A descriptive study of a Smoke-free Teens Programme to promote smoke-free culture in schools and the community in Hong Kong.

BACKGROUND: Youth smoking continues to be a significant global public health concern. To ensure healthier lives for youths, healthcare professionals need to increase awareness among the youth of the health risks and addictive nature of smoking, strengthen their ability to resist negative peer influence and curiosity, and help those who smoked to quit. The Smoke-free Teens Programme was launched in 2012 to equip youngsters with up-to-date information about smoking and global trends in tobacco control and to encourage them to play a pioneering role in tobacco control. This paper describes the process and outcomes of this programme for youths in Hong Kong. METHODS: The Smoke-free Teens Programme contained three major components: (i) a 2-day-1-night training camp; (ii) creative activities to promote smoke-free messages in schools and the community; and (iii) an award presentation ceremony to recognize the efforts of outstanding Smoke-free Teens in establishing a smoke-free culture. All secondary school students or teenagers aged 14 to 18 years from secondary schools, youth centres and uniform groups were invited to join the programme. The outcome measures were changes in (1) knowledge about smoking hazards; (2) attitudes towards smoking, tobacco control, and smoking cessation; and (3) practices for promoting smoking cessation. RESULTS: A total of 856 teenagers were recruited during the study period (July 2014 to March 2017). The results showed statistically significant changes in participants' knowledge about smoking hazards, attitudes towards tobacco control, and practice for promoting smoking cessation. CONCLUSIONS: The Smoke-free Teens Programme demonstrated effectiveness in equipping youngsters with up-to-date information about smoking and global trends in tobacco control and in encouraging them to play a pioneering role in tobacco control. The trained Smoke-free Teens not only promoted the smoke-free messages among their schoolmates, friends, and families, but also gathered community support for a smoke-free Hong Kong. The programme has been instrumental in fostering a new batch of Smoke-free Teens to advocate smoke-free culture and protect public health. TRIAL REGISTRATION: Clinicaltrials.gov ID NCT03291132 (retrospectively registered on September 19, 2017).

Effectiveness of a musical training programme in promoting happiness and quality of life of underprivileged preschool children.

AIMS AND OBJECTIVES: To test the effectiveness of a musical training programme in promoting happiness and quality of life of Hong Kong Chinese underprivileged preschool children. BACKGROUND: The impact of poverty and income disparity on the psychological well-being of children remains a profound global public health concern. There is substantial evidence that poverty and income disparity have many negative impacts on children's psychological well-being, adversely affecting their quality of life. METHODS: A nonequivalent, quasi-experimental, two-group, pretest and post-test, between-subjects design was conducted with 171 Hong Kong Chinese underprivileged preschool children (aged 3-6 years). Participants (n = 100) in the experimental group attended a weekly 1-hr musical training lesson for 12 weeks conducted by the Music Children Foundation. Participants (n = 71) in the wait list control group received the same training after all data had been collected. Data collection for both groups was conducted at baseline and 12-week follow-up. The measured outcomes were happiness level and quality of life. A TREND checklist was completed. RESULTS: Participants in the experimental group reported significantly higher levels of happiness (p = .002) and quality of life (p = .44) than those in the wait list control group. CONCLUSIONS: The present study indicates the effectiveness of a musical training programme in promoting happiness and quality of life of Hong Kong Chinese underprivileged preschool children. It also demonstrated the feasibility of implementing the programme in a community context. RELEVANCE TO CLINICAL PRACTICE: This study aids to inform nurses the beneficial effect of the musical training programme in improving underprivileged children's psychological well-being and quality of life. Indeed, community nurses may act as facilitators to promote the musical training programme to underprivileged children. The involvement of community nurses may greatly enhance the sustainability of the programme, thus making it to be a routine health promotion activity.

Factors contributing to the low physical activity level for Hong Kong Chinese children hospitalised with cancer: an exploratory study.

