Predictors of changing patterns of adherence to containment measures during the early stage of COVID-19 pandemic: an international longitudinal study.

BACKGROUND: Identifying common factors that affect public adherence to COVID-19 containment measures can directly inform the development of official public health communication strategies. The present international longitudinal study aimed to examine whether prosociality, together with other theoretically derived motivating factors (self-efficacy, perceived susceptibility and severity of COVID-19, perceived social support) predict the change in adherence to COVID-19 containment strategies. METHOD: In wave 1 of data collection, adults from eight geographical regions completed online surveys beginning in April 2020, and wave 2 began in June and ended in September 2020. Hypothesized predictors included prosociality, self-efficacy in following COVID-19 containment measures, perceived susceptibility to COVID-19, perceived severity of COVID-19 and perceived social support. Baseline covariates included age, sex, history of COVID-19 infection and geographical regions. Participants who reported adhering to specific containment measures, including physical distancing, avoidance of non-essential travel and hand hygiene, were classified as adherence. The dependent variable was the category of adherence, which was constructed based on changes in adherence across the survey period and included four categories: non-adherence, less adherence, greater adherence and sustained adherence (which was designated as the reference category). RESULTS: In total, 2189 adult participants (82% female, 57.2% aged 31-59 years) from East Asia (217 [9.7%]), West Asia (246 [11.2%]), North and South America (131 [6.0%]), Northern Europe (600 [27.4%]), Western Europe (322 [14.7%]), Southern Europe (433 [19.8%]), Eastern Europe (148 [6.8%]) and other regions (96 [4.4%]) were analyzed. Adjusted multinomial logistic regression analyses showed that prosociality, self-efficacy, perceived susceptibility and severity of COVID-19 were significant factors affecting adherence. Participants with greater self-efficacy at wave 1 were less likely to become non-adherence at wave 2 by 26% (adjusted odds ratio [aOR], 0.74; 95% CI, 0.71 to 0.77; P < .001), while those with greater prosociality at wave 1 were less likely to become less adherence at wave 2 by 23% (aOR, 0.77; 95% CI, 0.75 to 0.79; P = .04). CONCLUSIONS: This study provides evidence that in addition to emphasizing the potential severity of COVID-19 and the potential susceptibility to contact with the virus, fostering self-efficacy in following containment strategies and prosociality appears to be a viable public health education or communication strategy to combat COVID-19.

The role of psychological flexibility in the relationships between burnout, job satisfaction, and mental health among nurses in combatting COVID-19: A two-region survey.

BACKGROUND: A growing body of evidence suggests that the COVID-19 pandemic is adversely impacting the mental health and well-being of frontline nurses worldwide. It is therefore important to understand how such impact can be mitigated, including by studying psychological capacities that could help the nurses regulate and minimize the impact. AIM: To examine the role of psychological flexibility in mitigating the adverse impacts of burnout and low job satisfaction on mental health problems (i.e., anxiety, depression, and stress) and well-being among the frontline nurses in Hong Kong and Switzerland during the COVID-19 pandemic. DESIGN: Cross-sectional, two-region survey study. METHOD: Four hundred fifty-two nurses from Hong Kong (n = 158) and Switzerland (n = 294) completed an online survey. An adjusted structured equation model was used to examine the interrelationship of the constructs. RESULTS: Psychological flexibility was found to partially mediate the effects of job satisfaction on mental well-being (ß = 0.32, 95% CI [0.19, 0.57], p = 0.001) and mental health problems (ß = -0.79, 95% CI [-1.57, -0.44], p = 0.001), respectively. Similarly, this partial mediation was found in the effects of burnout on mental well-being (ß = -0.35, 95% CI [-0.89, -0.15], p = 0.002) and mental health problems (ß = 0.89, 95% CI [0.48, 3.65], p = 0.001). CONCLUSION: Psychological flexibility could be a crucial psychological resilience factor against the adverse impact of nurses' burnout on their mental health problems and well-being during COVID-19. CLINICAL RELEVANCE: Organizational measures should focus on fostering psychological flexibility in nurses through highly accessible, brief psychotherapeutic interventions, such as Acceptance and Commitment Therapy, to reduce the impact on mental health.

