Identity, culture, and feminism: Golda Meir - Israel's prime minister (1969-1974).

Like most historical leaders, Israel's fourth prime minister, Golda Meir, is a controversial figure. Some consider her the worst prime minister in Israel's history, who was responsible for Israel's lack of preparedness for the Yom Kippur War, and others perceive her to be the only 'man' who stood in the way of Arabs' countries victory over Israel. Some view her to be conservative, not brilliant, dogmatic, masculine, and racist, and some others, as a simple, modest, warm, and empathetic woman. The authors bridge between these two conflicting views by employing theories of identity, culture, and gender role bias to investigate how Golda Meir's early age trauma caused by pogroms against Jews, cultural transition between Russia, the USA, and Mandatory Palestine, and serving as a powerful woman leader in an all-men political system, influenced her personal and political behaviour and her public image.

Public perceptions of the brand image of nursing: Cross-cultural differences between the United States and China.

BACKGROUND: Measures of public opinion regarding nursing's brand image are needed to identify and correct perceptions that are incongruent with the breadth and scope of contemporary nursing practice. Misperceptions of nursing's influence may serve to minimize or disregard nursing's unique contributions to addressing the Social Determinants of Health which are foundational for improving the health of global populations. PURPOSE: To compare public perceptions of the brand image of nursing between China and the United States (US) and determine whether sociodemographic variables influenced factors between the two countries. METHODS: A cross-sectional online survey was distributed among members of the Chinese and U.S. public. Perceptions of nursing's brand image were assessed through the original Nursing Brand Image Scale-Public Version in the US (NBIS-P) and when translated to Chinese (NBIS-P-C). Descriptive statistics and multigroup confirmatory factor analyses were used to compare perceptions of the brand image of nursing and to examine the influence of demographics. DISCUSSION: The reliability of the Chinese version of the NBIS-P-C was confirmed by this study. Age and gender did not influence public perceptions of nursing's brand image in either China or the US. Instead, educational attainment was the significant demographic variable and positively correlated with the public's perceptions of nursing in both countries (p < .05). Public respondents with lower educational attainment scored both the traditional nursing factor "Caregiver Virtues/Attributes" (e.g., Trusted, Caring, Nurturing/Mothering) and the factor "Lack Authority/Identity" (e.g., White Cap/Uniform, Subservient, Female) higher, while scoring the factor for "Leadership" (e.g., Decision Makers, Influential, Leaders) significantly lower than those with higher educational levels. CONCLUSION: A disparity exists between nursing's contemporary contributions to healthcare and the public's limited understanding of the diverse leadership roles all nurses provide, across a variety of settings, and in global public health initiatives. The virtuous traits of the nurse are perceived most directly and immediately by the public while their roles as autonomous decision-makers and leaders are less (or not at all) visible. Enhancing the accuracy and visibility of a strong brand image could advance public perceptions of nurses as experts and leaders in nursing science, thus paving the way for nurses to more effectively direct and influence the health of the public, particularly those with lower educational attainment who represent some of the most vulnerable populations. Targeted interventions that incorporate the educational level of the public offer a foundational opportunity for the nursing profession to correct inaccurate and outdated stereotypes that prevent nurses from achieving their desired brand image as influential leaders. Such campaigns could also be used to inform policy, guide strategic planning, and transform the future direction of the nursing profession.

Neuropsychiatric symptoms after moderate-to-severe traumatic brain injury in Vietnam: Assessment, prevalence, and impact on caregivers.

