Factors influencing food-related quality of life in patients with inflammatory bowel disease: A systematic review.

BACKGROUND: People diagnosed with Inflammatory bowel disease (IBD) often have severe dietary restrictions and avoidance due to the uncertainty of intestinal symptoms. Inadequate dietary intake may increase the risk of malnutrition and result in impaired food-related quality of life (FRQoL). Few studies investigated factors influencing FRQoL in patients with IBD. This study aimed to synthesize the existing evidence regarding FRQoL among patients with IBD, including the current situation, measurement instruments, and related influencing factors. METHOD: The comprehensive literature search was conducted in databases including PubMed, Embase, CINAHL, PsycInfo, Cochrane Library, as well as the most commonly used Chinese databases (CNKI, Wanfang and CBM). Studies published between January 2015 and December 2023 on FRQoL in patients with IBD were included. The Joanna Briggs Institute (JBI) critical appraisal checklist was utilized to evaluate the methodological quality of the selected studies. RESULTS: Finally, only five studies met the inclusion criteria were reviewed, including three cross-sectional studies and two case-control studies. The Food-related quality of life-29 Scale (FR-QoL-29) with a total core of 145 was the most used instrument measuring FRQoL in patients with IBD. The mean scores of FRQoL ranged from 69.9 to 102.3 in adult patients with IBD and 94.3 in children. A diverse range of factors were associated with FRQoL, including socio-demographic, clinical, psychological, diet-related, and nutrient intake factors. CONCLUSIONS: The main influencing factors of FRQoL among patients with IBD included disease activity status, severe symptoms, history of IBD surgery, negative emotion reaction, and restrictive eating behaviour. Clinicians should work in concert with dietitians, keeping an eye on the disease status, nutrition intake, and restrictive eating habits, assessing FRQoL and providing personalized dietary recommendation for the patients with IBD.

Association between cooking patterns and the prevalence of hyperlipidemia in Eastern China.

BACKGROUND: Hyperlipidemia is a major risk factor for many diseases. Previous studies have shown that diet is closely associated with hyperlipidemia. However, the relationship between cooking methods and hyperlipidemia remains unclear. The objective of this study was to identify the major cooking patterns existing in the Eastern Chinese population and evaluate their association with the prevalence of hyperlipidemia. METHODS: We interviewed 4,710 residents in Eastern China regarding the consumption frequency of each cooking method when they prepare food at home or when eating out and regarding the prevalence of hyperlipidemia. Factor analysis, Chi-square tests, analysis of variance, and binary logistic regression analysis were used to identify the cooking patterns and analyze the characteristics of participants' categories of cooking patterns and the relationship between different cooking patterns and prevalence of hyperlipidemia. RESULTS: Three major cooking patterns were identified: Traditional Chinese, Bland (little or no oil is used to process the food), and High-temperature cooking patterns. After controlling for potential confounders, participants in the highest quartile of the Bland cooking pattern had lower odds of hyperlipidemia than those in the lowest quartile. Nevertheless, no significant associations were observed between the Traditional Chinese and High-temperature cooking patterns and the prevalence of hyperlipidemia. CONCLUSIONS: This study confirms the association between cooking patterns and the prevalence of hyperlipidemia and indicates that the Bland cooking pattern is associated with a reduced prevalence of hyperlipidemia.

Job burnout is associated with poorer hand-washing behaviors among restaurant kitchen chefs: evidence from Jiangsu Province, China.

Inadequate hand-washing among chefs is a major contributor to outbreaks of foodborne illnesses originating in restaurants. Previous studies have found that mental health influences hygiene behaviors among food handlers, who have a high rate of job burnout. However, it is still unclear whether job burnout leads to restaurant kitchen chefs' poor hand washing behaviors (HWBs). In this study, we interviewed 453 restaurant kitchen chefs in Jiangsu Province, China regarding job burnout and HWBs during the summer (July-August) of 2020. The aims were to investigate job burnout (an individual internal motivation factor), identify determinants of job burnout, and examine the association between job burnout and HWBs. Variance analysis, post hoc multiple comparisons, linear regression models, and structural equation modeling were used to analyze the response data. This study revealed that chef age and the scale of the restaurant were significantly and negatively associated with reduced professional efficacy. Combined cuisine and pastry chefs had a more positive perception of their own professional efficacy than the other kitchen chefs, whereas the incidence of exhaustion was significantly higher in pastry chefs than in cuisine chefs and kitchen hands. Reduced professional efficacy was significantly and negatively associated with HWBs for all chefs. To improve the level of hand hygiene among chefs, measures should be taken to enhance chefs' professional efficacy. Furthermore, close attention should be paid to chefs in small-scale restaurants, younger chefs, cuisine chefs, pastry chefs, and kitchen hands.

