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BACKGROUND: The outbreak of the coronavirus disease 2019 (COVID-19) pandemic has generated negative effects on psychological well-being worldwide, including in schoolchildren. Government requirements to stay at home and avoid social and school settings may impact psychological well-being by modifying various behaviors such as problematic phone and Internet use, yet there is a paucity of research on this issue. This study examined whether the COVID-19 outbreak may have impacted problematic smartphone use (PSU), problematic gaming (PG), and psychological distress, specifically the pattern of relationships between PSU, PG, and psychological distress in schoolchildren. METHODS: Longitudinal data on psychological distress, PSU, and PG were collected from 575 children in primary schools in 3 waves: Waves 1 and 2 were conducted before the COVID-19 outbreak and Wave 3 during the outbreak. Cross-lagged panel models were used to examine relationships between factors across the 3 waves. RESULTS: Cross-lagged models found that higher levels of PSU were not significantly related prospectively to greater psychological distress before the COVID-19 outbreak, but this prospective relationship became significant during the COVID-19 outbreak. Whereas PG was associated prospectively with psychological distress before the COVID-19 outbreak (ie, between Waves 1 and 2), this association became nonsignificant during the COVID-19 lockdown (ie, between Waves 2 and 3). CONCLUSIONS: The COVID-19 outbreak has seemed to change prospective relationships between PSU and psychological distress and PG and psychological distress in schoolchildren. Future research should examine whether restrictions on or information provided to schoolchildren may exacerbate PSUs effects on psychological distress.

To examine female youth's intentions for safe sex with the relationship partners based on the extended theory of planned behaviour (TPB) model and explore the direct and indirect impact of parent-child communication about sex, peer interaction related to sexual issues, and exposure to sexually explicit materials on female youth's safe sexual behaviour intentions.A non-experimental, cross-sectional research design.A convenience sampling was employed for data collection and 731 female youth aged 15-24 years old were recruited in 2013-2014. An anonymous, self-report structured questionnaire was used as a research instrument to collect participants' basic information and measure the internal and additional variables in the extended TPB model.The extended TPB model explained 42-45% of the total variance. Perceived behavioural control (PBC) and subjective norms had a positive effect on female youth's intentions for contraceptive use, condom use, and dual use with relationship partner; PBC was found to have the greatest influence. Among the additional variables in the extended TPB model, more parent-child communication about sex was found to lead to more positive dual use intentions. More peer interaction related to sexual issues was found to lead to less dual use intentions.To improve female youth's sexual health, the priorities are to reinforce their PBC and subjective norms and enhance parent-child communication about sex. Future efforts should strengthen sex education in families and schools and shape a social environment that facilitates safe sex.The extended TPB model can successfully predict female youth's safe sexual behaviour intentions. Empowering female youth to establish a sense of subjectivity and awareness of being a mature individual with physical autonomy, is importance for their sexual health.目的: 根据扩展计划行为理论(TPB)模型,研究青年女性与伴侣进行安全性行为的倾向,并探讨父母与子女就性行为和与性话题相关的同伴互动的沟通的直接和间接影响,以及接触色情材料对青年女性安全性行为倾向的直接和间接影响。 设计: 非实验性横向研究设计。 方法: 采用方便抽样方法进行数据收集,2013年至2014年共招募了731名15-24岁的青年女性。采用匿名、自我报告结构化问卷作为调研工具,收集参与者的基本信息,并测量扩展计划行为理论模型中的内部变量和附加变量。 结果: 扩展计划行为理论模型解释说明了总方差的42-45%。感知行为控制(PBC)和主观规范对青年女性服用避孕药、使用避孕套、与伴侣采取双重避孕措施的倾向有正向影响,且感知行为控制的影响最大。在扩展计划行为理论模型的附加变量中,我们发现,父母与子女之间进行更多的性行为沟通对采取双重避孕措施的倾向具有积极影响。而更多的有关性话题的同伴互动对采取双重避孕措施的倾向影响较低。 结论: 为改善青年女性的性健康水平,重点在于加强她们的感知行为控制和主观规范,增加父母与子女之间有关性行为的沟通交流。今后应加强家庭和学校的性教育,形成有利于安全性行为的社会环境。 影响: 扩展计划行为理论模型可成功预测青年女性的安全性行为倾向。帮助青年女性建立主体性意识以及掌握身体自主性的成熟个体意识,对其性健康具有重要意义。.

