"Shame on Me": Exploring the Role of Self-Stigma in Psychological Outcomes Among Type 2 Diabetes Patients in Hong Kong.

BACKGROUND: Studies have suggested that type 2 diabetes mellitus (T2DM) are at risk of self-stigmatization (i.e., internalized sense of shame about having diabetes). Self-stigma has been found to be associated with poorer psychological outcomes among chronic disease patients; relevant studies examining such an association and its psychosocial mechanisms are scarce among Chinese T2DM patients. This study aimed to examine the association between self-stigma and psychological outcomes among T2DM patients in Hong Kong. Self-stigma was hypothesized to be associated with higher psychological distress and lower quality of life (QoL). Such associations were also hypothesized to be mediated by lower perceived social support, lower self-care self-efficacy, plus higher self-perceived burden to significant others. METHODS: T2DM patients (N = 206) recruited from hospitals and clinics in Hong Kong were invited to complete a cross-sectional survey measuring the aforementioned variables. RESULTS: After controlling for covariates, multiple mediation analysis results indicated the indirect effects from self-stigma to psychological distress via increased self-perceived burden (ß = 0.07; 95% CI = 0.02, 0.15) and decreased self-care self-efficacy (ß = 0.05; 95% CI = 0.01, 0.11) were significant. Moreover, the indirect effect from self-stigma to QoL via decreased self-care self-efficacy was also significant (ß = -0.07; 95% CI = -0.14, -0.02). After considering the mediators, the direct effects from self-stigma to higher psychological distress and lower QoL remained significant (ßs = 0.15 and -0.15 respectively, ps < .05). CONCLUSIONS: Self-stigma could be linked to poorer psychological outcomes through increased self-perceived burden and decreased self-care self-efficacy among T2DM patients. Targeting those variables when designing interventions might facilitate those patients' psychological adjustments.

Common stressors, coping processes, and professional help-seeking of medical professionals in Hong Kong: A qualitative study.

Despite the high prevalence of perceived stress and mental health problems among medical professionals (MPs), their professional help-seeking is extremely low. This qualitative study explored MPs' stressors, stress-coping, barriers and facilitators of professional help-seeking. 10 MPs (30% male, Mage = 34.8 years) were recruited by purposive-sampling for views from different roles/settings. Thematic analyses revealed five central stressors: emerging novel diseases, challenges from technology-advancement, patient-communication difficulties, lack of workplace mental health care culture, excessive workload/manpower shortage. Participants predominantly used peer support/supervision and de-stress activities for stress-coping. Five factors affecting professional help-seeking were time constraint versus flexibility, mental health stigma versus de-stigmatization, concern over confidentiality/anonymity versus sense of privacy, worry about damage on professional role versus least work disruption, doubts of service providers versus perceived efficacy. All participants indicated a preference for online mental health service delivery. Results reflected unmet needs and service gaps from MPs' perspectives for the development of future interventions.

Positive Psychology Interventions for Improving Self-management Behaviors in Patients with Type 1 and Type 2 Diabetes: a Narrative Review of Current Evidence.

PURPOSE OF REVIEW: Interests have been emerging in using positive psychology interventions (PPIs) to improve diabetes self-management (DSM) behaviors (e.g., blood glucose monitoring, physical activity). To explore the impact of those interventions on DSM behaviors, we summarized the evidence of PPIs on self-management behaviors among both type 1 diabetes (T1D) and type 2 diabetes (T2D) patients between 2012 and 2022. RECENT FINDINGS: Among the eight studies identified, different study designs and types of PPIs were apparent. Typical PPIs (e.g., activities enhancing positive affect/gratitude/self-affirmation/optimism) were usually applied to T1D patients (N = 5); PPIs were usually combined with motivational interviewing for T2D patients (N = 3). Contrary to expectations, PPIs did not consistently demonstrate positive effects on self-management behaviors' change regardless of the types of diabetes patients, compared to the control groups. Improvements in diabetes patients' self-management behaviors from PPIs are still unclear. Future studies should more rigorously evaluate and identify the active ingredients of PPIs for behavioral changes among diabetes patients.

"My Cross-Border PhD Journey": A Qualitative Study on the Educational and Life Challenges of Mainland Chinese PhD Students in Hong Kong.

