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Ng DWL, So SCY, Fielding R, Mehnert-Theuerkauf A, Kwong A, Suen D, Wong L, Fung SWW, Chun OK, Fong DYT, Chan S, Molasiotis A, So WKW, Lam WWT. Return to work, work productivity loss and activity impairment in Chinese breast cancer survivors 12-month post-surgery: a longitudinal study. Front Public Health 2024; 12:1340920. [PMID: 38463159 PMCID: PMC10920332 DOI: 10.3389/fpubh.2024.1340920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 02/05/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction Existing evidence of returning-to-work (RTW) after cancer comes predominately from Western settings, with none prospectively examined since the initial diagnostic phase. This study prospectively documents RTW-rate, time-to-RTW, work productivity loss, and activity impairment, within the first-year post-surgery among Chinese women with breast cancer (BCW) and identify potential causal co-variants. Methods This observational longitudinal study followed 371 Chinese BCW who were employed/self-employed at the time of diagnosis at 4-week post-surgery (baseline). RTW-status and time-to-RTW were assessed at baseline (T1), 4-month (T2), 6-month (T3), and 12-month (T4) post-baseline. WPAI work productivity loss and activity impairment were assessed at T4. Baseline covariates included demographics, medical-related factors, work satisfaction, perceived work demand, work condition, RTW self-efficacy, B-IPQ illness perception, COST financial well-being, EORTC QLQ-C30 and QLQ-BR23 physical and psychosocial functioning, and HADS psychological distress. Results A 68.2% RTW-rate (at 12-month post-surgery), prolonged delay in RTW (median = 183 days), and significant proportions of T4 work productivity loss (20%), and activity impairment (26%), were seen. BCW who were blue-collar workers with lower household income, poorer financial well-being, lower RTW self-efficacy, poorer job satisfaction, poorer illness perception, greater physical symptom distress, impaired physical functioning, and unfavorable work conditions were more likely to experience undesired work-related outcomes. Discussion Using a multifactorial approach, effective RTW interventions should focus on not only symptom management, but also to address psychosocial and work-environmental concerns. An organizational or policy level intervention involving a multidisciplinary team comprising nurses, psychologists, occupational health professionals, and relevant stakeholders in the workplace might be helpful in developing a tailored organizational policy promoting work-related outcomes in BCW.
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Affiliation(s)
- Danielle Wing Lam Ng
- LKS Faculty of Medicine, School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Serana Chun Yee So
- LKS Faculty of Medicine, School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Richard Fielding
- LKS Faculty of Medicine, School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Anja Mehnert-Theuerkauf
- University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, The University of Leipzig, Leipzig, Germany
| | - Ava Kwong
- LKS Faculty of Medicine, School of Clinical Medicine, Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Dacita Suen
- LKS Faculty of Medicine, School of Clinical Medicine, Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ling Wong
- Department of Surgery, Tung Wah Hospital, Hospital Authority, Hong Kong, Hong Kong SAR, China
| | - Sara Wai Wun Fung
- Department of Surgery, Kwong Wah Hospital, Hospital Authority, Hong Kong, Hong Kong SAR, China
| | - Oi Kwan Chun
- Department of Surgery, Kwong Wah Hospital, Hospital Authority, Hong Kong, Hong Kong SAR, China
| | - Daniel Y. T. Fong
- LKS Faculty of Medicine, School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sharon Chan
- Department of Surgery, United Christian Hospital, Hospital Authority, Hong Kong, Hong Kong SAR, China
| | - Alex Molasiotis
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
- College of Arts, Humanities and Education, University of Derby, Derby, United Kingdom
| | - Winnie K. W. So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wendy Wing Tak Lam
- LKS Faculty of Medicine, School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Lam WWT, Ng DWL, Fielding R, Sin V, Tsang C, Chan WWL, Foo CC, Kwong A, Chan KKL. Implementing a nurse-led screening clinic for symptom distress with community-based referral for cancer survivors: A feasibility study. Psychooncology 2024; 33:e6261. [PMID: 38047720 DOI: 10.1002/pon.6261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/12/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
INTRODUCTION This prospective, single-arm, pragmatic implementation study evaluated the feasibility of a nurse-led symptom-screening program embedded in routine oncology post-treatment outpatient clinics by assessing (1) the acceptance rate for symptom distress screening (SDS), (2) the prevalence of SDS cases, (3) the acceptance rate for community-based psychosocial support services, and (4) the effect of referred psychosocial support services on reducing symptom distress. METHODS Using the modified Edmonton Symptom Assessment System (ESAS-r), we screened patients who recently completed cancer treatment. Patients screening positive for moderate-to-severe symptom distress were referred to a nurse-led community-based symptom-management program involving stepped-care symptom/psychosocial management interventions using a pre-defined triage system. Reassessments were conducted at 3-months and 9-months thereafter. The primary outcomes included SDS acceptance rate, SDS case prevalence, intervention acceptance rate, and ESAS-r score change over time. RESULTS Overall, 2988/3742(80%) eligible patients consented to SDS, with 970(32%) reporting ≥1 ESAS-r symptom as moderate-to-severe (caseness). All cases received psychoeducational material, 673/970(69%) accepted psychosocial support service referrals. Among 328 patients completing both reassessments, ESAS-r scores improved significantly over time (p < 0.0001); 101(30.8%) of patients remained ESAS cases throughout the study, 112(34.1%) recovered at 3-month post-baseline, an additional 72(22%) recovered at 9-month post-baseline, while 43(12.2%) had resumed ESAS caseness at 9-month post-baseline. CONCLUSION Nurse-led SDS programs with well-structured referral pathways to community-based services and continued monitoring are feasible and acceptable in cancer patients and may help in reducing symptom distress. We intend next to develop optimal strategies for SDS implementation and referral within routine cancer care services.
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Affiliation(s)
- Wendy Wing Tak Lam
- Centre for Psycho-Oncology Research and Trainig, Division of Behavioural Sciences, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
- LKS Faculty of Medicine Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, SAR, China
| | - Danielle W L Ng
- Centre for Psycho-Oncology Research and Trainig, Division of Behavioural Sciences, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
- LKS Faculty of Medicine Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, SAR, China
| | - Richard Fielding
- Centre for Psycho-Oncology Research and Trainig, Division of Behavioural Sciences, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
- LKS Faculty of Medicine Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, SAR, China
| | - Vivian Sin
- LKS Faculty of Medicine Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, SAR, China
| | - Catherine Tsang
- LKS Faculty of Medicine Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, SAR, China
| | - Wendy W L Chan
- Department of Clinical Oncology, LKS Faculty of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Chi Chung Foo
- Department of Surgery, LKS Faculty of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Ava Kwong
- Department of Surgery, LKS Faculty of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Karen K L Chan
- Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, SAR, China
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Chan J, Ng DWL, Liao Q, Fielding R, Soong I, Chan KKL, Lee C, Ng AWY, Sze WK, Chan WL, Lee VHF, Lam WWT. Trajectories of sleep disturbance in cancer survivors during the first 2 years post-treatment. Sleep 2023; 46:zsad052. [PMID: 36861253 DOI: 10.1093/sleep/zsad052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/13/2023] [Indexed: 03/03/2023] Open
Abstract
STUDY OBJECTIVES To examine the trajectories of sleep disturbance in cancer survivors during the first 2 years post-treatment and to investigate whether psychological, cognitive, and physical factors differentiate trajectories. METHODS A total of 623 Chinese cancer survivors of diverse cancer types participated in a 2-year-long prospective study after the completion of cancer treatment. Sleep disturbance was measured using Pittsburgh Sleep Quality Index at 3 (T2), 6 (T3), 12 (T4), 18 (T5), and 24 (T6) months after baseline (within 6-months post-treatment; T1). Latent growth mixture modeling identified distinctive sleep disturbance trajectories and tested if these longitudinal patterns were predicted by baseline psychological distress, attentional control, attentional bias and physical symptom distress and T2 cancer-related distress. Fully adjusted multinomial logistic regression then identified whether these factors differentiated trajectories. RESULTS Two distinct sleep disturbance trajectories were identified, namely stable good sleepers (69.7%) and persistent high sleep disturbance (30.3%). Compared to those in the stable good sleep group, patients in the persistent high sleep disturbance group were less likely to report avoidant (OR=0.49, 95% CI = 0.26-0.90), while more likely to report intrusive thoughts (OR = 1.76, 95% CI = 1.06-2.92) and cancer-related hyperarousal (OR = 3.37, 95% CI = 1.78-6.38). Higher depression scores also predicted persistent high sleep disturbance group membership (OR = 1.13, 95% CI = 1.03-1.25). Attentional bias, attentional control, anxiety, and physical symptom distress did not predict sleep trajectory membership. CONCLUSIONS One in three cancer survivors experienced persistent high sleep disturbance. Screening and managing depressive symptoms and cancer-related distress in early cancer rehabilitation may reduce risk of persistent sleep disturbance among cancer survivors.
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Affiliation(s)
- Julia Chan
- School of Public Health, Centre for Psycho-Oncology Research and Training, University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Li Ka Shing Faculty of Medicine, Jockey Club Institute of Cancer Care, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Danielle Wing Lam Ng
- School of Public Health, Centre for Psycho-Oncology Research and Training, University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Li Ka Shing Faculty of Medicine, Jockey Club Institute of Cancer Care, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Qiuyan Liao
- School of Public Health, Centre for Psycho-Oncology Research and Training, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Richard Fielding
- School of Public Health, Centre for Psycho-Oncology Research and Training, University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Li Ka Shing Faculty of Medicine, Jockey Club Institute of Cancer Care, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Inda Soong
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong SAR, China
| | - Karen Kar Loen Chan
- Department of Obstetrics and Gynaecology, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Conrad Lee
- Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong, Hong Kong SAR, China
| | - Alice Wan Ying Ng
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, Hong Kong SAR, China
| | - Wing Kin Sze
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, Hong Kong SAR, China
| | - Wing Lok Chan
- Li Ka Shing Faculty of Medicine, Department of Clinical Oncology, University of Hong Kong, Hong Kong SAR, China
| | - Victor Ho Fun Lee
- Li Ka Shing Faculty of Medicine, Department of Clinical Oncology, University of Hong Kong, Hong Kong SAR, China
| | - Wendy Wing Tak Lam
- School of Public Health, Centre for Psycho-Oncology Research and Training, University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Li Ka Shing Faculty of Medicine, Jockey Club Institute of Cancer Care, University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Liao Q, Fielding R, Lam WWT, Yang L, Tian L, Lee TC. Climate change beliefs, perceptions of climate change-related health risk, and responses to heat-related risks among Hong Kong adults: abridged secondary publication. Hong Kong Med J 2023; 29 Suppl 4:16-17. [PMID: 37690801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Affiliation(s)
- Q Liao
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - R Fielding
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - W W T Lam
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - L Yang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - L Tian
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - T C Lee
- Climate Information Services and Tropical Cyclone, Hong Kong Observatory, Hong Kong SAR, China
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Lam WWT, Fielding R, Choi LY. Optimizing palliative care and support for pets -perspectives of the pet-parent and the veterinarian. Front Vet Sci 2023; 10:1162269. [PMID: 37275606 PMCID: PMC10235628 DOI: 10.3389/fvets.2023.1162269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/05/2023] [Indexed: 06/07/2023] Open
Abstract
As animals benefit from improved chronic disease care, more pet-parents and veterinarians face issues of late life and terminal care. Management of life limiting disease commonly considers the timing of euthanasia, often overlooking the role of supportive palliative care. Necessary communications between vet and pet-parents are rarely emphasized. However, as in human palliative care, the central role of good communications is critical. In particular, three communication elements are primary, namely: empathic communication and shared decision-making; managing progressive symptoms, and; advanced directives. Moreover, focusing only on euthanasia can easily discount the profound emotional legacy of bereavement. This Perspective illustrates how communications policies derived from human palliative care are exemplified in the management of a case of canine lung cancer, to the wider practice benefits of pets, pet-parents and veterinary practice staff.