This study assessed fear of the novel coronavirus-2019 (COVID-19), preventive COVID-19 infection behaviors, and the association between fear of COVID-19 and preventive COVID-19 infection behaviors among older people in Iran and Taiwan. Older people aged over 60 years (n = 144 for Iranians and 139 for Taiwanese) completed the Fear of COVID-19 Scale (FCV-19S) and two items on preventive COVID-19 infection behaviors (i.e., hand washing and mouth covering when sneezing). Iranian older people had a significantly higher level of fear of COVID-19 than did Taiwanese older people. Moreover, Iranian older people had significantly lower frequencies of preventive COVID-19 infection behaviors than did Taiwanese older people. Different timings in implementing COVID-19 infection control policies in Iran and Taiwan may explain why Iranian older people had greater fear of COVID-19 and lower preventive COVID-19 infection behaviors than did Taiwanese older people.

Background and aimsPatients with schizophrenia are known to use potentially addictive psychoactive substances as self-medication and to ease psychological distress. Other potentially addictive behaviors such as online gaming are also used to self-medicate and ease psychological distress. However, the role of online gaming and problematic gaming (in the form of internet gaming disorder [IGD]) has not previously been investigated for patients with schizophrenia facing distress.MethodsOne hundred and four participants diagnosed with schizophrenia were recruited and completed a number of psychometric scales including the Personal and Social Performance Scale (PSPS), Internet Gaming Disorder Scale-Short Form (IGDS-SF9), Self-Stigma Scale-Short (SSS-S), and Depression, Anxiety, Stress Scale (DASS-21).ResultsThe results showed significant negative associations between PSPS, IGDS-SF9, and DASS-21, and significant positive correlations between the IGDS-SF-9, SSS-S and DASS-21. Moreover, IGD did not mediate the association between self-stigma and depression. However, IGD significantly mediated the association between self-stigma and anxiety, and the association between self-stigma and stress. In addition, (i) age and self-stigma were significant predictors for IGD; (ii) social function and self-stigma were significant predictors for depression; (iii) social function, self-stigma, and IGD were significant predictors for anxiety; and (iv) self-stigma and IGD were significant predictors for stress.ConclusionThe findings suggest that online gaming may be a coping strategy for individuals with schizophrenia with psychological stress and self-stigma and that for some of these individuals, their gaming may be problematic.

Objective Fear of cancer recurrence (FCR) is the most commonly reported problem and unmet need among breast cancer survivors. The aim of this qualitative study was to explore the experience of recurrence fears among Taiwanese breast cancer survivors. Methods Three focus groups were included in this study. A purposive sampling technique was used to recruit 11 recurrence-free women at least 20 years of age from southern Taiwan who were diagnosed with breast cancer within the previous 2 years. Data were analysed and interpreted using content analysis. Results Three themes reflecting the experience of FCR were extracted from the transcript analyses: "Trapped in insecurity," "Suffering in silence," and "Pretending as if nothing happened." Participants endured a complex set of circumstances akin to silently walking the survival tightrope. Breast cancer survivors were still insecure and suffering, rather than celebrating survival, after the completion of treatment. Fear of cancer recurrence silently dominated their lives. Conclusions An avoidance mindset and an unspoken FCR leave survivors insecure, resulting in a silent survival journey. These difficult thoughts and feelings that may impact the reconstruction of post-cancer life should be acknowledged. The development of appropriate survivorship care programs and emotional resilience regarding recurrence is needed for Taiwanese breast cancer survivors.