AIMS AND OBJECTIVES: To explore the factors contributing to the low physical activity level for Hong Kong Chinese children hospitalised with cancer. BACKGROUND: Notwithstanding the fact that regular physical activity can ameliorate cancer-related fatigue and other adverse effect of cancer treatment on children's physical and psychological well-being, physical inactivity is a common problem among children undergoing cancer treatment. Understanding the factors that affect their physical activity level is an important step towards planning and evaluating an appropriate intervention that promotes the adoption and maintenance of regular physical activity. DESIGN: A phenomenological design was used in this qualitative study. METHODS: A purposive sample of 25 children with cancer was recruited in a paediatric oncology unit of an acute care public hospital in Hong Kong. They were asked to participate in a semistructured interview by their bedside lasting about 30 minutes. All the interviews were tape-recorded and immediately transcribed. Content analysis was used to analyse the qualitative data. RESULTS: The findings revealed that the patients' physical condition, misunderstanding about physical activity by children, parents and healthcare professionals, emotional disturbances and social influences are four important factors impeding children from engaging in regular physical activity during cancer treatment. CONCLUSION: This study addresses a gap in the literature by identifying the factors that negatively influence the physical activity levels of Hong Kong Chinese children hospitalised with cancer. RELEVANCE TO CLINICAL PRACTICE: Understanding these factors, nurses can explore interventions that target on correcting the misunderstanding and providing relevant information about the importance of physical activity, eventually promoting the adoption and maintenance of regular physical activity and enhancing the quality of life.

Effectiveness of an integrated adventure-based training and health education program in promoting regular physical activity among childhood cancer survivors.

BACKGROUND: There is growing concern about declining levels of physical activity in childhood cancer survivors. This study aimed to examine the effectiveness of an integrated adventure-based training and health education program in promoting changes in exercise behavior and enhancing the physical activity levels, self-efficacy, and quality of life of Hong Kong Chinese childhood cancer survivors. METHODS: A randomized controlled trial, two-group pretest and repeated post-test, between-subjects design was conducted to 71 childhood cancer survivors (9- to 16-year-olds). Participants in the experimental group joined a 4-day integrated adventure-based training and health education program. Control group participants received the same amount of time and attention as the experimental group but not in such a way as to have any specific effect on the outcome measures. Participants' exercise behavior changes, levels of physical activity, self-efficacy, and quality of life were assessed at the time of recruitment, 3, 6, and 9 months after starting the intervention. RESULTS: Participants in the experimental group reported statistically significant differences in physical activity stages of change (p < 0.001), higher levels of physical activity (p < 0.001) and self-efficacy (p = 0.04) than those in the control group. Besides, there were statistically significant mean differences (p < 0.001) in physical activity levels (-2.6), self-efficacy (-2.0), and quality of life (-4.3) of participants in the experimental group from baseline to 9 months after starting the intervention. CONCLUSIONS: The integrated adventure-based training and health education program was found to be

A Descriptive Study on Multiple Health-Risk Behaviors among Chinese Adults in Hong Kong.

This study investigated the prevalence and clustering patterns of multiple health-risk behaviors and their associations with non-communicable diseases among Chinese adults in Hong Kong. A large sample survey was conducted in all 18 districts of Hong Kong between 21 June and 31 August 2021. A total of 5737 adults completed the survey. Overall, 4605 (80.3%) had at least one health-risk behavior and 2696 (47.0%) had two or more health-risk behaviors. Multiple health-risk behaviors were more prevalent among men. The prevalence of smoking and alcohol consumption among Hong Kong Chinese women was considerably lower than in most Western countries. In contrast to previous findings, this study revealed that a high proportion of adults with high educational attainment or household income had multiple health-risk behaviors. In addition, this study revealed that the health-risk behaviors in Chinese adults co-occurred in clusters, with smoking and alcohol consumption co-occurring with other health-risk behaviors. Those who smoked or consumed alcohol had the highest proportion of multiple health-risk behaviors and the highest proportion of non-communicable diseases. The findings of this study add further evidence that health-risk behaviors co-occur in clusters and can contribute to non-communicable diseases.

Coping strategies used by children hospitalized with cancer: an exploratory study.

OBJECTIVES: The treatment of cancer is a stressful and threatening experience, particularly for children. Knowing how children cope with cancer is a crucial step toward designing appropriate psychological interventions that help them ease the burden of cancer treatment. The purpose of this study was to examine the coping strategies used by Chinese children hospitalized with cancer, an area of research that is under-represented in the existing literature. METHODS: Hong Kong Chinese children (9-16-year olds) admitted for cancer treatment to the pediatric oncology units of two different regional acute public hospitals were invited to participate. A short one-to-one structured interview was conducted with each participant. Content analysis was conducted to analyze the interview data. RESULTS: A convenience sample of 88 children was recruited and participated in the interviews during an 8-month period. The coping strategies used by Chinese children hospitalized with cancer did not differ according to gender and diagnosis, but only according to age, with younger children using less problem-focused and more emotion-focused coping strategies than older children. The overall results indicated that 30% of these Chinese patients used problem-focused coping strategies, while 70% used emotion-focused coping. CONCLUSIONS: Findings from this study indicated that children use different coping strategies at different developmental stages. The study also revealed that Chinese children used more emotion-focused than problem-focused coping strategies than their Western counterparts. The information derived from this study will help health-care professionals design and shape appropriate psychological interventions that can help reduce the burden of cancer treatment. Copyright © 2010 John Wiley & Sons, Ltd.