Food frequency questionnaire for dietary assessment among adults at a risk of coronary heart disease: A mixed-methods study.

AIMS AND OBJECTIVES: To develop and psychometrically test a food frequency questionnaire for adults at risk of coronary heart disease (Cardio-FFQ). BACKGROUND: Comprehensive dietary assessment is critical for the prevention of cardiovascular disease, but appropriate instruments to perform this work are lacking. DESIGN: A sequential mixed-methods study followed the COREQ and STROBE guidelines. METHODS: This study was conducted between April 2016 and November 2017. It started with dietary history interviews (Phase 1) to identify candidate food items of the Cardio-FFQ, which validity and reliability were assessed (Phase 2) through expert consultation and four seasonal measurements, including test and retest with a 2-week gap every season. Physical activity and blood glucose and lipids were assessed seasonally, while another FFQ was administered during the fourth measurement. Content analysis was used to analyse verbatim interview transcripts, while descriptive and inferential analyses were used to simplify the Cardio-FFQ and examine its psychometric properties. RESULTS: Phase I involved 34 participants during their first onset of acute coronary syndrome and generated 176 candidate food items (consumed by at least three participants) under 12 food categories. These food items were simplified to form the 133-item Cardio-FFQ after discarding items with trivial contributions to food commonalities or between-person variance. Further analysis showed that the simplified questionnaire had satisfactory content validity, concurrent validity, convergent validity, predictive validity, known-group validity and test-retest reliability. CONCLUSION: The 133-item Cardio-FFQ is a valid and reliable tool for a comprehensive dietary assessment appropriate for adults at risk of coronary heart disease. RELEVANCE TO CLINICAL PRACTICE: Nurses may use the Cardio-FFQ to conduct a dietary assessment to better support people to commit to healthy diets, aiming to reduce the risk of coronary heart disease.

The effects of decision aids for genetic counselling among people considering genetic testing: A systematic review.

AIM: To assess the effectiveness of decision aids for genetic counsellees to improve their conflicts in decision-making and psychological well-being when considering genetic tests for inherited genetic diseases, and their knowledge about these tests and their genetic risks. DESIGN: Systematic review. DATA SOURCES: Six electronic databases (PubMed, MEDLINE, OVID Nursing, APA PsycINFO, EMBASE and CINAHL) were searched from inception to May 2022. REVIEW METHODS: Only randomised controlled trials that examined the effect of decision aids for information provision centring genetic testing on outcomes including decisional conflicts, informed choice making, knowledge on genetic risks or genetic tests, and psychological outcomes among participants who had undergone genetic counselling were included. Their risk of bias was assessed using the Version 2 of the Cochrane risk of bias tool for randomised trials. Results were presented narratively. The review was conducted according to the PRISMA checklist. RESULTS: Eight included studies examined the effect of booklet-based, computer-based, film-based or web-based decision aids on individuals considering genetic testing for their increased cancer risks. Despite contrasting findings across studies, they showed that decision aids enable genetic counsellees to feel more informed in decision-making on genetic tests, although most showed no effect on decisional conflict. Knowledge of genetic counsellees on genetic risks and genetic tests were increased after the use of decision aids. Most studies showed no significant effect on any psychological outcomes assessed. CONCLUSIONS: Review findings corroborate the use of decision aids to enhance the effective delivery of genetic counselling, enabling genetic counsellees to gain more knowledge of genetic tests and feel more informed in making decisions to have these tests. RELEVANCE TO CLINICAL PRACTICE: Decision aids can be used to support nurse-led genetic counselling for better knowledge acquisition and decision-making among counsellees. NO PATIENT OR PUBLIC CONTRIBUTION: Patient or public contribution is not applicable as this is a systematic review.

The Effectiveness of Interventions on Improving the Mental Health Literacy of Health Care Professionals in General Hospitals: A Systematic Review of Randomized Controlled Trials.