The purpose of this study was to investigate the factors influencing occupational burnout among psychiatric nurses. Psychiatric nurses are often misunderstood and subjected to social bias due to the nature of their work. Their work entails responding to emergencies and they must endure the psychological stress of the threat of aggression from patients. Thus, it is easy for such nurses to experience occupational burnout. A cross-sectional study was undertaken from February to April 2012 among hospitals psychiatric nurses in southern Taiwan. Of 235, 217 nurses eligible for the study completed survey (response rate 92.3%). Information on personal characteristics, workplace stressors (QMWS), and burnout (MBI) was obtained through structured questionnaire survey. The results indicated that a nurse's age, hospital level, work unit, seniority, psychiatric work, and overtime work were associated with the nurse's level of occupational burnout and its three dimensions. According to our findings, there is positive correlation between job stress and burnout. In addition, our study also showed that overall job stress, total years in nursing, age, maintenance of relationships with patients, personal assessment system, and encountering medical disputes are predictive factors for psychiatric nurses' overall occupational burnout and its three dimensions of emotional exhaustion, depersonalization, and personal accomplishment. In conclusions, our study could help psychiatric nurses to be more aware of their working stress. In order to improve the quality of professional care, hospital management should provide psychiatric nurses with positive and healthy coping strategies.

The purpose of this study was to investigate the correlation between job stress, job satisfaction, and quality of life for nurse anesthetists at medical centers in Southern Taiwan. The study adopted a cross-sectional study design. The interviewees were nurse anesthetists at three medical centers in Southern Taiwan who had been employed in their respective units for over 6 months. The recruitment period was from January 2012 to March 2012. Data was collected using a structured questionnaire composed of the following sections: basic personal characteristics, perceived source of job stress for medical work scale, job satisfaction for nurses scale, and SF-36 quality of life scale. A total 150 nurses participated in the study. The results showed a statistically significant difference in monthly overtime amounts in relation to overall job stress. Hospital, age, work place, overtime amount, intention to resign, and nurse anesthetist work terms also showed significant differences in relation to subjects' overall job satisfaction. After using stepwise multiple regression, the average quality of life score for subjects with intention to resign was 8.231 points lower than that of those without such intention; for each increase of 1 point in the "overall job satisfaction" section, the score for quality of life rose by 0.481 points; those with exercise habits scored 5.942 points higher than those without; those in a subspecialty showed an average score of 5.287 points higher than those without. In conclusion, intention to resign, overall job satisfaction, exercise habits, and having a subspecialty are the critical factors influencing quality of life among anesthesia nurses.

Few empirical studies have evaluated the mediating effects of quality of life (QoL) among people living with HIV/AIDS (PLWHA). The purposes of this study were to identify the predictors of QoL and to test the mediating effects of social support on depression and QoL among patients enrolled in an HIV case-management program in Taiwan. A cross-sectional, descriptive correlation design collected data from 108 HIV-infected individuals. Individuals were assessed using the Beck Depression Inventory II, the short version of the World Health Organization Quality of Life Assessment (WHOQOL-BREF), and the Multidimensional Scale of Perceived Social Support between September 2007 and April 2010. After adjusting for sociodemographic characteristics (including age, gender, and mode of transmission) and clinical information (including CD4 count and time since diagnosis with HIV), the study findings showed that QoL was significantly and positively correlated with both social support and the initiation of highly active antiretroviral therapy (HAART), and was negatively correlated with depression and time since diagnosis with HIV. The strongest predictors for QoL were depression followed by the initiation of HAART and social support, with an R(2) of 0.40. Social support partially mediated the relationship between depression and QoL. Health professionals should enhance HIV-infected individuals' social support to alleviate the level of depression and further increase the QoL among PLWHA.

The objectives of this study were to explore the post-traumatic responses of abused women to marital violence and to examine the correlation between these responses and demographics. This study aimed to raise awareness of post-traumatic responses in abused women among health care providers, who are supposed to pay more attention to this problem. A cross-sectional survey-interview with structured questionnaires was used. Subjects were recruited from the Kaohsiung area. Of the 127 women who participated in this study, 109 (85.8%) completed the questionnaires. The most frequent post-traumatic response was: "I had a strong feeling toward this thing." The least frequent response was: "I felt it seemed that this thing had never happened or it was not true." The standardized mean score of the intrusion subscale (3.12) was higher than that of the avoidance subscale (1.84). The more children an abused woman had, the fewer avoidance responses she exhibited. Of the abused women, 93.6% had a high post-traumatic response score (or = 19). The results indicate that marital violence leads to post-traumatic responses in abused women in Taiwan. The results can help health care providers to identify post-traumatic responses of abused women at an early stage and can also provide information for planning further treatment strategies for abused women.