Correlation between dietary information sources and knowledge of adequate diets in Eastern China.

Knowledge of adequate diets can improve an individual's health status. Although previous studies have identified the main resources from which Chinese people acquire dietary knowledge, it is still unclear whether information sources regarding diets (ISRDs) can increase individuals' knowledge of adequate diets (KAD) and which ISRDs are most effective in conveying KAD to the Chinese population. In this study, we interviewed 4,710 residents in Eastern China regarding their ISRDs and KAD. Descriptive statistics, ANOVA, and multivariate linear regression were used to analyze the effectiveness of different ISRDs in transmitting KAD to Chinese individuals and to determine the relationship between ISRDs and KAD. Results showed that the KAD scores of the respondents were low overall in Eastern China. Providing dietary information through expert lectures, books, newspapers, magazines, and social media could significantly improve the average KAD score of Chinese individuals. Respondents with a greater number of ISRDs were more likely to have higher KAD scores. These findings suggest that the number of ISRDs should be increased. In particular, emphasis should be placed on the role of expert lectures, books, newspapers, magazines, and social media.

Chicken meat taste preferences, perceived risk of human infection with avian influenza virus, and self-reported chicken meat consumption in China.

Chinese consumers often prefer to buy live chickens for cooking at home rather than chilled or frozen chicken meat because of the superior flavor. Even though the purchase of live chickens for consumption was restricted by the Chinese government after the avian influenza (AI) virus outbreak in 2013, people continue to buy live chickens. Thus, it is important to understand why people make this decision. The goal of this study was to investigate the relationships among chicken meat taste preferences, perceived risk of human infection with AI virus, and chicken meat consumption behaviors in China. To address this, a survey of 1108 individuals was carried out in Jiangsu Province. This province was selected because its per capita consumption of poultry products is higher than the national average, and it is at the highest risk for avian influenza A H7N9 and H5N1 virus epidemics out of all provinces in China. Descriptive statistics, multivariate linear regression, and hierarchical regression modeling were used to analyze the data. The results showed that Chinese consumers still buy live chickens at a high rate due to taste preferences, and have a very low perceived risk of infection with AI virus. Multivariate linear and hierarchical regression analyses showed that total monthly household income was significantly and positively associated with the perceived importance of chicken taste; the number of people in the household and the perceived importance of chicken taste were significantly and positively associated with the purchase of live chickens for consumption; age was significantly and negatively associated with the purchase of chilled and frozen chicken for consumption; and education and expertize in livestock-related fields were significantly and positively associated with the purchase of live chickens for consumption. Expertize in livestock-related fields was significantly and positively associated with perceived risk of human infection with AI virus, and perceived risk was significantly and positively associated with the purchase of chilled chicken for consumption. However, the perceived risk of human infection with AI virus had no effect on the relationship between the perceived importance of chicken taste and the purchase of live chickens for consumption. The findings from this study suggest that, over time and with increasing public education, the purchase of live poultry for consumption will gradually decline in China. However, to accelerate this process, measures should be taken to reduce consumer perception of taste differences between chilled chicken meat and meat from freshly killed chickens. In addition, educating consumers about livestock to enhance their risk perception could also be another effective means of promoting the purchase of chilled and frozen chicken meat.

Psychometric Evaluation of the Chinese Version of Decisional Conflict Scale in Chinese Young Women Making HPV Vaccination Decisions.