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Affiliation(s)
- Wendy W. T. Lam
- Jockey Club Institute of Cancer Care, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR China
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR China
| | - Richard Fielding
- Jockey Club Institute of Cancer Care, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR China
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR China
| | - Lok Yi Choi
- Tung Chung Animal Clinic, Hong Kong, SAR China
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Ng DWL, Fielding R, Tsang C, Ng C, Chan J, Or A, Kong IWM, Tang JWC, Li WWY, Chang ATY, Foo CC, Kwong A, Ng SSM, Suen D, Chan M, Chun OK, Chan KKL, Butow PN, Lam WWT. Study protocol of ConquerFear-HK: a randomised controlled trial of a metacognition-based, manualised intervention for fear of cancer recurrence among Chinese cancer survivors. BMJ Open 2023; 13:e065075. [PMID: 36669845 PMCID: PMC9872480 DOI: 10.1136/bmjopen-2022-065075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 12/30/2022] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Fear of cancer recurrence (FCR) is a prevalent and frequently debilitating response to a cancer diagnosis, affecting a substantial proportion of cancer survivors. Approximately 30% of local Hong Kong Chinese cancer survivors in a recent survey reportedly experienced persistent high FCR over the first-year post-surgery. This was associated with lower levels of psychological well-being and quality of life. A manualised intervention (ConquerFear) developed primarily based on the Self-Regulatory Executive Function Model and the Rational Frame Theory, has been found to reduce FCR effectively among Caucasian cancer survivors. The intervention now has been adapted to a Chinese context; ConquerFear-HK. The primary aim of this study is to evaluate its efficacy vs a standard-survivorship-care control (BasicCancerCare) in FCR improvement in a randomised control trial (RCT). METHODS AND ANALYSIS In this RCT, using the sealed envelope method, 174 eligible Chinese cancer survivors will be randomised to either the ConquerFear-HK or BasicCancerCare intervention. Both interventions include six sessions over 10 weeks, which will be delivered via face to face or online by trained therapists. The ConquerFear-HK intervention incorporates value classification, metacognitive therapy, attentional training, detached mindfulness and psychoeducation; BasicCancerCare includes relaxation training, dietary and physical activity consultations. Participants will be assessed at prior randomisation (baseline; T0), immediately postintervention (T1), 3 months (T2) and 6 months postintervention (T3) on the measures of FCR (Fear of Cancer Recurrence Inventory) as a primary outcome; metacognition (30-item Metacognitions Quesionnaire) and cognitive attentional syndrome (Cognitive-attentional Syndrome Questionnaire) as process outcomes; psychological distress (Hospital Anxiety and Depression Scale), cancer-related distress (Chinese Impact of Events Scale), quality of life (European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire) and treatment satisfaction are secondary outcomes. ETHICS AND DISSEMINATION Ethics approval has been obtained from HKU/HA HKW Institutional Review Board (ref: UW19-183). The patients/participants provide their written informed consent to participate in this study. The study results will be disseminated through international peer-review publications and conference presentations. TRIAL REGISTRATION NUMBER NCT04568226.
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Affiliation(s)
- Danielle Wing Lam Ng
- Centre for Psycho-Oncological Research and Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Richard Fielding
- Centre for Psycho-Oncological Research and Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Catherine Tsang
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Carmen Ng
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Joyce Chan
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Amy Or
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Izy Wing Man Kong
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Julia Wei Chun Tang
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Wylie Wai Yee Li
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Amy Tien Yee Chang
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong, Hong Kong
| | - Chi Choo Foo
- Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong
| | - Ava Kwong
- Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong
| | - Simon Siu-Man Ng
- Department of Surgery, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Dacita Suen
- Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong
| | - Miranda Chan
- Department of Surgery, Kwong Wah Hospital, Hong Kong Hospital Authority, Hong Kong, Hong Kong
| | - Oi-Kwan Chun
- Department of Surgery, Kwong Wah Hospital, Hong Kong Hospital Authority, Hong Kong, Hong Kong
| | - Karen Kar Loen Chan
- Department of Obstetric and Gynaecology, The University of Hong Kong, Hong Kong, Hong Kong
| | - Phyllis N Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Wendy Wing Tak Lam
- Centre for Psycho-Oncological Research and Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
- HKU Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
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Liao Q, Dong M, Yuan J, Lam WWT, Fielding R. Community vulnerability to the COVID-19 pandemic: A narrative synthesis from an ecological perspective. J Glob Health 2022; 12:05054. [PMID: 36462204 PMCID: PMC9719409 DOI: 10.7189/jogh.12.05054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background We aimed to conduct a narrative synthesis of components and indicators of community vulnerability to a pandemic and discuss their interrelationships from an ecological perspective. Methods We searched from PubMed, Embase, Web of Science, PsycINFO, and Scopus (updated to November 2021) for studies focusing on community vulnerability to a pandemic caused by novel respiratory viruses on a geographic unit basis . Studies that reported the associations of community vulnerability levels with at least one disease morbidity or mortality outcome were included. Results Forty-one studies were included. All were about the COVID-19 pandemic. Suitable temperature and humidity environments, advanced social and human development (including high population density and human mobility, connectivity, and occupations), and settings that intensified physical interactions are important indicators of vulnerability to viral exposure. However, the eventual pandemic health impacts are predominant in communities that faced environmental pollution, higher proportions of socioeconomically deprived people, health deprivation, higher proportions of poor-condition households, limited access to preventive health care and urban infrastructure, uneven social and human development, and racism. More stringent social distancing policies were associated with lower COVID-19 morbidity and mortality only in the early pandemic phases. Prolonged social distancing policies can disproportionately burden the socially disadvantaged and racially/ethnically marginalized groups. Conclusions Community vulnerability to a pandemic is foremost the vulnerability of the ecological systems shaped by complex interactions between the human and environmental systems. Registration PROSPERO (CRD42021266186).
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So SCY, Ng DWL, Liao Q, Fielding R, Soong I, Chan KKL, Lee C, Ng AWY, Sze WK, Chan WL, Lee VHF, Lam WWT. Return to Work and Work Productivity During the First Year After Cancer Treatment. Front Psychol 2022; 13:866346. [PMID: 35496253 PMCID: PMC9039203 DOI: 10.3389/fpsyg.2022.866346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/24/2022] [Indexed: 01/01/2023] Open
Abstract
Objectives Working-age cancer patients face barriers to resuming work after treatment completion. Those resuming work contend with reduced productivity arising from persisting residual symptoms. Existing studies of return to work (RTW) after cancer diagnosis were done predominantly in Western countries. Given that employment and RTW in cancer survivors likely vary regionally due to healthcare provision and social security differences, we documented rates and correlates of RTW, work productivity, and activity impairment among Chinese cancer survivors in Hong Kong at one-year post-treatment. Methods Of 1,106 cancer patients assessed at six-months post-cancer treatment (baseline), 593 previously worked; detailed work status, psychological distress (HADS), physical symptom distress (MSAS-SF), supportive care needs (SCNS-SF34-C), health-related quality of life (SF12), and illness perception (B-IPQ) were assessed. Six months later (follow-up), work productivity and activity impairment were assessed (WPAI; n = 402). Descriptive analyses examined RTW rate. Fully adjusted regressions determined RTW, work productivity, and activity impairment predictors. Results At baseline, 39% (232/593) were working, 26% (153/593) on sick leave, and 35% (208/593) were unemployed. Compared to patients returning to work, unemployed participants were older, likely manual/service-oriented workers, and had lower family income, chemotherapy, fewer unmet health system and information needs, poorer physical functioning, and negative illness perceptions. Sick leave participants were likely service-oriented workers, who had head and neck cancer, chemotherapy, and poor physical functioning. At FU, baseline depressive symptoms, physical symptom distress, and negative illness perceptions predicted presenteeism and work productivity loss; gynecological cancer, fewer unmet health system and information needs, and greater unmet sexuality needs predicted absenteeism; physical symptom distress, negative illness perception, and poor physical functioning predicted activity impairment. Conclusion Cancer survivors who had more physically demanding jobs and poorer physical functioning delayed RTW. Unmanaged physical symptom and psychological distress hindered work productivity.
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Affiliation(s)
- Serana Chun Yee So
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Danielle Wing Lam Ng
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Qiuyan Liao
- School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Richard Fielding
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Inda Soong
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong SAR, China
| | - Karen Kar Loen Chan
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Conrad Lee
- Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong, Hong Kong SAR, China
| | - Alice Wan Ying Ng
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong SAR, China
| | - Wing Kin Sze
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong SAR, China
| | - Wing Lok Chan
- Department of Clinical Oncology, The University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Victor Ho Fun Lee
- Department of Clinical Oncology, The University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Wendy Wing Tak Lam
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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de Souto Barreto P, Cesari M, Morley JE, Roberts S, Landi F, Cederholm T, Rolland Y, Vellas B, Fielding R. Appetite Loss and Anorexia of Aging in Clinical Care: An ICFSR Task Force Report. J Frailty Aging 2022; 11:129-134. [PMID: 35441188 PMCID: PMC8898654 DOI: 10.14283/jfa.2022.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Appetite loss/anorexia of aging is a highly prevalent and burdensome geriatric syndrome that strongly impairs the quality of life of older adults. Loss of appetite is associated with several clinical conditions, including comorbidities and other geriatric syndromes, such as frailty. Despite its importance, appetite loss has been under-evaluated and, consequently, under-diagnosed and under-treated in routine clinical care. The International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force met virtually on September 27th 2021 to debate issues related to appetite loss/anorexia of aging. In particular, topics related to the implementation and management of appetite loss in at-risk older adult populations, energy balance during aging, and the design of future clinical trials on this topic were discussed. Future actions in this field should focus on the systematic assessment of appetite in the care pathway of older people, such as the Integrated Care for Older People (ICOPE) program recommended by the World Health Organization. Moreover, clinical care should move from the assessment to the treatment of appetite loss/anorexia. Researchers continue to pursue their efforts to find out effective pharmacologic and non-pharmacologic interventions with a favorable risk/benefit ratio.