BACKGROUND: Suboptimal mental health literacy levels among general hospital health care professionals negatively impact the care coordination of patients with physical-mental comorbidity. AIMS: This review is to examine the evidence on the effectiveness of interventions to improve the mental health literacy of general hospital health care professionals. METHODS: A systematic search of literature was conducted in 13 electronic databases with manual searching of reference lists from 1980 to 2021. Studies were screened by pre-set eligibility criteria, that is, participants who were general hospital health care professionals taking care of adult patients, the interventions aimed at improving any components of participants' mental health literacy, comparisons were alternative active intervention or no intervention, and the primary outcomes were any aspects of mental health literacy. RESULTS: Eight randomized controlled trials (N = 1,732 participants) were included in this review. Evidence indicated that mental health literacy interventions with educational components can improve components of the health care professionals' mental health literacy, in terms of mental health knowledge and mental illness-related attitudes/stigma. In addition, few studies evaluated all components of participants' mental health literacy. CONCLUSIONS: Based on the available evidence, educational interventions had a positive effect on components of general hospital health care professionals' mental health literacy. Health care organizations should provide educational programs to enhance general hospital health care professionals' mental health literacy. Further studies are needed to explore interventions that target all components of general hospital staff's mental health literacy and to evaluate its impact on the psychiatric consultation-liaison service utilization in general hospitals, as well as patient outcomes.

Ethical challenges experienced by care home staff during COVID-19 pandemic.

BACKGROUND: Care homes have been disproportionately affected during the COVID-19 pandemic. Practical challenges of enacting infection control measures in care home settings have been widely reported, but little is known about the ethical concerns of care home staff during the implementation of such measures. . OBJECTIVES: To understand the ethical challenges perceived by care home staff during the early months of the COVID-19 pandemic. RESEARCH DESIGN: An exploratory qualitative study. PARTICIPANTS AND RESEARCH CONTEXT: A purposive sample of 15 care home staff in different roles and ranks in Hong Kong was recruited to take part in semi-structured interviews between June and August 2020. ETHICAL CONSIDERATIONS: Ethical approval for this study was obtained. Participation was voluntary and anonymous. Participants had the right to withdraw from the study at any time without reprisal. FINDINGS: Three themes were identified: unclear legitimacy regarding infection control measures, limited autonomy in choices over infection control measures and inevitable harms to residents' well-being. While the participants expected that they would have legitimated power to implement infection control measures, they were resistant when their right to self-determination of testing and vaccination was infringed. They also felt trapped between ethical duties to protect care home residents from infection risk and the anticipated detrimental effects of infection control measures. CONCLUSIONS: The findings of this study reveal tensions among the ethical obligations of care home staff in response to a public health emergency. They highlight the importance of strengthening ethical sensitivity and ethical leadership in identifying and resolving the challenges of pandemic responses.

Influenza-Associated Hospitalizations and Risk of Subsequent Heart Failure Hospital Admissions: A 20-Year Territorywide Registry Study in Hong Kong, China.

Little is known about the risk of hospitalization for cardiovascular disease after influenza infection in younger adults. In a territorywide Hong Kong, China, study using clinical registry data for 1997-2017, we examined the association between influenza-associated hospitalizations and the risk of subsequent hospitalization for heart failure (HHF) in 3 age groups: 18-44 years, 45-65 years, and >65 years. Exposure was defined as any infection with influenzavirus as a primary principal diagnosis for hospitalization, whereas the nonexposed control group comprised persons with hospitalizations for elective orthopedic surgery. Logistic regression was used to determine the risk of HHF within 12 months of hospital discharge for the exposed group versus the nonexposed group. Results showed that influenza-associated hospitalization in the preceding 12 months was associated with increased risk of subsequent HHF in all age groups (all P values < 0.001). Notably, the age group 18-44 years was found to have the highest elevated risk of HHF (adjusted odds ratio = 14.90, 95% confidence interval: 4.48, 49.58). In view of the relatively small number of subsequent HHF episodes in this age group, future studies are needed to confirm the elevated risk in this group and to explore the role of age in the relationship between influenza-associated hospitalization and subsequent HHF.