OBJECTIVE: Neuropsychiatric symptoms (NPSs) after moderate-to-severe traumatic brain injury (TBI) have been well documented in WEIRD (Western, educated, industrialized, rich, and democratic) populations. In non-WEIRD populations, such as Vietnam, however, patients with TBI clinically remain uninvestigated with potential neuropsychiatric disorders, limiting on-time critical interventions. This study aims to (1) adapt the Vietnamese Neuropsychiatric Inventory (V-NPI), (2) examine NPSs after moderate-to-severe TBI and (3) evaluate their impact on caregiver burden and well-being in Vietnam. METHOD: Caregivers of seventy-five patients with TBI completed the V-NPI, and other behavior, mood, and caregiver burden scales. RESULTS: Our findings demonstrated good internal consistency, convergent validity, and structural validity of the V-NPI. Caregivers reported that 78.7% of patients with TBI had at least three symptoms and 16.0% had more than seven. Behavioral and mood symptoms were more prevalent (ranging from 44.00% to 82.67% and from 46.67% to 66.67%, respectively) and severe in the TBI group. Importantly, NPSs in patients with TBI uniquely predicted 55.95% and 33.98% of caregiver burden and psychological well-being, respectively. CONCLUSION: This study reveals the first evidence for the presence and severity of NPSs after TBI in Vietnam, highlighting an urgent need for greater awareness and clinical assessment of these symptoms in clinical practice. The adapted V-NPI can serve as a useful tool to facilitate such assessments and interventions. In addition, given the significant impact of NPS on caregiver burden and well-being, psychosocial support for caregivers should be established.

Altruism and hyperaltruism in children of three cultures.

Children's inclination to prioritize others' welfare over their own (hyperaltruism) was investigated from a developmental and cross-cultural perspective. The distribution of rewarding or aversive items to self and another child was probed in 3- to 14-year-old children (final sample: N = 158; 87 girls) from urban China (n = 51; Mage = 9.1 years, SD = 1.81; 27 girls), urban United States (n = 55; Mage = 8.89 years, SD = 2.18; 30 girls), and rural Samoa (n = 52; Mage = 8.6 years, SD = 2.61; 30 girls). In two counterbalanced conditions, the children were first asked to split either rewards (stickers or treats) or potentially harmful insects (biting bugs) with another child. In a third condition, children were asked to choose various levels of hypothetical pain to be inflicted on either themselves or another child in exchange for commensurate rewards. Results indicated that in conditions where children distributed rewards, older children were more egalitarian (i.e., gave an equal number of candies to self and other) compared with younger children. However, in conditions where they needed to allocate potential harm, older children displayed more altruism (taking more harm onto themselves so that others could be spared). These results varied by culture, where Chinese children showed more altruism, U.S. children were more egalitarian, and Samoan children showed no clear patterns of either egalitarianism or altruism. The results show that although there are some universal trends toward egalitarian and altruistic ways of sharing, significant group differences exist.

Self-compassion, mental health shame and work motivation in German and Japanese employees.

In Germany, more than two-thirds of employees report mental health issues, while in Japan, more than half of the country's workforce are mentally distressed. Although both countries are socio-economically developed in similar ways, their cultures differ strongly. This article investigates mental health constructs among German and Japanese employees. A cross-sectional design was employed in which 257 German and 165 Japanese employees completed self-report scales regarding mental health problems, mental health shame, self-compassion and work motivation. T-tests, correlation and regression analyses were conducted. Results show that German employees have significantly higher levels of mental health problems, mental health shame, self-compassion and work motivation than Japanese employees. While many correlations were similar, mental health problems were associated with intrinsic motivation in Germans, but not in Japanese. Shame was associated with both intrinsic and extrinsic motivation in Japanese, but not in Germans. Self-compassion - defined as a complex of compassion, humanity, care and unconditional, compassionate love - was associated with gender and age in Japanese, but not in German employees. Lastly, regression analysis uncovered that self-compassion was the strongest predictor of mental health problems in Germans. In Japanese employees, mental health shame is the strongest predictor of mental health problems. Results can guide managers and psychologists in internationalised organisations to effectively approach employee mental health.

How the bereaved behave: a cross-cultural study of emotional display behaviours and rules.

Cultural norms may dictate how grief is displayed. The present study explores the display behaviours and rules in the bereavement context from a cross-cultural perspective. 86 German-speaking Swiss and 99 Chinese bereaved people who lost their first-degree relative completed the adapted bereavement version of the Display Rules Assessment Inventory. Results indicated that the German-speaking Swiss bereaved displayed more emotions than the Chinese bereaved. The Chinese bereaved, but not the German-speaking Swiss bereaved, thought that bereaved people should display more emotions than they actually did when they were with their close others (but not when they were alone). Bereaved people endorsed more emotional expression "when alone" than "when with close others", demonstrating a social disconnection tendency, which was more evident in the Chinese sample. Bereaved people endorsed more expression of positive emotions (e.g. affection/love) and less expression of powerful negative emotions (e.g. blame/guilt, anger) across cultures. Compared to their Chinese counterparts, the German-speaking Swiss sample indicated more actual expressions for most emotion types (i.e. joy/happiness, affection/love, sadness, anger, and denial) but thought bereaved people should express more joy/happiness and less blame/guilt. The results suggest that bereaved people's display behaviours and rules are influenced by culture, situation, and type of emotion.

