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BACKGROUND: It is unknown whether questionnaires measuring psychosocial constructs related to low back pain (LBP) that were originally designed for adults are suitable for adolescents, and if paper and web-versions have similar measurement properties. OBJECTIVES: To examine selected psychometric properties for the paper- and web-based Back-Beliefs Questionnaire (BBQ) and the Fear Avoidance Beliefs Questionnaire (FABQ-phys) among adults and adolescents in two diverse countries and to determine whether differences existed between countries and pain groups. METHODS: A sample of 156 adults (Hong Kong, n = 75; Australia, n = 81) and 96 adolescents (Hong Kong, n = 61; Australia, n = 35) participated in this cross-sectional study. RESULTS: Main effects for country and administration mode were observed in adult BBQ scores, where Australian adults reported significantly higher BBQ scores than Hong Kong adults (mean difference (MD); 95% CI: 2.85; 0.96-4.74) and significantly higher scores were recorded on the web mode compared to the paper mode (MD 0.74; 0.10-1.38). Similarly, Hong Kong adults and adolescents reported higher FABQ-phys scores than Australian adults and adolescents (MD; 95% CI: 3.40; 1.37-5.43 and 4.88; 0.53-9.23, respectively). Internal consistency values were mostly acceptable (α⩾0.7). CONCLUSION: Differences exist between cultures for LBP-related beliefs. The BBQ and FABQ-phys have acceptable measurement properties in both administration modes. [ABSTRACT FROM AUTHOR]

Aim: Cognitive assessment services were found to be beneficial to older people with cognitive complaints but information is limited on adherence to the recommendations provided. This study aimed to identify predictors of clients' adherence to nursing recommendations after attending a community‐based nurse‐led cognitive assessment service in Hong Kong. Methods: A cross‐sectional design was adopted. We analysed a dataset routinely collected from clients attending the services between January 2012 and January 2018. Multiple regression analyses were conducted to identify predictors (demographics, functional health status and cognitive performance) of the clients' adherence. Their satisfaction with the services was also examined. Results: Two hundred and twenty‐three clients attended the clinic. Of the 133 who completed the telephone follow‐up at the 6 months postconsultation, 44.1% did not adhere to the recommendations. Clients with a higher Clinical Dementia Rating (OR = 4.17), lower Clock Drawing Test score (OR = 1.13) and lower education level (OR = 0.91) were found to be less likely to adhere to the nursing recommendations. Ninety‐six percent (190/198) were satisfied with the overall services. Conclusion: Cognitive assessment services in nurse‐led clinics could provide a self‐referred service for older people with cognitive complaints. However, low adherence to nursing recommendations was found among clients with poorer cognitive functions and lower education levels. Summary statement: What is already known about this topic: Community‐based nurse‐led cognitive assessment services were found to be beneficial to older people with cognitive complaints by providing clients with timely screening, assessment, education and advice.Nonadherence to the recommendations of health‐care professionals could pose significant risks to the clients' health.There has been limited research on clients' adherence to the recommendations of nurses at community‐based cognitive assessment services. What this paper adds: About 44.1% of clients receiving a cognitive assessment did not adhere to the nursing recommendations. Those with poorer cognitive functions and lower education levels were found to be less likely to be adherent.About 96% of clients attending the community‐based cognitive assessment services in a nurse‐led clinic expressed satisfaction with them. The implications of this paper: Community‐based cognitive assessment clinics should develop appropriate strategies to improve clients' adherence, especially those with poor cognitive functions and lower education levels.Future research should investigate why clients with poor cognitive functions and lower education levels are less likely to adhere to nursing recommendations. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Family‐involved interventions can result in better outcomes than traditional mental health care for both service users and their families.Nurses' attitudes towards family involvement can affect family participation in care.Earlier studies on psychiatric nurses' attitudes towards family involvement in care report ambiguous findings. Hong Kong's unique integrated cultures may influence Hong Kong psychiatric nurses' attitudes towards family involvement in nursing care. What the paper adds to existing knowledge?: The majority of psychiatric nurses had positive views on family involvement in care in Hong Kong.Four variables (i.e. gender, clinical experience, nature of working unit and family nursing training) of psychiatric nurses are associated with their attitudes towards family involvement in care in Hong Kong. What are the implications for practice?: Policy makers should develop strategies to increase psychiatric nurses' awareness of the importance of family involvement in patient care.Nurse educators help to design family nursing training to enhance psychiatric nurses' competence in collaborating with families of people suffering from mental disorders. Introduction: In Hong Kong, involving the family in nursing care is still optional and mainly depends on nurses' attitudes and the willingness of the family. Hong Kong psychiatric nurses' attitudes towards family involvement in nursing care may be influenced by the unique integrated Eastern and Western cultures, however earlier studies report ambiguous findings. Aims: This study aimed to assess Hong Kong psychiatric registered nurses' attitudes towards family involvement in care and its associated factors. Methods: This study is a cross‐sectional descriptive online survey with convenience sampling based on the Families' Importance in Nursing Care‐Nurses' Attitudes (FINC‐NA) instrument. Results: Most of the psychiatric nurses had supportive attitudes towards family involvement in care. Females with more clinical experience, working in a rehabilitation‐related unit and having attended a family nursing education course were associated with positive attitudes towards family involvement in care. Discussion: The supportive attitude of psychiatric nurses may be explained by the shift of mental health nursing care from hospital care to community care in recent decades. Implications for practice: Mental health nurse education and training in Hong Kong could place more emphasis on building family work skills, particularly for newly qualified nurses and those working in acute inpatient settings. [ABSTRACT FROM AUTHOR]

INTRODUCTION Smoke or aerosols from cigarettes, e-cigarettes (ECs), or heated tobacco products (HTPs) are harmful. Yet, there is little knowledge about the specific patterns of secondhand tobacco exposure by source within household settings and the socioeconomic status (SES) differences in adolescents. METHODS We used territory-representative student data from a cross-sectional school-based survey in 2020-2021 to calculate the weighted prevalence of secondhand exposure to cigarettes, e-cigarettes, and HTPs in the past seven days. Parental education and perceived family affluence were used as indicators of socioeconomic status. Generalized linear mixed models were used to analyze associations. RESULTS Among 22039 participants, 29.8% reported any secondhand tobacco exposure (SH-Any) at home, primarily from cigarettes (27.4%), followed by e-cigarettes (4.0%) and HTPs (0.9%). Tertiary parental education level was associated with lower SH-Any exposure (Adjusted odds ratio, AOR=0.49; 95% CI: 0.45-0.53, p<0.001), fewer exposure days (β= -0.685, p<0.001), lower exposure to cigarettes (SH-CC) (AOR=0.49; 95% CI: 0.45-0.54, p<0.001) and to e-cigarettes or HTPs (SH-EC/HTP) (AOR=0.57; 95% CI: 0.45-0.71, p<0.001). 'Poor' family affluence was associated with higher exposures [AOR(SH-Any) =1.14; 95% CI: 1.06-1.22, p=0.001; β(days)=0.160, p<0.001; AOR(SH-CC) =1.15; 95% CI: 1.07-1.24, p<0.001], except for SH-EC/HTP exposure, which was higher in students in an affluent family (AOR =1.66; 95% CI: 1.25-2.21, p<0.001). Significant SES differences in SH-EC/HTP exposure were found only in groups with low parental education level. Dose-response relationships were found between lower SH-Any and SH-CC and higher SES categories (p for trend<0.001). CONCLUSIONS Adolescents experienced a high prevalence of tobacco smoke exposure at home, primarily from cigarettes. Higher SES was associated with lower tobacco exposure, except for SH-EC/HTP, which was higher among adolescents from affluent families. Additionally, high parental education level was protective against exposure to SH-EC/HTP. Comprehensive control measures to reduce the use of these tobacco products are needed to protect adolescents of diverse socioeconomic backgrounds. [ABSTRACT FROM AUTHOR]

Family wellbeing is studied worldwide. However, there is a dearth of studies on the wellbeing of families in Chinese societies such as Hong Kong, nor is there any socially relevant and culturally unique instrument for measuring such wellbeing. This paper reports the validity and reliability of an instrument that was developed to assess the wellbeing of Hong Kong Chinese families. Through a comprehensive literature review, interviews with service users from a diversity of backgrounds, consultation meetings with experts on families and related issues, and a pilot study, the framework of a family wellbeing index was developed. Using data from 1343 participants collected via a cross-sectional telephone survey, we employed exploratory factor analysis and confirmatory factor analysis to develop the factorial structure of the tool. Six domains, six subdomains, 23 single-question indicators, and 26 questions were constructed. The six domains were family solidarity, family resources, family health, social involvement, social resources, and work-life balance. The internal consistency of the overall index was 0.904. The scale had a significant predictive effect on the subjective appraisal of the current and future status of the wellbeing of a family, which provided initial evidence of convergent validity. The results of the confirmatory factor analysis confirmed that the construct of the tool encompassed different domains. This study is significant because it provides directions for future studies on family wellbeing and insights for social policy formulation and social service development. Highlights: Five steps were used to develop a family wellbeing index for Hong Kong Chinese families. The results of the exploratory factor analysis showed that the factorial structure of this family wellbeing index included six domains and six subdomains. The results of the confirmatory factor analysis indicate that the six-factor index fits the data well. This is the first study in a Chinese context to develop a socially relevant and culturally specific index of family wellbeing. [ABSTRACT FROM AUTHOR]