Center for Epidemiologic Studies Depression Scale for Children: psychometric testing of the Chinese version.

AIM: This paper is a report of psychometric testing of the Chinese version of the Center for Epidemiologic Studies Depression Scale for Children. BACKGROUND: The availability of a valid and reliable instrument that accurately detects depressive symptoms in children is crucial before any psychological intervention can be appropriately planned and evaluated. There is no such an instrument for Chinese children. METHODS: A test-retest, within-subjects design was used. A total of 313 primary school students between the ages of 8 and 12 years were invited to participate in the study in 2009. Participants were asked to respond to the Chinese version of the Center for Epidemiologic Studies Depression Scale for Children, short form of the State Anxiety Scale for Children and Rosenberg's Self-Esteem Scale. The internal consistency, content validity and construct validity and test-retest reliability of the Chinese version of the Center for Epidemiologic Studies Depression Scale for Children were assessed. RESULTS: The newly-translated scale demonstrated adequate internal consistency, good content validity and appropriate convergent and discriminant validity. Confirmatory factor analysis added further evidence of the construct validity of the scale. CONCLUSION: Results suggest that the newly-translated scale can be used as a self-report assessment tool in detecting depressive symptoms of Chinese children aged between 8 and 12 years.

Coping behaviour checklist for Chinese children: development and psychometric testing.

AIM: This paper is a report of development and psychometric testing of the coping behaviour checklist for Chinese children. BACKGROUND: An understanding of the coping behaviour of children is an essential prerequisite for the design of an appropriate psychological intervention to enhance children's ability to cope with stressful medical procedures and hospitalization. Review of literature reveals that there is lack of child-sensitive measurement tools in the Chinese culture for assessing coping behaviours of children with good psychometric properties. METHODS: An instrument development and validation study was conducted. Phase 1 was designed to develop a checklist of coping behaviour for Chinese children, while in phase 2 the psychometric properties of the new scale were tested. A total of 168 (phase 1) and 236 (phase 2) children between the ages of 7 and 12 years, were invited to participate in this study in 2008 and 2009, respectively; 228 completed both phases of data collection. RESULTS: On the basis of the results of qualitative interview data, the coping behaviour checklist for Chinese children was developed. The newly developed scale had adequate internal consistency reliability and test-retest reliability, high content validity and appropriate construct validity. Confirmatory factor analysis further added evidence of the construct validity of the scale. CONCLUSION: The instrument can be used to identify the coping behaviour of Hong Kong Chinese children aged between 7 and 12 years. Knowing the coping behaviour of children in advance can help nurses to shape and design appropriate psychological interventions that can help children better cope with stressful medical procedures and hospitalization.

The relationship between children's locus of control and their anticipatory anxiety.

OBJECTIVES: This study investigated the relationship between children's locus of control and their state anxiety scores, and determined whether children's locus of control could predict their state anxiety scores before academic examinations. DESIGN: A test-retest within subjects design was used. SAMPLE: 519 school children were invited to participate in the study. MEASUREMENTS: Participants were asked to respond to the Chinese version of the Nowicki-Strickland locus of control scale and state anxiety scale for children in stressful and nonstressful situations. The data were collected in 2005. RESULTS: There were significant strong positive correlations between the state anxiety and locus of control scores in the period before academic examinations. Multiple regression analysis showed that the Nowicki-Strickland locus of control score was a good predictor of children's state anxiety in a stressful situation. CONCLUSIONS: This study supports the use of the Nowicki-Strickland locus of control scale as a screening tool to identify school children who are most likely to exhibit high levels of anxiety before academic examinations. Understanding children's locus of control in advance is a necessary step toward designing appropriate interventions to reduce their stress and bolster their coping mechanisms.

Impact of brain tumor and its treatment on the physical and psychological well-being, and quality of life amongst pediatric brain tumor survivors.

