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This study presented preliminary results on the efficacy of a novel group debriefing model called Strength-Focused and Meaning-Oriented Approach for Resilience and Transformation (SMART). The SMART debriefing (1) aimed at boosting resilience and catalyzing transformation among persons undergoing stressful events, (2) adopted a growth-oriented and holistic approach of health promotion, and (3) employed methods drawn from various indigenous sources (e.g. Asian philosophies and Traditional Chinese Medicine). Participants (N=51) were people with chronic diseases recruited about 1 month (August 2003) after the Severe Acute Respiratory Syndrome (SARS) outbreak was eventually under control, after causing widespread panic in Hong Kong. After the one-day group debriefing, participants showed significant decrease in depression level, as measured by Brief Symptom Inventory (Derogatis & Melisaratos, 1983, Psychological Medicine, 13(3), 595-605) and changes in cognitive appraisal towards SARS. Such changes were sustained in a 1-month follow-up. Clinical implications and directions for further study were discussed. [ABSTRACT FROM AUTHOR]

Body-Mind-Spirit (BMS) model by Chan (2001) have been applied to interventions for a variety of clienteles and the effectiveness has been supported by positive psychological outcomes. This study aims to complement these studies by evaluating the efficacy of a one-hour Eastern stress management session in reducing salivary cortisol levels in working adults in Hong Kong. Pre- and post-test salivary cortisol levels were measured and a significant drop after the session when compared with local normative data was evident. The efficacy of the stress management session, limitations of this study and suggestions for further research are discussed. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The Body-Mind-Spirit model of health promotion (Chan, Ho&Chow, 2002) guided the construction of a multidimensional inventory for assessing holistic health. Named Body-Mind-Spirit Well-Being Inventory (BMSWBI), it comprises four scales: Physical Distress, Daily Functioning, Affect, and Spirituality (differentiated from religiosity and conceived as ecumenical). Respondents (674 Chinese adults from Hong Kong) completed the BMSWBI via the Internet. Results indicate that all four scales have high reliability, with alpha coefficients ranging from .87 to .92, and concurrent validity. Factor analysis indicates that (a) positive and negative affect form two distinct factors; and (b) spirituality comprises three distinct aspects, tranquility, resistance to disorientation, and resilience. Spirituality is positively associated with mental well-being, positive affect, satisfaction with life, and hope; but negatively associated with negative affect and perceived stress. These results suggest that the inventory may be used to assess different dimensions of health satisfactorily. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 43-year-old female presented with a 10-month history of recurrent regurgitation of undigested foods which was later diagnosed as rumination syndrome. It notes ineffective esophageal motility (IEM) as the best alternative treatment over a trial of trial of metoclopramide, domperidone, amitriptyline and baclofen.

The influence of gaze cues on target prioritization (reaction times (RTs)) and movement execution (movement trajectories) differs based on the ability of the human gaze cue model to manually interact with the targets. Whereas gaze cues consistently impacted RTs, movement trajectories may only be affected when the hands of the human model had the potential to interact with the target. However, the perceived ability to interact with the targets was confounded by the proximity between the model's hands and the targets. The current study explored if the influence of gaze cues on movement trajectories is shaped by the model's potential to access and interact with the targets using their hands or simply the proximity of the hands. A centrally presented human model randomly gazed towards one of two peripheral target locations. Participants executed aiming movements to targets that non-predictively appeared at one location at a stimulus onset asynchrony of 100, 350, or 850 ms. In Experiment 1, the model's hands could not directly access the targets as each was holding a tray. In Experiment 2, the hands had direct access to the targets, but their palms-downwards orientation and wrist-flexed posture rendered efficiently interacting with the targets unlikely. Although RTs showed a facilitation effect of the gaze cue in both experiments, changes in movement trajectories were only observed when the model had direct access to the target (Experiment 2). The results of the current study suggest that the gaze model's direct hand access is necessary for the social gaze cues to influence movement execution.