Purpose: The Decisional Conflict Scale (DCS) is a well-known scale for measuring personal decisional conflict, particularly when a person feels uninformed about the risks/benefits of choices, is unclear about personal values, and feels unsupported in making a choice. Higher scores of DCS indicate higher decisional conflict. In the present study, we aimed to assess the psychometric properties of the Chinese version of the DCS among Chinese young women making HPV vaccination decisions. Methods: A total of 107 HPV-unvaccinated Chinese women aged 18-26 completed the survey assessing decisional conflict, knowledge and decision of HPV vaccination. Factorial validity, construct validity, and reliability of the DCS were examined. Results: The mean score of the DCS-16 was 41.5 (SD=20.0). Principal component analysis extracted a 3-factor model of DCS containing 13 items (DCS-13), but both the original DCS-16 and extracted DCS-13 showed poor factorial validity. An alternative DCS-10 revealed a good fit to the data with Cronbach's alpha 0.86. Some subscales of the three versions of DCS showed inconsistent correlation. Conclusion: The DCS-10 demonstrated good model fit to the data. By using the DCS-10 total score rather than sub-scores to measure Chinese young women's HPV vaccination decisional conflict a more valid assessment can be obtained.

Hand Hygiene Knowledge and Self-Reported Hand Washing Behaviors among Restaurant Kitchen Chefs in Jiangsu Province, China.

Inadequate hand washing among chefs is a major contributor to outbreaks of foodborne illnesses originating in restaurants. Although many studies have evaluated hand hygiene knowledge (HHK) and self-reported hand washing behaviors (HWBs) in restaurant workers in different countries, little is known about HHK and HWBs in restaurant kitchen chefs, particularly in China. In this study, we interviewed 453 restaurant kitchen chefs in Jiangsu Province in China regarding their HHK and HWBs and used Chi-square tests (Fisher exact tests), pairwise comparisons, and linear regression models to analyze the responses and identify determinants of HHK and HWBs. Results reveal that less frequent hand washing after leaving work temporarily and after touching used cutlery were the main issues among restaurant kitchen chefs in Jiangsu Province. Kitchen hands had lower levels of HHK and engaged less frequently in good HWBs than the other type of chefs. Furthermore, working in a large restaurant and having worked in the restaurant industry for a longer amount of time were correlated with better HHK and HWBs. These findings suggest that close attention should be paid to the HWBs of chefs during food preparation, that kitchen hands are the key group of restaurant kitchen workers who need training in HHK, and that regulatory activities should focus on small-scale restaurants.

Development and pre/post testing of a decision aid supporting Chinese parental and young women's HPV vaccination decision-making.

We developed and tested the acceptability and utility of a novel HPV vaccination decision aid (DA) among Chinese young women aged 18-26 years and parents of adolescent girls aged 9-17 years. From March to May 2016, a total of 101 parents plus 109 young women completed baseline surveys assessing their HPV vaccination knowledge, decision self-efficacy, decision conflict, and HPV vaccination intention. Two weeks after receiving the DA, 84 (83.2%) parents and 92 (84.4%) young women completed re-assessments. Chi-square tests or t-tests were performed to compare the before-and-after differences. Cohen's d was calculated to indicate the effect size. After reading the DA, both participating young women's and parents' knowledge of HPV vaccination (Cohen's d = 0.62 among young women and d = 0.59 among parents) and decision self-efficacy (d = 0.38 among young women and d = 0.59 among parents) significantly increased. Both young women's and parents' decision conflict (d = -0 · 98 and -1.06) significantly decreased. The proportion of young women intending to receive HPV vaccination and parents deciding to vaccinate daughters against HPV significantly increased (p < 0 · 0001). The DA showed good acceptability and utility facilitating HPV vaccination decision-making for most Chinese young women and parents of adolescent girls. Further randomized controlled trials of this tool are essential.

A Comparative Analysis of Risk Perception and Coping Behaviors among Chinese Poultry Farmers Regarding Human and Poultry Infection with Avian Influenza.

Poultry farmers face a dual risk when mutant avian influenza (AI) virus exhibits zoonotic characteristics. A/H5N1 and A/H7N9 are two principal strains of the AI virus that have captured public attention in recent years, as they have both been reported and can infect poultry and humans, respectively. Previous studies have focused either on poultry farmers' risk perception and biosecurity preventive behaviors (BPBs) against A/H5N1 infection with poultry, or on their risk perception and personal protective behaviors (PPBs) against human infection with A/H7N9, even though these two strains often appear simultaneously. To bridge this research gap, a survey (N = 426) was conducted in the Chinese provinces of Jiangsu and Anhui to assess risk perception and coping behaviors adopted by poultry farmers facing the dual risk of these two viral strains. Paired sample t-tests revealed that farmers' perceived risk of poultry infection with A/H5N1 was significantly higher than their perceived risk of human infection with A/H7N9, and that their reported frequency of BPBs against A/H5N1 was significantly higher than the frequency of PPBs against A/H7N9. Moreover, farmers were less familiar with AI infection in human beings compared to that in poultry, but they felt a higher sense of control regarding human AI infection. Multivariate regression analyses showed that farm size and perceived risks of both human and poultry infection with AI were positively associated with BPBs and PPBs. The findings of this research suggest that a campaign to spread knowledge about human AI infection among poultry farmers is needed, and that a policy incentive to encourage large-scale poultry farming could be effective in improving implementation of BPBs and PPBs.