PhD students' poor mental health has been increasingly concerning. However, challenges among PhD students studying aboard are understudied. The Educational and Life Transitions (ELT) model postulates that international PhD students are subject to both academic and acculturative stressors; however, relevant research is limited in the Chinese context. We examined mainland Chinese PhD students' study and living experiences in Hong Kong using a qualitative approach. Through purposive sampling, 37 mainland Chinese PhD students in different disciplines from public-funded universities in Hong Kong were recruited to participate in online focus group interviews (December 2020-February 2021). The interviews were analyzed using the framework analysis method. Ten themes of academic/acculturative stressors were identified. The academic stressors included: (1) high expectations from the supervisors; (2) emphasis on self-discipline as PhD students; (3) peer comparison in academia; (4) difficulties shifting research directions/academic disciplines; (5) uncertainties about future career. The acculturative stressors included: (1) differences in the political environment; (2) language barriers; (3) difficulties living in Hong Kong; (4) limited social interaction with others; (5) local people's discriminatory behaviors. This study sheds light on the stressors experienced by mainland Chinese PhD students in Hong Kong. To better address those students' academic and acculturative stressors, cross-cultural training and additional support from supervisors/the university could be provided.

"The light after the storm": Psychosocial correlates of adversarial growth among nurses in Hong Kong amid the fifth wave of the COVID-19 pandemic.

OBJECTIVE: Healthcare professionals are highly susceptible to adverse psychological outcomes amid the COVID-19 pandemic due to their job duties. As the largest part of the healthcare workforce, growing attention has been paid to nurses' adjustments to the pandemic. Despite the distress, recent studies found that nurses could still experience positive changes (i.e., adversarial growth, AG) during the pandemic. Research on the general populations has indicated that individuals' stress responses, coping resources, and coping strategies are associated with their AG during the pandemic. This study examined how sociodemographic characteristics, secondary traumatic and posttraumatic stress, coping resources, and coping strategies were associated with AG among nurses in Hong Kong amid the fifth wave (i.e., the most disastrous wave) of the COVID-19 pandemic. METHOD: Recruited through local nursing associations between May 24 and June 13, 2022, 209 nurses in Hong Kong completed an online questionnaire measuring the abovementioned variables. RESULTS: Hierarchical regression results found that those affiliating with a religion, having participated in mental health-related workshops, higher levels of secondary traumatic stress (STS), social support, job satisfaction, plus more frequent emotional processing were associated with higher AG (ßs ranging from 0.15 to 0.31, ps < .01). CONCLUSIONS: Nurses did report AG during the fifth wave of the COVID-19 pandemic in Hong Kong. To promote AG among those nurses, future interventions should enhance nurses' understanding about the potential impact of STS on their well-being, solicit their interpersonal and work-related coping resources, plus facilitate their use of effective coping strategies. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

'Caring for the helpers': factors associated with professional quality of life among Hong Kong nurses during the fifth wave of the COVID-19 pandemic.

BACKGROUND: Western studies have found that nurses are likely to experience both positive and negative emotions in their job, as a helping profession [professional quality of life (ProQoL)] during the coronavirus disease 2019 (COVID-19) pandemic, and that psychosocial and work-related variables (e.g. pandemic-related stressors, interpersonal and organizational support, coping strategies) are associated with such outcomes. However, relevant studies on nurses in the Asian context are limited. OBJECTIVE: This study examined the psychosocial correlates of three indicators of ProQoL, i.e. compassion satisfaction, secondary traumatic stress (STS), and burnout, among nurses during the fifth wave of the COVID-19 pandemic in Hong Kong. METHOD: Nurses in Hong Kong (N = 220) working in hospitals and community settings during the COVID-19 pandemic were recruited between 24 May and 27 June 2022 through nursing associations to complete an online survey measuring the aforementioned psychosocial variables. RESULTS: Hierarchical regression results found that stressors from clinical work environments, insufficient emotional support, and less positive reframing were associated with poorer ProQoL (i.e. lower compassion satisfaction; higher STS and burnout) (ß from 0.16, p > .05, to 0.44, p > .001). In addition, COVID-19-related worries/uncertainties and emotional processing were associated with higher STS (ß from 0.21 to 0.23, p < .01), whereas insufficient organizational support for communication with the healthcare system was associated with higher burnout (ß = 0.12, p < .05). CONCLUSIONS: Our findings identified the important psychosocial determinants in ProQoL among nurses in Hong Kong and provide recommendations for services supporting the mental health of these nurses. Providing workshops for nurses to train their skills in coping with COVID-19-related uncertainties, worries, and stressors from the clinical work environment, in using adaptive coping strategies (e.g. positive reframing), and in soliciting emotional support from important others could facilitate their ProQoL. Moreover, the provision of organizational support through timely and transparent communication with the healthcare system could reduce STS in nurses.