Introduction: This cross-sectional survey research investigated mental health symptoms and quality of life among Chinese parents and their children with eczema at a paediatric dermatology clinic in Hong Kong from November 2018 to October 2020., Methods: Health-related quality of life, eczema severity, and mental health among children with eczema, as well as their parents' mental health, were studied using the Children's Dermatology Life Quality Index (CDLQI), Infants' Dermatitis Quality of Life Index (IDQOL), Nottingham Eczema Severity Score (NESS), Patient-Oriented Eczema Measure (POEM), and the Chinese version of the 21-item Depression, Anxiety, and Stress Scales (DASS-21)., Results: In total, 432 children and 380 parents were recruited. Eczema severity (NESS and POEM) and health-related quality of life (CDLQI) were significantly positively associated with parental and child depression, anxiety, and stress levels according to the DASS-21, regardless of sex (children: r=0.28- 0.72, P<0.001 to 0.007; parents: r=0.20-0.52, P<0.001 to 0.034). Maternal depression was marginally positively associated with increased anxiety in boys with eczema (r=0.311; P=0.045). Younger parents had higher risk of developing more anxiety and stress compared with the older parents (adjusted odds ratio [aOR]=-0.342, P=0.014 and aOR=-0.395, P=0.019, respectively). Depression level of parents with primary to secondary education was 58% higher than their counterparts with post-secondary education or above (aOR=-1.579; P=0.007)., Conclusion: Depression, anxiety, and stress among children with eczema and their parents were associated with eczema severity and impaired quality of life in those children. These findings regarding impaired mental health in children with eczema and their parents highlight the need to include mental well-being and psychosocial outcomes in future studies and clinical practice., Competing Interests: As an editor of the journal, KL Hon was not involved in the peer review process. Other authors have disclosed no conflicts of interest.

Introduction: This study presents contemporary epidemiological data regarding the prevalence and severity of asthma and wheezing among children in Hong Kong, which provides an update to the results of the International Study of Asthma and Allergies in Childhood (ISAAC) conducted in 1994-1995 and 2001-2003., Methods: This cross-sectional investigation was based on the ISAAC study protocol. Responses from 1100 children aged 6 to 7 years (Primary 1-2) and 1048 children aged 13 to 14 years (Secondary 2-3) in Hong Kong between September 2020 and August 2021 were analysed. Sex differences within each age-group were assessed using Chi squared and independent t tests. Demographic information was entered into hierarchical logistic regression models to identify potential predictive factors associated with asthma severity. Annual change in prevalence was calculated via division of the prevalence by the number of years between surveys. Logistic regression modelling was conducted to identify risk factors associated with asthma severity., Results: The prevalences of current wheezing were 6.19% and 4.97% in the primary and secondary school groups, respectively. The prevalences of asthma ever were 5.55% and 6.12%, whereas those of wheezing ever were 20.38% and 12.05%, in the primary and secondary school groups, respectively., Conclusion: Asthma severity and prevalence have decreased in Hong Kong since 1994-1995. A followup study will explore the protective and risk factors contributing to these trends., Competing Interests: All authors have disclosed no conflicts of interest.

The emotional consequences of infertility are well documented. However, relatively few studies have emphasized the dyadic emotional interaction within couples, despite infertility being a shared life event. This study adopted a dyadic (between two people) approach to explore the emotional complexity that infertile couples face. A descriptive qualitative study was conducted with 24 participants, including eight infertile couples and eight wives undergoing infertility treatments. Conjoint and individual interviews were conducted through purposive sampling in a large fertility centre in Tianjin, China, between June and August 2015. Thematic analysis identified two main themes: (i) 'decisional ambivalence', with subthemes of 'ambivalent attitudes towards treatment', 'uncertainty about treatment outcomes', and 'treatment-related lifestyle changes'; and (ii) 'relational ambivalence' which included subthemes of 'intergenerational ambivalence' and 'partner ambivalence'. Complex emotions of ambivalence among infertile couples were common as infertility clearly shattered their assumptive world on family formation. With complex entanglement of mixed emotions, ambivalence was intimately associated with cultural norms, social expectations, and active or over engagement of family members in Chinese societies. Since ambivalence could threaten mental and physical health during pregnancy, healthcare professionals should be prepared to assist infertile couples with identifying, articulating, and normalizing decisional and relational ambivalence during the treatment process.

Competing Interests: As an editor of the journal, KL Hon was not involved in the peer review process. Other authors have no conflicts of interest to disclose.