Can psychological flexibility and prosociality mitigate illness perceptions toward COVID-19 on mental health? A cross-sectional study among Hong Kong adults.

BACKGROUND: The negative impact of COVID-19 pandemic on public mental health can be persistent and substantial over a long period of time, but little is known regarding what psychological factors or processes can buffer such impact. The present study aimed to examine the mediating roles of coping, psychological flexibility and prosociality in the impacts of perceived illness threats toward COVID-19 on mental health. METHOD: Five-hundred and fourteen Hong Kong citizens (18 years or above) completed an online survey to measure illness perceptions toward COVID-19, coping, psychological flexibility, prosociality, and mental health, together with their socio-demographic variables. Structural equation modelling was used to explore the explanatory model that was the best-fit to illustrate the relationships between these constructs. RESULTS: Serial mediation structural equation model showed that only psychological flexibility (unstandardised beta coefficient, ß = - 0.12, 95% CI [- 0.20, - 0.02], p = 0.031) and prosociality (unstandardised ß = 0.04, 95% CI [0.01, 0.08], p = 0.001) fully mediated the relationship between illness perceptions toward COVID-19 and mental health. In addition, psychological flexibility exerted a direct effect on prosociality (standardised ß = 0.22, 95% CI [0.12, 0.32], p < 0.001). This best-fit model explained 62% of the variance of mental health. CONCLUSIONS: Fostering psychological flexibility and prosocial behaviour may play significant roles in mitigating the adverse effects of COVID-19 and its perceived threats on public mental health.

Psychometric Evaluation of the Chinese Version of Hypertension Self-care Profile.

BACKGROUND: Valid and reliable assessment of the multidimensional self-care of patients with hypertension is important to tailor individualized care. The Hypertension Self-care Profile (HBP SCP), which comprises behavior, motivation, and self-efficacy scales, has been widely tested in various settings. OBJECTIVE: The aims of this study were to translate the HBP SCP into a Chinese version (HBP SCP-C) and evaluate its psychometric properties among Chinese adults with hypertension. METHODS: The HBP SCP was translated to Chinese using Cha's combined translation technique, and its content validity was examined by a panel of 7 experts. The psychometric properties of HBP SCP-C were tested in 200 Chinese patients with hypertension. Reliability tests included internal consistency and test-retest reliability. Exploratory factor analysis was performed to explore the structure of HBP SCP-C. Discriminative validity was examined by the known-group approach. RESULTS: The HBP SCP-C demonstrated satisfactory content validity. The 2-factor structures of the behavior ("health promotion" and "habit modification") and self-efficacy ("intake management" and "health maintenance") scales and 1-factor structure of the motivation scale were determined. The behavior, motivation, and self-efficacy scales had Cronbach α coefficients of 0.86, 0.94, and 0.93, respectively, and test-retest reliabilities were 0.82 to 0.98, 0.90 to 0.98, and 0.81 to 0.95, respectively. Significant differences between patients with or without comorbidities in behavior (t = 2.55, P = .011), motivation (t = 3.25, P = .001), and self-efficacy (t = 3.02, P = .003) supported the discriminative validity of HBP SCP-C. CONCLUSIONS: The HBP SCP-C could be a reliable and valid instrument for evaluating hypertension self-care in Chinese patients.

A qualitative exploration of the experiences of school nurses during COVID-19 pandemic as the frontline primary health care professionals.

