Using the health belief model to understand the factors influencing the perceptions of people of Chinese ancestry about reducing salt consumption for hypertension prevention: A cross-sectional study.

BACKGROUND: High-salt diets are linked to hypertension. Chinese people in Australia, are at increased risk of hypertension due to the combination of routine addition of high quantities of salt to food during cooking and high salt levels in processed western foods. There is a scarcity of salt-related behavioural studies on this population group. This study aimed to explore the habitual salt consumption of Chinese Australians and factors that influence their perceptions about sustaining salt-related behavioural changes for hypertension prevention. METHOD: A cross-sectional descriptive study using an adapted Determinants of Salt-Restriction Behaviour Questionnaire was conducted on 188 Chinese Australians. A non-probability sampling method was used to attract participants from different parts of Australia. Statistical analyses such as descriptive analysis, t-tests and Pearson correlation tests were performed in the study. RESULTS: Over 97% of participants did not measure the amount of salt added to their meals. Many participants reported that salt was added to their meals based on their experience (39.4%) and food taste (31.9%). Over 80% of participants did not know the recommended level of daily salt consumption. Although salt-related knowledge had no significant correlation with individuals' salty food taste preferences, there were significant correlations with the perceptions of the severity of disease and health benefits of reducing salt consumption (p = .001 and < .001 respectively). People with stronger salty taste preferences perceived a higher level of health threat than people with lighter salty taste preferences (p = .003). CONCLUSION: Findings from this study show that knowledge about salt-reduction alone had no significant effects on salt-related behaviours. Adequate culturally relevant practice-based education in salt-reduction strategies may facilitate salt-related behavioural changes in Chinese Australians. Overall, single young Chinese Australian men with stronger salty taste preferences is the group who needs salt reduction interventions the most.

Validity and reliability of an Emotional Thermometer tool: an exploratory cross-sectional study.

INTRODUCTION: There are a few screening tools to detect psychological symptoms among people with multiple chronic conditions (MCCs) in China. AIM: The aim of this study was to examine the validity and reliability of a translated version of the Emotional Thermometer (ET) tool. MATERIALS AND METHODS: This cross-sectional study consisted of two phases: (1) translation and content validity testing; and (2) assessment of psychometric properties, including internal consistency, test-retest reliability, and construct validity. For the first phase, the authors used a forward-backward translation approach for the Chinese version of the instrument and tested its content validity with a panel of six experts. For the second phase, the data, including the ET tool and demographic characteristics were collected in a convenience sample of 197 Chinese people with MCCs recruited from a university hospital. The first 50 participants participated in the two-week retest. RESULTS: The Chinese version of the ET tool had satisfactory psychometric properties; content validity index (0.83), internal consistency (0.92), and ICC (0.93 to 0.98 [p < 0.01]). Principal component analysis showed that there was only one component with an eigenvalue greater than 1 (value = 3.80), with 76.67% of the variance responding. All items loaded significantly onto this factor and demonstrated strong loadings of > 0.70. CONCLUSION: The Chinese-version of the ET tool is psychometrically sound. It has the potential to be used as a screening tool for psychological symptoms in Chinese people with MCCs. IMPACT STATEMENT: Findings from testing the Chinese translation of the Emotional Thermometer indicate this could be a convenient and useful screening tool to detect psychological symptoms in patients with multiple chronic conditions.

Urban-rural differences in mental health among Chinese patients with multiple chronic conditions.

Mental health is impacted by social, economic, and environmental influences related to where people live. Mental health problems commonly co-occur with long-term physical conditions and impact individuals' health synergistically. Multiple chronic conditions (MCCs) including mental health problems are becoming a public health challenge globally. However, there is limited information about urban-rural differences in mental health among patients with MCCs in China. The present study aimed to identify differences in mental health between urban and rural patients with MCCs. Using a cross-sectional design, 347 patients with MCCs were recruited from a tertiary hospital in North Anhui, China. A self-reported questionnaire, including socio-demographic and clinical variables, the 12-item Short-Form survey version 2 on quality of life, and the Hospital Anxiety and Depression Scale, was administered to outpatients. Findings showed that rural participants reported more symptoms of anxiety and depression and had worse mental health compared to urban participants. Unemployment status, lower educational level, more long-term health conditions, and a higher degree of anxiety were associated with worse mental health. This study highlights disparities in mental health among patients with MCCs living in urban and rural areas of China. Appropriate mental health support programmes should be developed for patients with MCCs, especially for those living in rural areas.