Community Violence Exposure and Eating Disorder Symptoms among Belgian, Russian and US Adolescents: Cross-Country and Gender Perspectives.

Community violence exposure (CVE) is one of the most common adverse childhood experiences worldwide. Despite this, its potential effect on disordered eating in adolescents from different cultures is underexplored. In the present cross-sectional study, self-reported data were collected from 9751 students (Mean age = 14.27) from Belgium, Russia and the US on CVE (witnessing violence and violence victimization), eating disorder (ED) symptoms (ED thoughts with associated compensatory behaviors), and comorbid symptoms of posttraumatic stress, depression and anxiety. Increased CVE (from no exposure to witnessing to victimization) was associated with more ED symptoms, and the associations remained significant after adjusting for comorbid conditions. The associations were similar for adolescents across the three countries. No gender differences were observed in the association between CVE and ED symptoms, even though girls in general reported more ED symptoms than boys. We conclude that CVE appears to be associated with ED symptoms in three culturally different samples of adolescents.

Existential isolation and prolonged grief in bereaved people: The moderating role of culture.

OBJECTIVE: Existential isolation refers to an individual's awareness of the unbridgeable gulf between oneself, other people and the world. This kind of isolation has been found to be higher in individuals with nonnormative experiences, such as racial or sexual minorities. Bereaved individuals may experience a stronger sense of existential isolation and feel that no one shares their feelings or perceptions. However, research on bereaved people's experiences of existential isolation and its effects on post-loss adaptation is scarce. This study aims to validate the German and Chinese versions of the Existential Isolation Scale, investigate cultural and gender differences in existential isolation and explore the associations between existential isolation and prolonged grief symptoms in German-speaking and Chinese bereaved individuals. METHODS: A cross-sectional study with 267 Chinese and 158 German-speaking bereaved participants was conducted. The participants completed self-report questionnaires assessing existential isolation, prolonged grief symptoms, social networks, loneliness and social acknowledgement. RESULTS: The results indicated that the German and Chinese versions of the Existential Isolation Scale demonstrated adequate validity and reliability. No cultural or gender differences (or their interaction) were found for existential isolation. Higher existential isolation was associated with elevated prolonged grief symptoms, which was further moderated by the cultural group. The relationship between existential isolation and prolonged grief symptoms was significant for the German-speaking bereaved people but not significant for those from China. CONCLUSION: The findings highlight the role of existential isolation in the adaptation to bereavement and how different cultural backgrounds moderate the effect of existential isolation on post-loss reactions. Theoretical and practical implications are discussed.

Comparing psychotic experiences in low-and-middle-income-countries and high-income-countries with a focus on measurement invariance.

BACKGROUND: The prevalence of psychotic experiences (PEs) is higher in low-and-middle-income-countries (LAMIC) than in high-income countries (HIC). Here, we examine whether this effect is explicable by measurement bias. METHODS: A community sample from 13 countries (N = 7141) was used to examine the measurement invariance (MI) of a frequently used self-report measure of PEs, the Community Assessment of Psychic Experiences (CAPE), in LAMIC (n = 2472) and HIC (n = 4669). The CAPE measures positive (e.g. hallucinations), negative (e.g. avolition) and depressive symptoms. MI analyses were conducted with multiple-group confirmatory factor analyses. RESULTS: MI analyses showed similarities in the structure and understanding of the CAPE factors between LAMIC and HIC. Partial scalar invariance was found, allowing for latent score comparisons. Residual invariance was not found, indicating that sum score comparisons are biased. A comparison of latent scores before and after MI adjustment showed both overestimation (e.g. avolition, d = 0.03 into d = -0.42) and underestimation (e.g. magical thinking, d = -0.03 into d = 0.33) of PE in LAMIC relative to HIC. After adjusting the CAPE for MI, participants from LAMIC reported significantly higher levels on most CAPE factors but a significantly lower level of avolition. CONCLUSION: Previous studies using sum scores to compare differences across countries are likely to be biased. The direction of the bias involves both over- and underestimation of PEs in LAMIC compared to HIC. Nevertheless, the study confirms the basic finding that PEs are more frequent in LAMIC than in HIC.

