Continuing bonds, attachment style, and adjustment in the conjugal bereavement among Hong Kong Chinese.

The present study examined the effects of attachment style and continuing bonds, defined as the extent to which a bereaved individual feels that the deceased remains a part of his/her life, on postbereavement adjustment among 71 conjugally bereaved individuals. It was shown that bereaved individuals with an anxious attachment style tended to show more externalized continuing bonds as well as more grief symptoms. An anxious attachment style played a direct and significant role in postbereavement adjustment over and above the contribution of externalized continuing bonds. Interventions to facilitate restoration tasks and to reduce externalized continuing bonds would be discussed.

Coping flexibility and complicated grief: a comparison of American and Chinese samples.

BACKGROUND: The ability to process a death and the ability to remain optimistic and look beyond the loss are both thought to be effective means of coping with loss and other aversive events. Recently, these seemingly contrary dimensions have been integrated into the idea of coping flexibility. METHODS: In this study, we assessed the ability of married and bereaved individuals in the United States and Hong Kong to use both coping approaches as operationalized by the trauma-focused and forward-focused coping scales of a previously validated questionnaire. We also calculated a single flexibility score. RESULTS: Bereaved participants reported greater trauma-focused coping ability than did married participants. However, bereaved participants meeting criteria for complicated grief (CG) reported less forward-focused coping than both asymptomatic bereaved and married participants. The CG group also showed less overall coping flexibility than the asymptomatic bereaved and married groups. Country was not a factor. CONCLUSION: Findings suggest that deficits in coping flexibility are indicative of pathology in bereaved individuals, and that this relationship extends across cultures. Limitations of the study and directions for future research are discussed.

Validation of the Chinese version of pain self-efficacy questionnaire.

BACKGROUND: Self-efficacy is a person's belief in his or her ability to perform a certain behavior that achieves a desired outcome. Belief in self-efficacy influences the use of pain-coping strategies, physical and psychological function, and rehabilitation outcome in chronic pain patients. We conducted this prospective study to validate the psychometric properties of a Chinese version of the Pain Self-Efficacy Questionnaire (PSEQ-HK). METHODS: A previously translated PSEQ-HK was evaluated with the author's consent. Forward-backward translation was conducted, followed by critical appraisal by an expert panel. Reliability was examined by completing the PSEQ-HK twice over a 1-wk interval. One-hundred-twenty Chinese patients with chronic nonmalignant pain were asked to self-complete a set of health-related instruments in Chinese: Numeric Pain Rating Scale, Hospital Anxiety and Depression Scale, Roland-Morris Disability Questionnaire, Pain Catastrophizing Scale, and Medical Outcome Study Short-Form 36 (SF36) Health Survey. RESULTS: PSEQ-HK had good retest reliability (intraclass correlation coefficient 0.75) and high internal consistency (Cronbach's alpha 0.93). Exploratory factor analysis showed a one-factor model that accounted for 61% of the total variance, with minimal factor loading of 0.69. It was significantly correlated with the Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, and five domains of SF36 (bodily pain, vitality, social functioning, role emotion, and mental health). Moderate correlations were observed with Roland-Morris Disability Questionnaire and two domains of SF36 (role physical, general health). It had no correlation with pain score and medication use. CONCLUSIONS: PSEQ-HK is a reliable Chinese clinical assessment tool with satisfactory psychometric properties. Our results provided preliminary support for the construct validity of PSEQ-HK in a heterogeneous Chinese population with chronic nonmalignant pain.