PURPOSE: Compelling evidence has shown that pediatric brain tumor survivors are more susceptible to physical, neurocognitive, and psychological sequelae. This study assessed the impact of cancer and its treatment on the physical and psychological well-being, and quality of life of Hong Kong Chinese pediatric brain tumor survivors. METHODS: A total of 157 pediatric cancer survivors aged 8-16 were recruited. Of whom, 77 were pediatric brain tumor survivors and 80 were survivors of other cancers. Participants' depressive symptoms, level of self-esteem and quality of life were assessed. Additionally, 16 pediatric brain tumor survivors were randomly selected for a semi-structured interview. RESULTS: More than 70% pediatric brain tumor survivors presented significant number of depressive symptoms. Moreover, findings indicated that greater symptoms of depression in survivors were associated with lower level of self-esteem and quality of life. Qualitative interviews revealed that brain tumor and its treatment posed negative impact on the multiple domains of their daily life. CONCLUSION: The findings of this study has addressed the literature gap by showing pediatric brain tumors have poorer psychological well-being, in terms of greater number of depressive symptoms, lower levels of self-esteem, and more severely compromised quality of life than survivors of other pediatric cancers. It is vital for healthcare professionals to develop and evaluate appropriate interventions with the aims to enhance the psychological well-being and quality of life among pediatric brain tumor survivors.

The Impact of Hematologic Cancer and Its Treatment on Physical Activity Level and Quality of Life Among Children in Mainland China: A Descriptive Study.

BACKGROUND: The effects of hematologic cancer and its treatment on Chinese children's physical activity level and quality of life (QoL) remain unclear despite numerous studies conducted in Western countries and Hong Kong. OBJECTIVE: The aim of this study was to examine the effects of hematologic cancer and its treatment on the physical activity level and QoL among Chinese children. METHODS: A cross-sectional study was conducted. One hundred twenty-five children who were admitted for treatment of hematologic cancer and 243 healthy counterparts of similar age participated in this study. All participants were asked to complete the Chinese University of Hong Kong: Physical Activity Rating for Children and Youth and Pediatric Quality of Life Inventory. The children with hematologic cancer also completed a therapy-related symptom checklist. RESULTS: There were statistically significant differences in the mean physical activity and QoL between children with hematologic cancer and their healthy counterparts. Multiple regression analyses showed that physical activity levels and the adverse effects of hematologic cancer treatment had statistically significant effects on the children's QoL. CONCLUSIONS: Physical activity level and QoL in children with hematologic cancer were both lower than those in their healthy counterparts. IMPLICATIONS FOR PRACTICE: This study provides further evidence that hematologic cancer and the adverse effects of its treatment have negative effects on Chinese children's QoL. Although a lack of physical activity is deeply embedded in Chinese culture, nurses should take a proactive role in effecting change by educating parents about the benefits to their children's physiologic and psychological well-being of physical activity during and after treatment.

Relationships among fatigue, physical activity, depressive symptoms, and quality of life in Chinese children and adolescents surviving cancer.

PURPOSE: Fatigue is the most common concern reported by childhood cancer survivors. Assessing its occurrence and severity is a prerequisite for planning and evaluating appropriate interventions. Nevertheless, there is a lack of large-scale surveys which examine the occurrence and severity of fatigue and its associated factors. The study aimed to shed light on this under researched area. METHODS: A cross-sectional study was used. A total of 400 childhood cancer survivors (7- to 18-year olds) were invited to participate in the study. The cancer-related fatigue, depressive symptoms, physical activity level, and quality of life of participants were assessed. RESULTS: An average of 46.4% of children and 48.4% of adolescents were found to display symptoms of cancer-related fatigue between "half the time" and "all the time" over the previous seven days. Besides, greater occurrence and severity of fatigue in childhood cancer survivors were associated with more self-reported depressive symptoms, lower level of physical activity and quality of life. In addition, the study revealed that physical activity level is a significant factor associated with cancer-related fatigue. CONCLUSION: The findings provide further support that cancer and its treatment have adverse effects on survivors' fatigue, which can manifest months or even years after the completion of treatment. Importantly, this study reveals that physical activity is a significant factor associated with fatigue in children and adolescents. It is crucial for healthcare professionals to identify strategies that can help children and adolescents surviving cancer increase their adoption and maintenance of regular activity throughout their life.

Sustainability of an Integrated Adventure-Based Training and Health Education Program to Enhance Quality of Life Among Chinese Childhood Cancer Survivors: A Randomized Controlled Trial.