Hong Kong experienced the SARS pandemic in 2003. Seventeen years later, the Covid-19 pandemic now challenges Hong Kong and the world. This study aims to unveil the impact of the pandemic on health social workers. One hundred and sixty-six health care social workers in Hong Kong were recruited to join a cross-sectional online survey from November 2020 to March 2021. This paper includes the analysis of the demographic information, fear of contamination, resilience, perceived social support and physical health only. Irrespective of the demographic background, the level of fear of contamination, resilience, perceived social support and physical health were similar. The mean scores of the two dimensions of fear of contamination (Harm avoidance: m = 7.49, s.d. = 3.25; Disgust avoidance: m = 7.75, s.d. = 2.90) were higher than those of general public and clinical samples with Obsessive-Compulsive Disorder. No moderation effects were found in resilience and perceived social support in the relationship of fear of contamination and physical health. Instead, direct effects were shown.The impact of the pandemic on health social workers was universal. Psychoeducational programs to alleviate the fear of contamination and organizational-level interventions to improve workplace social support are highly needed. [ABSTRACT FROM AUTHOR]

This paper examines the effectiveness and efficiency of welfare programmes that are relevant to child poverty reduction in Hong Kong. We employ data from a cross‐sectional survey of a representative sample of families, conducted in 2015 through face‐to‐face interviews. Our results indicate that all four welfare programmes were inadequate in alleviating child poverty. This was either due to the deep poverty gap to be filled or high rates of exclusion error. Most programmes are also inefficient because of inclusion error. We conclude by suggesting some policy implications for the welfare programmes. [ABSTRACT FROM AUTHOR]

The East Asian experience in tackling COVID-19 has been highly praised, but this high-level generalisation neglects variation in pandemic response measures adopted across countries as well as the socio-political factors that shaped them. This paper compares the early pandemic response in Singapore and Hong Kong, two Asian city-states of similar sizes, a shared history of SARS, and advanced medical systems. Although both were able to contain the virus, they did so using two very different approaches. Drawing upon data from a cross-national, probability sample Internet survey conducted in May 2020 as well as media and mobility data, we argue that the different approaches were the result of the relative strength of civil society vs. the state at the outset of the outbreak. In protest-ridden Hong Kong, low governmental trust bolstered civil society, which focused on self-mobilisation and community mutual-help. In Singapore, a state-led response model that marginalised civil society brought early success but failed to stem an outbreak among its segregated migrant population. Our findings show that an active civil society is pivotal to effective outbreak response and that trust in government may not have been as important as a factor in these contexts. [ABSTRACT FROM AUTHOR]

INTRODUCTION Perceived risk of COVID-19 infection is associated with smoking behaviors, but the change in smoking across different settings are uncertain. We examined the associations of perceived increased susceptibility to COVID-19 due to smoking with change in smoking at home and on the streets. METHODS We analyzed data of 1120 current cigarette smokers aged >15 years from a population-based telephone survey in Hong Kong. Perceived increased susceptibility to COVID-19 due to smoking, change in smoking, intention to quit, and tobacco dependence were measured. We used Poisson regression with robust variance to estimate adjusted risk ratio (ARR) for associations, adjusting for sociodemographic characteristics, intention to quit, and time to first cigarette after waking. RESULTS More current smokers reduced smoking on the streets (46.1%; 95% CI: 42.8-50.0) than at home (8.7%; 95% CI: 7.0-10.8). Perceived increased susceptibility to COVID-19 due to smoking was associated with smoking reduction at home (ARR=3.29; 95% CI: 1.80-6.00, p<0.001) but not on the streets (ARR=1.13; 95% CI: 0.98-1.30, p=0.09). More smokers with stronger quit intention and lower tobacco dependence reduced smoking at home but not on the streets in those with high perceived increased susceptibility to COVID-19 due to smoking. CONCLUSIONS This is the first report showing that more cigarette smokers reduced smoking on the streets than at home, and the perceived increased susceptibility to COVID-19 due to smoking was only associated with smoking reduction at home but not on the streets. Improving smokers' awareness of the susceptibility to COVID-19 may be an effective strategy to reduce tobacco consumption and secondhand smoke exposure at home within the context of future respiratory pandemics. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to use the case of Hong Kong to assess the equalisation and individualization claim of the risk society approach to studying experience and coping of employment risks.Design/methodology/approach Two types of survey data are used: quarterly official surveys from the year of 1993 to 2008 and a cross-sectional territory-wide representative telephone survey conducted in 2009.Findings The findings show that contrary to the equalisation claim, experiences of employment risks have continued to concentrate on disadvantaged groups: unskilled manual workers and those with education levels below lower secondary school had continuously fared worse than professionals, managers and university degree holders. These disadvantaged groups were also not particularly proactive in adopting either capital-based or work-related coping methods when they encountered unemployment.Research limitations/implications The lack of trend data to examine the use of different coping means is one of the main drawbacks of the current study. The study carries important theoretical implications.Practical implications Policy implications for the government to provide more comprehensive and proactive employment-related support measures and further expansion of university education.Originality/value This paper examines the case of Hong Kong so as to extend the empirical assessment of the risk society approach beyond the Anglo-Saxon context to mature Asian economies. The study further shows that we need to go beyond the secular trend globalisation which the risk society theory emphasises. Historical factors and business-government-labour power relations are critical factors that shape the policies and institutions of labour market regulations and welfare provision in the local context [ABSTRACT FROM AUTHOR]

This study examined the role of face-to-face intergenerational contact in reducing ageism among 467 young Chinese people. The results showed that the quality of face-to-face intergenerational contact contributed significantly to young people's attitudes toward older people, and that equal intergenerational status and frequent phone communication were positively associated with the perceived quality of their face-to-face contact between older and younger people. Also, attitudes toward older people and phone communication had a significant positive influence on their prosocial behavior toward older people. Strategies to reduce ageism should include policies to strengthening positive intergenerational relationships especially in families with elderly members, and efforts to implementing intergenerational programs that feature an equal intergenerational status. [ABSTRACT FROM AUTHOR]

INTRODUCTION How changes in smoking routine due to COVID-19 restrictions (e.g. refraining from smoking outdoors and stockpiling tobacco products) influence smoking behaviors remains understudied. We examined the associations of changes in smoking-related practices with quit attempts and smoking consumption in current smokers using a mixed-methods design. METHODS In a community-based telephone survey conducted between the second and third wave of the COVID-19 pandemic in Hong Kong, 659 smokers (87.1% male; 45.2% aged 40--59 years) were asked about quit attempts and changes in cigarette consumption and five smoking-related practices since the COVID-19 outbreak. Logistic regression was used to calculate adjusted odds ratio (AOR), adjusting for sex, age, education level, chronic disease status, heaviness of smoking (HSI), psychological distress (PHQ-4) and perceived danger of COVID-19. A subsample of 34 smokers provided qualitative data through semi-structured interviews for thematic analyses. RESULTS Favorable changes in smoking-related practices, including having avoided smoking on the street (prevalence: 58.9%) and reduced going out to buy cigarettes (33.5%), were associated with a quit attempt (AOR: 2.09 to 2.26; p<0.01) and smoking reduction (AOR: 1.76 to 4.97; p<0.05). Avoiding smoking with other smokers (50.5%) was associated with smoking reduction (AOR=1.76; p<0.05) but not quit attempt (AOR=1.26; p>0.05). Unfavorable changes, including having increased smoking at home (25.0%) and stockpiled tobacco products (19.6%), were associated with increased smoking (AOR: 2.84 to 6.20; p<0.05). Low HSI (0--2) was associated with favorable changes (p<0.01), while high HSI score (3--6) was associated with unfavorable changes (p<0.01). Qualitative interviews revealed a double-edged effect of staying at home on smoking consumption and that pandemic precautionary measures (e.g. mask-wearing) reduced outdoor smoking. CONCLUSIONS Amid the pandemic, favorable changes in smoking-related practices in smokers were mostly associated with quit attempts and smoking reduction, while unfavorable changes were associated with increased smoking. Smokers with higher nicotine dependence were more negatively impacted. [ABSTRACT FROM AUTHOR]