Stressors from clinical work environments, insufficient emotional support, and less positive reframing were associated with poorer professional quality of life among nurses in Hong Kong during the COVID-19 pandemic.COVID-19-related worries/uncertainties and emotional processing were associated with higher secondary traumatic stress.Insufficient organizational support for communication with the healthcare system was associated with higher burnout.

Role of human HSPE1 for OPA1 processing independent of HSPD1.

The human mtHSP60/HSPD1-mtHSP10/HSPE1 system prevents protein misfolding and maintains proteostasis in the mitochondrial matrix. Altered activities of this chaperonin system have been implicated in human diseases, such as cancer and neurodegeneration. However, how defects in HSPD1 and HSPE1 affect mitochondrial structure and dynamics remains elusive. In the current study, we address this fundamental question in a human cell line, HEK293T. We found that the depletion of HSPD1 or HSPE1 results in fragmentation of mitochondria, suggesting a decrease in mitochondrial fusion. Supporting this notion, HSPE1 depletion led to proteolytic inactivation of OPA1, a dynamin-related GTPase that fuses the mitochondrial membrane. This OPA1 inactivation was mediated by a stress-activated metalloprotease, OMA1. In contrast, HSPD1 depletion did not induce OMA1 activation or OPA1 cleavage. These data suggest that HSPE1 controls mitochondrial morphology through a mechanism separate from its chaperonin activity.

The effects of culturally adapted expressive writing interventions on depressive and anxiety symptoms among Chinese American breast cancer survivors: A randomized controlled trial.

BACKGROUND: Expressive writing interventions confer mental health benefits for non-Hispanic Whites. However, research is lacking in adapting this paradigm for minoritized groups. This study evaluated the impacts of two culturally adapted expressive writing interventions on depressive and anxiety symptoms and potential mediators (perceived stress and intrusive thoughts) among Chinese American breast cancer survivors (CABCS). METHODS AND RESULTS: CABCS (N = 136) were randomly assigned to one of three conditions to write three weekly essays: enhanced self-regulation condition (ESR) to write about stress and coping (Week 1), deepest feelings (Week 2), and finding benefits (Week 3); self-regulation condition (SR) to write about deepest feelings (Week 1), stress and coping (Week 2), and finding benefits (Week 3); and control condition to write about facts relevant to their cancer experience (Weeks 1-3). Compared with the control condition, the ESR but not SR, reduced depressive and anxiety symptoms at all follow-up time points (1, 3, and 6-months) through reductions in perceived stress. CONCLUSION: A cultural adaptation altering the order of expressive writing prompts resulted in the greatest benefit for CABCS' depressive and anxiety symptoms. Research testing both the content and ordering of components may be vital to advance cultural adaptation science and optimize intervention efficacy. CLINICAL TRIAL REGISTRATION NUMBER: NCT02946619.

Provision of a personalized survivorship care plan and its impact on cancer-related health literacy among childhood cancer survivors in Hong Kong.