BACKGROUND: Physical activity is of paramount importance to enhance the quality of life of childhood cancer survivors. OBJECTIVE: The objectives of this study were to examine the sustainability, feasibility, and acceptability of an adventure-based training and health education program in changing the exercise behavior and enhancing the physical activity levels, self-efficacy, and quality of life of childhood cancer survivors. METHODS: A follow-up study (12 and 18 months) of a previous study was conducted. Participants in the experimental group (n = 33) joined a 4-day integrated adventure-based training and health education program. The control group (n = 36) received the standard medical care. Changes in exercise behavior, levels of physical activity, self-efficacy, and quality of life were assessed from the time of recruitment, and at 12 and 18 months after starting the intervention. Process evaluation was conducted to determine whether the program was feasible and acceptable to participants. RESULTS: From baseline to 18 months after the intervention, the experimental group reported statistically significant differences in the stages of change in physical activity and higher levels of physical activity, self-efficacy, and quality of life than did the control group. The results of process evaluation revealed that the program was both feasible and acceptable to participants. CONCLUSIONS: The program was found to have substantial effects on enhancing the physical activity levels, self-efficacy, and quality of life of childhood cancer survivors over at least 18 months. IMPLICATIONS FOR PRACTICE: Healthcare professionals should consider adopting such programs to promote the regular physical activity among childhood cancer survivors.

Effective Prevention and Management of Tumor Lysis Syndrome in Children With Cancer: The Important Contributions of Pediatric Oncology Nurses.

The practice guidelines aimed to identify appropriate nursing management for the prevention and treatment of tumor lysis syndrome, in line with the current evidence-based medical guidelines. Using a systematic approach, 15 relevant articles were identified for the review. The evaluation of patient risk factors for tumor lysis syndrome and the appropriate medical and nursing assessment were identified. The treatment algorithms for the prevention of tumor lysis syndrome from both the medical and nursing perspectives have been established. In particular, the guidelines highlight the importance of pediatric oncology nurses in contributing to the prevention and management of tumor lysis syndrome.

Predisposing factors to the quality of life of childhood cancer survivors.

The aim of this study was to examine the predisposing factors to the quality of life of Hong Kong Chinese childhood cancer survivors. A cross-sectional study was conducted with 153 survivors (9-16 years of age) during follow-up at the oncology outpatient clinic. The study found that depressive symptoms are a strong predictor of quality of life in childhood cancer survivors and that systematic screening of this population is important. It is essential for health care professionals to develop, plan, and evaluate interventions with the aim of alleviating depressive symptoms for childhood cancer survivors so as to enhance their quality of life.

A descriptive study of the psychosocial well-being and quality of life of childhood cancer survivors in Hong Kong.

BACKGROUND: Research indicates that increased survival rates are accompanied by an increase in associated psychosocial problems. Whereas much of the attention has focused on the physiological care of childhood cancer survivors, the consequences of cancer and its treatments on psychosocial well-being and quality of life remain relatively underexplored. OBJECTIVE: The aim of this study was to describe the psychosocial well-being and quality of life of Hong Kong Chinese childhood cancer survivors. METHODS: A cross-sectional study was used. A total of 137 childhood cancer survivors (9- to 16-year olds) who underwent medical follow-up in the outpatient clinic were invited to participate in the study. RESULTS: A significant number of childhood cancer survivors had low self-esteem and experienced high levels of depression. The study also indicated that greater symptoms of depression in childhood cancer survivors were associated with higher state anxiety, lower self-esteem, and poor quality of life. CONCLUSIONS: Cancer and its treatments can have adverse effects on the psychosocial well-being and quality of life of survivors. IMPLICATIONS FOR PRACTICE: It is essential for nurses to develop and evaluate interventions with the aim of promoting psychosocial well-being and quality of life for childhood cancer survivors. Knowing the self-esteem and coping behavior of survivors can help design appropriate and effective psychosocial interventions to promote their psychosocial well-being.

Relationships among mental health, self-esteem and physical health in Chinese adolescents: an exploratory study.

This study explored the relationships among mental health, self-esteem and physical health in Hong Kong Chinese adolescents. Chinese students (N = 1945) between the ages of 12 and 19 from four secondary schools of different regions were invited to participate in the study. This study revealed that a significant number of adolescents in Hong Kong are experiencing depressive symptoms. The overall results indicated that self-esteem of adolescents was correlated to and a predictor of their physical and mental health. Health care professionals should take a more assertive role in promoting relevant health education to the community with emphasis on helping adolescents develop positive self-esteem.