Objective This study aimed to determine the temporal trends in sleep duration among Chinese adults.Methods In this series of repeated nationally representative cross-sectional surveys(China Chronic Disease and Risk Fa...Objective This study aimed to determine the temporal trends in sleep duration among Chinese adults.Methods In this series of repeated nationally representative cross-sectional surveys(China Chronic Disease and Risk Factors Surveillance)conducted between 2010 and 2018,a total of 645,420 adult participants(97,741 in 2010;175,749 in 2013;187,777 in 2015;and 184,153 in 2018)were included in the trend analysis.Linear and logistic regression models were utilized to assess trends in sleep duration.Results In 2018,the estimated overall mean sleep duration among the Chinese adult population was7.58(SD,1.45)hours per day,with no significant trend from 2010.A significant increase in short sleep duration(≤6 hours)was observed in the total population,from 15.3%(95%CI:14.1%–16.5%)in 2010 to18.5%(95%CI:17.7%–19.3%)in 2018(P<0.001).Similarly,the trend in long sleep duration(>9 hours)was also significant,increasing in weighted prevalence from 7.2%(95%CI:6.3%–8.1%)in 2010 to 9.0%(95%CI:8.2%–9.9%)in 2018(P<0.001).Conclusion The prevalence of both short and long sleep durations significantly increased among Chinese adults from 2010 to 2018,highlighting the urgency of health initiatives to promote optimal sleep duration in China.展开更多
Commentary The 21st century presents unprecedented challenges and opportunities to nursing.The explosion of information and technology,globalisation of health care,global nursing shortage,complexity of needs of client...Commentary The 21st century presents unprecedented challenges and opportunities to nursing.The explosion of information and technology,globalisation of health care,global nursing shortage,complexity of needs of clients with diverse cultural and socioeconomic backgrounds have driven nursing to rethink its model of care delivery.There is also an increasing demand for accountability for professional practice and effective use of the finite resources.These challenges are changing the milieu of nursing.There is a need to enhance the quality of nursing practice through research.展开更多
BACKGROUND The perinatal period is a challenging time of substantial emotional,physiological,social,and relational changes.Depression,anxiety,and stress symptoms are common,and co-exist in the perinatal period.Digital...BACKGROUND The perinatal period is a challenging time of substantial emotional,physiological,social,and relational changes.Depression,anxiety,and stress symptoms are common,and co-exist in the perinatal period.Digital technology continues to grow at an unprecedented pace with wide application,including psychotherapeutic intervention.A growing number of meta-analyses supported the application of digital psychotherapeutic intervention across different populations,but relatively few meta-and meta-regression analyses have concentrated on perinatal women.AIM To evaluate the effectiveness of digital psychotherapeutic intervention on improving psychological outcomes among perinatal women and identify its essential features.METHODS Randomized controlled trials(RCTs)were obtained from eight databases,including Cumulative Index to Nursing and Allied Health Literature,Cochrane Library,Embase,Scopus,PsycINFO,PubMed,Web of Science,and ProQuest Dissertation and Theses from inception up until November 24,2020.Comprehensive Meta-analysis 3.0 software was used to conduct meta-and metaregression analyses.The Cochrane risk-of-bias tool and the Grading of the Recommendation,Assessment,Development,and Evaluation system were adopted to assess the individual and overall qualities of the evidence,respectively.RESULTS A total of 25 RCTs that included 3239 women were identified.Meta-analyses revealed that intervention significantly improved depression(Hedges’s g=0.49),anxiety(g=0.25),and stress(g=0.47)symptoms compared to the control.Subgroup analyses demonstrated that a website platform with≥eight therapistguided sessions using the theoretical principle of cognitive behavioral therapy was more effective than other treatments in improving depression symptoms in postnatal women.Meta-regression analyses observed that the age of perinatal women and the type of psychotherapy also had statistically significant effects on depression symptoms.Egger’s regression asymmetry tests suggested that no publication biases occurred,but the overall quality of the evidence was very low.CONCLUSION This review suggests that digital psychotherapeutic intervention may be a potential solution to reduce psychological problems in perinatal women.Further high-quality RCTs with large sample sizes are needed.展开更多
Heart failure(HF)is not a single disease,but a chronic and complex clinical syndrome in which the heart is unable to fill or pump the blood well because of structural and/or functional cardiac disorders[1].This leads ...Heart failure(HF)is not a single disease,but a chronic and complex clinical syndrome in which the heart is unable to fill or pump the blood well because of structural and/or functional cardiac disorders[1].This leads to a decreased cardiac output that is insufficient to meet the body's metabolic demands[2].A number of diseases affecting the cardiovascular system can lead to HF[1],but the most common causes are coronary artery disease,hypertensive heart disease,valvular heart disease,tachyarrhythmia and idiopathic causes[1,3].展开更多