BACKGROUND: It is widely acknowledged that the experiences of frontline primary health care professionals during COVID-19 are important to understand how they respond and act under situations of pandemic as the gatekeepers in primary health care system. School nurses are primary health care professionals who lead health care in schools and practice in a holistic manner to address the needs of schoolchildren and school personnel. There are rising mental health concerns of frontline health care professionals with anxiety and panic disorders, somatic symptoms, and feeling isolated. No studies use a qualitative study approach to document community frontline school nursing professionals' experiences and challenges during the COVID-19 pandemic. Hence, understanding the school nurses' experiences and challenges to fight against COVID-19 in the communities is important. PURPOSE: This study aims to explore the experiences of school nurses during the COVID-19 pandemic in Hong Kong. METHODS: A qualitative study design adopted the principles of thematic analysis. Nineteen school nurses were recruited to participate in individual semistructured interviews and shared their roles and responsibilities during the COVID-19 pandemic. FINDINGS: Three themes indicated the school nurses' expand professional responsibilities to fight against COVID-19 emerged from the data analysis. These were "Managing Stress," "Navigating the School Through the Pandemic," and "Raising the Profile of the School Nurse Professional," DISCUSSION: Findings reveal the important role of school nursing professionals in minimizing the community-wide risk posed by pandemics and the need to integrate them into planning and implementation of school health policies and guidelines in the primary health care system. This essential role in schools is necessary to assess, implement, monitor, prevent, and reduce the spread of virus in school communities and to minimize the burden to and extra health care resources utilized in the acute care setting during COVID-19 pandemic.

Leisure-Time Physical Activity and Depressive Symptoms Among Patients With Coronary Heart Disease: The Mediating Role of Physical Activity Self-Efficacy.

BACKGROUND: Despite the positive effect of physical activity on reducing depressive symptoms among patients with coronary heart disease (CHD), the effect of physical activity on depressive symptoms is poorly understood. AIMS: To examine the mediating role of physical activity self-efficacy in the relationship between leisure-time physical activity and depressive symptoms in CHD patients. METHODS: This was a secondary data analysis study. A total of 593 CHD patients were included. Data on leisure-time physical activity, physical activity self-efficacy, and depressive symptoms were collected by validated questionnaires. Sociodemographic and clinical data were collected via patient interviews and medical records reviewing. The approach of Baron and Kenny was adopted to examine the mediating effect of physical activity self-efficacy on the association between leisure-time physical activity and depressive symptoms. RESULTS: On average, participants aged 56.9 (± 12.5) years old, with 66% male. Statistical analyses showed that leisure-time physical activity was significantly associated with depressive symptoms (ß = -0.041, p = .040) and physical activity self-efficacy (ß = 0.197, p = .001), and physical activity self-efficacy was significantly associated with depressive symptoms (ß = -0.223, p = .001) after adjusting for leisure-time physical activity. The indirect effect of leisure-time physical activity on depressive symptoms through physical activity self-efficacy was also significant (ß = -0.044, 95% confidence interval: -0.064, -0.027), suggesting a mediating role of physical activity self-efficacy on the relationship between leisure-time physical activity and depressive symptoms. LINKING EVIDENCE TO ACTION: Leisure-time physical activity is associated with reduced depressive symptoms among CHD patients, and this association is mediated by physical activity self-efficacy. This mediating model has important clinical implications, where integrating physical activity that is enjoyable and pleasant, and self-efficacy building elements in physical activity regimens should be considered, so as to improve psychological outcomes among CHD patients.

Measuring exercise self-efficacy in Hong Kong Chinese adults with cardiovascular risk: Validation of a Chinese version of the Cardiac Exercise Self-efficacy Instrument.

About one-third of adults are physically inactive and thus prone to cardiovascular diseases. While self-efficacy mediates health behavior, its influences on exercise behavior among Chinese is yet to be explored by a validated instrument. This study aimed to examine the psychometric properties of the Hong Kong Chinese version of the Cardiac Exercise Self-efficacy Instrument (CESEI-C), which had been translated previously by these authors. The psychometric properties of the CESEI-C were tested with 160 Hong Kong Chinese with cardiovascular risk. Participants were asked to complete the CESEI-C, a physical activity assessment tool, and perform the exercise stress test. Exploratory factor analysis identified a unidimensional structure of the CESEI-C. Good internal consistency (Cronbach's alpha = 0.91) and good content validity (content validity indices: 0.93-1.00) had been reported previously. The convergent validity of the CESEI-C was supported by the significant positive correlations between the CESEI-C score and the amount of moderate-to-vigorous exercise (r = 0.18, p = 0.03), and exercise capacity (r = 0.30, p < 0.01). A comparison of CESEI-C scores by exercise capacities indicated that those with moderate-to-high exercise capacity had significantly higher CESEI scores than those with low exercise capacity (t = 2.105, p = 0.04). Thus, the CESEI-C is a valid and reliable instrument to measure exercise self-efficacy among Hong Kong Chinese.