Food Literacy Evaluation Questionnaire (Chinese version, FLEQ-Ch): a validity and cross-cultural adaptation.

OBJECTIVE: To conduct a Food Literacy Evaluation Questionnaire Chinese Version (FLEQ-Ch) through a cross-cultural validation of the original questionnaire. DESIGN: This was an observational, cross-sectional study undertaken in two phases: (1) translation and cross-culture adaptation, and (2) psychometric evaluation. SAMPLE: A total of 509 residents in Yangzhou City, China were enrolled in this study. METHODS: A translation and cross-cultural adaptation of the FLEQ in Chinese was developed. The psychometric characteristics of FLEQ-Ch were analyzed for internal consistency, content validity, construct validity and discriminant validity. RESULTS: The KMO value of the questionnaire was 0.901 and the approximate chi-square value of Bartlett's sphericity test was 8132.538. The ranges of the Cronbach's α coefficient and the test-retest coefficient of the total questionnaire and three dimensions were 0.869-0.955 and 0.941-0.952, respectively. The value of content validity index of the total questionnaire was 0.945. Construct validity: (1) Aggregation coefficient was between 0.828 and 0.955; (2) Discrimination coefficient was between 0.004 and 0.227; (3) Correlation coefficient between each factor was between 0.046 and 0.188; the correlation coefficient between each factor and the total questionnaire ranged from 0.419 to 0.788. Discriminant validity: the standardized factor loadings of all items on the corresponding factors were 0.75-0.96. The results of the model-fit indices showed RMSEA was 0.08 and GFI was 0.91. CONCLUSIONS: The FLEQ-Ch can effectively evaluate the food literacy of the general public in terms of foods planning and management, foods selection, and foods-making attitudes. It covers the four areas of food literacy, and shows good practicability and operability.

Effect of "freedom of choice" on Task Performance and Well-Being During Leisure Activity: An Intercultural Study Among Older Adults in China and France.

Based on the perspective of self-determination theory (SDT) and the cross-cultural, the aim of the present study was to explore the effect of "freedom of choice" on the well-being of institution-dwelling older adults (elderly residences and nursing homes), in particular during leisure activities. Participants (NChina = 67, Mage = 80.55 years; NFrance = 90, Mage = 82.19 years) were randomly assigned to the "elderly-choice" group or "staff choice" group to participate in a puzzle game. Consistent with SDT, results showed that basic psychological needs satisfaction (autonomy, competence, relatedness) was positively associated with elderly well-being. However, our findings did not demonstrate the importance of freedom of choice for promoting such well-being in the context of leisure activities for either culture; this may be related to the recompense of close relationships or else the particularity of the elderly population. Interestingly, competence satisfaction was observed to act as a complete mediating variable between task performance and well-being only in the French population.

A Generalizable Multivariate Brain Pattern for Interpersonal Guilt.

Feeling guilty when we have wronged another is a crucial aspect of prosociality, but its neurobiological bases are elusive. Although multivariate patterns of brain activity show promise for developing brain measures linked to specific emotions, it is less clear whether brain activity can be trained to detect more complex social emotional states such as guilt. Here, we identified a distributed guilt-related brain signature (GRBS) across two independent neuroimaging datasets that used interpersonal interactions to evoke guilt. This signature discriminated conditions associated with interpersonal guilt from closely matched control conditions in a cross-validated training sample (N = 24; Chinese population) and in an independent test sample (N = 19; Swiss population). However, it did not respond to observed or experienced pain, or recalled guilt. Moreover, the GRBS only exhibited weak spatial similarity with other brain signatures of social-affective processes, further indicating the specificity of the brain state it represents. These findings provide a step toward developing biological markers of social emotions, which could serve as important tools to investigate guilt-related brain processes in both healthy and clinical populations.