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Affiliation(s)
- P de Souto Barreto
- Philipe de Souto Barreto, Gérontopôle de Toulouse, Institut du Vieillissement, 37 Allées Jules Guesde, 31000 Toulouse, France, +33 561 145 636,
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10
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Fielding R. The times, they are a changing-Still. Psychooncology 2022; 31:555. [PMID: 35396896 DOI: 10.1002/pon.5930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Richard Fielding
- Hong Kong Jockey Club Institute of Cancer Care, The University of Hong Kong Faculty of Medicine, Wong Chuk Hang, Hong Kong
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11
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Liao Q, Fielding R, Cheung DYT, Lian J, Lam WWT. WhatsApp groups to promote childhood seasonal influenza vaccination: a randomised control trial (abridged secondary publication). Hong Kong Med J 2022; 28 Suppl 1:38-41. [PMID: 35260516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Affiliation(s)
- Q Liao
- School of Public Health, The University of Hong Kong
| | - R Fielding
- School of Public Health, The University of Hong Kong
| | | | - J Lian
- School of Optometry, The Hong Kong Polytechnic University
| | - W W T Lam
- School of Public Health, The University of Hong Kong
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12
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Tang JWC, Lam WWT, Kwong A, Ma ASY, Fielding R. Dietary decision-making in Chinese breast cancer survivors: A qualitative study. Patient Educ Couns 2022; 105:460-465. [PMID: 34023175 DOI: 10.1016/j.pec.2021.05.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore the dietary practices and decision-making process among Chinese breast cancer (BCA) survivors. METHODS Using a grounded theory approach, this qualitative study involved individual semi-structured interviews with 30 BCA survivors. All interviews were audio-recorded and transcribed verbatim for analysis. RESULTS Most of the participants reported making long-term diet modification. Key themes were grouped into three stages: (1) Motivation, (2) Diet modification, and (3) Maintenance. Most participants reported to be motivated by cancer causal attributions formulated through the evaluation of past dietary habits. Others embarked on changes out of compliance to social expectations. BCA survivors interviewed were willing to make trade-offs for health, but also influenced by peer and traditional Chinese beliefs. The lack of awareness of dietary guidelines was a crucial barrier to adopting healthy eating. Lastly, maintenance of newly formed dietary habits was reinforced by positive feedback but hindered by a lack of both self-efficacy and social support. CONCLUSIONS While the majority of BCA survivors expressed willingness to improve their diets, changes made were often inconsistent with existing dietary recommendations. PRACTICE IMPLICATIONS Future interventions may target factors at different decision-making stages: guiding evaluation of past diet, building self-efficacy and giving approval to encourage maintenance of healthy dietary behaviors.
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Affiliation(s)
- Julia Wei Chun Tang
- School of Public Health/Jockey Club Institute of Cancer Care, University of Hong Kong, Hong Kong
| | - Wendy Wing Tak Lam
- School of Public Health/Jockey Club Institute of Cancer Care, University of Hong Kong, Hong Kong.
| | - Ava Kwong
- Department of Surgery, University of Hong Kong, Hong Kong
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13
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Liao Q, Cowling BJ, Xiao J, Yuan J, Dong M, Ni MY, Fielding R, Lam WWT. Priming with social benefit information of vaccination to increase acceptance of COVID-19 vaccines. Vaccine 2022; 40:1074-1081. [PMID: 35090777 PMCID: PMC8769881 DOI: 10.1016/j.vaccine.2022.01.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 01/10/2022] [Accepted: 01/15/2022] [Indexed: 01/24/2023]
Abstract
Vaccine hesitancy can be heightened due to increasing negative reports about vaccines. Emphasizing the social benefits of vaccination may shift individual attention from individual to social benefit of vaccination and hence promote prosocial vaccination. In six rounds of a population-based survey conducted over one major community epidemic of coronavirus disease 2019 (COVID-19) in Hong Kong from June to November 2020, we manipulated the question asking about acceptance of a COVID-19 vaccine with or without emphasizing the social benefit of vaccination against COVID-19 (prosocial priming) and monitored the changes of vaccine confidence by news media sentiment on vaccines. Population-weighted percentages of accepting COVID-19 vaccines by priming condition and vaccine confidence were compared across survey rounds. Logit regression models assessed the main effect of prosocial priming and the modification effects of vaccine confidence and perceived personal risk from COVID-19 on acceptance of COVID-19 vaccines. We found that prosocial priming significantly increased acceptance of COVID-19 vaccines across all survey rounds except for Round 3 when incidence of COVID-19 reached a peak. Vaccine confidence significantly declined in Round 6 when news media sentiment on vaccines became predominantly negative. The effect of prosocial priming on promoting vaccine acceptance was significantly greater in participants with low vaccine confidence and those perceiving the severity of COVID-19 to be mild/very mild. Our study suggests that packaging vaccination against COVID-19 as a prosocial behaviour can help overcome low vaccine confidence and promote prosocial vaccination particularly when disease incidence temporarily declines and the public perceive low severity of COVID-19.
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14
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Grassi L, Caruso R, Murri MB, Fielding R, Lam W, Sabato S, De Padova S, Nanni MG, Bertelli T, Palagini L, Zerbinati L. Association between Type-D Personality and Affective (Anxiety, Depression, Post-traumatic Stress) Symptoms and Maladaptive Coping in Breast Cancer Patients: A Longitudinal Study. Clin Pract Epidemiol Ment Health 2021; 17:271-279. [PMID: 35444709 PMCID: PMC8985468 DOI: 10.2174/1745017902117010271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 08/26/2021] [Accepted: 10/12/2021] [Indexed: 11/22/2022]
Abstract
Background: Type-D (distressed) personality has not been prospectively explored for its association with psychosocial distress symptoms in breast cancer patients. Objective: The objective of the study was to test the hypothesis that Type-D personality can be associated with psychosocial distress variables in cancer over a 2-point period (6 month-follow-up). Aims: The aim of the study was to analyze the role of Type-D personality in relation to anxiety, depression, post-traumatic stress symptoms, general distress, and maladaptive coping among cancer patients. Methods: 145 breast cancer patients were assessed within 6 months from diagnosis (T0) and again 6 months later (T1). The Type-D personality Scale, the Hospital Anxiety and Depression Scale, Depression subscale (HAD-D), the Brief Symptom Inventory (BSI-18) Anxiety subscale, the Distress Thermometer (DT), the Post-traumatic Symptoms (PTS) Impact of Event Scale (IES), and the Mini Mental Adjustment to Cancer (Mini-MAC) Anxious Preoccupation and Hopelessness scales were individually administered at T0 and T1. Results: One-quarter of cancer patients met the criteria for Type-D personality, which was stable over the follow-up time. The two main constructs of Type-D personality, namely social inhibition (SI) and negative affectivity (NA), were related to anxiety, depression, PTS, BSI-general distress and maladaptive coping (Mini-MAC anxious preoccupation and hopelessness). In regression analysis, Type-D SI was the most significant factor associated with the above-mentioned psychosocial variables, both at T0 and T1. Conclusion: Likewise other medical disorders (especially cardiology), Type-D personality has been confirmed to be a construct significantly related to psychosocial distress conditions and maladaptive coping that are usually part of assessment and intervention in cancer care. More attention to personality issues is important in oncology.
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15
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Liao Q, Dong M, Yuan J, Fielding R, Cowling BJ, Wong IOL, Lam WWT. Assessing Community Vulnerability over 3 Waves of COVID-19 Pandemic, Hong Kong, China. Emerg Infect Dis 2021; 27:1935-1939. [PMID: 34152957 PMCID: PMC8237886 DOI: 10.3201/eid2707.204076] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
We constructed a coronavirus disease community vulnerability index using micro district-level socioeconomic and demographic data and analyzed its correlations with case counts across the 3 pandemic waves in Hong Kong, China. We found that districts with greater vulnerability reported more cases in the third wave when widespread community outbreaks occurred.
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16
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LeBrasseur NK, de Cabo R, Fielding R, Ferrucci L, Rodriguez-Manas L, Viña J, Vellas B. Identifying Biomarkers for Biological Age: Geroscience and the ICFSR Task Force. J Frailty Aging 2021; 10:196-201. [PMID: 34105701 PMCID: PMC7933370 DOI: 10.14283/jfa.2021.5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The International Conference on Frailty and Sarcopenia Research Task Force met in March 2020, in the shadow of the COVID-19 pandemic, to discuss strategies for advancing the interdisciplinary field of geroscience. Geroscience explores biological mechanisms of aging as targets for intervention that may delay the physiological consequences of aging, maintain function, and prevent frailty and disability. Priorities for clinical practice and research include identifying and validating a range of biomarkers of the hallmarks of aging. Potential biomarkers discussed included markers of mitochondrial dysfunction, proteostasis, stem cell dysfunction, nutrient sensing, genomic instability, telomere dysfunction, cellular senescence, and epigenetic changes. The FRAILOMICS initiative is exploring many of these through various omics studies. Translating this knowledge into new therapies is being addressed by the U.S. National Institute on Aging Translational Gerontology Branch. Research gaps identified by the Task Force include the need for improved cellular and animal models as well as more reliable and sensitive measures.
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Affiliation(s)
- N K LeBrasseur
- Nathan K. LeBrasseur, Robert and Arlene Kogod Center on Aging and Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA,
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17
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Howell D, Mayer DK, Fielding R, Eicher M, Verdonck-de Leeuw IM, Johansen C, Soto-Perez-de-Celis E, Foster C, Chan R, Alfano CM, Hudson SV, Jefford M, Lam WWT, Loerzel V, Pravettoni G, Rammant E, Schapira L, Stein KD, Koczwara B. Management of Cancer and Health After the Clinic Visit: A Call to Action for Self-Management in Cancer Care. J Natl Cancer Inst 2021; 113:523-531. [PMID: 32525530 PMCID: PMC8096367 DOI: 10.1093/jnci/djaa083] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/29/2020] [Accepted: 06/04/2020] [Indexed: 12/25/2022] Open
Abstract
Individuals with cancer and their families assume responsibility for management of cancer as an acute and chronic disease. Yet, cancer lags other chronic diseases in its provision of proactive self-management support in routine, everyday care leaving this population vulnerable to worse health status, long-term disability, and poorer survival. Enabling cancer patients to manage the medical and emotional consequences and lifestyle and work changes due to cancer and treatment is essential to optimizing health and recovery across the continuum of cancer. In this paper, the Global Partners on Self-Management in Cancer puts forth six priority areas for action: Action 1: Prepare patients and survivors for active involvement in care; Action 2: Shift the care culture to support patients as partners in cocreating health and embed self-management support in everyday health-care provider practices and in care pathways; Action 3: Prepare the workforce in the knowledge and skills necessary to enable patients in effective self-management and reach consensus on core curricula; Action 4: Establish and reach consensus on a patient-reported outcome system for measuring the effects of self-management support and performance accountability; Action 5: Advance the evidence and stimulate research on self-management and self-management support in cancer populations; Action 6: Expand reach and access to self-management support programs across care sectors and tailored to diversity of need and stimulation of research to advance knowledge. It is time for a revolution to better integrate self-management support as part of high-quality, person-centered support and precision medicine in cancer care to optimize health outcomes, accelerate recovery, and possibly improve survival.