The suitability of motivational interviewing versus cognitive behavioural interventions on improving self-care in patients with heart failure: A literature review and discussion paper.

BACKGROUND: Chronic heart failure remains a major public health concern due to its high prevalence and disease burden. Although self-care has been advocated as the sustainable solution, it remains inadequate. Recent studies have shown the potential of integrating structured counselling elements into traditional educational programs to enhance self-care but the optimal counselling method remains unclear. AIM: To compare the applicability of cognitive behavioural interventions and motivational interviewing on improving self-care behaviours in patients with chronic heart failure. METHOD: A systematic three-step search strategy was used to identify studies that incorporated cognitive behavioural interventions and/or motivational interviewing to improve heart failure self-care. Quantitative and qualitative trial studies that met the inclusion criteria were appraised using the Joanna Brigg's Institute criteria. RESULTS: Motivational interviewing showed higher potential in improving HF self-care behaviours, but sustainability remains unclear. Cognitive behavioural interventions only showed effectiveness when applied to patients with comorbid depressive symptoms. Statistically significant results were only elucidated upon statistical adjustments and examination of behaviours individually. Potential effective components of CBI include setting up environmental reminders, addressing misconceptions and skills-training while that of MI was the communication style. CONCLUSION: MI and CBI could be used synergistically by extracting their key effective components to strengthen the intention-behaviour link in improving HF self-care behaviours. MI could be used to enhance the intention to change by evoking ambivalence and change talk. CBI could be used to enhance problem-solving skills and set environmental reminders to strengthen the translation of intention to behaviour.

Genetics and epigenetics of autism: A Review.

Autism is a developmental disorder that starts before age 3 years, and children with autism have impairment in both social interaction and communication, and have restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. There is a strong heritable component of autism and autism spectrum disorder (ASD) as studies have shown that parents who have a child with ASD have a 2-18% chance of having a second child with ASD. The prevalence of autism and ASD have been increasing during the last 3 decades and much research has been carried out to understand the etiology, so as to develop novel preventive and treatment strategies. This review aims at summarizing the latest research studies related to autism and ASD, focusing not only on the genetics but also some epigenetic findings of autism/ASD. Some promising areas of research using transgenic/knockout animals and some ideas related to potential novel treatment and prevention strategies will be discussed.

Relationship between sleep quality and cardiovascular disease risk in Chinese post-menopausal women.

BACKGROUND: Menopause is an inevitable stage affecting every middle-aged woman. China has a large and increasing group of post-menopausal women. Most post-menopausal women suffer from increased risks for cardiovascular diseases (CVD) and sleep problems. Previous studies have demonstrated the associations between sleep disorders and increased CVD risks in general population. The current study is to examine the relationship between sleep quality and CVD risks among Chinese post-menopausal women. METHODS: This study was a sub-study nested in a cross-sectional study that investigated the sleep quality of community-dwelling adults in Xian, Shaanxi Province, China. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and the Framingham 10-year risk score (FRS) were used to measure sleep quality and CVD risk among 154 Chinese post-menopausal women. Multivariate regression and logistic regression were used to determine the association between sleep quality and CVD risk. RESULTS: The participants (age: 63.65 ± 4.47 years) experienced poor sleep quality (mean score of global PSQI = 8.58) and a 10-year risk of CVD of 12.54%. The CVD risk was significantly associated with sleep duration (ß = - 0.18, p = 0.04) and sleep disturbance (ß = 0.33, p < 0.001). Women with good sleep quality (PSQI ≤5) were less likely to be at high risk for CVD (FRS > 10%) (odds ratio = 0.51, p = 0.04). CONCLUSIONS: Poor sleep quality might increase the CVD risk in post-menopausal women. Interventions to promote the cardiovascular health of Chinese post-menopausal women may need to include sleep promotion strategies.

Social support as a predictor of diet and exercise self-efficacy in patients with coronary artery disease.