Sounds Healthy: Modelling sound-evoked consumer food choice through visual attention.

Food choice is a multifaceted construct that is not solely guided by our internal incentives. In fact, sensory scientist, consumer psychologists, and marketers have demonstrated that external ambient cues, including background music, can influence myriads of subconscious consumer behaviors, effectively leading to increased sales of food and beverages. However, the vast majority of literature in on this topic has thus far been confined to monocultural field studies in which the underlying mechanisms of food choice are unexplored. We therefore studied the explicit and implicit effects of custom-composed soundtracks on food choices and eye-movements in consumers from both 'East' and 'West'. Firstly, based on the results from a pre-study (N = 396), we composed a 'healthy' and 'unhealthy' soundtrack. Subsequently, we recruited 215 participants from China (n = 114) and Denmark (n = 101) respectively for in an in-laboratory eye-tracking food choice paradigm. For each culture, half of the participants listened to the 'healthy' soundtrack and the other half to the 'unhealthy' soundtrack during the experiment. Chi-square tests of independence revealed that across cultures, the healthy (vs. unhealthy) soundtrack led to more healthy food choices. Similarly, the generalized linear mixed models showed that the healthy soundtrack induced more and longer fixations on healthy (vs. unhealthy) food. Finally, a multiple mediation analysis signified a partial mediation effect of sound on food choice through the mediators of fixation duration, fixation count, and revisit count. Our results indicate that, with strategically chosen soundscapes, it is possible to influence consumers' decision-making processes and guide their attention towards healthier foods, providing valuable knowledge for local as well as global food business.

The anger superiority effect revisited: a visual crowding task.

Visual search studies have shown that threatening facial expressions are more efficiently detected among a crowd of distractor faces than nonthreatening expressions, known as the anger superiority effect (ASE). However, the opposite finding has also been documented. The present study investigated the ASE in the visual periphery with a visual crowding task. In the study, the target face either appeared alone (uncrowded condition) or was crowded by four neutral or emotional faces (crowded condition). Participants were instructed to determine whether the target face was happy or angry. Experiment 1 showed an ASE when crowded by neutral faces. Intriguingly, this superiority vanished when the target face was crowded by emotional faces that had a different expression from the target as well as when the target face was presented alone. Experiment 2 replicated this result in an independent sample of East Asians (vs. Caucasians in Experiment 1) and thus demonstrated the robustness and cross-cultural consistency of our findings. Together, these results suggest that the ASE in the visual periphery is contingent on task demands induced by visual crowding.

Social representation of hearing aids among people with hearing loss: an exploratory study.

OBJECTIVE: The aim of the current study was to examine the social representation (SR) of hearing aids in people with hearing loss (PHL) in India, the Republic of Korea (ROK), the United Kingdom (UK), and the United States of America (US). DESIGN: The study used a cross-sectional survey design. The data collected by using a free association task were analysed qualitatively (i.e. content analysis) and quantitatively (i.e. chi-square analysis, similarities analysis, prototypical analysis). STUDY SAMPLE: 424 participants with hearing loss. RESULTS: The most commonly reported categories across all countries were "beneficial," "cost and time," and "appearance and design." Approximately 50% of the associations reported were negative. There were variations in terms of the categories that were predominant in the SR of each country. "Others actions and attitude" category was predominantly reported by PHL in India. "Disturbance" and "dissatisfaction" of hearing aids and the "repairs and maintenance of hearing aids" categories were mainly reported from the ROK and the US, respectively. CONCLUSIONS: The current results highlight the main aspects that PHL report spontaneously when they think about hearing aids. The findings will help to further inform public health campaigns and will contribute to develop culturally appropriate media materials regarding hearing aids.

Cross-cultural variation in how much, but not whether, children overimitate.