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Affiliation(s)
- Doris Howell
- Department of Supportive Care, Princess Margaret Cancer Research Center and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Deborah K Mayer
- School of Nursing, University of North Carolina & Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Richard Fielding
- University of Hong Kong Jockey Club Institute of Cancer Care, Hong Kong, China
| | - Manuela Eicher
- Department of Oncology, Lausanne University Hospital, Institute of Higher Education and Research in Health Care, Faculty of Biology and Medicine, University of Lausanne, Switzerland
| | - Irma M Verdonck-de Leeuw
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam University Medical Centers, Amsterdam, the Netherlands
- Department of Otolaryongoly/Head & Neck Surgery, Cancer Centre, Amsterdam, The Netherlands
| | | | | | - Claire Foster
- School of Health Sciences, University of Southampton, Surrey, UK
| | - Raymond Chan
- Princess Alexander Hospital and Queensland University of Technology, Brisbane, Australia
| | | | - Shawna V Hudson
- Department of Family Medicine and Community Health, Rutgers Cancer Institute of New Jersey and Rutgers Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
| | - Michael Jefford
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Wendy W T Lam
- Division of Behavioural Sciences, School of Public Health, and Jockey Club Institute of Cancer Care, University of Hong Kong, Hong Kong, China
| | - Victoria Loerzel
- University of Central Florida College of Nursing, Orlando, FL, USA
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, Instituto Europeo di Oncologia (IEO), European Institute of Oncology, Milan, Italy
| | - Elke Rammant
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Lidia Schapira
- Stanford Cancer Institute, Stanford University, Stanford, CA, USA
| | - Kevin D Stein
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Bogda Koczwara
- Department of Medical Oncology, & Flinders University, Bedford Park, South Australia and members of the Global Partners for Self-Management in Cancer (GPS)
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18
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Fielding R, Perez S, Rosberger Z, Tatar O, Wang LDL. Cervical Cancer Screening and HPV Vaccination. Psychooncology 2021. [DOI: 10.1093/med/9780190097653.003.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Cervical cancer kills 300,000 women annually, despite being among the most preventable of all cancers, with a well-known cause (human papilloma virus [HPV]), established and successful screening strategies, and effective vaccination and treatments. This chapter examines the reasons for this inconsistency and begins by outlining the epidemiology and public health burden of cervical cancers. It describes HPV vaccine–related successes and challenges in low- and middle-income countries contrasted with high-income countries, with emphasis on the two most populous countries of India and China, before examining issues around strategies for cervical cancer screening in high- and low-resource settings. Following discussion of screening recommendations, the chapter describes barriers and facilitators to vaccination, screening, and testing. It then addresses screening and vaccination messaging and the psychological impact of testing and concludes with future directions.
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Ruiz JG, Dent E, Morley JE, Merchant RA, Beilby J, Beard J, Tripathy C, Sorin M, Andrieu S, Aprahamian I, Arai H, Aubertin-Leheudre M, Bauer JM, Cesari M, Chen LK, Cruz-Jentoft AJ, De Souto Barreto P, Dong B, Ferrucci L, Fielding R, Flicker L, Lundy J, Reginster JY, Rodriguez-Mañas L, Rolland Y, Sanford AM, Sinclair AJ, Viña J, Waters DL, Won Won C, Woo J, Vellas B. Screening for and Managing the Person with Frailty in Primary Care: ICFSR Consensus Guidelines. J Nutr Health Aging 2021; 24:920-927. [PMID: 33155616 PMCID: PMC7568453 DOI: 10.1007/s12603-020-1492-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- J G Ruiz
- John E. Morley, MB, BCh, Division of Geriatric Medicine, Saint Louis University, SLUCare Academic Pavilion, Section 2500 1008 S. Spring Ave., 2nd Floor, St. Louis, MO 63110, USA, , Twitter: @drjohnmorley
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20
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21
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Ng DWL, Fielding R, Lam WWT. The Generalization of Conscious Attentional Avoidance in Response to Threat Among Breast Cancer Women With Persistent Distress. Front Psychol 2021; 11:589088. [PMID: 33408666 PMCID: PMC7779411 DOI: 10.3389/fpsyg.2020.589088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/24/2020] [Indexed: 11/23/2022] Open
Abstract
Objectives A sample of women with persistent distress following breast cancer (BC) previously exhibited attentional bias (AB) away from supraliminally presented cancer-or threat-related information, responses consistent with avoidance coping, and showed negative interpretation bias. Here, we attempt to characterize the nature of supraliminal AB and interpretation bias in that sample of women by comparing against healthy controls. Methods Extending our previous work, we compared AB patterns for supraliminally presented negatively valenced words and cancer-related information (CRI) assessed by modified dot-probe tasks and negative interpretation bias assessed by an ambiguous cue task between 140 BC women previously identified as featuring low-stable or persistent high anxiety and 150 age-matched non-BC healthy controls having HADS-defined low or high anxiety (HADS-anxiety scores = 8). Results Attentional avoidance of non-cancer-related negatively valenced words was seen among the anxious BC group, while heightened attention toward such words was seen in anxious healthy controls, F(3, 282) = 3.97, p = 0.009. However, all anxious women in both BC and healthy groups directed attention away from CRI under supraliminal conditions. Interpretation bias scores were significantly higher in BC women with high anxiety vs. healthy controls with high anxiety, F(3, 282) = 13.26, p < 0.001. Conclusion Women with high anxiety generalized conscious attentional avoidance responses to negatively valenced stimuli, indicating a likely hypersensitivity to potential threat in ambiguous cues and exaggerated threat perception. This may cause (or reflect) maladaptive emotional regulation. Attention focus training, reducing threat salience or modifying threat appraisal, may help women alleviate anxiety levels after BC.
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Affiliation(s)
- Danielle Wing Lam Ng
- Division of Behavioural Sciences, Centre for Psycho-Oncological Research and Training, School of Public Health, The University of Hong Kong, Hong Kong, China.,Li Ka Shing Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, China
| | - Richard Fielding
- Division of Behavioural Sciences, Centre for Psycho-Oncological Research and Training, School of Public Health, The University of Hong Kong, Hong Kong, China.,Li Ka Shing Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, China
| | - Wendy Wing Tak Lam
- Division of Behavioural Sciences, Centre for Psycho-Oncological Research and Training, School of Public Health, The University of Hong Kong, Hong Kong, China.,Li Ka Shing Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, China
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22
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Zerbinati L, Murri MB, Caruso R, Nanni MG, Lam W, De Padova S, Sabato S, Bertelli T, Schillani G, Giraldi T, Fielding R, Grassi L. Post-traumatic Stress Symptoms and Serotonin Transporter (5-HTTLPR) Polymorphism in Breast Cancer Patients. Front Psychiatry 2021; 12:632596. [PMID: 33967853 PMCID: PMC8097040 DOI: 10.3389/fpsyt.2021.632596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/10/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction: Post-traumatic Symptoms (PTSS) and Post-traumatic Stress Disorder (PTSD) have been reported to affect a quite significant proportion of cancer patients. No study has examined the relationship between serotonin transporter gene-linked polymorphic region (5-HTTLPR) and cancer, including Gene-Environment interactions between this polymorphism and specific causes of distress, such as cancer related problems (CRP) or life stressful events (SLE). Methods: One hundred and forty five breast cancer outpatients participated in the study and were assessed using the Impact of Event Scale (IES), the Problem List (PL) developed by the National Comprehensive Cancer Network (NCCN) Distress Management Guidelines and the Paykel's Life Events Interview to evaluate the exposure to SLE during the year before the cancer diagnosis. Each patient was genotyped for 5-HTTLPR polymorphism by analyzing genomic DNA obtained from whole blood cells. Gene-Environment interactions were tested through moderation analysis. Results: Twenty-six patients (17.7%) were classified as PTSS cases using the IES. Genotype and phenotype distributions did not differ across individuals with/without PTSS (genotype: χ2 = 1.5; df = 2; p = 0.3; phenotype χ2 = 0.9; df = 1; p = 0.2). For both the genotype and phenotype model, using CRP as a predictor showed significant gene-environment interactions with IES total score (p = 0.020 and p = 0.004, respectively), with individuals carrying the l/l allele showing a greater probability of experiencing PTSS. No interaction was found in relationship to SLE (p = 0.750). Conclusion: This study showed a significant GEI between CRP and PTSS in breast cancer patients, with carriers of the l/l allele showing indicators consistent with greater sensitivity to stress.
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Affiliation(s)
- Luigi Zerbinati
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Martino Belvederi Murri
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Rosangela Caruso
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Maria Giulia Nanni
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
| | - Wendy Lam
- Centre for Psycho-Oncological Research and Training, School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Silvia De Padova
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola, Italy
| | - Silvana Sabato
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Tatiana Bertelli
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola, Italy
| | - Giulia Schillani
- Child Onco-Hematology Unit, Maternal and Child Health, Istituto di Ricovero e Cura a Carattere Scientifico (IRCSS) Burlo Garofolo, Trieste, Italy
| | - Tullio Giraldi
- Section of Pharmacology, Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Richard Fielding
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy.,Centre for Psycho-Oncological Research and Training, School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Luigi Grassi
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy
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Ruiz JG, Dent E, Morley JE, Merchant RA, Beilby J, Beard J, Tripathy C, Sorin M, Andrieu S, Aprahamian I, Arai H, Aubertin-Leheudre M, Bauer JM, Cesari M, Chen LK, Cruz-Jentoft AJ, Barreto PDS, Dong B, Ferrucci L, Fielding R, Flicker L, Lundy J, Reginster JY, Rodriguez-Mañas L, Rolland Y, Sanford AM, Sinclair AJ, Viña J, Waters DL, Won CW, Woo J, Vellas B. Erratum to: Screening for and Managing the Person with Frailty in Primary Care: ICFSR Consensus Guidelines. J Nutr Health Aging 2020. [PMCID: PMC7790018 DOI: 10.1007/s12603-020-1547-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ng DWL, Chan FHF, Barry TJ, Lam C, Chong CY, Kok HCS, Liao Q, Fielding R, Lam WWT. Psychological distress during the 2019 Coronavirus Disease (COVID-19) pandemic among cancer survivors and healthy controls. Psychooncology 2020; 29:1380-1383. [PMID: 32497353 PMCID: PMC7300758 DOI: 10.1002/pon.5437] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 05/20/2020] [Accepted: 05/26/2020] [Indexed: 11/21/2022]
Affiliation(s)
- Danielle W. L. Ng
- Centre for Psycho‐Oncological Research and Training, Division of Behavioural Sciences, School of Public HealthThe University of Hong KongPok Fu LamHong Kong
- Jockey Club Institute of Cancer Care, LKS Faculty of MedicineThe University of Hong KongPok Fu LamHong Kong
| | | | - Tom J. Barry
- Department of PsychologyThe University of Hong KongPok Fu LamHong Kong
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonEngland
| | - Cherry Lam
- Centre for Psycho‐Oncological Research and Training, Division of Behavioural Sciences, School of Public HealthThe University of Hong KongPok Fu LamHong Kong
- Jockey Club Institute of Cancer Care, LKS Faculty of MedicineThe University of Hong KongPok Fu LamHong Kong
| | - Ching Y. Chong
- Centre for Psycho‐Oncological Research and Training, Division of Behavioural Sciences, School of Public HealthThe University of Hong KongPok Fu LamHong Kong
- Jockey Club Institute of Cancer Care, LKS Faculty of MedicineThe University of Hong KongPok Fu LamHong Kong
| | - Hiu C. S. Kok
- Centre for Psycho‐Oncological Research and Training, Division of Behavioural Sciences, School of Public HealthThe University of Hong KongPok Fu LamHong Kong
- Jockey Club Institute of Cancer Care, LKS Faculty of MedicineThe University of Hong KongPok Fu LamHong Kong
| | - Qiuyan Liao
- Centre for Psycho‐Oncological Research and Training, Division of Behavioural Sciences, School of Public HealthThe University of Hong KongPok Fu LamHong Kong
| | - Richard Fielding
- Centre for Psycho‐Oncological Research and Training, Division of Behavioural Sciences, School of Public HealthThe University of Hong KongPok Fu LamHong Kong
- Jockey Club Institute of Cancer Care, LKS Faculty of MedicineThe University of Hong KongPok Fu LamHong Kong
| | - Wendy W. T. Lam
- Centre for Psycho‐Oncological Research and Training, Division of Behavioural Sciences, School of Public HealthThe University of Hong KongPok Fu LamHong Kong
- Jockey Club Institute of Cancer Care, LKS Faculty of MedicineThe University of Hong KongPok Fu LamHong Kong
- School of NursingThe University of Hong KongPok Fu LamHong Kong
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Liao Q, Yuan J, Dong M, Yang L, Fielding R, Lam WWT. Public Engagement and Government Responsiveness in the Communications About COVID-19 During the Early Epidemic Stage in China: Infodemiology Study on Social Media Data. J Med Internet Res 2020; 22:e18796. [PMID: 32412414 PMCID: PMC7284407 DOI: 10.2196/18796] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/11/2020] [Accepted: 05/14/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Effective risk communication about the outbreak of a newly emerging infectious disease in the early stage is critical for managing public anxiety and promoting behavioral compliance. China has experienced the unprecedented epidemic of the coronavirus disease (COVID-19) in an era when social media has fundamentally transformed information production and consumption patterns. OBJECTIVE This study examined public engagement and government responsiveness in the communications about COVID-19 during the early epidemic stage based on an analysis of data from Sina Weibo, a major social media platform in China. METHODS Weibo data relevant to COVID-19 from December 1, 2019, to January 31, 2020, were retrieved. Engagement data (likes, comments, shares, and followers) of posts from government agency accounts were extracted to evaluate public engagement with government posts online. Content analyses were conducted for a random subset of 644 posts from personal accounts of individuals, and 273 posts from 10 relatively more active government agency accounts and the National Health Commission of China to identify major thematic contents in online discussions. Latent class analysis further explored main content patterns, and chi-square for trend examined how proportions of main content patterns changed by time within the study time frame. RESULTS The public response to COVID-19 seemed to follow the spread of the disease and government actions but was earlier for Weibo than the government. Online users generally had low engagement with posts relevant to COVID-19 from government agency accounts. The common content patterns identified in personal and government posts included sharing epidemic situations; general knowledge of the new disease; and policies, guidelines, and official actions. However, personal posts were more likely to show empathy to affected people (χ21=13.3, P<.001), attribute blame to other individuals or government (χ21=28.9, P<.001), and express worry about the epidemic (χ21=32.1, P<.001), while government posts were more likely to share instrumental support (χ21=32.5, P<.001) and praise people or organizations (χ21=8.7, P=.003). As the epidemic evolved, sharing situation updates (for trend, χ21=19.7, P<.001) and policies, guidelines, and official actions (for trend, χ21=15.3, P<.001) became less frequent in personal posts but remained stable or increased significantly in government posts. Moreover, as the epidemic evolved, showing empathy and attributing blame (for trend, χ21=25.3, P<.001) became more frequent in personal posts, corresponding to a slight increase in sharing instrumental support, praising, and empathizing in government posts (for trend, χ21=9.0, P=.003). CONCLUSIONS The government should closely monitor social media data to improve the timing of communications about an epidemic. As the epidemic evolves, merely sharing situation updates and policies may be insufficient to capture public interest in the messages. The government may adopt a more empathic communication style as more people are affected by the disease to address public concerns.