PURPOSE: To evaluate the short-term effectiveness of a personalized survivorship care plan (SCP) in improving cancer-related literacy among childhood cancer survivors, and to identify characteristics of survivors who demonstrated minimal gain from the intervention. METHODS: We recruited survivors diagnosed with cancer at ≤18 years old and were >2 years post treatment. The intervention included a personalized SCP and 30-minute health risk counseling. The participants' knowledge of their cancer diagnosis and potential treatment-related late effects (LEs) was assessed at baseline, immediately post intervention, and 1-3 months post intervention. Generalized estimating equation was used to test for changes in the awareness scores, with interacting terms (time*factor) added to identify differences in the score trajectory across clinically relevant subgroups. RESULTS: In total, 248 survivors completed the intervention (mean age: 19.4 [SD = 6.7] years; 54.1% male; 66.1% hematological malignancies), of whom 162 completed all assessments. There was significant increase in survivors' awareness of their cancer diagnoses (mean adjusted score: baseline 66.9, post intervention 86.3; p < .001) and potential LEs (baseline 30.9, post intervention 66.3; p < .001). The proportion of survivors who demonstrated awareness of their potential LEs increased from 9.7% to 54.3%. The interaction analysis showed that there was significantly less improvement in awareness among survivors of non-central nervous system (non-CNS) solid tumors (p = .032), lower socioeconomic status (p = .014), and parents of pediatric survivors (vs. adult survivors; p = .013). CONCLUSIONS: The provision of a personalized SCP showed preliminary effectiveness in improving survivors' understanding of their treatment-related LEs. Health counseling with SCP should be reinforced in vulnerable subgroups. Future work includes evaluating its long-term impact on lifestyle and health outcomes.

Physical Competence, Physical Well-Being, and Perceived Physical Literacy among Older Adults in Day Care Centers of Hong Kong.

In Hong Kong, where the aging problem is inevitable, it is increasingly common for older adults to be admitted to day care centers. However, there has been limited research exploring conceivable indicators of healthy aging among older adults in such settings. The present study investigated the associations among the three indicators (physical competence, physical well-being, and perceived physical literacy) among older adults in day care centers of Hong Kong. A total of 97 participants (aged 60 years old or above) participated in the study from April to July 2021 amid the COVID-19 pandemic. Data on participants' sociodemographic information, physical competence (PC), physical well-being (PWB), and perceived physical literacy (PPL) were collected. Our results showed that the level of PC reached a high level among the participants. Positive correlations were found between PC and PWB and between PPL and PWB (r = 0.22−0.23, p < 0.05). However, PC was not associated with PPL (r = 0.11, p > 0.05). In addition, as a component within PPL, "knowledge and understanding" (KU) was found to be correlated with PC (r = 0.21, p < 0.05) and had a positive and moderate correlation with PWB (r = 0.35, p < 0.01). The results suggest that older adults admitted to day care centers maintain and enhance their physical competence to improve their physical well-being. Greater knowledge and understanding of physical literacy and physical health should be delivered among day care centers considering future development.

Differential associations among social support, health promoting behaviors, health-related quality of life and subjective well-being in older and younger persons: a structural equation modelling approach.

BACKGROUND: Extensive studies have confirmed social support as a critical protective factor of people's health-related quality of life (HRQoL) and subjective well-being (SWB). However, health promoting behaviors as a potential mechanism and age differences in this mechanism has received fewer attention. This study aims to examine the associations among social support, health promoting behaviors, HRQoL and SWB in older and younger persons in Hong Kong. METHOD: A convenience sample of both younger (12-35 years old) and older persons (55 years old and above) were recruited from three non-government organizations to complete a survey. Structural Equation Model (SEM) was conducted to test both the measurement model and structural models to examine the relationship between social support, health promoting behaviors, HRQoL and SWB. Multi-group SEM was also performed and compared to test whether there were significant age differences in the pathways between the key variables. RESULTS: A final sample of 408 participants (older-persons: N = 200 (mean age: 71.63 (8.16); 180/200 female), younger-persons: N = 208 (mean age: 18.10 (5.04); 155/208 female) were included in the final analysis. Results showed that social support was positively associated with SWB directly and indirectly through health promoting behaviors for the whole sample (CFI = .95, IFI = .94, RMSEA = .07, SRMR = 0.056). Results suggested that the association between the variables differed across age samples. While social support showed a positive association with health promoting behaviors for both younger and older persons, how each of them associated with HRQoL and SWB was different. CONCLUSION: Findings suggest that the pathway which social support linked with HRQoL and SWB might differ across age groups. Age-specific strategies should be considered when promoting HRQoL and SWB among the younger and older population.

Finding the positives from the COVID-19 pandemic: factors associated with posttraumatic growth among nurses in Hong Kong.