This study explored how social workers located in Sydney and Hong Kong conceptualised client empowerment. Further, it investigated these professionals' perceived facilitators and barriers to their empowerment practices, based on an ecological framework. A cross-sectional online survey was used, where the original Empowerment Scale for clients with mental health issues was adapted to measure conceptualisation of client empowerment from social workers' perspectives. Eighty-three social workers serving people with mental health issues (MHIs) in Sydney and eighty in Hong Kong responded. A two-factor model was generated suggesting that practitioners tend to conceptualise client empowerment into two aspects: a relation-based dimension and a resource-oriented one. Compared with their Sydney counterparts, the Hong Kong practitioners considered resource-oriented empowerment as more integral to client empowerment (t (161) = 4.17, p  < 0.001). Several key factors were found to be independently associated with endorsement of the two-factor client-empowerment model by practitioners: perceived less support from medical specialists but more support from teams serving the same client, perceived benefits of social work training and, finally, beliefs in the importance of social workers' role in client empowerment. The study highlights the multiple dimensions of client empowerment and a wide range of inter-professional and sociostructural factors enabling social workers' practices that support empowerment. Our paper highlights the role of professional empowerment as a stepping stone to enable their client-empowerment practices through policy support and inter-professional collaboration. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine the association of various family factors with children’s fruit and vegetable (FV) intake.Design/methodology/approach A cross-sectional analysis of data from 601 parent-child dyads with children aged three to six years old was conducted. Parents completed questionnaires on child’s FV intake, parenting styles, parental feeding practices, family functioning, television viewing at mealtimes and frequency of family meals. Logistic regression was used to assess the association between various family factors and the likelihood of meeting the child’s daily FV recommendation with adjustment for different demographic variables.Findings Multivariate model adjusting for sociodemographic data indicated that meeting vegetable recommendation was associated with lower frequency of dining with grandparents (Odds ratio (OR) 0.94, 95% confidence interval (CI) 0.89–0.99, p=0.031) and positively associated with parents using more desirable parental feeding practices (OR 1.15, 95% CI 1.09–1.21, p<0.001). Meeting fruit recommendation was associated with parents using more desirable parental feeding practices (OR 1.13, 95% CI 1.09–1.17, p<0.001), higher frequency of dining with grandparents (OR 1.05, 95% CI 1.00–1.10, p=0.041), lower frequency of dining with father (OR 0.89, 95% CI 0.82–0.98, p=0.014) and higher score on authoritative parenting style (OR 1.05, 95% CI 1.01–1.08, p=0.009).Originality/value This study highlights the potential protective roles of various family factors, in particular authoritative parenting style and parental feeding practices, such as role modeling, moderate restrictive practices for less healthy foods, avoidance of forced feeding, and not using junk food as reward in relation to meeting FV recommendation in children. The role of grandparents in influencing the young children’s eating behaviors within the Chinese family warrants further investigation. [ABSTRACT FROM AUTHOR]

INTRODUCTION Changes in tobacco use since the COVID-19 outbreak differed by countries and little is known about changes in the use of specific tobacco products. METHODS We analyzed data from four cross-sectional telephone/online surveys from April to June 2020 to investigate such changes since the 1st and 2nd wave outbreaks (February to April 2020) in Hong Kong. The respondents were 1595 adults (83.2% male) who used tobacco before the COVID-19 outbreak from our previous intervention study and surveys. We investigated the changes in tobacco use, intention to quit and quit attempts during the outbreak. RESULTS About two-thirds (65.3%) of respondents reported no change in overall tobacco use, while 23.1% used less (including cessation) and 11.6% used more, resulting in a net decrease of 11.5 percentage points. A greater net decrease was observed for cigarettes (14.3% points) than heated tobacco products (HTPs, 3.3% points) and electronic cigarettes (e-cigarettes, 2.5% points). Decreased use was mainly due to the more extended stay at home (63.2%), health considerations (52.6%) and mask-wearing (47.4%), while increased use was for passing time (75.0%) and releasing stress (46.4%). Eight percent of cigarette, HTP and e-cigarette users reported a higher intention to quit since the pandemic outbreak. Nineteen percent of tobacco users (176/948) attempted to quit during the pandemic. Only 2.9% (46/1569) were abstinent at the time of the survey. CONCLUSIONS Overall tobacco use decreased after the first two waves of the COVID-19 outbreak in Hong Kong. A greater proportion of cigarette users decreased use than HTP and e-cigarette users. Given the different methods used in the four surveys, future studies should aim for a large and representative sample. [ABSTRACT FROM AUTHOR]

Background: Although it is widely acknowledged that access to civil justice (ATJ) is a key social determinant of health (SDOH), the existing literature lacks empirical evidence supporting ATJ as a SDOH for specific dimensions of health. Methods: A legal epidemiological, cross-sectional, postal survey was conducted on n = 908 randomly sampled participants in Hong Kong in March 2023. Data collected were perceptions of the civil justice system, health, and sociodemographics. Perceived ATJ was assessed using a modified version of the Inaccessibility of Justice scale (IOJ) and Perceived Inequality of Justice scale (PIJ), i.e. the "modified IOJ-PIJ", consisting of 12 of the original 13 items from both scales divided into two subdomains: "procedural fairness", and "outcome neutrality". For health data, quality of life was assessed using the Hong Kong version of the Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-BREF(HK)), psychological distress (including symptoms of anxiety and depression) was assessed using the four-Item Patient Health Questionnaire (PHQ-4), and having comorbidities was assessed using Sangha's Self-Administered Comorbidity Questionnaire (SCQ). Structural equation modelling (SEM) was used to investigate the relationships between perceived ATJ and the measured health outcomes. Results: SEM demonstrated that both subdomains for ATJ had significantly negative associations (B < 0; p < 0.05) with all quality-of-life subdomains, except for between outcome neutrality with social relationships; both subdomains for ATJ had significantly positive association (B > 0; p < 0.05) with both anxiety and depression; and, after adjusting for age, only "procedural fairness" had significantly positive association (B > 0; p < 0.05) with having comorbidities. Conclusion: This study provided empirical evidence that ATJ is a SDOH for specific dimensions of health. The results of this study encourage laws, policies, and initiatives aimed at improving ATJ, as well as collaborative efforts from the legal and health sectors through health-justice partnerships, and from the broader community, to safeguard and promote public health by strengthening ATJ. [ABSTRACT FROM AUTHOR]

Background: The rapidly aging global population has increased the demand for caregivers. Many caregivers simultaneously engage in paid employment, and the dual role makes the needs of caregiver employees conceivably more remarkable. However, there is a gap in the literature about the specific needs of caregiver employees. Method: Caregiver employees (n = 1205) across Hong Kong caring for those ≥65 years were recruited for a cross-sectional face-to-face survey from December 2021 to January 2022, to evaluate mental well-being measured by the Short Warwick –Edinburgh Mental Well-being Scale. Univariate and multivariate analyses were conducted; significant variables (p < 0.05) were included in multiple linear regression, along with caregiver-friendly workplace policies' availability, to understand their association with their mental well-being. Findings: The mean score of the Short Warwick–Edinburgh Mental Well-being Scale among caregiver employees in this study was 24.9, with 7.2% indicative of probable clinical depression and 10.0% possible mild depression. In addition, the current study showed that 30.2% of the caregiver employees felt distressed about the caregiving role. Among external factors, family support (measured by the Lubben Social Network Scale) and workplace culture (measured by the Marshall Supervision Subscale) positively correlated with mental well-being with regression coefficients of 0.252 (p < 0.001) and 0.482 (p < 0.001), respectively. In the fully adjusted model, a negative regression coefficient was observed for overall spillover (−0.050, p < 0.001) and Short Warwick–Edinburgh Mental Well-being Scale scores, while positive regression coefficients were observed for overall self-rate (0.041, p < 0.001), Lubben (0.124, p < 0.001), and corporate culture (0.365, p < 0.001). Better Short Warwick–Edinburgh Mental Well-being Scale scores were observed when caregiver-friendly workplace policies were clearly stated than when they were made on a case-by-case discretionary basis. Conclusions: Caregiver-friendly workplace policies may be critical to Hong Kong's sustainable future, both economically and socially, as they ensure a healthy and productive workforce to support an aging population. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Warwick-Edinburgh Mental Well-being Scale (WEMWBS) which is a measurement of mental health and well-being, was translated into Chinese to assess the reliability and validity in a sample of undergraduate nursing trainees in Wenzhou. What this paper adds to existing knowledge? Currently, there is no a reliable assessment tool to systematically evaluate mental well-being in mainland China. Therefore, we undertook the translation and cultural adaptation of the WEMWBS and tested the scale's reliability and validity. The reliability and validity of the Chinese version of the Short Warwick-Edinburgh Mental Well-being Scale have been demonstrated in Hong Kong, but the WEMWBS has not been validated in mainland China in either clinical or non-clinical settings. What are the implications for practice? It might provide a reliable quantitative tool to evaluate mental well-being in non-clinical settings, which has important implications for mental health nursing. In future,it might be a reliable quantitative tool for evaluating mental well-being in other population such as hospitalized patients to improve their life quality. Abstract Introduction There is growing interest worldwide in the evaluation of positive mental health and wellbeing. Aim This study was to translate the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) into Chinese and assess the reliability and validity of this scale in a sample of undergraduate nursing trainees. Methods A forward and backward translation protocol was used to translate the scale into Chinese. The psychometric properties of the C-WEMWBS, such as internal consistency reliability, test-retest reliability and factorial validity, were analysed. Results All 14 items of the initial C-WEMWBS were rated as conceptually equivalent to those of the original version. Confirmatory factor analysis indicated the emergence of a single factor. The psychometric properties of the C-WEMWBS were satisfactory, with an internal consistency reliability of .94 and a test-retest reliability of .83. The item-total correlations ranged from .66 to .83. There was a moderate relationship ( r = .52) between the C-WEMWBS and the WHO-5. Implications for practice This was the first Chinese version of the WEMWBS to be developed and psychometrically assessed with a sample of undergraduate nursing trainees. It provides a reliable quantitative tool to evaluate mental well-being in non-clinical settings, which has important implications for mental health nursing. [ABSTRACT FROM AUTHOR]