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Affiliation(s)
- Qiuyan Liao
- School of Public Health, The University of Hong Kong, Hong Kong
| | - Jiehu Yuan
- School of Public Health, The University of Hong Kong, Hong Kong
| | - Meihong Dong
- School of Public Health, The University of Hong Kong, Hong Kong
| | - Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
| | | | - Wendy Wing Tak Lam
- School of Public Health, The University of Hong Kong, Hong Kong.,School of Nursing, The University of Hong Kong, Hong Kong
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Affiliation(s)
- Maggie Watson
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Oncogenetics, Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Wendy W T Lam
- Division of Behavioural Sciences, School of Public Health, Adjunct Associate Professor, School of Nursing, Director, Jockey Club Institute of Cancer Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - William Pirl
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Richard Fielding
- Hong Kong Jockey Club Institute of Cancer Care, Faculty of Medicine, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
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Liao Q, Fielding R, Cheung YTD, Lian J, Yuan J, Lam WWT. Effectiveness and Parental Acceptability of Social Networking Interventions for Promoting Seasonal Influenza Vaccination Among Young Children: Randomized Controlled Trial. J Med Internet Res 2020; 22:e16427. [PMID: 32130136 PMCID: PMC7070348 DOI: 10.2196/16427] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 12/05/2019] [Accepted: 01/26/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Seasonal influenza vaccination (SIV) coverage among young children remains low worldwide. Mobile social networking apps such as WhatsApp Messenger are promising tools for health interventions. OBJECTIVE This was a preliminary study to test the effectiveness and parental acceptability of a social networking intervention that sends weekly vaccination reminders and encourages exchange of SIV-related views and experiences among mothers via WhatsApp discussion groups for promoting childhood SIV. The second objective was to examine the effect of introducing time pressure on mothers' decision making for childhood SIV for vaccination decision making. This was done using countdowns of the recommended vaccination timing. METHODS Mothers of child(ren) aged 6 to 72 months were randomly allocated to control or to one of two social networking intervention groups receiving vaccination reminders with (SNI+TP) or without (SNI-TP) a time pressure component via WhatsApp discussion groups at a ratio of 5:2:2. All participants first completed a baseline assessment. Both the SNI-TP and SNI+TP groups subsequently received weekly vaccination reminders from October to December 2017 and participated in WhatsApp discussions about SIV moderated by a health professional. All participants completed a follow-up assessment from April to May 2018. RESULTS A total of 84.9% (174/205), 71% (57/80), and 75% (60/80) who were allocated to the control, SNI-TP, and SNI+TP groups, respectively, completed the outcome assessment. The social networking intervention significantly promoted mothers' self-efficacy for taking children for SIV (SNI-TP: odds ratio [OR] 2.69 [1.07-6.79]; SNI+TP: OR 2.50 [1.13-5.55]), but did not result in significantly improved children's SIV uptake. Moreover, after adjusting for mothers' working status, introducing additional time pressure reduced the overall SIV uptake in children of working mothers (OR 0.27 [0.10-0.77]) but significantly increased the SIV uptake among children of mothers without a full-time job (OR 6.53 [1.87-22.82]). Most participants' WhatsApp posts were about sharing experience or views (226/434, 52.1%) of which 44.7% (101/226) were categorized as negative, such as their concerns over vaccine safety, side effects and effectiveness. Although participants shared predominantly negative experience or views about SIV at the beginning of the discussion, the moderator was able to encourage the discussion of more positive experience or views and more knowledge and information. Most intervention group participants indicated willingness to receive the same interventions (110/117, 94.0%) and recommend the interventions to other mothers (102/117, 87.2%) in future. CONCLUSIONS Online information support can effectively promote mothers' self-efficacy for taking children for SIV but alone it may not sufficient to address maternal concerns over SIV to achieve a positive vaccination decision. However, the active involvement of health professionals in online discussions can shape positive discussions about vaccination. Time pressure on decision making interacts with maternal work status, facilitating vaccination uptake among mothers who may have more free time, but having the opposite effect among busier working mothers. TRIAL REGISTRATION Hong Kong University Clinical Trials Registry HKUCTR-2250; https://tinyurl.com/vejv276.
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Affiliation(s)
- Qiuyan Liao
- University of Hong Kong, Hong Kong, China (Hong Kong)
| | | | | | - Jinxiao Lian
- The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Jiehu Yuan
- University of Hong Kong, Hong Kong, China (Hong Kong)
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Tang JWC, Lam WWT, Ma ASY, Law WL, Wei R, Fielding R. Dietary changes adopted by Chinese colorectal cancer patients: A qualitative study. Eur J Cancer Care (Engl) 2019; 28:e13159. [DOI: 10.1111/ecc.13159] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 07/05/2019] [Accepted: 08/01/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | - Wai Lun Law
- Division of Colorectal Surgery, Department of Surgery University of Hong Kong Hong Kong Hong Kong
| | - Rockson Wei
- Division of Colorectal Surgery, Department of Surgery University of Hong Kong Hong Kong Hong Kong
| | - Richard Fielding
- School of Public Health University of Hong Kong Hong Kong Hong Kong
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Fielding R, Lam WWT, Wu JTK, Wang LDL, Liao QY. Chinese parental decision making on HPV vaccination for adolescent girls: a longitudinal study. Hong Kong Med J 2019; 25 Suppl 7:9-12. [PMID: 31761763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Affiliation(s)
- R Fielding
- Division of Behavioural Health, School of Public Health, The University of Hong Kong
| | - W W T Lam
- Division of Behavioural Health, School of Public Health, The University of Hong Kong
| | - J T K Wu
- Division of Epidemiology and Biostatistics, School of Public Health, The University of Hong Kong
| | - L D L Wang
- Division of Behavioural Health, School of Public Health, The University of Hong Kong
| | - Q Y Liao
- Division of Behavioural Health, School of Public Health, The University of Hong Kong
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Fielding R. Developing a preventive psycho-oncology for a global context. The International Psycho-Oncology Society 2018 Sutherland Award Lecture. Psychooncology 2019; 28:1595-1600. [PMID: 31222864 DOI: 10.1002/pon.5139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/22/2019] [Accepted: 05/22/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Growing rates of cancer and survivorship, in situations of severe resource constraints, force a rethink about managing cancer-related psychosocial distress (CRPD). Here, a prevention-oriented natural history of distress is proposed, derived from developments in our understanding of the evolution and decay of CRPD. METHODS The literature indicates that at least four classes or natural histories of CRPD are identifiable. These are described in the context of prevention-oriented activities in psycho-oncology: (1) CRPD in persons with good coping resources, resulting from reaction to the diagnosis and treatment lifestyle disruption, which is largely self-limiting and preferably self-managed; (2) CRPD arising from residual, or late effects of disease or treatment, potentially persistent and debilitating; (3) CRPD in persons with preexisting coping difficulties; and (4) CRPD arising from existential issues such as mortality and fear of recurrence. RESULTS It is hypothesized that different natural histories of CRPD display different evolution, indicating potential causal processes, treatment priorities, and preventive strategies. In particular, the effective management of residual symptoms is crucial to prevent CRPD chronicity. Optimal patient involvement in treatment decision-making is also required. CONCLUSIONS There is a need to develop methods to differentiate if, early in the illness trajectory, the distressed patient is not able to self-manage the stress of cancer diagnosis and treatment. Not all distressed patients want or need help, and addressing just the CRPD may be inadequate where unresolved residual symptoms prevent renormalization after treatment. Improved doctor-patient communication around treatment decisions is warranted.
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Affiliation(s)
- Richard Fielding
- Centre for Psycho-Oncology Research & Training and Hong Kong Jockey Club Integrated Cancer Centre, The University of Hong Kong, Pokfulam, Hong Kong
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Wang LDL, Lam WWT, Fielding R. Development and pre/post testing of a decision aid supporting Chinese parental and young women's HPV vaccination decision-making. Women Health 2019; 60:330-340. [PMID: 31195899 DOI: 10.1080/03630242.2019.1626791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
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.