Chinese poultry farmers' decision-making for avian influenza prevention: a qualitative analysis.

Poultry farmers faced dual risk when mutant avian influenza (AI) virus showed the zoonotic characteristics. A/H5N1 and A/H7N9 were two dominant AI virus strains that have captured the attention of the public over the years for they have been reported to bring about greater loss to poultry and human, respectively. Previous studies mainly used quantitative methods investigating either the means that poultry farmers adopted for protecting their poultry against A/H5N1 infection or the poultry farmers' self-protective behaviours against A/H7N9 infection. We sought insights into the underlying factors influencing Chinese poultry farmers' protective behaviours in response to the dual risk of AI by a qualitative way. Semi-structured in-depth interviews were conducted with 25 Chinese chicken farmers recruited by purposive sampling between November 2016 and May 2017, the peak season of AI. All interviews were audio-taped, transcribed and analysed using a grounded theory approach. From participants' experiences, we revealed five main themes: Measures adopted for protecting poultry and farmers, Emotional response to the AI epidemic, Perceived risk of AI, Perceived effectiveness of the preventive measures adopted and Perceived self-efficacy to take preventive measures. The information of AI outbreak directly triggered Chinese chicken farmers' emotional response and thereafter preventive actions. Compared to the perceived risk of poultry infection with A/H5N1 which mainly connected to economic loss, participants perceived much lower risk of human infection with A/H7N9. AI epidemic information played a key role triggering poultry farmers' response behaviours. Chinese poultry farmers weighted more attention on the risk of poultry infection which was highly associated with economic losses. The government should build and improve an early AI warning and information transmission network to poultry farmers. Further reinforcement of related self-protective and preventive knowledge training towards poultry farmers is necessary.

Determinants of human papillomavirus vaccination uptake among adolescent girls: A theory-based longitudinal study among Hong Kong Chinese parents.

Human papillomavirus (HPV) vaccination uptake among Chinese adolescent girls remains extremely low. This two-year longitudinal study examined theoretical predictors of adolescent girls' HPV vaccination uptake using an extended Theory of Planned Behaviour (TPB). Between February and November 2014, a random sample of 1996 (response rate 60%) Hong Kong Chinese parents of 12- to 17-year-old HPV unvaccinated girls completed baseline telephone interviews assessing attitudes and intention towards HPV vaccination. Six and 12months later 1255 and 979 parents reported their daughters' HPV vaccination status, respectively. Structural equation modelling tested data fit to an TPB-derived hypothesized model of baseline factors predicting parental decisionmaking for adolescent girls' subsequent HPV vaccination uptake. Overall, at 1-year follow-up, only 9.8% (97/988) of participants' daughters received at least one dose of HPV vaccines. Descriptive norms (ß=0.28), perceived greater benefits of HPV vaccination (ß=0.17), anticipated affective consequences (ß=0.32), and attitude to general optional vaccines (ß=0.09) were associated with parental vaccination intention. Barriers to HPV vaccination (ß=-0.31), descriptive norms (ß=0.17), perceived self-efficacy (ß=0.73), and vaccination intention (ß=0.11) were associated with vaccination planning. Vaccination intention (ß=0.31) and planning (ß=0.18) modestly predicted vaccination uptake. The lack of government-organized HPV vaccination programme may result in persistent low HPV vaccination uptake and many young women may remain vulnerable to future cervical cancer risk in Hong Kong.

Hong Kong Chinese parental attitudes towards vaccination and associated socio-demographic disparities.