Background: Studies on the relationship between childhood allergic disease and health-related quality of life (HRQOL) have mostly been confined to a single allergic condition. Therefore, a composite allergic score (CAS) was derived to assess the accumulated effect of eczema, asthma, and allergic rhinitis on HRQOL in Hong Kong schoolchildren., Methods: Parents of grade one/two or grade eight/nine schoolchildren completed a questionnaire assessing the prevalence and severity of eczema (POEM), asthma (C-ACT/ACT), and allergic rhinitis (VAS) and schoolchildren's HRQOL (PedsQL). Three rounds of recruitment were conducted. A total of 19 primary and 25 secondary schools agreed to participate., Results: Data from 1140 caregivers of grade one/two schoolchildren and 1048 grade eight/nine schoolchildren were imputed and analyzed. The proportion of female respondents were lower in grade one/two (37.7%) but higher in grade eight/nine (57.3%). 63.8% of grade one/two and 58.1% of grade eight/nine schoolchildren reported having at least one allergic disease. In general, greater disease severity was significantly associated with lower HRQOL. After controlling for age, gender, and allergic comorbidity in hierarchical regressions, CAS significantly predicted all HRQOL outcomes in both grade one/two and grade eight/nine schoolchildren. Female grade eight/nine schoolchildren reported lower HRQOL outcomes., Conclusion: Composite allergic score may be a practical tool to evaluate allergic comorbidity and the effectiveness of treatments targeting common pathological mechanisms of allergic diseases. Non-pharmaceutical approaches should be considered, especially for patients with more than one allergic disease and greater severity., (© 2023 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)

Background: The manifestations of Polycystic Ovary Syndrome (PCOS), including acne, hirsutism, obesity, uncertain fertility, etc., can make women anxious, worried, or even depressed with their appearance and body. However, little relevant research has been conducted in the Chinese context. This mixed-method study aimed to understand how women with PCOS in China perceive their bodies and to examine the association between body image and depression., Methods: First, 101 PCOS patients participated in a survey using the Body Surveillance subscale of the Objectified Body Consciousness Scale, the Short-form Mishel Uncertainty in Illness Scale, the Appearance Anxiety Scale, and the Beck Depression Inventory-II, which measured participants' self-objectification, illness ambiguity, appearance anxiety, and depression, respectively. Second, fifteen women joined face-to-face semi-structured in-depth interviews, investigating their illness ambiguity, objectified experience, and behaviors to pursue beauty., Results: Results indicated a high level of self-objectification, illness ambiguity, appearance anxiety, and depression among women with PCOS in China and supported the significant associations among the outcomes. Qualitative findings presented a body image of the precarious body, indiscernible identity, and distraught mind., Limitations: A convenient sampling method was used. The generalization of the study results needs further validation. Future longitudinal studies are necessary to clarify the causal relationships among outcomes., Conclusions: This study presented women's body image with PCOS and found the negative impact of body image on their depression levels. This study was of both theoretical and practical significance. Appropriate mind-body therapies were suggested for them., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Introduction: Atopic dermatitis (AD) is the most common childhood inflammatory skin problem affecting 15%-30% of children. Although AD adversely impacts the psychosocial well-being of children and their parent caregivers, parents' psychosocial well-being is seldom mentioned in most non-pharmacological education programmes. A family-based psychosocial intervention, Integrative Body-Mind-Spirit (I-BMS) intervention, is examined. This study compares the efficacy of two versions of the I-BMS intervention (one delivered to both parents and children; one delivered to parents only) with a health education active control (delivered to parents only) in promoting adaptive emotional regulation and quality of life of children with AD and their parent caregivers., Methods and Analysis: This is a three-arm, with equal randomisation, parallel randomised controlled trial. 