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Affiliation(s)
- Linda Dong-Ling Wang
- School of Medicine, Yangzhou University, Yangzhou, China.,Centre for Psycho-Oncology Research and Training, School of Public Health, University of Hong Kong, Pokfulam, Hong Kong
| | - Wendy Wing Tak Lam
- Centre for Psycho-Oncology Research and Training, School of Public Health, University of Hong Kong, Pokfulam, Hong Kong
| | - Richard Fielding
- Centre for Psycho-Oncology Research and Training, School of Public Health, University of Hong Kong, Pokfulam, Hong Kong
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Devine K, Lewis J, Fielding R, Hill J, Haugk B, Johnson S, James A. MON-415 Pituitary Carcinoma With Sequential Hormone Hypersecretion And A Novel Renal Complication Of Hormone Excess. J Endocr Soc 2019. [PMCID: PMC6551174 DOI: 10.1210/js.2019-mon-415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Pituitary carcinoma is a rare diagnosis, occurring in <1% of pituitary tumours. Most are hormonally active and resistant to conventional treatment. We present a rare case of a malignant lactotroph tumour whose extreme and evolving secretory phenotype has induced an unprecedented form of nephropathy. Case: A 55 year old man presented to ophthalmology with painful right third nerve palsy. Subsequent imaging revealed a 24 x 26 mm sellar mass extending into the right cavernous sinus and encroaching upon the optic chiasm. Endocrine evaluation demonstrated prolactin (PRL) of 68,000 mIU/L and accompanying hypogonadism (testosterone 1.3 nmol/L, FSH 1.8 IU/L, LH 1.4 IU/L), hypoadrenalism (peak cortisol 272 nmol/L after 250 mcg synacthen) and hypothyroidism (TSH 2.9 mIU/L, T4 8 pmol/L). IGF1-1 was also at the lower end of the reference range (10 nmol/L). He made an initial good response to cabergoline with PRL falling to 1570 mIU/L, resolution of visual symptoms, tumour shrinkage to 7 x 16 mm and restoration of HPA axis function. Five years later he demonstrated escape from hormone control with PRL rising to 32,000 mIU/L and return of the ophthalmoplegia, despite escalation of cabergoline to 3.5mg weekly. Unexpectedly, he also developed acute ketotic diabetes mellitus secondary to new onset acromegaly (GH >100 ug/L, IGF-1 97 nmol/L). The tumour remnant had expanded into the cavernous sinus on MRI. Biopsy of the lesion showed a tumour with strong PRL staining, micro-vacuolation, sparse GH staining and Ki-67 of 15-20% suggesting an aggressive nature and potentially in keeping with the rare acidophilic stem cell tumour subtype. He underwent stereotactic pituitary radiotherapy and later commenced pegvisomant therapy after a failed octreotide trial. Following this, prolactin levels continued to rise. Unfortunately, subsequent investigations for back pain with bilateral hand paraesthesia (at first considered secondary to acromegaly) revealed metastatic lesions in spine, lung and stomach - the latter confirmed to be of PRL-secreting neuroendocrine origin on biopsy. There was no uptake on octreotide scan. In response to new renal dysfunction (creatinine 463 umol/L with microscopic haematuria and proteinuria), a renal biopsy was also performed and revealed changes compatible with interstitial nephritis with cast nephropathy. The tubular casts stained positive for PRL, and serum PRL at this time reached a peak of 3.7 million mIU/L. Temolozamide has been commenced, and the patient may later be considered for immunotherapy . Conclusion: This is the first documented case of prolactin cast nephropathy and a rare example of a changing tumour secretion pattern, with intractable acute on chronic hyperprolactinaemia and acute acromegaly, in a case of metastatic pituitary carcinoma.
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Affiliation(s)
- Kerri Devine
- Royal Victoria Infirmary, Newcastle Upon Tyne, , United Kingdom
| | - Joanne Lewis
- Freeman Hospital, Newcastle Upon Tyne, , United Kingdom
| | | | - John Hill
- Royal Victoria Infirmary, Newcastle Upon Tyne, , United Kingdom
| | - Beate Haugk
- Royal Victoria Infirmary, Newcastle Upon Tyne, , United Kingdom
| | - Sarah Johnson
- Royal Victoria Infirmary, Newcastle Upon Tyne, , United Kingdom
| | - Andy James
- Royal Victoria Infirmary, Newcastle Upon Tyne, , United Kingdom
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Iyasere O, Brown E, Gordon F, Collinson H, Fielding R, Fluck R, Johansson L, Morgan N, Stoves J, Vardhan A, Woodrow G, Davenport A. Longitudinal Trends in Quality of Life and Physical Function in Frail Older Dialysis Patients: A Comparison of Assisted Peritoneal Dialysis and In-Center Hemodialysis. Perit Dial Int 2019; 39:112-118. [DOI: 10.3747/pdi.2018.00086] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 09/17/2018] [Indexed: 11/15/2022] Open
Abstract
Background In-center hemodialysis (HD) has been the standard treatment for older dialysis patients, but reports suggest an associated decline in physical and cognitive function. Cross-sectional data suggest that assisted peritoneal dialysis (aPD), an alternative treatment, is associated with quality of life (QoL) outcomes that are comparable to in-center HD. We compared longitudinal changes in QoL between modalities. Methods We enrolled 106 aPD patients, matched with 100 HD patients from 20 renal centers in England and Northern Ireland. Patients were assessed quarterly for 2 years using the Hospital Anxiety and Depression Scale (HADS), SF-12 physical and mental scores, symptom score, Illness Intrusiveness Rating Scale (IIRS), Barthel's score, and the Renal Treatment Satisfaction Questionnaire (RTSQ). Mixed model analysis was used to assess the impact of dialysis modality on these outcomes during follow-up. P values were adjusted for multiple significance testing. Results Multivariate analysis showed no difference in any of the outcome measures between aPD and HD. Longitudinal trends in outcomes were also not significantly different. Higher age at baseline was associated with lower IIRS and RTSQ scores during follow-up. One-hundred and twenty-five (60.6%) patients dropped out of the study: 59 (28.6%) died, 61 (29.6%) withdrew during follow-up, and 5 (2.5%) were transplanted. Conclusions Quality of life outcomes in frail older aPD patients were equivalent to those receiving in-center HD. Assisted PD is thus a valid alternative to HD for older people with end-stage kidney disease (ESKD) wishing to dialyze at home.
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Affiliation(s)
- Osasuyi Iyasere
- John Walls Renal Unit, Leicester General Hospital, Leicester, UK
| | - Edwina Brown
- Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK
| | - Fabiana Gordon
- Statistical Advisory Service, School of Public Health, Imperial College, London, UK
| | | | | | | | - Lina Johansson
- Imperial College London, Department of Nutrition and Dietetics, Hammersmith Hospital, London, UK
| | - Neal Morgan
- Renal Unit, Daisy Hill Hospital, Southern Health and Social Care Trust, Northern Ireland, UK
| | - John Stoves
- Renal Unit, Bradford St Luke's Hospital, Bradford, UK
| | - Anand Vardhan
- Department of Renal Medicine, Manchester Royal Infirmary, Manchester, UK
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Hui LL, Lam HS, Lau EYY, Nelson EAS, Wong TW, Fielding R. Prenatal exposure to dioxins and subsequent neurocognitive and developmental function in Hong Kong Chinese children. Hong Kong Med J 2019; 25 Suppl 3:35-39. [PMID: 30792372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Affiliation(s)
- L L Hui
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong
| | - H S Lam
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong
| | - E Y Y Lau
- Department of Psychology, The University of Hong Kong
| | - E A S Nelson
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong
| | - T W Wong
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong
| | - R Fielding
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong
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Tang L, Zhang Y, Pang Y, He Y, Wang Y, Fielding R, Deng L. A comparison of psychosocial care preferences of breast cancer women in Mainland China and Hong Kong. Psychooncology 2018; 28:343-350. [PMID: 30569663 DOI: 10.1002/pon.4947] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 11/15/2018] [Accepted: 11/15/2018] [Indexed: 11/10/2022]
Abstract
PURPOSE Despite shared cultural values, Mainland China's health care system differs from that of Hong Kong. We compared preferences for psychosocial care in Mainland breast cancer women with their Hong Kong counterparts to determine core preferences for, and correlates of, clinical psychosocial care implementation. METHODS Two hundred eighty breast cancer patients from 23 hospitals located in 15 provinces across Mainland China were recruited to complete the 55-item Chinese version of the Australian National Health and Medical Research Council's National Breast Cancer Centre assessment. Items ranked by proportions of women endorsing them as "essential" for care were compared with similar rankings by Hong Kong Chinese women with breast cancer. RESULTS Valid response rate was 83% (231/280). Among 231 breast cancer patients, greater than 40% endorsed 15/55 items as essential for effective psychosocial care. Of the top 10 ranked "repeatable" items, seven items were common to both Chinese and Hong Kong breast cancer women, while of the top 10 ranked "once-only" items, nine were common. Mainland breast cancer women ranked help with anxiety and social roles higher than did their Hong Kong counterparts. Demographic factors significantly associated with psychosocial care needs included ethnicity, age, income source and level, religious beliefs, education level, marital status, residential status, and current therapies. CONCLUSIONS Chinese breast cancer patients prioritize both disease and treatment information and psychosocially sensitive care, making these core items in comprehensive psychosocial care implementation by clinicians and nurses.
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Affiliation(s)
- Lili Tang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yening Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Ying Pang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yi He
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yan Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Richard Fielding
- Centre for Psycho-oncology Research & Training, Division of Behavioral Sciences, School of Public Health, The University of Hong Kong, Hong Kong
| | - Lisha Deng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing, China
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36
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Liao Q, Wu P, Wing Tak Lam W, Cowling BJ, Fielding R. Trajectories of public psycho-behavioural responses relating to influenza A(H7N9) over the winter of 2014-15 in Hong Kong. Psychol Health 2018; 34:162-180. [PMID: 30430862 DOI: 10.1080/08870446.2018.1515436] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To explore trajectories of public psycho-behavioural responses over one influenza A(H7N9) epidemic wave, and examine the interplays among social norm influence, disease worry and protective behaviours. METHODS Participants were 464 adults who completed the baseline and at least two follow-up assessments on their H7N9-related Perceived Susceptibility, Perceived Severity, Perceived Efficacy, Worry, Social Norms influence and Protective Behaviours in a five-phase longitudinal survey over one H7N9 epidemic wave. Latent growth modelling (LGM) identified trajectories of these psycho-behavioural responses while multi-process LGM examined the inter-relationships among trajectories of Social Norms influence, Worry and Protective Behaviours. RESULTS Trajectories of Perceived Susceptibility, Worry, Social Norms and Protective Behaviours increased initially but declined as the epidemic decayed, while Perceived Severity increased linearly and Perceived Efficacy remained stable across the epidemic. Change in Social Norms influence was significantly associated with change in Worry (β = 0.65) which was significantly associated with change in Protective Behaviours (β = 0.62). CONCLUSION The public's threat appraisal but not efficacy appraisal may have been well-informed by epidemic-related information. Social Norms may be important contributors of public emotional response to an epidemic. Communication via social networks during an epidemic could be important for regulating public emotional response and guiding their behavioural change.