Expert by Experience Involvement in Mental Health Nursing Education: Nursing Students' Perspectives on Potential Improvements.

Expert by experience involvement in mental health education for health professional programmes has increased in recent decades. The related literature has articulated the benefits, and changes in attitudes have been measured in some studies. Less attention has been devoted to ways this learning approach could be improved. The aim of this paper is to present the nursing students perspectives on how Expert by Experience input into nursing curricula could be enhanced. Qualitative exploratory research was undertaken, involving focus groups with students who had completed a mental health learning module co-produced by Experts by Experience and nurse academics. Results show two main themes: getting the structure right, and changes to content and approach. Some student responses could directly influence changes to the learning module. In other instances, responses indicate the need to better prepare students of the value of lived experience knowledge in its own right, rather than adjunct to more traditional methods of education. These findings are important in encouraging reflection on how future learning modules co-produced by Experts by Experience and Mental Health Nursing academics can be refined and better articulated.

Integrative Review on the Effectiveness of Internet-Based Interactive Programs for Women With Breast Cancer Undergoing Treatment.

PROBLEM IDENTIFICATION: Internet-based interactive programs have been developed to address health needs for women with breast cancer undergoing treatment, but evidence has been inadequate to establish the effectiveness of these programs. This article aims to synthesize studies published in English or Chinese regarding the effectiveness of these programs on the outcomes of symptom distress, social support, self-efficacy, quality of life, and psychological well-being for women with breast cancer undergoing treatment.
. LITERATURE SEARCH: CINAHL Complete, MEDLINE®, Mosby's Nursing Index, PsycINFO®, Scopus, Web of Science, Joanna Briggs Institute, Cochrane Library, Embase, and China National Knowledge Infrastructure. Databases were searched from the start of the database to April 2015.
. DATA EVALUATION: 174 articles were retrieved, yielding 23 eligible articles. A manual search led to an additional five eligible articles. After 10 were excluded, 3 qualitative and 15 quantitative studies were evaluated. Data were analyzed to identify similarities and differences across articles.
. SYNTHESIS: Internet-based interactive programs moderated by healthcare professionals have demonstrated positive effects on women's self-efficacy, symptom distress, and psychological well-being, but inconclusive effects have been found on social support and quality of life.
. CONCLUSIONS: Moderated Internet-based interactive programs are a promising intervention for women with breast cancer undergoing treatment.
. IMPLICATIONS FOR RESEARCH: Studies with more robust research designs and theoretical frameworks and conducted in different countries and cultures are warranted to elucidate the effectiveness of these programs.

Factors affecting caregiver burden of terminally ill adults in the home setting - A systematic review.

EXECUTIVE SUMMARY: Background: Terminally ill people have complex physical and psychological needs. As a result, their caregivers may experience high levels of burden, and some caregivers are unable to cope with the burden. Thus, it is important to determine the various factors that may influence caregiver burden, so that healthcare professionals may implement strategies to reduce caregiver burden. In this review, "caregiver burden" was expanded to include "caregiver stress" and "caregiver strain", as the two terms were related to caregiver burden. OBJECTIVES: The objective of this systematic review was to identify the factors that may influence caregiver burden of a terminally ill adult in the home setting. INCLUSION CRITERIA: Types of participants: This review considered adult participants (above age 18) who were the main caregivers of a terminally ill adult in the home setting, and providing care for the terminally ill person at the point of participation in the study.Types of intervention: There was no specific intervention of interest for the study.Types of outcomes: The focus of study was the factors that affected caregiver burden of the terminally ill person.Types of studies: Quantitative studies such as randomised controlled trials (RCTs), controlled clinical trials (CCTs), interrupted time series (ITSs), controlled before after designs (CBAs), observational design (cohort, case-control), and descriptive surveys were included in the study. SEARCH STRATEGY: This review was limited to papers in English and Mandarin. A literature search from the inception of the database to October 2010 was conducted using major electronic databases. The databases used were CINAHL, MEDLINE, PsycINFO (Ovid), Scopus, SpringerLink, ScienceDirect, Web of Science, Mosby's Nursing Consult, Mednar: Deep web medical search, Proquest Dissertations and Theses and China Journal Net.Methodological quality: The quality of the potential studies was assessed by two independent reviewers using the critical appraisal checklists for descriptive/case studies from the JBI-MAStARI (Joanna Briggs Institute-Meta Analysis of Statistics Assessment and Review Instrument). DATA EXTRACTION: Quantitative data were extracted from included papers using standardised data extraction tools from the JBI-MAStARI. DATA SYNTHESIS: Findings were presented in narrative form, as statistical pooling was not possible. RESULTS: Seven studies were included in the review. All the studies used a cross-sectional descriptive survey for the collection of data. Four main factors that influenced caregivers' perception of caregiving burden were identified: 1. Caregiver characteristics, 2. Patient characteristics, 3. Social support, and 4. Caregivers' personal protective resources. CONCLUSION: Caregiver characteristics, patient characteristics, social support, and attitude of caregiver towards the caregiving situation, were found to influence caregivers' perceived caregiving burden. IMPLICATIONS FOR PRACTICE: Additional support is required for caregivers who are employed, known to have financial difficulties, caring for patient indicating symptom distress, and caring for a patient at the terminal stage (Level III). IMPLICATIONS FOR RESEARCH: Future studies may attempt to develop a framework to identify factors that impact on caregiver burden. More studies on caregiver burden in males, caregiver burden of patients who were at the terminal stages of the various chronic illnesses should be explored.