OBJECTIVES: This study examined the role of social support and other factors in relation to exercise and diet self-efficacy in Chinese patients with coronary heart disease in Hong Kong. METHODS: A cross-sectional study was conducted on a convenience sample identified from two cardiac rehabilitation centers. Eighty-five participants joined the study. RESULTS: Both self-efficacy measures correlated with social support, in particular in the domains of emotional/informational support and positive social interactions. Stronger social support was independently associated with a higher level of exercise and diet self-efficacy. Patients with a higher body mass index had a lower level of exercise self-efficacy, whereas social drinkers had a lower level of diet self-efficacy. CONCLUSIONS: Our data supported an association between social support and self-efficacy. It was suggested that social companions would help patients get greater confidence in overcoming barriers to lifestyle modification. Further studies may investigate what type of social support contributes to improving the self-efficacy beliefs of patients.

Psychosocial interventions for improving mental health and family functioning in families with parental cancer: A systematic review.

PURPOSE: Parental cancer significantly impacts both parents and children, necessitating psychosocial interventions to enhance family well-being. This systematic review aimed to assess the effectiveness of psychosocial interventions targeting parents with cancer on their mental health, quality of life, their children's well-being, and family functioning. METHODS: A comprehensive search was conducted in Ovid MEDLINE, PubMed, PsycINFO, and Cochrane Central Register of Controlled Trials databases for relevant articles published from 2006 to 2023. The methodological aspects of eleven studies from diverse countries were critically evaluated. RESULTS: The review included 496 parents, primarily female breast cancer patients, and their children. Narrative synthesis highlighted interventions that aimed to strengthen parent-child connection (Enhancing Connection (EC)), enhance family communication, improve psychological well-being of parents (Struggle for Life Intervention), and address children's mental health (Wonders and Worries (W&W)). Additionally, interventions like Cancer PEPSONE Program (CPP) aimed to expand social networks and support systems. These interventions demonstrated success in reducing depressive and anxiety symptoms, parenting stress, and mitigating children's externalizing and internalizing problems. However, they were not exempt from methodological limitations such as participant selection bias, lack of blinding, and low follow-up rates. CONCLUSIONS: Based on the review, psychological support for parents with cancer is an emerging field, predominantly explored in Western countries with a significant emphasis on maternal experiences. The early stage of this field and inherent methodological limitations warrant cautious interpretation of these findings and further research for comprehensive understanding and application.

Effect of simulation-based zoom learning on clinical decision-making among undergraduate nursing students and experiences of students and instructors: A mixed methods study.

Aim: To determine the effect of simulation-based Zoom learning (SBZL) on perceived capabilities and clinical decision-making skills among undergraduate nursing students and to explore experiences of the instructors and students participating in SBZL. Background: Nursing is a practice profession and students acquire clinical decision-making skills in clinical settings. However, the COVID-19 pandemic has disrupted conventional clinical learning activities. In this study, the outcomes of implementing SBZL in an undergraduate programme to support students' clinical learning were examined. Design: A mixed methods design was employed. Methods: This study recruited 195 final-year students to participate in the SBZL programme, which was developed based on the NLN Jeffries Simulation Theory to guide its design, implementation and evaluation. Case scenarios were developed and simulated through Zoom. Students' perceived capabilities, perceptions of the learning environment and clinical decision-making skills were assessed before and after SBZL. A historical control group of 226 previous final year students who had received a clinical practicum was included for comparison. Semi-structured interviews were conducted with 11 instructors and 19 students to explore their experiences of participating in SBZL. Results: A total of 102 students completed the post-SBZL questionnaire. An increase in perceived creative thinking (mean difference = 0.24, p < 0.001) was observed post-SBZL. After SBZL, the perceptions of the learning environment were significantly improved. However, the SBZL group demonstrated lower perceived problem-solving capability than the control group (mean difference = 0.14, p = 0.007). Clinical decision-making was significantly improved in the SBZL group than in the control group (p < 0.001). Both the instructors and students reported positive experiences with SBZL, and highlighted challenges and factors for improving its implementation. Conclusions: SBZL showed improvement in perceived creative thinking, perceptions of the learning environment and clinical decision-making. This innovative teaching and learning method can be valuable for nursing education in various regions to prepare students for real-life roles. Tweetable abstract: Simulation-based Zoom learning is better than traditional teaching in improving clinical decision-making skills among undergraduate nursing students.