Children from Western industrialized populations tend to copy actions modeled by an adult with high fidelity even if these actions are functionally irrelevant. This so-called overimitation has been argued to be an important driver of cumulative cultural learning. However, cross-cultural and developmental evidence on overimitation is controversial, likely due to diverging task demands regarding children's attention and memory capabilities. Here, children from a recent hunter-gatherer population (Hai||om in Namibia) were compared with urban Western children (Germany) using an overimitation procedure with minimal cognitive task demands. Although the proportion of children engaging in any overimitation was similar across the two populations, German overimitators copied irrelevant actions more persistently across tasks. These results suggest that the influence of culture on children's overimitation may be one of degree, not kind.

Overcoming existential loneliness: a cross-cultural study.

BACKGROUND: Moving into a long-term care facility (LTCF) can reduce the ability for older adults to engage in meaningful roles and activities and the size of their social network. These changes and losses can lead them to experience existential loneliness (EL)-the intolerable emptiness and lack of meaningful existence resulted from the losses they have experienced. While EL has often been understood as a universal human experience, it has primarily been studied in people from Western cultures; little is known about how EL may be experienced by and manifested in people from Eastern cultures. Hence, this qualitative study aimed to describe the experience and coping of EL in Hong Kong Chinese and Swedish older adults living in LTCFs. METHODS: A qualitative study using Thorne's (2004) interpretive description was conducted. Thirteen Chinese and 9 Swedes living in LTCFs in Hong Kong, China and Malmo, Sweden, respectively were interviewed about their experience of EL in two series of semi-structured interviews. Data were analyzed using thematic analysis. RESULTS: The core theme of "overcoming EL" described the participants' experience of EL, which came about through the combined process of "Feeling EL" and "Self-Regulating". Both Chinese and Swedish participants had similar experience with EL. Realizing that they did not want to living with EL anymore, they coped by reframing their experience and identifying new meaning in their life. CONCLUSIONS: The study findings suggested that early and clear counselling support that help older adults to define new meaning in life may help them cope. In addition, more opportunities should be available at the LTCFs to promote quality relationships, enable older adults to reflect on their lives with pride, and support their ability to do the things they enjoy.

Adaptation and psychometric evaluation of the simplified Chinese version of the identification of functional ankle instability questionnaire in Chinese-speaking patients with chronic ankle instability disorders.

BACKGROUND: The aims of this study were to adapt the Identification of Functional Ankle Instability (IdFAI) questionnaire into a simplified Chinese version and to assess its reliability, validity, and responsiveness in Chinese-speaking patients with chronic ankle instability (CAI) disorders. METHODS: The simplified Chinese version of the IdFAI (SC-IdFAI) questionnaire was developed with a five-step procedure involving cross-cultural translation and adaptation. Three questionnaires, including the SC-IdFAI, Medical Outcomes Study Short-Form 36 (SF-36), and Foot and Ankle Ability Measure (FAAM), were administered to the recruited patients. Then, the Cronbach's alpha value, intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC), Spearman's correlation coefficient (rs), effect size (ES), and standardized response mean (SRM) were calculated to evaluate the reliability, validity, and responsiveness of the SC-IdFAI questionnaire. RESULTS: A total of 131, 119, and 86 patients with CAI successfully completed the first, second, and third rounds of the questionnaires, respectively. Good or excellent internal consistency and test-retest reliability were found for the overall scale and subscales of the SC-IdFAI questionnaire. The values for the SEM (1.346) and MDC (3.73) were low, indicating that small clinical changes can be detected by the SC-IdFAI questionnaire. The correlations of the SC-IdFAI with FAAM and SF-36 were generally in agreement with the a priori hypotheses (85%, 34/40), suggesting the SC-IdFAI questionnaire has good construct validity. Moreover, the results suggest that the SC-IdFAI (ES = 1.123 and SRM = 1.554) has an acceptable level of responsiveness. CONCLUSION: The SC-IdFAI scale may be an effective tool, and it is responsive, reliable and valid for the assessment of Chinese patients suffering from CAI.

Wearable Technology Acceptance in Health Care Based on National Culture Differences: Cross-Country Analysis Between Chinese and Swiss Consumers.