Background: Due to active involvement with patients for COVID-19 treatments, nurses are susceptible to adverse psychological outcomes amid the COVID-19 pandemic. Despite the distress, studies have suggested that nurses are able to experience positive changes (i.e. posttraumatic growth; PTG) during the pandemic. Research on other populations has also indicated that COVID-19-specific worries and work-related coping resources are associated with people's positive changes during the pandemic. Objective: This study examined how socio-demographic characteristics, COVID-19-related worries, and work-related variables (satisfaction with work and workplace pandemic guidelines) were associated with PTG among nurses in Hong Kong. Methods: Nurses (N = 1510) working in hospitals and community settings were recruited through nursing associations in Hong Kong between 8 August 2020 and 22 September 2020. They were invited to complete a cross-sectional survey measuring their sociodemographic characteristics, COVID-19 worries, and satisfaction with work and workplace pandemic-control measures. Results: Results from hierarchical regressions found that those working non-full-time (ß = -0.06), affiliating with a religion (ß = 0.24), having higher COVID-19-related worries and psychological distress (ßs ranging from 0.12-0.15), and having higher work satisfaction (ß = 0.14) were associated with higher PTG (ps < .05). Moreover, a significant interaction between psychological distress and satisfaction with workplace pandemic control guidelines emerged in explaining PTG (ß = 0.08, p < .05), such that guideline satisfaction was only associated with higher PTG among those with higher distress (ß = 0.09, p = .03), but not those with lower distress (ß = -0.05, p > .05). Conclusions: Nurses in Hong Kong did report positive changes amid the COVID-19 pandemic. Future studies could focus on the contributing factors of PTG to design for effective strategies to enhance resources for nurses to promote positive psychosocial outcomes.

Antecedentes: Debido a la participación activa de pacientes en los tratamientos de COVID-19, las/os enfermeras son susceptibles a resultados psicológicos adversos en medio de la pandemia de COVID-19. A pesar de la angustia, los estudios han sugerido que las(os) enfermeras(os) pueden experimentar cambios positivos (es decir, crecimiento postraumático; CPT) durante la pandemia. Investigación en otras poblaciones también ha indicado que las preocupaciones específicas por COVID-19 y los recursos de afrontamiento relacionados con el trabajo están asociados a cambios positivos de las personas durante la pandemia.Objetivo: Este estudio examinó cómo las características sociodemográficas, las preocupaciones relacionadas a COVID-19 y las variables relacionadas con el trabajo (satisfacción con el trabajo y pautas pandémicas en el lugar de trabajo) se asociaron con el CPT entre las(os) enfermeras(os) de Hong Kong.Métodos: Las(os) enfermeras(os) (N = 1510) que trabajan en hospitales y entornos comunitarios fueron reclutadas(os) a través de asociaciones de enfermería en Hong Kong entre el 8 de agosto del 2020 y el 22 de septiembre del 2020. Los participantes fueron invitados a completar una encuesta transversal que midió sus características sociodemográficas, preocupaciones sobre COVID-19 y satisfacción con el trabajo y las medidas de control de pandemias en el lugar de trabajo.Resultados: Los resultados de regresiones jerárquicas encontraron que aquellos que: no trabajaban a tiempo completo (ß = −0.06), se afiliaban a una religión (ß = 0.24), tenían mayores preocupaciones y angustia psicológica relacionadas por COVID-19 (ßs que oscilan entre 0.12­0.15) y tenían una mayor satisfacción laboral (ß = 0.14), se asociaron con CPT más alto (ps < .05). Además, una interacción significativa entre la angustia psicológica y la satisfacción con las pautas de control de la pandemia en el lugar de trabajo, surgió al explicar el CPT (ß = 0.08, p < .05), de modo que la satisfacción de la guía sólo se asoció con un CPT más alto entre aquéllos con mayor angustia (ß = 0.09, p = .03), pero no en aquéllos con menor angustia (ß = −0.05, p > .05).Conclusiones: Las(os) enfermeras(os) en Hong Kong informaron cambios positivos en medio de la pandemia por COVID-19. Los estudios futuros podrían centrarse en los factores que contribuyen a la CPT para diseñar estrategias eficaces con el fin de mejorar los recursos de las(os) enfermeras(os) para promover resultados psicosociales positivos.

Social constraints and fear of recurrence among Chinese American breast cancer survivors: An exploration of psychosocial mediators.

