom 222 had breast-fed for more than 3 weeks. Logistic regression analysis revealed a monthly family income less than HK

Electronic-based lifestyle interventions in overweight or obese perinatal women: a systematic review and meta-analysis

5000 to be significantly associated with breast-feeding initiation and that housewives or part-time workers with antenatal depressive symptoms at 32 weeks of gestation were significantly more likely to breast-feed for longer duration. Conclusions These findings help explicate breast-feeding practices among Chinese women and indicate that effective breast-feeding promotion should consider sociodemographic correlates and perinatal depressive symptoms. The studys limitations and implications are discussed.