Background: The proportion of hospital deaths has declined in the past few decades, while the proportions of nursing home deaths have increased. This trend of increasing deaths in long-term care facilities underlines the importance of improving end-of-life care provisions in these settings to meet individual preferences and needs. Under these circumstances, a comprehensive understanding of end-of-life care preferences in local nursing home residents can help healthcare professionals and policymakers develop strategies to increase the advance directive completion rate and quality of care. This study aimed to explore and compare advance directive and end-of-life care preferences of nursing home residents in Hong Kong and Taiwan. Methods: A structured questionnaire was developed by the research team to investigate advance directive and end-of-life care preferences in older Chinese nursing home residents. Nursing home residents with frail or pre-frail status and over the age of 64 were invited to participate in the study, and information on demographics, functional status, advance directive experiences, and end-of-life care expectations was collected through questionnaire interviews. Results: A total of 325 eligible participants from 32 facilities completed the survey, including 238 older residents in Hong Kong and 87 in Taiwan. A significantly lower proportion of the Hong Kong residents had completed an advance directive compared with the Taiwanese (3 vs. 13%, p = 0.001). Among participants who did not have an advance directive, 46% of the Taiwanese participants said they would consider completing one in the future, compared with 20% of the Hong Kong participants (p < 0.001). A total of 79% of the Hong Kong participants and 80% of the Taiwanese participants responded that prolonging life in the given hypothetical dying scenario was "not important" (p = 0.76). Only 14% of participants in Hong Kong and 18% of participants in Taiwan reported prior occurrence of end-of-life care discussions with family members or health professionals (p = 0.37). Conclusions: This paper adds evidence in support of improving end-of-life communication and the advance directive completion rate in nursing homes in Hong Kong and Taiwan. Further research is necessary to explore cross-cultural differences in end-of-life preferences and its applications in predicting decision-making and the quality of end-of-life care. [ABSTRACT FROM AUTHOR]

This study investigated the cross-sectional relationships between reading-related affective and cognitive factors and reading skills among adolescents with and without dyslexia. Participants were 120 Chinese-speaking eighth graders, including 60 adolescents with dyslexia and 60 typically developing adolescents from Hong Kong, China. Adolescents completed questionnaires on general anxiety, reading anxiety, and reading self-concept. They were also assessed on measures of rapid digit naming, verbal working memory, word reading, reading fluency, and reading comprehension. The results showed that readers with dyslexia reported higher levels of general anxiety and reading anxiety and lower levels of reading self-concept than typical readers. They also showed difficulties in rapid digit naming and verbal working memory. Importantly, controlling for rapid digit naming and verbal working memory, reading self-concept was uniquely associated with word reading and reading fluency for readers with and without dyslexia. Furthermore, reading anxiety and reading self-concept were uniquely associated with reading comprehension for the two groups of readers. The findings point to the importance of considering affective factors when examining the reading skills of Chinese readers and the utility of targeting these factors when supporting the learning of adolescents with and without dyslexia. [ABSTRACT FROM AUTHOR]

With the continuous development of digital technology, the widespread use of virtual spokespersons to promote city images is becoming increasingly prevalent. This study responds to this trend by employing a factor analysis and entropy weight methodology to explore the different dimensions and priorities in shaping the image of virtual city spokespersons in China. The aim is to offer insights into the design strategies and directions for shaping the image of virtual city spokespersons. For the research, we first conducted a literature review and semi-structured interviews to investigate the requirements of users in mainland China and Hong Kong regarding the image shaping of virtual city spokespersons. Building upon this groundwork, a questionnaire was designed and distributed, and it successfully gathered 512 valid responses. Subsequently, a factor analysis was utilized to identify eight key dimensions in shaping the images of Chinese virtual city spokespersons: "Design elements", "Anthropomorphism", "Evolutionary", "Emotionalization", "Narrativity", "Culturalism", "Interactivity", and "Reliability". Then, the entropy weighting method was applied to analyze the weights of each indicator within these dimensions. The results revealed that "Design elements" have the highest priority in shaping the image of virtual city spokespersons, followed by "Anthropomorphism", "Emotionalization", "Evolutionary", "Culturalism", "Narrativity", "Reliability", and "Interactivity". Based on these findings, a series of design optimization strategies are proposed, including but not limited to shaping visually appealing images aligned with user perceptions, establishing emotional connections with users, and meeting the functional experience needs of users. These strategies not only contribute to the image shaping of virtual city spokespersons, but also provide vital guidance for innovative directions in promoting the publicity and marketing of Chinese cities. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Frailty and multimorbidity are common in later life. A higher level of frailty is associated with a higher risk of adverse physical and psychological health situations., Older adults with pain have been reported to be lonelier and more depressed, as well as less happy and less satisfied with their life as compared to those without pain., In view of the high prevalence of pain among older adults and the reversibility of frailty, it is important to explore the relationship between pain, frailty and psychological parameters in order to devise patient-centred interventions., What this paper adds to existing knowledge? Frailty index is positively correlated with the presence of pain, and associated with gender, functional mobility and loneliness., Among these significant variables, loneliness was the factor that contributed the most to the frailty index., What are the implications for practice? It is essential to put the focus of healthcare on both the physical and psychological aspects of well-being., All nurses are advised to improve the management of pain in older people in order to lower the levels of pain, frailty and psychological distress among this population., Nursing care should address the loneliness level especially the problem of social loneliness among older adults particularly those living in nursing homes., Abstract Introduction In view of the high prevalence of pain among older adults and the reversibility of frailty, it is important to explore the relationship between pain, frailty and psychological parameters in order to devise patient-centred interventions. Aim To examine the levels of frailty, pain and psychological parameters among older adults living in Hong Kong nursing homes, and the cross-sectional relationships among these items. Methods A cross-sectional study was conducted among 178 residents from six nursing homes. Frailty, pain, mobility, happiness, loneliness and life satisfaction of participants were assessed using validated questionnaires. Results A multiple linear regression ( R2 = 0.338, P < 0.05) showed that the frailty index was associated with loneliness, functional mobility and gender. Among these significant variables, loneliness was the factor that contributed the most to the frailty index. Discussion It is essential to put the focus of healthcare on both the physical and psychological aspects of well-being. Findings suggest that apart from improving mobility and reducing pain, loneliness could be a target of psychosocial interventions to reduce frailty and improve quality of life. Implications for practice It is advised that nursing care should address loneliness, especially the problem of social loneliness among older adults particularly those living in nursing homes. [ABSTRACT FROM AUTHOR]

Background: Training has been found effective in improving healthcare professionals' knowledge, confidence, and skills in conducting advance care planning (ACP). However, the association between training and its actual practice in the clinical setting has not been well demonstrated. To fill this gap, this paper examines the association between their readiness for ACP, in terms of perceived relevancy of ACP with their clinical work, attitudes toward and confidence and willingness to perform it, based on the Theory Planned Behavior and relevant training experiences. Methods: An online survey about experiences about ACP of healthcare professionals, including physicians, nurses, social workers, and allied healthcare professionals, currently working in hospital and community care in Hong Kong was conducted. Results: Of 250 respondents, approximately half (52.0%) had received ACP-related training. Those with relevant training reported significantly more positive in the perceived clinical relevance, willingness, and confidence in conducting ACP and different levels of agreement with 19 out of the 25 statements in a questionnaire about attitudes toward ACP than those without (ps ≤ 0.001–0.05). Respondents who received training only in a didactic format reported a significantly lower level of confidence in conducting ACP than did others who received a blended mode of learning (p = 0.012). Notwithstanding significant differences between respondents with and without relevant training, respondents generally acknowledged their roles in initiating conversations and appreciated ACP in preventing decisional conflict in surrogate decision-making regardless of their training experience. Conclusions: This paper revealed the association between training and higher level of readiness toward ACP among healthcare professionals. The findings showed that training is a predictor of their readiness for ACP in terms of perceived relevancy, willingness, and confidence. Those who had received training were less likely to consider commonly reported barriers such as time constraints, cultural taboos, and avoidance among patients and family members as hindrances to ACP implementation. [ABSTRACT FROM AUTHOR]