OBJECTIVE: Fear of cancer recurrence (FCR) is commonly experienced among Caucasian and Chinese American breast cancer survivors (BCS). Emerging studies have suggested that Caucasian BCS' communication with family members contributes to their FCR. However, whether such findings apply to Chinese American BCS has yet to be explored. This study examined the association between social constraints (i.e., perceived barriers from significant others inhibiting cancer-related disclosure) and FCR among 136 Chinese American BCS, plus proposed that self-stigma (i.e., internalized feelings of shame about having cancer), bodily pain, and ambivalence over emotional expression (AEE; conflict between the desire to express emotions and the fear of its consequences) would mediate the association. METHODS: Participants recruited through cancer associations in the USA were invited to complete a cross-sectional survey measuring their socio-demographic/cancer-related variables and the above-mentioned psychological variables. RESULTS: Higher levels of social constraints, AEE, self-stigma, and bodily pain were associated with higher FCR (rs ranged from 0.27 to 0.40, ps < 0.01). After controlling for covariates, path analysis results supported the proposed mediation model with satisfactory fit indices (χ2 (7) = 2.08, Comparative Fit index = 1.00, Tucker Lewis Index = 1.08, Root Mean Square Error of Approximation = 0.00). Specifically, social constraints were associated with higher FCR through increased self-stigma (ß = 0.10, 95% confidence interval [CI] = 0.02, 0.17), AEE (ß = 0.14, 95% CI = 0.01, 0.27), and bodily pain (ß = 0.09, 95% CI = 0.02, 0.17), indicating significant mediation effects. After considering the mediators, the direct effect from social constraints to FCR was no longer significant. CONCLUSIONS: The association between social constraints and higher FCR could be mediated by increased self-stigma, AEE, and bodily pain among Chinese American BCS. Interventions targeting to address those variables may reduce FCR among those BCS.

Finding the silver linings in the COVID-19 pandemic: Psychosocial correlates of adversarial growth among Filipina domestic helpers in Hong Kong.

OBJECTIVE: The coronavirus (COVID-19) pandemic has disrupted many people's life. Negative impacts of pandemic measures and economic hardship on psychological well-being are common among the global populations. In Hong Kong, the pandemic not only affects the local populations, but also the migrant Filipina domestic helpers (FDH). Despite the distress, evidence suggests that people still experience positive changes (aka adversarial growth) amid the COVID-19 pandemic. We expect the same applies to FDH in Hong Kong. Studies have shown that coping resources (e.g., resilience, social support, literacy of trauma-related information), cognitive appraisal, and coping strategies are associated with adversarial growth among individuals living with highly stressful events. Relevant studies for migrant populations in the COVID-19 context are limited. This study examined the psychosocial correlates of adversarial growth among FDH in Hong Kong. METHOD: By convenient sampling, FDH (N = 266) recruited from public gathering venues were asked to complete a cross-sectional survey. Their COVID-19-related distress, work-related stress, COVID-19 information literacy, emotional and material support, resilience, cognitive appraisals (harm, threat, challenge), and coping strategies (religious coping, positive reframing, acceptance) were measured. RESULTS: Controlled for covariates, hierarchical regression results showed that higher levels of resilience (ß = .21), emotional support (ß = .16), COVID-19-related information literacy (ß = .15), and religious coping (ß = .16) were associated with higher adversarial growth (ps < .05). CONCLUSIONS: FDH in Hong Kong reported positive changes amid the COVID-19 pandemic. Based on our findings, facilitating those FDH's resilience, emotional support, COVID-19 information literacy, and religious coping might be important strategies to enhance their adversarial growth. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Perceptions of Infertility Risk Among Chinese Parents of Children with Cancer: A Qualitative Study.