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Affiliation(s)
- Qiuyan Liao
- a Division of Behavioural Sciences, School of Public Health , The University of Hong Kong , Hong Kong , China
| | - Peng Wu
- b Division of Epidemiology and Biostatistics, School of Public Health , The University of Hong Kong , Hong Kong , China
| | - Wendy Wing Tak Lam
- a Division of Behavioural Sciences, School of Public Health , The University of Hong Kong , Hong Kong , China
| | - Benjamin J Cowling
- b Division of Epidemiology and Biostatistics, School of Public Health , The University of Hong Kong , Hong Kong , China
| | - Richard Fielding
- a Division of Behavioural Sciences, School of Public Health , The University of Hong Kong , Hong Kong , China
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Benard T, Parnell L, Lessard S, Fielding R, Rivas D. SHIFTS IN MICRORNA EXPRESSION PROFILES WITHIN SKELETAL MUSCLE AND ADIPOSE ACROSS THE LIFESPAN. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - L Parnell
- USDA Agricultural Research Service, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | | | - R Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
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Rivas DA, Fielding R, Benard T, Margolis L. MIR-19B EXPRESSION IN CIRCULATION IS ASSOCIATED WITH INCREASED LEAN MASS AFTER RESISTANCE TRAINING IN OLDER ADULTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D A Rivas
- Tufts University, Boston, Massachusetts, United States
| | - R Fielding
- Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
| | - T Benard
- Tufts University, Boston, MA, United States
| | - L Margolis
- Tufts University, Boston, MA, United States
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Grosicki G, Englund D, Price L, Iwai M, Kashiwa M, Liu C, Reid K, Fielding R. SKELETAL MUSCLE FATIGABILITY PREDICTS PHYSICAL FUNCTION IN MOBILITY-LIMITED OLDER ADULTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- G Grosicki
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - D Englund
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - L Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center; Tufts Clinical and Translational Science Institute, Tufts University; Boston, MA, USA
| | - M Iwai
- Astellas Pharma Inc., Itabashi ku, Tokyo, Japan
| | - M Kashiwa
- Astellas Pharma Inc., Itabashi ku, Tokyo, Japan
| | - C Liu
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University; Geriatrics Section, Department of Medicine, Boston Medical Center, Boston, MA, USA
| | - K Reid
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - R Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
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Zhang N, Fielding R, Soong I, Chan KK, Lee C, Ng A, Sze WK, Tsang J, Lee V, Lam WWT. Illness perceptions as predictors of psychological distress among head and neck cancer survivors: a longitudinal study. Head Neck 2018; 40:2362-2371. [PMID: 30307664 DOI: 10.1002/hed.25343] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 01/21/2018] [Accepted: 05/07/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Leventhal's commonsense model implies illness perceptions influence illness outcomes. This study examined illness perceptions among head and neck cancer survivors, and whether these predicted subsequent psychological distress. METHODS A total of 124 survivors of head and neck cancer (87% nasopharyngeal carcinoma; NPC) completed measures of psychological distress (Hospital Anxiety and Depression Scale; HADS), illness perceptions (Brief Illness Perception Questionnaire; B-IPQ), dispositional optimism (revised Chinese version of the Life Orientation Test; C-LOT-R), and clinical and demographic data approximately12.9 months after diagnosis (T1). Six months later (T2) psychological distress (HADS) was again measured. Adjusted multivariate analyses tested whether illness perceptions predicted T2 HADS scores. RESULTS Illness perception dimensions were significantly intercorrelated (0.01-0.68), explaining 8.0% of anxiety and 4.8% of depression symptom variability at T2. After adjustment for T1 distress, illness identity (β = 0.270, P < .01) and sex identification as a woman (β = 0.275, P < .01) predicted T2 anxiety symptoms while illness identity (β = 0.195, P < .05), unemployment (β = 0.195, P < .05), and pessimism (β = -0.227, P < .01) predicted T2 depression symptoms. CONCLUSION Perceived illness identity predicted psychological distress, accounting for modest levels of distress variance. Unresolved symptoms may exacerbate distress.
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Affiliation(s)
- Na Zhang
- Centre for Psycho-Oncology Research & Training, School of Public Health, University of Hong Kong, Patrick Manson Building, 7, Sassoon Rd., Pokfulam, HongKong
| | - Richard Fielding
- Centre for Psycho-Oncology Research & Training, School of Public Health, University of Hong Kong, Patrick Manson Building, 7, Sassoon Rd., Pokfulam, HongKong
| | - Inda Soong
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | - Karen Kk Chan
- Department of Obstetrics & Gynaecology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Conrad Lee
- Department of Clinical Oncology, Princess Margaret Hospital, Kowloon, Hong Kong
| | - Alice Ng
- Department of Clinical Oncology, TuenMun Hospital, Tuen Mun, HongKong
| | - Wing Kin Sze
- Department of Clinical Oncology, TuenMun Hospital, Tuen Mun, HongKong
| | - Janice Tsang
- Department of Clinical Oncology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Victor Lee
- Department of Clinical Oncology, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Wendy Wing Tak Lam
- Centre for Psycho-Oncology Research & Training, School of Public Health, University of Hong Kong, Patrick Manson Building, 7, Sassoon Rd., Pokfulam, HongKong
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Fielding R, Wu JT, Lam WW, Wang LD. Decision-making process of families about human papillomavirus vaccination of adolescent daughters: a qualitative study of Hong Kong Chinese families. Hong Kong Med J 2018; 24 Suppl 6:30-33. [PMID: 30229734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Affiliation(s)
- R Fielding
- Division of Behavioural Health, School of Public Health, The University of Hong Kong
| | - J T Wu
- Division of Epidemiology and Biostatistics, School of Public Health, The University of Hong Kong
| | - W Wt Lam
- Division of Behavioural Health, School of Public Health, The University of Hong Kong
| | - L Dl Wang
- Division of Behavioural Health, School of Public Health, The University of Hong Kong
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Lam WW, Fielding R, Yoon SW, Tsang J, Soong I. Living with advanced breast cancer in women resilient to distress versus women with persistent distress: a qualitative study. Hong Kong Med J 2018; 24 Suppl 4:38-41. [PMID: 30135274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Affiliation(s)
- W Wt Lam
- School of Public Health, The University of Hong Kong
| | - R Fielding
- School of Public Health, The University of Hong Kong
| | - S W Yoon
- School of Public Health, The University of Hong Kong
| | - J Tsang
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital
| | - I Soong
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital
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Leung GM, Ni MY, Wong PT, Lee PH, Chan BH, Stewart SM, Schooling CM, Johnston JM, Lam WW, Chan SS, McDowell I, Lam TH, Pang H, Fielding R. Cohort Profile: FAMILY Cohort. Int J Epidemiol 2018; 46:e1. [PMID: 25617647 DOI: 10.1093/ije/dyu257] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2014] [Indexed: 11/12/2022] Open
Abstract
The FAMILY Cohort is a longitudinal study of health, happiness and family harmony (the '3Hs') at individual, household and neighbourhood levels in Hong Kong. Using a family living in the same household as the sampling unit, the study (n = 20 279 households and 46 001 participants) consists of a composite sample from several sources, including: a population-representative random core sample (n = 8115 households and 19 533 participants); the first-degree relatives of this sample (n = 4658 households and 11 063 participants); and oversampling in three new towns (n = 2891 households and 7645 participants) and in three population subgroups with anticipated changes in family dynamics (n = 909 households and 2160 participants). Two household visits and five telephone- or web-based follow-ups were conducted over 2009-14. Data collected include socio-demographics, anthropometrics, lifestyle and behavioural factors, measures of social capital, and standardized instruments assessing the 3Hs. We also intend to collect biomaterials in future. The analytical plan includes multilevel inter-relations of the 3Hs for individuals, households, extended families and neighbourhoods. With Hong Kong's recent history of socioeconomic development, the FAMILY Cohort is therefore relevant to global urban populations currently experiencing similarly rapid economic growth. The FAMILY Cohort is currently set up as a supported access resource.
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Affiliation(s)
- Gabriel M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Michael Y Ni
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Paul Tk Wong
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong.,Early Psychosis Foundation (EPISO), Hong Kong
| | - Paul H Lee
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong.,School of Nursing, Hong Kong Polytechnic University, Hong Kong
| | - Brandford Hy Chan
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Sunita M Stewart
- Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas, Dallas, TX
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong.,School of Public Health, Hunter College and CUNY, New York, NY
| | - Janice M Johnston
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Wendy Wt Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Sophia Sc Chan
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong and
| | - Ian McDowell
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON
| | - Tai Hing Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Herbert Pang
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Richard Fielding
- School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong
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Lam WWT, Kwong A, Suen D, Tsang J, Soong I, Yau TK, Yeo W, Suen J, Ho WM, Wong KY, Sze WK, Ng AWY, Fielding R. Factors predicting patient satisfaction in women with advanced breast cancer: a prospective study. BMC Cancer 2018; 18:162. [PMID: 29415669 PMCID: PMC5803988 DOI: 10.1186/s12885-018-4085-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 01/31/2018] [Indexed: 11/17/2022] Open
Abstract
Background The present study (1) examined patient satisfaction with care over the first year following the diagnosis of advanced breast cancer and (2) tested if unmet health system and information needs, physical symptom distress, and psychological distress predicted patient satisfaction. Methods Prospective study of 213 Chinese women with advanced breast cancer assessed while awaiting or receiving initial chemotherapy (baseline), then again at 1.5-, 3-, 6-, and 12-months post-baseline. Health system and information unmet (HSI) needs, psychological distress, physical symptom distress, and patient satisfaction were assessed at baseline; patient satisfaction was reassessed at each follow-up assessment. Latent growth curve analysis assessed changes in patient satisfaction over the 12 months follow-up; hierarchical multiple regression analysis tested if baseline health system information needs, physical symptom distress, anxiety and depression predicted patient satisfaction at one-year post-baseline. Results The level of patient satisfaction was high and did not change significantly over time. Only HSI needs (β = − 0.27, p < 0.005) significantly associated with baseline patient satisfaction. Patient satisfaction at one-year post-baseline was predicted by HSI needs (β = − 0.26, p < 0.005), Anxiety (β = 0.23, p < 0.05) and Depression (β = − 0.28, p < 0.005), adjusting for the effect of baseline patient satisfaction (β = 0.22, p < 0.005). Conclusions Unmet health information needs and greater depressive symptoms at initial treatment phased predicted subsequent poorer patient satisfaction. This highlights a need to reinforce the importance of patient-centered care model in managing advanced breast cancer.