The present study aimed to examine work environment related factors and frontline primary healthcare profes-sionals’mental-emotional wellbeing during the COVID-19 pandemic in school communities of Hong Kong.A total o...The present study aimed to examine work environment related factors and frontline primary healthcare profes-sionals’mental-emotional wellbeing during the COVID-19 pandemic in school communities of Hong Kong.A total of 61(20%)school health nurses(frontline primary healthcare professionals)participated in a cross-sec-tional online survey from March to June 2020.Outcomes of mental-emotional health were measured using the Mental Health Continuum-Short Form(14-item scale with three subscales related to emotional,social and psychological wellbeing);the Perceived Stress Scale(10-item scale with two subscales related to perceived help-lessness and lack of self-efficacy);and the Coping Orientation to Problems Experienced Inventory(Brief COPE),a 28-item inventory with two subscales related to adaptive and maladaptive strategies.Almost half(42.6%)of par-ticipants experienced mental health problems.Those employed in government subsidized schools had signifi-cantly lower scores in mental health wellbeing than those who worked in private schools.Factors relating to increased mental health problems included lack of emotional support,inadequate training relating to infection prevention and control measures,disengagement and self-blame.A variety of factors influencing school health nurses’social,emotional and psychological wellbeing in their work environment during the COVID-19 pandemic were also reported.The mental-emotional wellbeing of school nurses may relate to their subjective feeling of lone-liness as participants were the sole frontline primary healthcare professional working in the school community during the COVID-19 pandemic.Studyfindings provide relevant evidence for management teams to build a cul-ture of psychological and social support into workplace policies and procedures.Continuous staff development and adequate social support are important to promote the mental-emotional wellbeing of primary healthcare pro-fessionals in school communities as they play a significant role in safeguarding resources during pandemics.展开更多
A patient-centered approach is used to build a therapeutic alliance between patients and the healthcare professionals in care process which should be supported by a good engagement of both parties. The study aimed to ...A patient-centered approach is used to build a therapeutic alliance between patients and the healthcare professionals in care process which should be supported by a good engagement of both parties. The study aimed to explore the gap between healthcare professionals and patients on patient engagement in hospital. It was a cross-sectional survey. 2774 doctors and nurses from Department of Medicine of public hospitals completed the self-administered questionnaire and 1042 patients discharged from corresponding wards completed the telephone interviews. Participants were interviewed using structural questionnaires. The Mann-Whitney test or Pearson’s chi-square test was used to analyze the agreement between health-care professionals and patients on the views and experiences of patient engagement. A difference was considered to be statistically significant when the p-value was <0.05. Although both groups valued the importance of patient engagement, there was a discrepancy on understanding, views and experiences. More healthcare professionals particularly in nursing were concerned about the possible negative impact of the engagement. The majority of healthcare professionals reported that they engaged well with patients, and perceived more difficulties than patients did. The findings highlighted the mutual understanding of patient engagement, involvement and challenges encountered by both groups in Department of Medicine, which was crucial in efforts to provide meaningful patient engagement in regards to jurisdictions, health system, specialty, discipline and background of patients. It provided insight that a collaborative strategy involving both healthcare professional and patients might be an alternative approach to improving patient engagement.展开更多