Effectiveness of a home-based music-paced physical activity programme on exercise-related outcomes after cardiac rehabilitation: a randomized controlled trial.

AIMS: A randomized controlled trial was conducted to examine the effects of a home-based music-paced physical activity programme guided by Information-Motivation-Strategy (IMS) model and Self-determination theory on exercise-related outcomes for patients with coronary heart disease (CHD) after cardiac rehabilitation (CR). METHODS AND RESULTS: A total of 130 patients with CHD from a regional CR centre in Hong Kong were recruited and randomly allocated into intervention (n = 65) or control groups (n = 65). The intervention group received theory-guided practical sessions on performing prescribed home-based physical activity with individualized synchronized music, and follow-up telephone calls. The primary outcome was exercise capacity. Secondary outcomes included exercise self-efficacy, physical activity level, and exercise self-determination. Data were collected at baseline, 3 months, and 6 months after study entry. The generalized estimating equations model was used to assess the intervention effects. Patients with CHD in the intervention group demonstrated significantly greater improvements in exercise capacity at 3 months [ß = 35.68, 95% confidence interval (CI) 2.69-68.68, P = 0.034] and significantly improved exercise self-efficacy at 6 months (ß = 3.72, 95% CI 0.11-7.32, P = 0.043) when compared with the control group. However, no significant group differences were found in physical activity level and exercise self-determination. CONCLUSION: The study findings provide evidence on an innovation on improving the exercise capacity and exercise self-efficacy of patients with CHD. The music-paced physical activity guided by the IMS model and Self-determination theory requires further investigation on its long-term effects in future studies. CLINICAL TRIAL REGISTRATION: ChiCTR-IOR-17011015.

Genetic/genomic literacy, attitudes and receptivity of nursing students and practising nurses: A cross-sectional online survey.

BACKGROUND: The growing demand for personalised nursing care in the genomic era requires nursing students and practising nurses to be better prepared to apply the knowledge of genetics/genomics to nursing practice. Several studies have shown that, despite having positive attitudes/receptivity towards integrating genetics/genomics into nursing practice, nursing students and professionals report a low level of genetic/genomic literacy. However, little is known about the status in Hong Kong. OBJECTIVES: We assessed and compared the genetic/genomic literacy and attitudes/receptivity towards integrating genetics/genomics into nursing practice among nursing students and practising nurses in Hong Kong. We also explored the relationships between the students' background characteristics, attitudes/receptivity towards integrating genetics/genomics into nursing practice and genetic/genomic literacy. DESIGN: A cross-sectional online survey conducted between March 2020 and January 2022. SETTINGS: A government-funded university in Hong Kong. PARTICIPANTS: We recruited a convenience sample of 234 nursing students, 145 were final-year undergraduate students (median age = 22 years, 84.1 % female) and 89 were practising registered nurses (postgraduate students studying part-time programme, median age = 28 years, 77.5 % female). METHODS: The survey collected the participants' background information, attitudes/receptivity towards integrating genetics/genomics into nursing practice and levels of genetic/genomic literacy. RESULTS: Overall, the participants reported positive attitudes/receptivity towards practice integration but had low levels of genetic/genomic literacy. Practising nurses were more likely to have lower genetic/genomic literacy, but more positive attitudes/receptivity towards practice integration, than undergraduate students. Multiple regression analysis suggested that the level of study (postgraduate/undergraduate programme) and perceptions of the disadvantages of 'needing to re-tool professionally' were significant independent factors associated with the level of genetic/genomic literacy. CONCLUSIONS: Findings from this study call for the strategic integration of genetics/genomics education into all levels of nursing education in Hong Kong and across the globe. In particular, sustained efforts should be made to ensure that practising nurses receive further education in genetics/genomics.