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Affiliation(s)
- Wendy W T Lam
- Centre for Psycho-Oncology Research & Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong(HKU), 5/F, WMW Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Pokulam, Hong Kong.
| | - Ava Kwong
- Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong
| | - Dacita Suen
- Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong
| | - Janice Tsang
- Department of Clinical Oncology, The University of Hong Kong, Pokfulam, Hong Kong
| | - Inda Soong
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | - Tze Kok Yau
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | - Winnie Yeo
- Department of Clinical Oncology, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Joyce Suen
- Department of Clinical Oncology, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Wing Ming Ho
- Department of Clinical Oncology, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Ka Yan Wong
- Department of Oncology, Princess Margaret Hospital, Kwai Chung, Hong Kong
| | - Wing Kin Sze
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - Alice W Y Ng
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - Richard Fielding
- Centre for Psycho-Oncology Research & Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong(HKU), 5/F, WMW Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Pokulam, Hong Kong
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Lam WW, Ng D, Wong S, Lee TM, Kwong A, Fielding R. The role of cognitive bias in relation to persistent distress among women diagnosed with breast cancer. Psychooncology 2018; 27:983-989. [DOI: 10.1002/pon.4620] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 12/12/2017] [Accepted: 12/12/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Wendy W.T. Lam
- Centre for Psycho-Oncology Research and Training, School of Public Health; The University of Hong Kong; Pokfulam Hong Kong
| | - Danielle Ng
- Centre for Psycho-Oncology Research and Training, School of Public Health; The University of Hong Kong; Pokfulam Hong Kong
| | - Sarah Wong
- Centre for Psycho-Oncology Research and Training, School of Public Health; The University of Hong Kong; Pokfulam Hong Kong
| | - Tatia M.C. Lee
- Laboratory of Neuropsychology; The University of Hong Kong; Pokfulam Hong Kong
| | - Ava Kwong
- Department of Surgery; The University of Hong Kong; Pokfulam Hong Kong
| | - Richard Fielding
- Centre for Psycho-Oncology Research and Training, School of Public Health; The University of Hong Kong; Pokfulam Hong Kong
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Dent E, Morley JE, Cruz-Jentoft AJ, Arai H, Kritchevsky SB, Guralnik J, Bauer JM, Pahor M, Clark BC, Cesari M, Ruiz J, Sieber CC, Aubertin-Leheudre M, Waters DL, Visvanathan R, Landi F, Villareal DT, Fielding R, Won CW, Theou O, Martin FC, Dong B, Woo J, Flicker L, Ferrucci L, Merchant RA, Cao L, Cederholm T, Ribeiro SML, Rodríguez-Mañas L, Anker SD, Lundy J, Gutiérrez Robledo LM, Bautmans I, Aprahamian I, Schols JMGA, Izquierdo M, Vellas B. International Clinical Practice Guidelines for Sarcopenia (ICFSR): Screening, Diagnosis and Management. J Nutr Health Aging 2018; 22:1148-1161. [PMID: 30498820 DOI: 10.1007/s12603-018-1139-9] [Citation(s) in RCA: 447] [Impact Index Per Article: 74.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Sarcopenia, defined as an age-associated loss of skeletal muscle function and muscle mass, occurs in approximately 6 - 22 % of older adults. This paper presents evidence-based clinical practice guidelines for screening, diagnosis and management of sarcopenia from the task force of the International Conference on Sarcopenia and Frailty Research (ICSFR). METHODS To develop the guidelines, we drew upon the best available evidence from two systematic reviews paired with consensus statements by international working groups on sarcopenia. Eight topics were selected for the recommendations: (i) defining sarcopenia; (ii) screening and diagnosis; (iii) physical activity prescription; (iv) protein supplementation; (v) vitamin D supplementation; (vi) anabolic hormone prescription; (vii) medications under development; and (viii) research. The ICSFR task force evaluated the evidence behind each topic including the quality of evidence, the benefit-harm balance of treatment, patient preferences/values, and cost-effectiveness. Recommendations were graded as either strong or conditional (weak) as per the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Consensus was achieved via one face-to-face workshop and a modified Delphi process. RECOMMENDATIONS We make a conditional recommendation for the use of an internationally accepted measurement tool for the diagnosis of sarcopenia including the EWGSOP and FNIH definitions, and advocate for rapid screening using gait speed or the SARC-F. To treat sarcopenia, we strongly recommend the prescription of resistance-based physical activity, and conditionally recommend protein supplementation/a protein-rich diet. No recommendation is given for Vitamin D supplementation or for anabolic hormone prescription. There is a lack of robust evidence to assess the strength of other treatment options.
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Affiliation(s)
- E Dent
- Dr. Elsa Dent, , Torrens University Australia, Wakefield Street, Adelaide, SA, Australia
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Liao Q, Lam WWT, Cowling BJ, Fielding R. Psychosocial Influences on Parental Decision-Making Regarding Vaccination Against Seasonal Influenza for Young Children in Hong Kong: a Longitudinal Study, 2012-2013. Int J Behav Med 2017; 23:621-34. [PMID: 26987657 DOI: 10.1007/s12529-016-9551-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Vaccination uptake remained low, although annual subsidies are provided to encourage 6-72-month-old Hong Kong children to be vaccinated against seasonal influenza. This study was aimed to investigate the psychosocial influences on parental decision-making regarding young children's seasonal influenza vaccination. METHODS One-thousand two-hundred twenty-six parents of eligible children were recruited using random digit dialing in August-October 2012 to assess baseline perceptions and re-contacted in March 2013 to record children's vaccination uptake. Structural equation modeling (SEM) was performed to examine factors associated with parental decision about children's vaccination based on the complete data of 1222 respondents. RESULTS Of the 1226 respondents who completed the follow-up survey, 34.3 % reported that their child was vaccinated during the follow-up period. Child's past influenza vaccination history (β = 0.48), belief in vaccination safety (β = 0.35), and social norms (β = 0.25) were strongly associated with parental intention to vaccinate their child which directly predicted child vaccination uptake (β = 0.57). Belief in vaccination safety (β = 0.42) and social norms (β = 0.36) were strongly associated with vaccination intention of parents whose children never received influenza vaccine. CONCLUSION Interventions that address concerns on vaccination safety and utilize social norms may be effective to initiate Chinese parents to vaccinate their children.
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Affiliation(s)
- Qiuyan Liao
- School of Public Health, Li Ka Shing Faculty of Medicine, Hong Kong Special Administrative Region, The University of Hong Kong, Hong Kong, China.
| | - Wendy Wing Tak Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, Hong Kong Special Administrative Region, The University of Hong Kong, Hong Kong, China
| | - Benjamin J Cowling
- School of Public Health, Li Ka Shing Faculty of Medicine, Hong Kong Special Administrative Region, The University of Hong Kong, Hong Kong, China
| | - Richard Fielding
- School of Public Health, Li Ka Shing Faculty of Medicine, Hong Kong Special Administrative Region, The University of Hong Kong, Hong Kong, China
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Wang LDL, Lam WWT, Fielding R. Determinants of human papillomavirus vaccination uptake among adolescent girls: A theory-based longitudinal study among Hong Kong Chinese parents. Prev Med 2017; 102:24-30. [PMID: 28652087 DOI: 10.1016/j.ypmed.2017.06.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 05/24/2017] [Accepted: 06/18/2017] [Indexed: 01/13/2023]
Abstract
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 (β=0.28), perceived greater benefits of HPV vaccination (β=0.17), anticipated affective consequences (β=0.32), and attitude to general optional vaccines (β=0.09) were associated with parental vaccination intention. Barriers to HPV vaccination (β=-0.31), descriptive norms (β=0.17), perceived self-efficacy (β=0.73), and vaccination intention (β=0.11) were associated with vaccination planning. Vaccination intention (β=0.31) and planning (β=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.
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Affiliation(s)
- Linda Dong-Ling Wang
- College of Medicine, Yangzhou University, Jiangsu Province, China; Division of Behavioural Sciences, School of Public Health, University of Hong Kong, Hong Kong.
| | - Wendy Wing Tak Lam
- Division of Behavioural Sciences, School of Public Health, University of Hong Kong, Hong Kong.
| | - Richard Fielding
- Division of Behavioural Sciences, School of Public Health, University of Hong Kong, Hong Kong.
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Vellas B, Fielding R, Bhasin S, Cerreta F, Goodpaster B, Guralnik JM, Kritchevsky S, Legrand V, Forkin C, Magaziner J, Morley JE, Rodriguez-Manas L, Roubenoff R, Studenski S, Villareal DT, Cesari M. Sarcopenia Trials in Specific Diseases: Report by the International Conference on Frailty and Sarcopenia Research Task Force. J Frailty Aging 2017; 5:194-200. [PMID: 27883164 DOI: 10.14283/jfa.2016.110] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Muscle atrophy occurs as a consequence of a number of conditions, including cancer, chronic obstructive pulmonary disease (COPD), diabetes mellitus, heart failure, and other chronic diseases, where it is generally a predictor of poor survival. It also occurs as a consequence of disuse and an age-related loss of muscle mass and strength (sarcopenia). The aims of the 2016, International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force were to examine how these specific chronic conditions have been employed in treatment trials thus far and how future trials using these patient groups might be designed for efficient identification of effective sarcopenia interventions. Functional limitations assessed as gait speed, distance walked over a set time period, or other attributes of physical performance have been suggested as outcome measures in sarcopenia trials. Indeed, such measures have already been used successfully in a number of trials aimed at preventing disability in older adults.
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Affiliation(s)
- B Vellas
- Bruno Vellas, MD. Gérontopôle, CHU Toulouse; Service de Médecine Interne et Gérontologie Clinique. 170 Avenue de Casselardit, 31059 Toulouse, France. Phone: +33 (0)5 6177-6425; Fax: +33 (0)5 6177-6475. E-mail:
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Lam WWT, Tse MA, Ng CNL, Chung EKM, Fielding R. Psychometric Assessment of the Chinese Version of the Abbreviated Expanded Prostate Cancer Index Composite (EPIC-26) and the Clinical Practice Version (EPIC-CP) in Chinese Men With Prostate Cancer. J Pain Symptom Manage 2017; 53:1085-1090. [PMID: 28438583 DOI: 10.1016/j.jpainsymman.2017.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 01/20/2017] [Accepted: 02/19/2017] [Indexed: 11/23/2022]
Abstract
PURPOSE The Expanded Prostate Cancer Index Composite (EPIC) instrument was designed to assess a range of health-related quality-of-life issues specifically relevant to patients with prostate cancer. This study examined the validity and reliability of Chinese versions of the 26-item EPIC and of the 16-item EPIC for Clinical Practice (EPIC-CP) in Chinese patients with prostate cancer. MATERIALS AND METHODS A Chinese version of the 26-item EPIC and the 16-item EPIC-CP were self-completed by 252 Chinese patients with prostate cancer who were recruited from three community-based cancer service centers. Confirmatory factors analysis assessed the factor structures of the EPIC and the EPIC-CP. Internal consistency and construct and clinical validities of the factor structures were assessed. RESULTS Confirmatory factor analysis revealed that the original factor structure of both EPIC-26 and EPIC-CP showed good fit to this sample. A correlated model was superior to a hierarchical model in both EPIC-26 and EPIC-CP supporting the utility of the domain scores over the total scores. Cronbach α ranged from 0.55 to 0.91 for EPIC-26 and 0.44 to 0.67 for EPIC-CP. Construct validity was supported by correlations between EPIC-26/EPIC-CP and psychological distress measures. Clinical validity was supported by differentiation between patients with and without prostatectomy. CONCLUSIONS These Chinese versions of the five-factor EPIC-26 and the EPIC-CP are valid and practical measures for assessing a range of health-related quality-of-life issues related to the diagnosis and treatment of prostate cancer, highlighting their utility in assessing health-related quality of life for patients diagnosed with prostate cancer.
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Affiliation(s)
- Wendy W T Lam
- Centre for Psycho-oncology Research and Training, Division of Behavioral Sciences, School of Public Health, The University of Hong Kong, Hong Kong.
| | - Michael A Tse
- Institute of Human Performance, The University of Hong Kong, Hong Kong
| | | | | | - Richard Fielding
- Centre for Psycho-oncology Research and Training, Division of Behavioral Sciences, School of Public Health, The University of Hong Kong, Hong Kong
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