BACKGROUND: Most previous studies on parental attitudes towards vaccination focused on a disease-specific vaccine. In this study we describe general attitudes towards vaccination in Chinese parents and associated socio-demographic disparities. METHODS: Data were collected from a random sample of 1996 Hong Kong Chinese parents by telephone interviews (response rate 60%). Multiple linear regression analysis was performed. RESULTS: Most parents believed vaccination to be effective (91.6%) and beneficial (78.7%), though many considered optional vaccines unimportant (39.5%) and unnecessary (62.1%). Demographic characteristics associated with parental negative attitudes to vaccination included being female, born in Hong Kong, married, having fewer children, and children ever experienced vaccination side effects. Lower personal income and religious affiliation were associated with more hesitant attitudes towards optional vaccines. CONCLUSION: Segments of the population hold significantly negative attitudes towards vaccination and optional vaccines, suggesting a need for targeted efforts on vaccination communication in these groups.

Nurses' blame attributions towards different types of cancer: A cross-sectional study.

BACKGROUND: Public health education increasingly emphasizes the link of personal lifestyle with cancer risk, which may result in unintended negative social effects such as triggering stigma and/or blame towards cancer patients when their illness is perceived to be caused by personal behaviours or disapproved lifestyles. OBJECTIVES: To explore nurses' blame attributions towards patients with different types of cancer and to identify associated factors. DESIGN: Cross-sectional survey. SETTING: A tertiary cancer-specialized hospital in Beijing. PARTICIPANTS: 317 Chinese oncology nurses working in the cancer hospital. METHODS: Participant nurses completed a self-administrated anonymous questionnaire and rated how much they would blame someone with a diagnosis of breast cancer, cervical cancer, colon cancer, liver cancer, lung cancer, as well as leukaemia and obesity. RESULTS: More than half of the oncology nurses (57.1%) attributed at least some blame to patients with leukaemia, following with breast cancer (67.5%), cervical cancer (79.2%), liver cancer (79.2%), and colon cancer (78.5%). Lung cancer patients attracted at least some blame by 82.0% of participating nurses. Attributions of blame for patients with lung, cervical, colon and liver cancer were most common among nurses with shorter working experience. CONCLUSIONS: This study demonstrated that a high proportion of Chinese nurses attributed at least some blame to patients with different cancers despite being working in a cancer-specialized hospital. Future education and support for nurses are essential to avoid negative attitudes and blame attributions to cancer patients in order to enhance the quality of care.

Psychosocial determinants of Chinese parental HPV vaccination intention for adolescent girls: preventing cervical cancer.

BACKGROUND: Intention is an important precursor of decisions to undergo vaccination. Using an extensively modified theory of planned behaviour, we explored psychosocial determinants of vaccination intention against human papillomavirus (HPV) among Hong Kong Chinese parents. METHODS: A random sample of 368 (response rate 54.6%) Chinese parents who had at least one daughter aged 12-17 years, had heard of HPV vaccine before but had not vaccinated daughters against HPV and had completed telephone interviews between February and April 2014. Hierarchical multiple regression analysis examined the additive effect of theoretical constructs. Stepwise multiple regression analysis determined which variables contributed the most to the prediction of vaccination intention. RESULTS: Principal determinants of parental HPV vaccination intention were anticipated worry if not vaccinated (ß = 0.23, p = 0.001), anticipated anxiety reduction after HPV vaccination (ß = 0.19, p = 0.005), proneness to peer influence (ß = 0.17, p = 0.002), private health insurance for children (ß = 0.14, p = 0.009), perceiving daughter's susceptibility to cervical cancer (ß = 0.17, p = 0.003), number of daughters (ß = -0.13, p = 0.011), descriptive norms of HPV vaccination (ß = 0.13, p = 0.021), perceiving cervical cancer as behaviour-preventable disease (ß = -0.11, p = 0.031) and anticipated regret if not vaccinated (ß = 0.14, p = 0.046). Cervical cancer-related worry/anxiety explained 32.8% of the variance in parental HPV vaccination intention. CONCLUSIONS: Results suggest that cervical cancer-related worry/anxiety is the most important predictor of parental HPV vaccination intention in Hong Kong Chinese and possibly other populations. Social influences also play an important role affecting parental vaccination intention, particularly peer influence and descriptive norm beliefs. Implications of these results are discussed in terms of future HPV vaccination promotion and cervical cancer prevention programme. Copyright © 2015 John Wiley & Sons, Ltd.