Background: Puberty is associated with a clustering of cardiometabolic risk factors (CMRFs) during adolescence that are manifested in later life. Although anthropometric variables such as body mass index (BMI) can predict cardiometabolic risk in children and adolescents, it is not clear whether there is an interaction between pubertal stage and BMI associated with cardiometabolic risk in this age group. This paper examines the association of pubertal stage and BMI with CMRFs in Hong Kong Chinese children.Methods: A cross-sectional school-based study was conducted among 1985 (95.1%) students aged 6 to 18 years. Fasting lipid profile and plasma glucose, blood pressure, body weight, body height and waist circumference were measured. A self-reported pubertal stage questionnaire was used to assess pubertal stage of participants. Two cardiometabolic risk scores, alpha and beta, were constructed to quantify cardiometabolic risk. Cardiometabolic risk score alpha refers to the sum of z-scores of sex-specific, age-adjusted waist circumference, height-adjusted systolic and diastolic blood pressure, fasting plasma glucose, triglyceride and low-density lipoprotein cholesterol, and minus z-score of sex-specific age-adjusted high-density lipoprotein cholesterol. Cardiometabolic risk score beta includes all components of risk score alpha except waist circumference.Results: The interaction of BMI z-score (ZBMI) and pubertal stage demonstrated a further increase in variance explained in both the cardiometabolic risk scores alpha and beta (0.5% and 0.8% respectively) in boys and (0.7% and 0.5% respectively) in girls.Conclusions: Pubertal stage has an interaction effect on the association of cardiometabolic risk by BMI in boys and may have a similar but lesser effect in girls. [ABSTRACT FROM AUTHOR]

Background: Female migrant domestic workers (MDW), approximately 8.5 million globally, often live in their employer's home under vulnerable conditions. In Hong Kong, MDWs currently comprise 5% of the population. This study was conducted to assess the association between employment conditions and mental health, and the mediating roles stress and job satisfaction have, among female MDWs in Hong Kong. Methods: Participants completed an online cross-sectional survey. A total of 1,965 survey were collected between August 2020 and August 2021. Questions in the survey were related to MDWs background information, employment conditions, stress, job satisfaction, and two mental health outcomes: anxiety and depression. An employment conditions score was created to assess the cumulative effect poor employment conditions had on mental health. A multicategorical parallel mediation analysis was used to assess the direct effect employment conditions have on mental health and the indirect effects through stress and job satisfaction. Results: Overall, 17.7% of MDWs were reported to be suffering from anxiety and 30.8% from depression. An increase in poor employment conditions was statistically associated with an increase in both outcomes, while stress levels and job satisfaction mediated this association. Conclusions: The findings call for increased scrutiny of employment conditions and mental well-being of MDWs. [ABSTRACT FROM AUTHOR]

Background: Chronic back and knee pain impairs health- related quality of life (HRQoL) and patient enablement can improve HRQoL. Aim: To determine whether enablement was a moderator of the effect of chronic back and knee pain on HRQoL. Design and setting: A cross-sectional study of Chinese patients with chronic back and knee problems in public primary care clinics in Hong Kong. Method: Each participant completed the Chinese Patient Enablement Instrument-2 (PEI-2), the Chinese Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Pain Rating Scale (PRS). Multivariable regression examined the effects of PRS score and PEI-2 score on WOMAC total score. A moderation regression model and simple slope analysis were used to evaluate whether the interaction between enablement (PEI-2) and pain (PRS) had a significant effect on HRQoL (WOMAC). Results: Valid patient-reported outcome data from 1306 participants were analysed. PRS score was associated with WOMAC total score (β = 0.326, P<0.001), whereas PEI-2 score was associated inversely with WOMAC total score (β = −0.260, P<0.001) and PRS score. The effect of the interaction between PRS and PEI-2 (PRS × PEI-2) scores on WOMAC total score was significant (β = −0.191, P<0.001) suggesting PEI-2 was a moderator. Simple slope analyses showed that the relationship between PRS and WOMAC was stronger for participants with a low level of PEI-2 (gradient 3.056) than for those with a high level of PEI-2 (gradient 1.746). Conclusion: Patient enablement moderated the impact of pain on HRQoL. A higher level of enablement can lessen impairment in HRQoL associated with chronic back and knee pain. [ABSTRACT FROM AUTHOR]

Aims This paper tests the mediating effect of institutional peer support on the relationship between physical declines and depressive symptoms among nursing home residents. Background As the number of older adults living in nursing homes increases, peer support received from other residents in the institutions is critical to the psychological well-being of residents who face physical declines and reduction in family support. This study tested whether institutional peer support would account for the detrimental effect of physical declines on depressive symptoms of Chinese older people residing in nursing homes. Design A cross-sectional design was used. Method The study was conducted between January-March 2009 by convenience sampling. The sample consisted of 187 nursing home residents, with 54 men and 133 women. Interviews were conducted by an experienced research assistant, and responses on physical abilities and institutional peer support were collected. Geriatric Depression Scale was used to assess depressive symptoms of each participant. Results Participants with poor physical abilities reported more depressive symptoms. Institutional peer support was negatively correlated with physical declines and depressive symptoms. Results of the regression analysis showed that the effect of physical declines on depressive symptoms was no longer significant when the influence of institutional peer support was statistically controlled, indicating a full mediation of institutional peer support on depression of older people. Conclusion Findings of this study reveal that institutional peer support positively contributes to the psychological well-being of nursing home residents. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a study comparing children with smoking parents and those with non-smoking parents, in terms of knowledge and attitude towards smoking and the influence of parents and peers on smoking initiation. Background. Adolescence is a developmental stage when smoking habits are likely to start. Adolescents are most influenced by the smoking habits of their parents and friends. Method. A cross-section study was conducted with students aged 13-15 years in two schools in 2008, using a questionnaire that collected information on the smoking habits of their parents and peers, knowledge and attitude towards smoking, initiation and inclination towards smoking. Chi-square tests and binary logistic regression were used to analyse the data. Results. A total of 257 of 575 (44.7%) students had smoking parent(s), and 25.4% reported having peers who smoked. Children with non-smoking parents were more likely than those with smoking parents to consider 'smoking as disgusting' (67.3% vs. 45.9%), and to know that 'smoking is addictive' (80.5% vs. 70.4%) and 'harmful to health' (81.8% vs. 67.7%). More of those with smoking parents had tried smoking than those with non-smoking parents (13.2% vs. 3.8%). Conclusion. Preventive programmes should involve smoking parents to increase their awareness of the impact their smoking has on their children. Interventions should include problem-solving skills for children to deal with daily stresses and thus eradicate the potential risk of smoking initiation. [ABSTRACT FROM AUTHOR]

The present study examined predictors of attitude toward professional psychological help-seeking in Hong Kong. A cross-sectional approach was adopted and a total of 166 participants (120 female) ranging in age from 20 to 60 years were recruited online. The relationship between attitudes toward professional help-seeking, self-stigma, and perceived accessibility and affordability of services were examined, gender differences were also examined. Findings revealed that self-stigma was significantly negatively associated with attitude toward professional psychological help-seeking, while perceived affordability was positively associated with attitudes. The current study demonstrates that stigma is still an ever-present obstacle, which could contribute to low utilization of services in Hong Kong. [ABSTRACT FROM AUTHOR]

During the pandemic of COVID-19 Hong Kong lead one of the world's longest and most stringent quarantine measures. To examine cross-sectionally (i) the relationship between the duration of mandatory hotel quarantine and mental health outcomes; (ii) whether indirect contact with nature and lifestyle factors (i.e. diet, sleep, exercises, social support, and sense of meaning), mitigated this relationship. A group of 248 participants under 14 or 21-d mandatory hotel quarantine in Hong Kong completed an online questionnaire that included quarantine and lifestyle-related questions, as well as mental health outcome measures. For those under a 21-d quarantine, there was a significant effect of the week of quarantine on the level of depressive symptoms (Patient Health Questionnaire-4), which peaked in Week 2. Worse quality of sleep, a lower sense of meaning, and a longer set (but not completed) duration of quarantine were predictors of worse mental health outcomes. The positive relationship between the day of quarantine and the level of perceived stress was moderated by the indirect contact with nature. The results shed light on the potential negative impact of prolonged periods of quarantine on mental health outcomes and the possible protective factors. [ABSTRACT FROM AUTHOR]