Predictors and correlates of maternal role competence and satisfaction.

BACKGROUND: Developing a sense of competence and satisfaction in the maternal role enhances positive parenting and healthy development of the child. There is limited longitudinal research on the predictive factors influencing maternal role competence and satisfaction. OBJECTIVES: The aim of this study was to determine the predictive and concurrent associations of prenatal perceived maternal role competence, learned resourcefulness, social support, stress, and depression to perceived maternal role competence and satisfaction at 6 weeks postpartum. METHOD: A longitudinal, descriptive design was used. A convenience sample of 184 first-time pregnant women with a singleton and uneventful pregnancy were recruited from two regional public hospitals in Hong Kong. The Parenting Sense of Competence Scale, Self-control Schedule, Medical Outcomes Study Social Support Survey, Social Readjustment Rating Scale, and Edinburgh Postnatal Depression Scale were used to assess maternal role competence and satisfaction, learned resourcefulness, social support, stress, and depressive symptoms, respectively. Data were collected during pregnancy and at 6 weeks postpartum. RESULTS: Multiple regression analysis showed that perceived maternal role competence and satisfaction at 6 weeks postpartum were predicted by prenatal perceived maternal role competence and learned resourcefulness and were associated with postnatal learned resourcefulness and depression. Social support and stress were not associated directly with perceived maternal role competence and satisfaction at 6 weeks postpartum. DISCUSSION: The present findings suggest that maternal learned resourcefulness and depression are important factors affecting perceived maternal role competence and satisfaction at postpartum. Culturally competent healthcare should be developed to promote the psychological well-being of women and to equip women with the learned resourcefulness skills to facilitate maternal role taking and enhance women's sense of competence and satisfaction in the maternal role.

Translation and validation of a chinese version of the parenting sense of competence scale in chinese mothers.

BACKGROUND: Women's sense of competence and satisfaction in the maternal role are essential for positive parenting practices and child development. Measures of maternal role competence and satisfaction are limited in the Chinese population. OBJECTIVES: To translate the Parenting Sense of Competence Scale into Chinese (C-PSOC) and to examine the psychometric properties of the C-PSOC. METHODS: A cross-sectional survey was conducted using a convenience sample of 170 mothers recruited from a postnatal unit. Participants completed the C-PSOC, Rosenberg's Self-Esteem Scale, and the Edinburgh Postnatal Depression Scale. A randomly selected subsample of 57 mothers participated in the 4-week retest. RESULTS: The C-PSOC demonstrated good internal consistency (Cronbach's alpha = .85) and test-retest reliability (intraclass correlation coefficient = .87). Factor analysis supported the two-factor structure reflecting the efficacy and satisfaction dimensions of the original instrument. The scale discriminated between primiparas and multiparas (t = 2.2, p < .05). Significant correlations with Rosenberg's Self-Esteem Scale (r = .60, p < .01) and the Edinburgh Postnatal Depression Scale (r = -.48, p < .01) demonstrated good construct validity. CONCLUSION: The C-PSOC has satisfactory psychometric properties. It has the potential to be used as a clinical and research instrument for measuring maternal role competence and satisfaction in the Chinese population.