BACKGROUND: The advancement of wearable devices and growing demand of consumers to monitor their own health have influenced the medical industry. Health care providers, insurers, and global technology companies intend to develop more wearable devices incorporating medical technology and to target consumers worldwide. However, acceptance of these devices varies considerably among consumers of different cultural backgrounds. Consumer willingness to use health care wearables is influenced by multiple factors that are of varying importance in various cultures. However, there is insufficient knowledge of the extent to which social and cultural factors affect wearable technology acceptance in health care. OBJECTIVE: The aims of this study were to examine the influential factors on the intention to adopt health care wearables, and the differences in the underlying motives and usage barriers between Chinese and Swiss consumers. METHODS: A new model for acceptance of health care wearables was conceptualized by incorporating predictors of different theories such as technology acceptance, health behavior, and privacy calculus based on an existing framework. To verify the model, a web-based survey in both the Chinese and German languages was conducted in China and Switzerland, resulting in 201 valid Chinese and 110 valid Swiss respondents. A multigroup partial least squares path analysis was applied to the survey data. RESULTS: Performance expectancy (ß=.361, P<.001), social influence (ß=.475, P<.001), and hedonic motivation (ß=.111, P=.01) all positively affected the behavioral intention of consumers to adopt wearables, whereas effort expectancy, functional congruence, health consciousness, and perceived privacy risk did not demonstrate a significant impact on behavioral intention. The group-specific path coefficients indicated health consciousness (ß=.150, P=.01) as a factor positively affecting only the behavior intention of the Chinese respondents, whereas the factors affecting only the behavioral intention of the Swiss respondents proved to be effort expectancy (ß=.165, P=.02) and hedonic motivation (ß=.212, P=.02). Performance expectancy asserted more of an influence on the behavioral intention of the Swiss (ß=.426, P<.001) than the Chinese (ß=.271, P<.001) respondents, whereas social influence had a greater influence on the behavioral intention of the Chinese (ß=.321, P<.001) than the Swiss (ß=.217, P=.004) respondents. Overall, the Chinese consumers displayed considerably higher behavioral intention (P<.001) than the Swiss. These discrepancies are explained by differences in national culture. CONCLUSIONS: This is one of the first studies to investigate consumers' intention to adopt wearables from a cross-cultural perspective. This provides a theoretical and methodological foundation for future research, as well as practical implications for global vendors and insurers developing and promoting health care wearables with appropriate features in different countries. The testimonials and support by physicians, evidence of measurement accuracy, and easy handling of health care wearables would be useful in promoting the acceptance of wearables in Switzerland. The opinions of in-group members, involvement of employers, and multifunctional apps providing credible health care advice and solutions in cooperation with health care institutions would increase acceptance among the Chinese.

A comparative study on healthcare employee satisfaction between Japan and China.

OBJECTIVES: To explore essential characteristics of healthcare employee satisfaction by comparing Japan and China in terms of job satisfaction model, satisfaction level, and the crucial factors predicting overall job satisfaction. METHODS: A questionnaire was developed with 35 facet-specific job-related satisfaction and 10 general satisfaction items. The Japanese survey collected 474 responses (74% response rate). Two additional items were added in the Chinese survey and 429 responses were collected (69%). RESULTS: The same five-factor satisfaction model was acquired from both countries with an additional factor labelled "relationship with patients" for China. Applying these factors, a moderate satisfaction level was observed for all professional groups in China, whereas it varied in Japan. A moderate-to-high satisfaction was seen for physicians, a moderate level for pharmacists and technologists, and a low level for nurses. Japanese physicians were significantly more satisfied than Chinese physicians, whereas Japanese nurses were less satisfied than Chinese nurses. Both countries shared crucial predictors of overall job satisfaction that were reputation, growth and development, and work demands and workload. Additionally, financial rewards and relationship with patients were critically important for the Chinese. CONCLUSIONS: Japanese and Chinese healthcare employees shared the job satisfaction model with an extra factor for Chinese. Satisfaction levels were similar for pharmacists and technologists in the two countries, but largely different for physicians and nurses. Because crucial satisfaction factors differed, it is suggested that strategies to improve job satisfaction should be specific to culture and profession, eg, in Chinese hospitals, management should support more to employees especially physicians for dealing with conflicts and medical disputes with patients.