INTRODUCTION Never smokers' responses to tobacco control policy are often overshadowed by the opposition from smokers and tobacco industry during policy advocacy and legislation. Very few studies have examined never smokers' exposure to point-of-sale (POS) tobacco displays and their effects. Therefore, we investigated the exposure, pro-smoking responses due to and attitudes towards such displays in never smokers in Hong Kong. METHODS We conducted two-stage, randomized cross-sectional telephone-based surveys in 2015 and 2016 of 1833 never-smoking adults. They were asked how often they noticed POS displays in the past 30 days (often, sometimes, never), whether they found POS displays attractive, felt encouraged to smoke, perceived POS displays as advertisements, and if they supported banning them. The distributions of the outcomes were analyzed by descriptive statistics with weighting to the general population. Risk ratios (RR) from Poisson regression models adjusted for sociodemographic characteristics were used to analyze the associations. RESULTS Our results showed that, in never smokers, the younger were more likely to often notice POS displays (RR=0.80, 95% CI: 0.72-0.89, p<0.01). Finding POS displays attractive was associated with primary (RR=2.52, 95% CI: 1.51-4.22, p<0.01) and secondary education (RR=1.68, 95% CI: 1.16-2.44, p=0.01) versus tertiary education. Often noticing displays was associated with perceived attractiveness (RR=1.90, 95% CI: 1.32-2.75, p<0.01). The positive association between often noticing displays and being encouraged to smoke was marginally significant (RR=4.05, 95% CI: 0.98-16.85, p=0.054). Respondents who often noticed POS displays (RR=0.87, 95% CI: 0.77-0.98, p=0.02) and did not perceive them as advertisements (RR=0.70, 95% CI: 0.61-0.98, p<0.01) showed less support on banning them than those who did not notice them. CONCLUSIONS Frequent exposure to POS displays was associated with greater perceived attractiveness and lower support for banning them. A total ban on POS displays is needed to eliminate the advertising and normalization effect of POS displays. [ABSTRACT FROM AUTHOR]

This paper explores the intrapersonal and sociocultural factors behind youth suicide in Hong Kong. The coroner's court reports of consecutive population-based youth suicide (below age of 25 years, n = 303) cases from 1986 to 1992 were reviewed. Compared with other countries, Hong Kong had low male but high female youth suicide rates. The number of undetermined deaths did not significantly affect the estimated suicide rates. Cross-cultural differences in youth suicide rates may be understood from a differential distribution of risk factors and cultural attitudes towards role behaviours and suicide. Youth suicides in Hong Kong were characterised by a high prevalence of psychiatric disturbances and age-normative precipitants; both findings bear great resemblances to samples studied elsewhere. The results were evaluated in light of studies in different sociocultural backgrounds and highlighted the universality and specificity of youth suicide in Hong Kong. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to determine the impact of adding selected mechanism of injury (MOI) to the existing trauma diversion criteria adopted in Hong Kong. Method: This is a cross-sectional study based on the trauma registry of New Territory West Cluster (NTWC) of Hospital Authority from January 2017 to December 2019. All adult patients aged 18 years or above were recruited if their injury occurred in the catchment area of Pok Oi Hospital (POH) or Tin Shui Wai Hospital (TSWH). Performance of the protocol before and after MOI criteria being added in terms of over-diversion and under-diversion rate was determined. Model discrimination was evaluated by plotting the receiver operating characteristic curve, and the area under the curve was compared before and after MOI criteria added. Net reclassification improvement and integrated discrimination improvement indices were evaluated. Result: A total of 502 patients were included for analysis. Before MOI criteria were added, the over-diversion rate and under-diversion rate were 31.1% and 54.7%, respectively. After MOI criteria were added, the over-diversion rate and under-diversion rate were 33.1% and 34.3%, respectively. The receiver operating characteristic curve of current primary trauma diversion (PTD) criteria had an area under the curve of 66.9% (95% confidence interval: 63%–71%). After adding MOI criteria, the new receiver operating characteristic curve yielded an area under the curve of 73.7% (95% confidence interval: 70%–78%), which is significantly better (p < 0.001). Net reclassification improvement and integrated discrimination improvement indices indicated that including MOI criteria would improve the model prediction. Conclusion: Adding mechanism of injury can improve trauma diversion protocol performance. [ABSTRACT FROM AUTHOR]

Background: Globally, the corona virus disease 2019 (COVID-19) pandemic has created an interpersonally threatening context within which other people have become a source of possible threat. This study reports on the development and validation of a self-report measure of pandemic paranoia; that is, heightened levels of suspicion and mistrust towards others due to the COVID-19 pandemic. Methods: An international consortium developed an initial set of 28 items for the Pandemic Paranoia Scale (PPS), which were completed by participants from the UK (n = 512), USA (n = 535), Germany (n = 516), Hong Kong (n = 454) and Australia (n = 502) using stratified quota sampling (for age, sex and educational attainment) through Qualtrics and translated for Germany and Hong Kong. Results: Exploratory factor analysis in the UK sample suggested a 25-item, three-factor solution (persecutory threat; paranoid conspiracy and interpersonal mistrust). Confirmatory factor analysis (CFA) on the remaining combined sample showed sufficient model fit in this independent set of data. Measurement invariance analyses suggested configural and metric invariance, but no scalar invariance across cultures/languages. A second-order factor CFA on the whole sample indicated that the three factors showed large loadings on a common second-order pandemic paranoia factor. Analyses also supported the test–retest reliability and internal and convergent validity. Conclusion: The PPS offers an internationally validated and reliable method for assessing paranoia in the context of a pandemic. The PPS has the potential to enhance our understanding of the impact of the pandemic, the nature of paranoia and to assist in identifying and supporting people affected by pandemic-specific paranoia. [ABSTRACT FROM AUTHOR]

Background: Young people often experience dramatic changes, both psychologically and physically, as they are transiting from students to working adults. However, there is still a lack of empirical studies on the relationship between the trait emotional intelligence and the career adaptability of youths in the Asia-Pacific region. This research examines that relationship in Chinese youths in Hong Kong. Method: Cross-sectional data (N = 500) was collected from two universities in 2019 and 2020. The 2019 sample was made up of 256 Chinese university students (117 males, 139 females; ages 21-25). The 2020 sample included 244 Chinese university students (132 males, 112 females; ages 21-25). The participants were asked to complete the Wong and Law Emotional Intelligence Scale (WLEIS) to evaluate their emotional intelligence in the domains of self-emotion appraisal, other people's emotion appraisal, regulation of emotion, and use of emotion. Participants completed the Career Adapt-Abilities Scale (CAAS) to assess their career adaptability in the areas of concern, control, curiosity, and confidence. Results: All domains of trait emotional intelligence were positively associated with career adaptability. Multiple Regression analysis showed that self-emotion appraisal and appraisal of other people's emotional were the most predictive factors in terms of career adaptability. Together, these two dimensions of emotional intelligence explain 12.5%, 26.2%, 13.4% and 69.4% respectively of the variance in students' concern, control, curiosity, and confidence in relation to career adaptability. Conclusion: The results highlight the importance of emotional intelligence in career adaptability. It is thus of value to study further whether career adaptability of young people may improve if emotional intelligence is incorporated into the student curriculum. The findings offer valuable insights for educators and teachers who are responsible for well-rounded development of students, and will thereby foster healthy lifestyles, stable emotional well-being and greater career adaptability in adolescents. [ABSTRACT FROM AUTHOR]

Background: Determining the core competence of advanced practice nurses is foundational for promoting optimal design and implementation of advanced practice nursing roles. Core competencies specific to the contexts of the advanced practice nurse in Hong Kong have been developed, but not yet validated. Thus, this study aims to assess the construct validity of advanced practice nurse core competence scale in Hong Kong. Methods: We performed a cross-sectional study using an online self-report survey. Exploratory factor analysis was used to examine the factor structure of a 54-item advanced practice nurse core competence scale through principal axis factoring with direct oblique oblimin rotation. A parallel analysis was conducted to determine the number of factors to be extracted. The Cronbach's α was computed to evaluate the internal consistency of the confirmed scale. The STROBE checklist was used as reporting guideline. Results: A total of 192 advanced practice nurse responses were obtained. Exploratory factor analysis led to the final 51-item scale with a three-factor structure, which accounted for 69.27% of the total variance. The factor loadings of all items ranged from 0.412 to 0.917. The Cronbach's alpha of the total scale and three factors ranged from 0.945 to 0.980, indicating robust internal consistency. Conclusion: This study identified a three-factor structure of the advanced practice nurse core competency scale: client-related competencies, advanced leadership competencies, and professional development and system-related competencies. Future studies are recommended to validate the core competence content and construct in different contexts. Moreover, the validated scale could provide a cornerstone framework for advanced practice nursing roles development, education, and practice, and inform future competency research nationally and internationally. [ABSTRACT FROM AUTHOR]

Aim: Student engagement is an important factor to the success of higher education. This study aimed to develop a Generic Student Engagement Scale (GSES) for face‐to‐face and online learning. Design: This was a cross‐sectional psychometric study. Methods: We tested the psychometric properties of GSES in 451 students at the school of nursing and health studies undertaking online and face‐to‐face learning at a local university in Hong Kong between 2016 and 2018. Results: Content validity, face validity and test–retest reliability of GSES were satisfactory. The 29‐item GSES contains five factors "self‐regulated learning," "cognitive strategy use," "experienced emotion," "teacher–student interaction," and "enjoyment of school life" with the good model fit. The GSES is a reliable and valid psychometric instrument to measure student engagement in face‐to‐face and online learning among undergraduates and higher diploma students. Our results implied that student engagement can be assessed in routine or research by using our instrument. [ABSTRACT FROM AUTHOR]