Background University students are internationally recognized as a population at risk due to unhealthy lifestyle behaviors and elevated health risks.Supporting positive behavioral change requires understanding their i...Background University students are internationally recognized as a population at risk due to unhealthy lifestyle behaviors and elevated health risks.Supporting positive behavioral change requires understanding their intentions to adopt healthier habits.This study aimed to psychometrically evaluate and culturally validate the healthy lifestyle intention scale(HLIS)in three countries and regions.Methods A cross-sectional methodological study was conducted in 2023 among university students in Finland(n=753),Singapore(n=750),and Hong Kong,China(n=767).The HLIS was developed based on the Adherence to Treatment of Patients with Chronic Disease Instrument.Psychometric evaluation included Spearman'sρ,Cronbach'sɑ,and both exploratory and confirmatory factor analyses.Results Findings from all three countries and regions indicated that Spearman'sρvalues ranged from weak to high across the dimensions of self-readiness(0.23–0.69),family support(0.42–0.78),peer support(0.48–0.80),and social media influence(0.48–0.80).Cronbach'sɑvalues demonstrated acceptable internal consistency(0.41–0.92).Structural validity was supported by confirmatory factor analysis.While the Finnish model suggested a need for further refinement(comparative fit index[CFI]=0.81,root mean square error of approximation[RMSEA]=0.11),the models for Singapore(CFI=0.92,RMSEA=0.07)and Hong Kong,China(CFI=0.92,RMSEA=0.07)showed strong fit indices.Conclusion The current version of the HLIS demonstrates promising psychometric properties for assessing health-related behavioral intentions among university students in a cross-cultural context.Further validation with more diverse international samples is recommended.展开更多
Introduction Vascular diseases,such as stroke and heart failure(HF),are associated with cognitive decline.Vascular cognitive impairment(CI)is commonly found in patients who had a stroke and with HF,ranging from mild C...Introduction Vascular diseases,such as stroke and heart failure(HF),are associated with cognitive decline.Vascular cognitive impairment(CI)is commonly found in patients who had a stroke and with HF,ranging from mild CI to dementia.Early detection of CI is crucial for effective management and rehabilitation.This study aimed to develop the VasCog Screen test,a screening tool to detect CI in patients who had a stroke and with HF.Method 427 patients who had a stroke and with HF were assessed using cognitive measures including Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA)and a formal neuropsychological battery.The short-MoCA was derived and combined with Symbol Digit Modalities Test(SDMT)to create the VasCog Screen.The discriminatory ability of different tests for CI was compared,establishing optimal cut-off points.Variants of short-MoCA including the SDMT were also evaluated.Results Similar prevalence rates of CI were found in stroke and HF cohorts.The most prevalent neuropsychological impairment was visuomotor speed,followed by visual memory and visuoconstruction.More than half of the patients were found to have CI.The VasCog Screen outperformed MMSE,MoCA and short-MoCA in detecting CI.The addition of SDMT to variants of the short-MoCA increased diagnostic accuracy.Conclusion The VasCog Screen test offers a cognitive screening tool,which is sensitive to cognitive deficits characteristically found in patients who had a stroke and with HF.It was found to have good sensitivity,specificity and classification accuracy.It is easy to administer in busy clinics,enabling early detection of CI and facilitating appropriate interventions.展开更多
基金supported by the National Natural Science Foundation of China(82341245,82371491)the Chinese Central Government(Key Project of Public Health Program)the National Key Research and Development Program of China(2018YFC1311706,2018YFC1311702)。
文摘Objective This study aimed to determine the temporal trends in sleep duration among Chinese adults.Methods In this series of repeated nationally representative cross-sectional surveys(China Chronic Disease and Risk Factors Surveillance)conducted between 2010 and 2018,a total of 645,420 adult participants(97,741 in 2010;175,749 in 2013;187,777 in 2015;and 184,153 in 2018)were included in the trend analysis.Linear and logistic regression models were utilized to assess trends in sleep duration.Results In 2018,the estimated overall mean sleep duration among the Chinese adult population was7.58(SD,1.45)hours per day,with no significant trend from 2010.A significant increase in short sleep duration(≤6 hours)was observed in the total population,from 15.3%(95%CI:14.1%–16.5%)in 2010 to18.5%(95%CI:17.7%–19.3%)in 2018(P<0.001).Similarly,the trend in long sleep duration(>9 hours)was also significant,increasing in weighted prevalence from 7.2%(95%CI:6.3%–8.1%)in 2010 to 9.0%(95%CI:8.2%–9.9%)in 2018(P<0.001).Conclusion The prevalence of both short and long sleep durations significantly increased among Chinese adults from 2010 to 2018,highlighting the urgency of health initiatives to promote optimal sleep duration in China.
文摘Commentary The 21st century presents unprecedented challenges and opportunities to nursing.The explosion of information and technology,globalisation of health care,global nursing shortage,complexity of needs of clients with diverse cultural and socioeconomic backgrounds have driven nursing to rethink its model of care delivery.There is also an increasing demand for accountability for professional practice and effective use of the finite resources.These challenges are changing the milieu of nursing.There is a need to enhance the quality of nursing practice through research.