Cervical cancer prevention practices through screening and vaccination: A cross-sectional study among Hong Kong Chinese women.

OBJECTIVE: No published data are available that currently evaluate Chinese adult women's cervical cancer prevention practices through screening and vaccination using population-based samples. This study describes patterns and correlates of these behaviors among Hong Kong Chinese women aged 30-59 years. METHODS: From February to November 2014 a random sample of 1482 Hong Kong Chinese women having at least one 12-17 year-old daughter, who had heard of HPV vaccine before but had not sought HPV vaccination for daughter(s) completed structured telephone interviews. Multiple logistic regression analyses were conducted to examine factors associated with participants' cervical screening attendance, HPV vaccination uptake and intention to uptake. RESULTS: Overall, 80.8% of the participants reported attending asymptomatic cervical screening and 73% had regular screening. Family income and attitudes to cervical smear testing were associated with asymptomatic cervical screening attendance. Only 3.0% (45/1482) of all participants had received HPV vaccination. Among those who had not received HPV vaccination, 12.3% (183/1437) indicated positive intentions. Age below 50, household income and encouragement from family/friends were significantly associated with women's intended and actual uptake of HPV vaccination. Trusting formal and informal HPV vaccination information was positively associated with vaccination intention, while lack of concrete recommendation from doctors was negatively associated with vaccination uptake. CONCLUSIONS: Information trust was associated with vaccination intention but not actual uptake whereas encouragement from family/friends facilitates women's HPV vaccination. Continued efforts are needed to ensure Chinese women adopting cervical cancer preventive behaviors, and must consider different specific needs of population subgroups.

Chinese new immigrant mothers' perception about adult-onset non-communicable diseases prevention during childhood.

Many non-communicable diseases (NCDs) are largely preventable via behaviour change and healthy lifestyle, which may be best established during childhood. This study sought insights into Chinese new immigrant mothers' perceptions about adult-onset NCDs prevention during childhood. Twenty-three semi-structured interviews were carried out with new immigrant mothers from mainland China who had at least one child aged 14 years or younger living in Hong Kong. Interviews were audio taped, transcribed and analysed using a Grounded Theory approach. The present study identified three major themes: perceived causes of adult NCDs, beliefs about NCDs prevention and everyday health information practices. Unhealthy lifestyle, contaminated food and environment pollution were perceived as the primary causes of adult NCDs. Less than half of the participants recognized that parents had responsibility for helping children establish healthy behaviours from an early age to prevent diseases in later life. Most participants expressed helplessness about chronic diseases prevention due to lack of knowledge of prevention, being perceived as beyond individual control. Many participants experienced barriers to seeking health information, the most common sources of health information being interpersonal conversation and television. Participants' everyday information practice was passive and generally lacked awareness regarding early prevention of adult-onset NCDs. Updated understanding of this issue has notable implications for future health promotion interventions.

Hong Kong Chinese women's lay beliefs about cervical cancer causation and prevention.

BACKGROUND: This study aimed to seek insights into Chinese women's lay beliefs about cervical cancer causal attributions and prevention. MATERIALS AND METHODS: Twenty-three new immigrant adult women from Mainland China and thirty-five Hong Kong adult women underwent semi-structured in-depth interviews. Interviews were audio taped, transcribed and analyzed using a Grounded Theory approach. RESULTS: This study generated three foci: causal beliefs about cervical cancer, perceived risk of cervical cancer, and beliefs about cervical cancer prevention. Personal risky practices, contaminated food and environment pollution were perceived as the primary causes of cervical cancer. New immigrant women more likely attributed cervical cancer to external factors. Most participants perceived cervical cancer as an important common fatal female cancer with increased risk/prevalence. Many participants, particularly new immigrant women participants, expressed helplessness about cervical cancer prevention due to lack of knowledge of prevention, it being perceived as beyond individual control. Many new immigrant participants had never undergone regular cervical screening while almost all Hong Kong participants had done so. CONCLUSIONS: Some Chinese women hold pessimistic beliefs about cervical cancer prevention with inadequate knowledge about risk factors. Future cervical cancer prevention programs should provide more information and include capacity building to increase Chinese women's knowledge and self-efficacy towards cervical cancer prevention.