Objective: Anticancer treatment may be associated with damage to the reproductive organs and risk of infertility in children with cancer. The collectivist cultural norms of Asian societies may lead Chinese parents to have unique concerns regarding infertility. This qualitative study explored the perceptions of infertility risk and parenthood among parents of childhood cancer survivors in Hong Kong. Methods: Thirteen parents were recruited via a snowball sampling approach from a nongovernmental organization in Hong Kong, representing nine survivors of childhood cancer (leukemia n = 5, solid tumors n = 4). The in-depth semistructured interviews were audiotaped and transcribed verbatim. A thematic analysis was performed using ATLAS.ti 8. Results: Parents mostly perceived their children's fertility status as a distant concern (n = 11, 85%) but emphasized the need for timely information from clinicians when their children reach young adulthood (n = 8, 62%). They reported receiving inconsistent fertility information from different oncology practitioners (n = 9, 69%). A few parents acknowledged that under the influence of the Chinese culture, their children, especially sons, have an important duty to continue the family lineage. However, even if the cancer treatment were associated with infertility risk, almost all parents (n = 12, 92%) stated that it would still not affect their willingness to let their child undergo treatment because survival and cure were still their highest priority. Conclusion: Our findings suggest the need to proactively provide fertility information to parents both during active treatment and when survivors reach reproductive age. Future studies should evaluate the benefits of developing culturally relevant decision-making aids to address parents' informational needs regarding fertility issues.

Feeling Anxious Amid the COVID-19 Pandemic: Factors Associated With Anxiety Symptoms Among Nurses in Hong Kong.

Background: The coronavirus (COVID-19) pandemic has increased the burden for the medical systems around the world. In Hong Kong, the pandemic not only affects the local populations, but also the healthcare workers. Healthcare workers, especially nurses, involving in COVID-19 treatments are highly susceptible to adverse psychological outcomes (e.g., anxiety symptoms). Studies have shown that socio-demographic characteristics, COVID-19-specific worries, and work settings-related variables are associated with healthcare workers' well-being during the COVID-19 pandemic. However, relevant studies for nurses in Hong Kong are limited. This study examined the psychosocial correlates of anxiety symptoms among nurses in Hong Kong. Methods: Nurses (N = 1,510) working in hospitals and community settings were recruited through nursing associations in Hong Kong between August 8, 2020 and September 22, 2020. They were invited to complete a cross-sectional survey measuring their anxiety symptoms, sociodemographic characteristics, COVID-19-specific worries, and satisfaction with work and workplace pandemic-control guidelines. Results: 17.2% of nurses reported moderate to severe levels of anxiety symptoms. Results from hierarchical regressions found that higher COVID-19-specific worries (contracting COVID-19, family members contracting COVID-19 due to their nursing work, insufficient protective equipment at workplace) (ßs ranged from 0.07 to 0.20, ps < 0.01), higher perceived stigma of being a healthcare worker (ß = 0.18, p < 0.001), and lower work satisfaction (ß = -0.21, p < 0.001) were associated with higher anxiety symptoms. Conclusion: A moderate proportion of nurses in Hong Kong did report levels of anxiety symptoms amid the COVID-19 pandemic. Futures studies could focus on the contributing factors of anxiety symptoms to design for effective strategies to promote nurses' well-being during pandemic situations.

Transition from Acute Treatment to Survivorship: Exploring the Psychosocial Adjustments of Chinese Parents of Children with Cancer or Hematological Disorders.

OBJECTIVES: Parents of children diagnosed with critical illnesses face multiple challenges during their caregiving experience. However, relevant studies have been limited in the Chinese context. Guided by the stress and coping model, we conducted a qualitative study to identify the stressors, coping strategies, and adjustment experiences of Hong Kong parents of children with cancer or hematological disorders. METHODS: We recruited 15 parents of children with cancer or hematological disorders requiring bone marrow transplantation and were currently >2 years post-treatment. They participated in a 30-min semi-structured interview. Thematic analysis was performed using the grounded theory approach. RESULTS: The stressors reported by parents included a high caregiving burden during their children's diagnosis and treatment stages. The fear of recurrence, the need for information, and concerns about late effects were also common among the parents during their children's transition/survivorship stage. To cope with these stressors, the parents commonly used problem-focused (e.g., seeking help from professionals and support groups) and emotion-focused (e.g., behavioral distractions, venting, and crying) strategies. Despite these stressors, parents reported positive changes through the caregiving experience, such as improved family relationships, developing health-protective habits, and the reprioritization of different aspects of life. CONCLUSIONS: Parents encounter different stressors during the cancer care continuum. Using different coping strategies, parents experience positive changes amidst caregiving. Future studies should explore culturally relevant adaptive coping strategies to enhance parents' psychosocial adjustment.