基金Ministry of Education Academic Research Fund(AcRF)Tier 1,No.NUHSRO/2017/054/T1。
文摘BACKGROUND The perinatal period is a challenging time of substantial emotional,physiological,social,and relational changes.Depression,anxiety,and stress symptoms are common,and co-exist in the perinatal period.Digital technology continues to grow at an unprecedented pace with wide application,including psychotherapeutic intervention.A growing number of meta-analyses supported the application of digital psychotherapeutic intervention across different populations,but relatively few meta-and meta-regression analyses have concentrated on perinatal women.AIM To evaluate the effectiveness of digital psychotherapeutic intervention on improving psychological outcomes among perinatal women and identify its essential features.METHODS Randomized controlled trials(RCTs)were obtained from eight databases,including Cumulative Index to Nursing and Allied Health Literature,Cochrane Library,Embase,Scopus,PsycINFO,PubMed,Web of Science,and ProQuest Dissertation and Theses from inception up until November 24,2020.Comprehensive Meta-analysis 3.0 software was used to conduct meta-and metaregression analyses.The Cochrane risk-of-bias tool and the Grading of the Recommendation,Assessment,Development,and Evaluation system were adopted to assess the individual and overall qualities of the evidence,respectively.RESULTS A total of 25 RCTs that included 3239 women were identified.Meta-analyses revealed that intervention significantly improved depression(Hedges’s g=0.49),anxiety(g=0.25),and stress(g=0.47)symptoms compared to the control.Subgroup analyses demonstrated that a website platform with≥eight therapistguided sessions using the theoretical principle of cognitive behavioral therapy was more effective than other treatments in improving depression symptoms in postnatal women.Meta-regression analyses observed that the age of perinatal women and the type of psychotherapy also had statistically significant effects on depression symptoms.Egger’s regression asymmetry tests suggested that no publication biases occurred,but the overall quality of the evidence was very low.CONCLUSION This review suggests that digital psychotherapeutic intervention may be a potential solution to reduce psychological problems in perinatal women.Further high-quality RCTs with large sample sizes are needed.
基金supported by the Health Services Research Grant(HSRGWS16Jul007)from National Medical Research Council(NMRC).
文摘Heart failure(HF)is not a single disease,but a chronic and complex clinical syndrome in which the heart is unable to fill or pump the blood well because of structural and/or functional cardiac disorders[1].This leads to a decreased cardiac output that is insufficient to meet the body's metabolic demands[2].A number of diseases affecting the cardiovascular system can lead to HF[1],but the most common causes are coronary artery disease,hypertensive heart disease,valvular heart disease,tachyarrhythmia and idiopathic causes[1,3].
文摘The present study aimed to examine work environment related factors and frontline primary healthcare profes-sionals’mental-emotional wellbeing during the COVID-19 pandemic in school communities of Hong Kong.A total of 61(20%)school health nurses(frontline primary healthcare professionals)participated in a cross-sec-tional online survey from March to June 2020.Outcomes of mental-emotional health were measured using the Mental Health Continuum-Short Form(14-item scale with three subscales related to emotional,social and psychological wellbeing);the Perceived Stress Scale(10-item scale with two subscales related to perceived help-lessness and lack of self-efficacy);and the Coping Orientation to Problems Experienced Inventory(Brief COPE),a 28-item inventory with two subscales related to adaptive and maladaptive strategies.Almost half(42.6%)of par-ticipants experienced mental health problems.Those employed in government subsidized schools had signifi-cantly lower scores in mental health wellbeing than those who worked in private schools.Factors relating to increased mental health problems included lack of emotional support,inadequate training relating to infection prevention and control measures,disengagement and self-blame.A variety of factors influencing school health nurses’social,emotional and psychological wellbeing in their work environment during the COVID-19 pandemic were also reported.The mental-emotional wellbeing of school nurses may relate to their subjective feeling of lone-liness as participants were the sole frontline primary healthcare professional working in the school community during the COVID-19 pandemic.Studyfindings provide relevant evidence for management teams to build a cul-ture of psychological and social support into workplace policies and procedures.Continuous staff development and adequate social support are important to promote the mental-emotional wellbeing of primary healthcare pro-fessionals in school communities as they play a significant role in safeguarding resources during pandemics.