Circulating concentrations of metabolites (collectively called kynurenines) in the kynurenine pathway of tryptophan metabolism increase during inflammation, particularly in response to interferon-gamma (IFN-γ). Neopterin and the kynurenine/tryptophan ratio (KTR) are IFN-γ induced inflammatory markers, and together with C-reactive protein (CRP) and kynurenines they are associated with various diseases, but comprehensive data on the strength of associations of inflammatory markers with circulating concentrations of kynurenines are lacking. We measured circulating concentrations of neopterin, CRP, tryptophan and seven kynurenines in 5314 controls from 20 cohorts in the Lung Cancer Cohort Consortium (LC3). The associations of neopterin, KTR and CRP with kynurenines were investigated using regression models. In mixed models, one standard deviation (SD) higher KTR was associated with a 0.46 SD higher quinolinic acid (QA), and 0.31 SD higher 3-hydroxykynurenine (HK). One SD higher neopterin was associated with 0.48, 0.44, 0.36 and 0.28 SD higher KTR, QA, kynurenine and HK, respectively. KTR and neopterin respectively explained 24.1% and 16.7% of the variation in QA, and 11.4% and 7.5% of HK. CRP was only weakly associated with kynurenines in regression models. In summary, QA was the metabolite that was most strongly associated with the inflammatory markers. In general, the inflammatory markers were most strongly related to metabolites located along the tryptophan–NAD axis, which may support suggestions of increased production of NAD from tryptophan during inflammation. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to examine and compare decision‐making preferences on end‐of‐life care for older people in Japan, the Hong Kong SAR and South Korea. Background: Cultural values and beliefs influence decision‐making on end‐of‐life care. Design: A cross‐sectional design was adopted. Methods: Community‐dwelling people aged ≥65 with additional requirements were recruited in 2016–2017 in the three regions. Their decision‐making preferences on end‐of‐life care were assessed using Pang et al.'s questionnaire. These preferences and their sociodemographic and personal experience variables were compared and analysed using univariate and multiple logistic regressions. The STROBE checklist was followed. Results: This study involved 415 participants. In all three regions, the most preferred decision maker and person with whom to discuss end‐of‐life care issues was a family member. Participants in the Hong Kong SAR were less likely to select a family member as their preferred decision maker than those in Japan (adjusted odds ratio = 0.129). Koreans were less likely to discuss end‐of‐life care issues with medical professionals than people in Japan (adjusted odds ratio = 0.278). More than 70% of the participants in each region indicated that they would not prefer to leave an advance directive to decide their end‐of‐life care. Conclusion: Older Asians prefer to make their own decisions after consulting others. Family members play an important role in helping older people plan their preferred end‐of‐life care arrangements, even acting as decision makers when older people become incapable of deciding for themselves. Relevance to clinical practice: Sufficient information should be provided to older people and their families for the older people to determine their preferred care. Helping families to understand and support the planned care and advance directives is a strategy for maximising family compliance with the care. Continuous efforts should be made to promote advance care planning and advance directives. [ABSTRACT FROM AUTHOR]

The sociodemographic and career-related characteristics of two types of youth who are not in education, employment or training (NEETs) in Hong Kong were examined and compared: longer-term (≥5 months, n = 787) and transitional (<5 months, n = 3,939). After controlling for sociodemographic variables, multivariate logistic regression analyses showed that longer-term NEETs are more likely to be associated with risk factors such as taking a carer role, seclusion at home, involvement in deviant activities, having addiction or health problems; whereas higher educational attainment, identification of career interest and plans for future work/study/ training, and higher career adaptability appeared to be protective factors for NEETs and identifiers of transitional NEETs. Implications are drawn for research and career support services for NEETs. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to explore and compare stress, coping, professional identity and work locus of control of new graduate nurses among Shanghai, Hong Kong and Taipei. Background: The transition from a student to a staff nurse role is recognized as a stressful experience and can be a rough journey. Many newly graduated nurses find it challenging to cope with their new roles in their first few months. Methods: A cross‐sectional research was used in the study. This study was completed in Shanghai, Hong Kong and Taipei with newly graduated nurses working in hospitals. A total of 591 graduate nurses who had worked within 1 year in hospitals were recruited using convenient sampling. Data were collected using a structured questionnaire, including demographics, the occupational stress scale, the Chinese trait coping style questionnaire, the nurse professional identity scale and the work locus of control scale (Chinese version). Results: The newly graduated nurses in Shanghai had significantly lower (p < 0.05) work stress score (2.65 ± 0.67) compared with their counterparts in Hong Kong (2.99 ± 0.69) and Taipei (2.94 ± 0.60). Newly graduated nurses in Shanghai tended to choose positive coping to deal with stressful situations, whereas those in Hong Kong would be more likely to adopt negative attitudes (p < 0.05). The newly graduated nurses in Taipei had the lowest level of professional identity (3.25 ± 0.55, p < 0.05), and their work control tended to be external (46.13 ± 6.20). In contrast, those in Shanghai (52.75 ± 6.04) and Hong Kong (59.41 ± 7.29) tended to be controlled internally. Conclusions: The study findings revealed the differences among newly graduated nurses in Shanghai, Hong Kong and Taipei with their level of stress, coping, professional identity and work locus of control. Proper leadership, mentoring for newly graduated nurses, and emphasis on first aid nursing training, emotional management and management of stress in newly graduated nurse transition programmes were suggested. Implications for Nursing Management: By comparing the results in the three regions, we recommend that nursing managers promote the right leadership style. In addition to coaching, nursing managers can assign additional mentors to newly graduated nurses to help them supplement their clinical knowledge and skills with psychological support. These mentors can come from senior nurses or nursing managers working on less demanding tasks. In addition to the existing post transfer training programmes, new graduate nurses should also focus on emergency nursing training, emotional management training and stress management training. [ABSTRACT FROM AUTHOR]

To investigate the risk factors associated with bedbug infestations among Hong Kong households, self-reported questionnaires in Chinese were distributed online between June 2019 and July 2020. The questionnaire collected data on participants' sociodemographics, history of bedbug infestation, and housing situation. Among the 663 participants who completed the questionnaire, 422 (63.7%) have experienced bedbug infestations in the past year, they were concentrated around the Kowloon region. Weighted bivariate and multivariate binary logistic regression were performed to identify the statistically significant (p value < 0.05) factors associated with bedbug infestations. Bivariate analysis shows a positive correlation between the number of reported dilapidated housing features and bedbug infestation. For multivariate analysis, those aged 45–64 (OR = 2.53, 95% CI 1.30–4.91), have primary education or below (OR = 9.43, 95% CI 3.12–28.44), and monthly household income ≤ HKD30,000 (OR = 1.69, 95% CI 1.15–2.5) were more likely to have bedbug infestation compared to their respective reference groups, i.e., ≥ 65, tertiary education, and > HKD30,000; housing risk factors identified are living in subdivided flats (OR = 16.53, 95% CI 1.01–269.72), crowded household (OR = 1.55, 95% CI 1.06–2.28), having second-hand furniture (OR = 2.97, 95% CI 1.16–7.58), housing cleanliness issues (OR = 2.66, 95% CI 1.13–6.25), and presence of bedbugs in neighbouring residential units (OR = 3.32, 95% CI 1.57–7.04) or on the streets (OR = 1.9, 95% CI 1.12–3.23). This study has identified lower income, lower education level, crowded household, living in subdivided flats, and certain dilapidated housing features to be risk factors of bedbug infestations; efforts and policies should prioritise vulnerable groups and focus on addressing the housing risk factors identified in this study. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) has recently been recognised as a global public health issue that can cause various kinds of long‐lasting physical, sexual and psychological health problems. Limited studies are available concerning the relationship between objective and subjective socioeconomic status (SES) and IPV, and the impact of experiencing IPV on health consequences. This is a cross‐sectional study aiming to examine the association between objective and subjective SES as risk factors of IPV, and further investigate how they affect health status in adults who experienced IPV. A total of 400 participants were recruited from June to September 2016 among 18 districts in Hong Kong. Results from multiple linear regression showed that having a higher education (adjusted B [aB] = 0.22, 95% CI = 0.01, 0.45), having lower levels of subjective SES (aB = −0.08, 95% CI = −0.15, −0.01), experiencing childhood stress (aB = 0.58, 95% CI = 0.27, 0.89) and being married (aB = 0.60, 95% CI = 0.01, 1.19) were significantly associated with IPV. While employment and household income were not associated with IPV. Participants with higher levels of subjective SES were more likely to report somatic symptom (aB = −0.44, 95% CI = −0.87, −0.02), anxiety (aB = −0.38, 95% CI = −0.72, −0.04) and depressive symptom (aB = −0.52, 95% CI = −0.94, −0.10). Low subjective SES, instead of low objective SES, was found associated with IPV in Chinese adults. A priority for future studies is the confirmation and expansion of subjective SES and its function in clinical measures. Programmes instilling hope and optimism will be helpful to enhance subjective SES and boost physical and mental well‐being in IPV survivors. [ABSTRACT FROM AUTHOR]