192 parent-child dyads will be recruited through hospitals and non-governmental organisations in Hong Kong. Each dyad will complete an individual pre-group screening interview. Eligible dyads will be randomised in a ratio of 1:1:1 into one of the three arms. Each arm consists of six weekly sessions. A computer-generated list of random numbers will be used to perform randomisation. The primary outcomes are quality of life and emotional regulation. Assessments are administered at baseline, post-intervention and 6-week follow-up. Mixed factorial Analysis of Covariance (ANCOVAs) based on intention-to-treat principle will be conducted to examine the efficacy of the two I-BMS interventions. Structural equation modelling will be conducted to examine the parent-child interdependent effects of intervention., Ethics and Dissemination: Ethics approval was obtained from the Human Research Ethics Committee of the University of Hong Kong (EA2001001) and the Institutional Review Board of the Hospital Authority of Hong Kong (UW 21-400, KC/KE-20-0360/FR-2, NTEC-2021-0408). Consent will be sought from participating parents and children. Parental consent for child participants will also be obtained. Findings will be presented in peer-reviewed journals and at conferences in medical dermatology, paediatrics and social work., Trial Registration Number: ClinicalTrials.gov Registry (NCT04617977)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Depressed people are prone to sleep disturbance, which may in return perpetuate the depression. Both depression and sleep disturbance influence proinflammatory cytokines interleukin (IL) 6 and 1β. Thus interventions for depression should consider the effect on sleep disturbance, and vice versa. Integrative Body-Mind-Spirit (IBMS) and Qigong interventions have been applied in a wide range of health and mental health conditions, including depression and sleep disturbance. This study aimed to evaluate the effect of these two mind-body therapies for persons with both depressive symptoms and sleep disturbance. A three-arm randomized controlled trial was conducted among 281 participants, who were randomly assigned to either IBMS, Qigong or wait list control group. Participants in IBMS and Qigong groups received eight weekly sessions of intervention. Outcome measures were plasma concentrations of IL-6 and IL-1β, and a questionnaire containing Pittsburgh Sleep Quality Index, Center for Epidemiologic Studies Depression Scale, Somatic Symptom Inventory, Perceived Stress Scale and Body-Mind-Spirit Holistic Well-being Scale. Outcomes were assessed at baseline (T0), immediate post-intervention (T1) and at three-months post-intervention (T2). Besides intervention efficacy analysis, path analysis was performed to explore the relations among perceived stress, depression, sleep disturbance, and IL-6 and IL-1β values. The study found both IBMS and Qigong reduced depression, sleep disturbance, painful and painless somatic symptoms, IL-6 and IL-1β levels, and increased holistic well-being. The effect sizes of IBMS and Qigong, mostly in the medium magnitude range, were approximatively equivalent. Path analysis models revealed a predictive role of perceived stress in depression and sleep disturbance, a bidirectional relationship between depression and sleep disturbance, and significant influence of depression and sleep disturbance on IL-6 and IL-1β. Compared with control, the findings support the efficacy of IBMS and Qigong interventions in relieving depression and sleep disturbance, and in reducing IL-6 and IL-1β levels., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Women with polycystic ovary syndrome (PCOS) suffer significant psychological distress, which may activate the hypothalamus-pituitary-ovary axis and further affect their physiological state. They often experience elevated levels of testosterone and triglycerides. Considering reports of psychological distress among women with PCOS, this study aimed to develop a psychosocial intervention to improve their emotional and physical health, particularly in Chinese society. This pilot study employed the Integrative Body-Mind-Spirit (I-BMS) intervention model for women with PCOS in China. After a 2 h health information session, 18 participants were randomly assigned to the I-BMS group (9) or the control group (9). The intervention group received 6 weekly, 3 h I-BMS sessions. Pre- and post-blood tests and psychosocial questionnaires were collected from all participants. Retention to treatment was high with 79.6% treatment adherence gained and an overall average of five sessions completed. Compared with the control group, depression and anxiety symptoms reduced significantly for those in the intervention group ( d = -1.24, p < 0.05 and d = -1.33, p < 0.01), their health-related quality of life improved significantly ( d = 1.02, p < 0.01) both at post-intervention and 3 month follow-up, and their testosterone and triglycerides levels reduced significantly ( d = -0.97, p < 0.001 and d = -0.41, p < 0.05) after joining the intervention. The I-BMS model is feasible and appears promising in improving psychological health, and reducing testosterone and triglyceride levels, in women with PCOS in China. Clinical Trial Registration: www.chictr.org.cn, identifier ChiCTR1900027606., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Yin, Du, Zou, Fung, Sun, Chan and Chan.)