文摘A patient-centered approach is used to build a therapeutic alliance between patients and the healthcare professionals in care process which should be supported by a good engagement of both parties. The study aimed to explore the gap between healthcare professionals and patients on patient engagement in hospital. It was a cross-sectional survey. 2774 doctors and nurses from Department of Medicine of public hospitals completed the self-administered questionnaire and 1042 patients discharged from corresponding wards completed the telephone interviews. Participants were interviewed using structural questionnaires. The Mann-Whitney test or Pearson’s chi-square test was used to analyze the agreement between health-care professionals and patients on the views and experiences of patient engagement. A difference was considered to be statistically significant when the p-value was <0.05. Although both groups valued the importance of patient engagement, there was a discrepancy on understanding, views and experiences. More healthcare professionals particularly in nursing were concerned about the possible negative impact of the engagement. The majority of healthcare professionals reported that they engaged well with patients, and perceived more difficulties than patients did. The findings highlighted the mutual understanding of patient engagement, involvement and challenges encountered by both groups in Department of Medicine, which was crucial in efforts to provide meaningful patient engagement in regards to jurisdictions, health system, specialty, discipline and background of patients. It provided insight that a collaborative strategy involving both healthcare professional and patients might be an alternative approach to improving patient engagement.
文摘Background University students are internationally recognized as a population at risk due to unhealthy lifestyle behaviors and elevated health risks.Supporting positive behavioral change requires understanding their intentions to adopt healthier habits.This study aimed to psychometrically evaluate and culturally validate the healthy lifestyle intention scale(HLIS)in three countries and regions.Methods A cross-sectional methodological study was conducted in 2023 among university students in Finland(n=753),Singapore(n=750),and Hong Kong,China(n=767).The HLIS was developed based on the Adherence to Treatment of Patients with Chronic Disease Instrument.Psychometric evaluation included Spearman'sρ,Cronbach'sɑ,and both exploratory and confirmatory factor analyses.Results Findings from all three countries and regions indicated that Spearman'sρvalues ranged from weak to high across the dimensions of self-readiness(0.23–0.69),family support(0.42–0.78),peer support(0.48–0.80),and social media influence(0.48–0.80).Cronbach'sɑvalues demonstrated acceptable internal consistency(0.41–0.92).Structural validity was supported by confirmatory factor analysis.While the Finnish model suggested a need for further refinement(comparative fit index[CFI]=0.81,root mean square error of approximation[RMSEA]=0.11),the models for Singapore(CFI=0.92,RMSEA=0.07)and Hong Kong,China(CFI=0.92,RMSEA=0.07)showed strong fit indices.Conclusion The current version of the HLIS demonstrates promising psychometric properties for assessing health-related behavioral intentions among university students in a cross-cultural context.Further validation with more diverse international samples is recommended.
基金a recipient of the Singapore National Medical Research Council(NMRC)Transition Award(TA)(NMRC/TA/0060/2017).
文摘Introduction Vascular diseases,such as stroke and heart failure(HF),are associated with cognitive decline.Vascular cognitive impairment(CI)is commonly found in patients who had a stroke and with HF,ranging from mild CI to dementia.Early detection of CI is crucial for effective management and rehabilitation.This study aimed to develop the VasCog Screen test,a screening tool to detect CI in patients who had a stroke and with HF.Method 427 patients who had a stroke and with HF were assessed using cognitive measures including Mini-Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA)and a formal neuropsychological battery.The short-MoCA was derived and combined with Symbol Digit Modalities Test(SDMT)to create the VasCog Screen.The discriminatory ability of different tests for CI was compared,establishing optimal cut-off points.Variants of short-MoCA including the SDMT were also evaluated.Results Similar prevalence rates of CI were found in stroke and HF cohorts.The most prevalent neuropsychological impairment was visuomotor speed,followed by visual memory and visuoconstruction.More than half of the patients were found to have CI.The VasCog Screen outperformed MMSE,MoCA and short-MoCA in detecting CI.The addition of SDMT to variants of the short-MoCA increased diagnostic accuracy.Conclusion The VasCog Screen test offers a cognitive screening tool,which is sensitive to cognitive deficits characteristically found in patients who had a stroke and with HF.It was found to have good sensitivity,specificity and classification accuracy.It is easy to administer in busy clinics,enabling early detection of CI and facilitating appropriate interventions.