A career ladder for nurses, including several levels of nursing practice and specific roles for advanced practice nurses, was introduced in Hong Kong around the start of the 21st century. To date no studies have distinguished the practices of advanced practice nurses in Hong Kong. This cross‐sectional study, conducted between November 2020 and March 2021, aims to identify and differentiate the practice patterns of advanced practice nurses by utilizing the Advanced Practice Role Delineation tool. A total of 191 responses were obtained. Three roles were identified: nurse consultant, advanced practice nurse, and advanced practice nurse in management. Among the five advanced practice nursing domains, nurses were most frequently involved in Education and in Direct Comprehensive Care activities, while least active in Research and in Publication and Professional Leadership. Identifying activities in various nursing roles helps to differentiate their responsibilities and provides new insights for role utilization and support. Although the role characteristics are shaped by country contexts, research evidence on practice patterns may be used to support international discussion and efforts to promote role clarity and effective role introduction and optimization. [ABSTRACT FROM AUTHOR]

Background: Protecting a person's right to privacy and confidentiality is important in healthcare services. As future health professionals, nursing students should bear the same responsibility as qualified health professionals in protecting patient privacy. Objectives: To investigate nursing students' practices of patient privacy protection and to identify factors associated with their practices. Research design: A cross-sectional study design was adopted. A two-part survey was used to collect two types of data on nursing students: (1) personal characteristics, including demographics, clinical experience and use of information and communication technology and social media and (2) practice of patient privacy protection, collected using the Patient Privacy Scale. Participants and research context: A total of 319 nursing students aged 18 or above, studying pre-registration nursing programmes and who had attended at least one block of clinical placement, were recruited from a university in Hong Kong. Ethical considerations: The study received ethical approval from the Survey and Behavioural Research Ethics Committee of the Chinese University of Hong Kong. The participants were informed of the study aim and written consent was obtained before completing the survey. Findings: The mean total score on the Patient Privacy Scale was 119.7 out of 135. Nursing students who were regular users of Instagram and those who had never taken photographs with patients and hence did not need to obtain patient consent were associated with better practices of patient privacy protection (higher total scores on the Patient Privacy Scale). Conclusions: The findings improve our understanding of nursing students' practice of patient privacy protection and the associated factors. This will inform the development and revision of current strategies to enhance nursing students' practice of patient privacy protection, especially their use of social media. [ABSTRACT FROM AUTHOR]

Grounded in social cognitive theory (SCT), this study sought to examine whether parents perceived social cognitive factors regarding children's physical activity (PA) behaviors were associated with preschool children's moderate-to-vigorous PA (MVPA) levels. A total of 142 Hong Kong parent-child pairs from five preschools/childcare centers completed all assessments in the cross-sectional study. Children's (42% girls; mean age = 4.52 ± 0.67 years) PA was measured through accelerometers. Parents (74% mothers; mean age = 37.38 ± 4.63 years) completed a paper-based questionnaire assessing the social cognitive factors on their children's PA participation. The data were analyzed using latent variable structural equation modeling. Findings revealed that the model showed acceptable fit with the data: χ2 (23) = 38.14, p =.025, χ2/df = 1.66, CFI = 0.955, TLI = 0.929, RMSEA = 0.068, 90% CI [0.025, 0.106], and SRMR = 0.072. The model accounted for 39.1% of the variance in the PA behavior of preschool-aged children. Structural equation modelling revealed parental self-efficacy (β = 0.29, 95% CI [0.95, 0.49]) and goal setting (β = 0.25, 95% CI [0.06, 0.44]) were directly associated with children's MVPA. Outcome expectations (β = 0.09, 95% CI [0.01, 0.03]) and goal setting (β = 0.18, 95% CI [0.05, 0.32]) mediated the association between parental self-efficacy and children's MVPA. Indirect associations of parental self-efficacy from setting goals via parental support (β = 0.15, 95%CI [0.02, 0.30]) and perceived barriers (β = 0.15, 95% CI [0.05, 0.28]) were uncovered. Results supported the use of SCT in understanding how the parents perceived social cognitive factors predict the PA behaviors of young children. This study provides insight into whether these theoretical variables could be modified or promoted in future intervention programs. Enhancing parents' abilities to ensure preschool-aged children are physically active is of great importance given the global decline in PA among children. • Social cognitive theory represents a useful model to understand preschool-aged children's physical activity. • Parental self-efficacy and goal setting exerted a direct effect on children's physical activity levels. • Goal setting was found to mediate the relationship between parental self-efficacy and child moderate-to-vigorous physical activity. • Parents play a pivotal role in shaping and sustaining their children's physical activity behaviors. [ABSTRACT FROM AUTHOR]

Loneliness (inclusive social loneliness and emotional loneliness) of older adults is a prominent public health issue internationally. Factors consistently associated with loneliness are age, gender, education, living arrangements, social network, and functional status. Intergenerational co‐living with spouse and adult children is important for the exchange of social, emotional, practical, and financial support provided to older adults. Co‐living with migrant domestic workers (MDWs) to care for older adults became an emergent phenomenon internationally, particularly in Asian countries. According to the convoy model of social relations, the effect of co‐living with MDWs on older adults' loneliness is unknown. This study examined (1) the prevalence of loneliness among community‐dwelling older adults; and (2) the association between co‐living with MDWs and older adult loneliness. Using the Chinese version of the 6‐item De Jong Gierveld Loneliness Scale on loneliness, 380 older adults were interviewed at busy points in Hong Kong, including subway stations. 35.3% of older adults experienced moderate‐to‐severe loneliness. Linear regression was performed to examine the association between co‐living with MDWs and loneliness. The results showed that co‐living with MDWs was significantly associated with lower levels of overall loneliness (β = −0.636; p =.022) and emotional loneliness (β = −0.298, p =.039), but not for social loneliness (β = −0.337, p =.084). While MDWs could be an attachment figure for older adults, they might not be effective in promoting the social integration of older adults. There is a need to investigate the barriers of social integration faced by older adults co‐living with MDWs. [ABSTRACT FROM AUTHOR]

Introduction: Dating is an occupation through which people form intimate relationships with others. Despite the importance of intimate relationships for wellbeing, there is limited information available in occupational therapy literature about the activities involved in dating and little guidance for practitioners who wish to support clients from diverse backgrounds who experience difficulties with dating. To address this gap, this study sought to explore dating among young adults (18–35 years) and compare dating activities between two contexts: Australia and Hong Kong. Methods: Data were collected using an e‐survey designed for this study and refined using cognitive interviewing (n = 12). It included questions about dating initiation and activities. Study design and reporting was guided by the Checklist for Reporting Results of Internet E‐Surveys. Data were analysed using descriptive statistics and between group comparisons. Reponses to open ended questions were subjected to interpretative content analysis and quantified. Results: In total, 2208 young adults aged 18–35 who had at least one dating experience and resided in either Australia or Hong Kong completed the survey. Participants met their dates most commonly through school, friends, dating apps, and work. The most frequent ways to ask a person on a date were by suggesting 'hanging out' or going out for food, drink or to the movies. Most participants reported that organising a date required extended negotiation between the parties. Differences were found between participants from Hong Kong and Australia. Conclusions: This is the first study of contemporary dating from an occupational perspective and provides an understanding of dating activities in two different cultural contexts. [ABSTRACT FROM AUTHOR]

Background: Traditional Chinese medicine (TCM) and Western medicine are available and have a long history in Hong Kong. Little is known on the intention to use TCM in Hong Kong. In this study, the intention to use TCM was examined by the extended theory of planned behavior. Methods: An online cross-sectional survey was conducted from 15 and 29 November 2021. Respondents' attitude towards using TCM, intention to use TCM, knowledge, perceived behavioral control, perceived service quality, satisfaction, subjective norms and demographic characteristics were collected from the survey. To examine the conceptual framework in this study, partial least square structural equation model (PLS-SEM) was adopted. Results: In total, 446 responses (completion rate = 74.3%) were analysed. Attitude towards TCM was the strongest predictor to the intention to use TCM followed by satisfaction and subjective norms. Attitude had a partial mediating effect on the relationship between subjective norms, perceived behavioral control and intention to use TCM. Attitude had a full mediating effect on the relationship between knowledge and intention to use TCM. Satisfaction had a full mediating effect on the relationship between perceived service quality and intention to use TCM. Conclusions: This is the first study to investigate the predictors of the intention to use TCM in Hong Kong by using TPB. Individuals' attitude towards TCM has showed stronger effect to the intention to use TCM than other predictors, such as satisfaction, perceived behavioral control and subjective norms. To enhance the intention to use TCM in Hong Kong, key stakeholders, including TCM professional organisations, health professionals and policymakers, should develop a positive attitude towards TCM among Hong Kong population. [ABSTRACT FROM AUTHOR]