Background: Physical activity (PA) has been positively associated with health-related quality of life (HRQoL) among cancer patients and family caregivers. However, there has been no relevant research for patient-caregiver dyads., Methods: Path analysis, based on the actor-partner interdependence model (APIM), was used to examine the relationship between physical activity and health-related quality of life and explore the mediating role of emotional distress in 233 dyads., Results: In both patients and caregivers, physical activity had a direct positive effect on physical quality of life (QoL) but not on mental. There was a significant indirect effect of physical activity on health-related quality of life via emotional distress for both dyad members. Patients' and caregivers' confidence in fighting cancer was negatively associated with their own emotional distress. Caregivers' confidence in fighting cancer was positively associated with their physical activity and also negatively associated with patients' emotional distress., Conclusions: Physical activity may be considered as a possible behavioral and rehabilitation strategy for improving health-related quality of life in patient-caregiver dyads and reducing negative symptoms. Future research and intervention may consider cancer patient-family caregiver dyad as a unit of care.

Background: Chlamydia is common amongst the sexually active population in Hong Kong. As most cases are asymptomatic, partner notification may be helpful in controlling chlamydia. This study examined attitudes towards partner notification for chlamydia among Hong Kong Chinese youths in order to inform a culturally appropriate, patient-empowering sexual health service., Methods: Sixteen individuals (aged 20 to 31) who received a confirmed diagnosis of chlamydia within the previous twelve months of data collection were recruited from two community-based organizations between June and December 2017. Semi-structured individual interviews were conducted by a health psychologist., Results: Nine participants notified a total of eleven current and ex-partners. Seven participants did not notify their sexual partner(s). Our findings revealed how participants struggled with the discrediting sexual aspect of their infection, and how de-sexualizing the infection and selected disclosure facilitated partner notification and social acceptance. Perceived stigma regarding chlamydia however did not dissipate with their disclosure. Participants did not perceive lasting impact of chlamydia on their well-being as they thought they have much control over whether and how to disclose to their (future) partners. All participants agreed there was a pressing need to raise public awareness on this silent but highly prevalent sexually transmitted infection., Conclusions: Our findings illustrate the complex struggle behind communicating about chlamydia to one's sexual partner and how strategizing the disclosure process served to circumvent embarrassment and foster testing of sexual partners.

Background: A burgeoning literature has found relationships between telomere length, telomerase activity, and human health and longevity. Although some research links a history of childhood adversity with shortened telomere length, our review found no prior research on the relationship between child maltreatment history and telomerase activity in adulthood. We hypothesized a negative relationship between child maltreatment and telomerase activity and hypothesized that the association would be moderated by sex., Methods: These relationships were tested on a sample of 262 Hong Kong Chinese adults (200 females versus 62 males) with mild to moderate depression., Results: Counterintuitively, emotional abuse was positively associated with telomerase activity, while other maltreatment types were non-significant. The positive relationship between emotional abuse and telomerase activity was significantly moderated by the sex of the participant., Conclusions: We advance two possible explanations for this finding (1) a culturally informed resilience explanation and (2) a homeostatic complexity explanation. The two explanations are not mutually exclusive. This trial is registered under Hong Kong Clinical Trial Register number HKCTR-1929., Significance Statement: Emotional abuse was significantly positively associated with telomerase activity. There are at least two non-mutually exclusive explanations for the findings. Simply put, either (1) in the cultural context of Hong Kong emotional abuse was not a risk factor, and/or (2) the conceptualization of telomerase activity as a straightforward indicator of longevity is overly simplistic. The first story we might term a "resilience explanation" while the second we might call a "homeostatic complexity" story.

Polycystic ovary syndrome (PCOS) has been proposed to be associated with several mental health problems, including anxiety, depression, diminished sexual satisfaction, and lowered health-related quality of life, etc. A systematic review and meta-analysis of published literature was conducted comparing the mental health of women with and without PCOS. Ten English and Chinese databases were searched up to 12/31/2018. Random-effects models were introduced, and subgroup analysis, sensitivity test, and meta-regression were carried out to determine the source for heterogeneity among studies. Forty-six studies, including 30,989 participants (9265 women with PCOS and 25,638 controls), were qualified for review according to the inclusion criteria. Twenty-eight studies reported depression symptoms, 22 studies were on anxiety, 16 studies showed quality of life (QoL) status, 12 studies were about sexual dysfunction, five on emotional distress, four on binge eating, and four on somatization. Women with PCOS reported significantly higher depression (SMD = 0.64; 95% CI 0.50-0.78), anxiety (SMD = 0.63; 95% CI 0.50-0.77), lower QoL (SMD = - 0.55; 95% CI -0.69 to -0.40), and not significant sexual dysfunction (SMD = - 0.24; 95% CI - 0.49 to 0.01). Studies from different countries, adopting various diagnosis criteria, using diverse instruments, as well as in different years, have reported heterogenetic results. Women with PCOS in China reported a larger effect size of depression and anxiety than patients from other countries. The results of this study have indicated that women with PCOS suffer from depression, anxiety, and experience a lower quality of life, whereas their sexual function is not distinct from that of healthy women. Psychological health care interventions for women with PCOS were addressed.

Purposes/objectives: This paper reports the comparative efficacies of integrative body-mind-spirit intervention (I-BMS) and cognitive behavioral therapy (CBT) in patient-caregiver parallel groups for Chinese patients with lung cancer. Design: Randomized controlled trial (RCT). Methods: One hundred and fifty-seven patient-caregiver dyads with no marked functional impairment were randomized into one of the two interventions with eight weekly patient-caregiver parallel groups. Assessments were conducted at baseline, within one, eight- and sixteen-weeks post-intervention. Effects of treatment group across time were analyzed by multilevel modeling. Findings: CBT led to greater reduction in emotional vulnerability than I-BMS. I-BMS resulted in greater increase in overall QoL and spiritual self-care, and more reduction in depression than CBT. Patients in both interventions experienced improvement in physical, emotional and spiritual, except social, domains of QoL. Conclusion: I-BMS was more efficacious for diverse domains of QoL, and CBT was more effective for emotional well-being, despite the relatively small between-group effect sizes. Implications for psychosocial providers/policy: (1) With the expanding repertoire of psychosocial interventions for families facing lung cancer, it has become imperative to investigate the comparative efficacies of empirically supported and culturally adapted interventions. (2) Our findings show that I-BMS was more effective for diverse domains of QoL, while CBT was more efficacious with emotional well-being, although both interventions led to significant improvements in physical, emotional and spiritual domains of patient QoL. (3) Patient-caregiver parallel groups have been shown to be effective for enhancing QoL of Chinese lung cancer patients. (4) Care professionals are encouraged to dispense interventions based on the idiosyncratic needs and preferences of the patients to maximize the treatment effects.

Background: Little research effort has been devoted to examining the role of patient enablement in alleviating health anxiety in primary care. In this study, we examined the role of patient enablement as a moderator in the relationship between health anxiety, psychological distress, and treatment seeking in traditional Chinese medicine (TCM)., Methods: The participants were 634 patients of a government-subsidized Chinese medicine outpatient clinic in Hong Kong. They were asked to complete a series of questionnaires on patient enablement, health anxiety, anxiety, depression, physical distress, annual clinic visits, and service satisfaction and provided various demographic details. Descriptive statistics, correlations, and general linear models were used to analyze the data., Results: We found that patient enablement correlated positively with service satisfaction. Patient enablement also interacted significantly with health anxiety in affecting indices of psychological distress (depression, anxiety) and treatment seeking (annual visits). Among highly enabled patients, the positive association between health anxiety and indices of psychological distress was weakened, and they also showed more health anxiety-driven treatment seeking as measured by annual clinic visits., Conclusion: These findings suggest a moderating mechanism by which patient enablement weakens the relationship between health anxiety on psychological well-being and increases treatment-seeking behavior in TCM. Practitioners are encouraged to provide sufficient information to patients to foster self-care and disease self-management using complementary and alternative medicine (CAM)., (Copyright © 2020 Chan, Lau, Chan, Leung, So and Chan.)

Childhood sexual abuse (CSA) has been shown to predict the coupling of depression and inflammation in adulthood. Trust within intimate relationships, a core element in marital relations, has been shown to predict positive physical and mental health outcomes, but the mediating role of trust in partners in the association between CSA and inflammation in adulthood requires further study. The present study aimed to examine the impact of CSA on inflammatory biomarkers (IL-6 and IL-1β) in adults with depression and the mediating role of trust. A cross-sectional survey data set of adults presenting with mood and sleep disturbance was used in the analysis. CSA demonstrated a significant negative correlation with IL-6 level (r = -0.28, p<0. 01) in adults with clinically significant depression, while trust showed a significant positive correlation with IL-6 level (r = 0.36, p < .01). Sobel test and bootstrapping revealed a significant mediating role for trust between CSA and IL-6 level. CSA and trust in partners were revealed to have significant associations with IL-6 level in adulthood. Counterintuitively, the directions of association were not those expected. Trust played a mediating role between CSA and adulthood levels of IL-6. Plausible explanations for these counterintuitive findings are discussed., Competing Interests: The authors have declared that no competing interests exist.

Purpose: The study adopted a randomized controlled trial to compare the effect of culturally compatible psychosocial interventions on multiple aspects of quality of life (QoL) for family caregivers of lung cancer patients., Methods: 157 Chinese informal caregivers of lung cancer patients were recruited together with the family members for whom they were providing care, and randomly assigned to either integrative body-mind-spirit intervention (I-BMS) or cognitive behavioral therapy (CBT). Patient-caregiver dyads attended the same arm of intervention in separate groups for 8 weeks. Assessments of generic QoL, anxiety, depression, perceived stress, insomnia, and caregiving burden were measured before intervention (T 0 ), within 1-week (T 1 ), 8-week (T 2 ), and 16-week (T 3 ) post-intervention., Results: Adopting the intention-to-treat analysis, family caregivers in receipt of both I-BMS and CBT exhibited a statistically significant improvement in generic QoL immediately following intervention and at follow-up assessments, with moderate effect size. Improvement of insomnia was found at T 1 for both modes, which deteriorated at follow-up; both modes reduced anxiety and perceived stress at follow-up. No intervention effect was observed in depression and domains of caregiving burden. There was no significant interaction effect between intervention type and time. No main or interaction effect between sample background variables and intervention type was found to predict symptomatic changes at T 1 and T 3 ., Conclusions: Culturally attuned I-BMS and CBT exhibited equivalent effectiveness in improving psychological distress and generic QoL for family caregivers of lung cancer patients. To improve the evaluation of outcomes, future study could benefit from incorporating a usual care control.

Background: While the literature on healthcare decision-making has long focused on doctor-patient interaction, fertility treatment is an exception, characterized by a triangular interplay between the doctor, the woman and her partner. This study examined treatment decision-making preferences of women undergoing in vitro fertilization (IVF) treatment, following an unsuccessful IVF cycle, especially their preferred level of doctor and spousal involvement., Methods: A cross-sectional survey was conducted with 246 Chinese women undergoing IVF recruited from an assisted reproduction clinic of a university-affiliated hospital in Hong Kong. Data collection was conducted between January 2014 and August 2015., Results: Most participants preferred sharing the decision-making tasks with their doctors (92%). In the doctor-patient relationship, passive roles were associated with higher marital satisfaction, presence of religious affiliation and secondary infertility, while autonomous roles were related to female-factor infertility. Fifty-two percent of participants anticipated sharing decision-making, while 46% preferred handing over the decision to their husbands. Preference for a passive rather than a shared role in the spousal relationship was related to a higher husband's age, greater marital satisfaction and higher anxiety., Conclusions: In brief, women tended to prefer sharing decision-making tasks with their doctor as well as actively engaging their partner in making decisions about fertility treatment. This study adds to our understanding of women's role preference and level of involvement in infertility treatment decision-making by providing quantitative evidence from women's experience. It highlights the importance of healthcare professionals in facilitating shared decision-making among couples.

Assessing the psychological effects on children and adolescents of suffering atopic dermatitis (AD) is essential, when planning successful management. This study aimed to systematically review the literature regarding risk of mental disorders in children and adolescents with, or without, AD; and to explore confounders. We identified potentially relevant studies from EMBASE, MEDLINE, PsycINFO, ERIC, the British Nursing Index, the Family and Society Studies Worldwide, the Social Work Abstracts, and the Sociological Abstracts from inception to Sep 30, 2018. Investigators independently screened titles and abstracts, and then full-texts. Investigators independently extracted data from included studies. Meta-analyses using random-effects models were performed, reporting odds ratios (ORs; 95% CIs). Thirty-seven studies ( n = 2,068,911 children/ adolescents) were included. Meta-analysis of 35 studies found that children and adolescents with AD had significantly higher risk of total mental disorders than those without AD (OR = 1.652; 95% CI, 1.463-1.864). There was no significant difference in risks for ADHD (OR = 1.563; 95% CI, 1.382-1.769); sleep disorders (OR = 2.100; 95% CI, 1.322-3.336); anxiety (OR = 1.339; 95% CI, 1.062-1.687); depression (OR = 1.402 95% CI, 1.256-1.565); conduct disorder (OR = 1.494 95% CI, 1.230-1.815); or ASD (OR = 2.574; 95% CI, 1.469-4.510; Q b = 8.344, p = 0.138). Race/ethnicity of child, target of comparison, type of studies, representativeness of the sample, measures of AD and mental disorders were significant moderators for total mental disorders. Integrated, holistic, multidisciplinary management of pediatric AD is significantly important, which emphasizes the well-being of the whole person.

Sexual minority women are at an elevated risk for depression compared to heterosexual women, yet less is known about how gender roles affect the mental health of sexual minority women. Existing studies examining the role of self-esteem in the relationship between gender roles and depression are scarce and have predominantly focused on heterosexual populations. Using a cross-sectional survey of Chinese lesbians in Hong Kong (N = 438), the study tested the direct and indirect effects of different types of gender roles (masculine, feminine, and androgynous) on depression through the mediating factor of self-esteem. We found that masculinity and androgyny were positively associated with self-esteem, while femininity was negatively associated with self-esteem. More importantly, self-esteem fully mediated the inverse relationship between masculinity and depression and that between androgyny and depression. The positive relationship between femininity and depression was also fully mediated by self-esteem. By examining different types of gender roles and incorporating gender roles, self-esteem, and depression into a unified framework, the research highlighted the particularly protective effect of androgyny, which had the strongest positive direct effect on self-esteem and indirect effect on depression through the mediation of self-esteem compared to the effects of other types of gender roles. Our results illuminate the importance of understanding how individual differences in gender roles relate to the mental health of sexual minority women in future research and interventions. Implications for interventions that help Chinese lesbians cope with gender expectations and improve their mental health are discussed.

Study Question: Do sense of meaning and acceptance mediate the relationships between gratitude and infertility-related stress among women undergoing IVF?, Summary Answer: Among women undergoing IVF, the negative relationships between gratitude and infertility-related stress are explained by a general sense of meaningfulness and acceptance of life., What Is Known Already: Infertility experts increasingly call for a re-balancing of the deficit-based view of psychosocial adjustment in IVF, which has been heavily dominated by studies of risk factors and psychological distress. Attention has been given to strength-based perspectives that emphasize character strengths and personal growth. Gratitude has been found to be a potent protective factor in coping with life stressors; however, its salutary effects and protective processes for infertile women undergoing IVF are yet to be explored., Study Design Size Duration: This study utilized baseline data of a randomized controlled trial for mind-body interventions with 357 Hong Kong Chinese women. Data collection was conducted between January 2015 and December 2017., Participants/materials Settings Methods: Eligible women were approached by a research assistant immediately after their first medical consultation at an ART centre of a major university-affiliated hospital. Participants were asked to complete a battery of questionnaires, including the Gratitude Questionnaire-6, the Fertility Problem Inventory, and the Holistic Well-Being Scale. Mediation analyses were conducted with bootstrapped samples., Main Results and the Role of Chance: Of the 494 women who were approached, 357 (72.3%) provided informed consent and participated in the study. Results show that gratitude was negatively associated with all infertility-related stress domains ( r s = -0.19 to -0.36), and these relationships are mediated by acceptance and loss of sense of meaning. Further, the link between gratitude and relationship concerns is mediated by loss of sense of meaning in women with a definable cause of infertility (95% CI = [-0.31, -0.08]), but by acceptance among those with unexplained infertility (95% CI = [-0.33, -0.01])., Limitations Reasons for Caution: The cross-sectional nature of the study precluded inferences of causality. Self-selection and self-report biases could be present. Our findings may not be readily generalizable to women who do not intend to undergo psychosocial intervention for their infertility or ART., Wider Implications of the Findings: Our findings support the salutary effects of gratitude in coping with IVF and highlight the role of unexplained infertility in the coping process. These findings offer preliminary support to the use of psychosocial interventions in promoting gratitude, acceptance, and meaning reconstruction for reducing infertility-related stress in women undergoing IVF., Study Funding/competing Interests: This study was funded by the Hong Kong University Grant Council-General Research Fund (HKU27400414). All authors declare no competing interests., Trial Registration Number: HKUCTR-1984.

Although stress has been widely acknowledged to link to psychosomatic dysfunctioning, the underlying mechanism that transmits the impact is not adequately investigated. This study examined self-compassion as a potential mediator that may explain the pathway from stress to depressive and somatic symptoms. Data in the present study were drawn from a baseline survey of 998 Chinese participants who enrolled in an intervention study on sleep disturbance in Hong Kong. Participants completed measures of perceived stress, self-compassion, depressive symptoms, and somatic symptoms. The results showed that stress was associated with depressive symptoms (r = .79, p < .01) and somatic symptoms (r = .47, p < .01). The path analyses showed that low levels of self-compassion mediated the association between stress and psychosomatic symptoms. Our findings provide insight into the pathway how stress affects psychosomatic symptoms. The intervention programs for stress management to improve psychological and physical functioning are recommended to consider self-compassion as a promising component in practice.

Purpose : Eczema is a pediatric skin disease that affects the psychosocial well-being of both children and their parent caregivers. This paper outlines a protocol for an experimental study that evaluates the effectiveness of a psychosocial empowerment program for children with eczema and their parent caregivers. Method : A multi-center randomized controlled trial is proposed, where parent-child dyads are randomized into two arms: an intervention group and wait-list control group. The intervention is delivered to participants in a parallel group format based on the Integrative Body-Mind-Spirit model which focuses on holistic well-being. Quality of life is measured before and after the intervention is provided, and five weeks after the intervention has been completed. Discussion : The suggested model fills a research gap in existing interventions, and provides new knowledge by evaluating the effectiveness of a tailored psychosocial intervention, delivered in group settings, for parent-child dyads affected by eczema.

Compared to cancers at other sites, lung cancer often results in greater psychosocial distress to both the patients and their caregivers, due to the poor prognosis and survival rate, as well as the heavy symptom burden. In recent years, making protocols of proposed or on-going studies publicly available via clinical trial registries and/or peer-reviewed journals has benefited health sciences with timely communication of the latest research trends and improved transparency in reporting. However, such practice is yet to be a common sight in evidence-informed social work. Hence, this paper discusses the value of publishing protocols in social work research and presents the protocol of a randomized controlled trial that compares the effectiveness of integrative body-mind-spirit intervention with cognitive behavioral therapy for enhancing quality of life of patients with lung cancer and their family caregivers. The data collection process was still on-going at the time of manuscript submission.