Participation in a government-subsidised colorectal cancer screening programme for asymptomatic individuals in Hong Kong.

BACKGROUND: A Government-subsidised colorectal cancer screening programme (CRCSP) was launched in Hong Kong. This study aimed to assess the participation rate in CRCSP among Chinese individuals between the ages of 50 and 75 years and to survey individuals' reasons for declining to participate in the CRCSP. METHODS: A cross-sectional study was performed. Asymptomatic Chinese individuals aged 50-75 years in Hong Kong who did not have a history of colorectal cancer were recruited. A survey was used to collect information about individuals' participation in the CRCSP. RESULTS: The survey was completed by 1317 participants. Of these, 432 (32.8%) joined the CRCSP and the remaining 885 participants (67.2%) did not join the CRCSP. The most common reason that participants provided for not joining the CRCSP was thinking that the screening was not necessary because they had no health problems (29.3%). Some (14.4%) of the participants claimed to lack information about the CRCSP and screening procedures. Some (12.5%) of them completed the screening before the CRCSP was launched, and the cost was covered by other sources. CONCLUSION: The participation in CRCSP for a screening among the Hong Kong population has generally increased, but obstacles to participating in screening programme remain.

Exploring social capital for family caregivers of patients with chronic organ failure: study protocol for a concept mapping study.

INTRODUCTION: Many family caregivers experience significant burdens, especially those who take care of patients with chronic organ failure. Although the social welfare system offers some material assistance, a more sustainable approach to supporting caregivers is warranted. This study aims to explore the social capital (ie, the internal strengths of a community that facilitate different social roles) available for these family caregivers. METHODS AND ANALYSIS: A participatory design based on Trochim's concept mapping framework will be used in this study. A total of 119 participants, including patients, family caregivers, professionals and other community members, will be recruited from the community. The study will be divided into three phases. In Phase I, qualitative methods will be used to prepare and generate statements. Participants will be asked to share their views on social capital for family caregivers through interviews. In Phase II, quantitative methods will be used to arrange these statements into a concept map, and participants will be asked to complete a questionnaire to prioritise the statements. Statistical methods will be used to create a map based on the responses. In Phase III, the concept map will be used to formulate action plans. The findings will be presented to the public to produce recommendations for social policy. ETHICS AND DISSEMINATION: This study was approved by The Chinese University of Hong Kong Survey and Behavioural Research Ethics Committee (Reference No.: SBRE-20-714). Informed consent will be obtained from all participants. This study will reveal which forms of social capital can be mobilised to support family caregivers of patients with chronic organ failure. Recommendations on policies to improve the caregiving experience, strengthen social capital and enhance social care will be produced. Findings will be disseminated through academic conferences and journals, as well as local media to create a greater social impact. TRIAL REGISTRATION NUMBER: ChiCTR2100044171.

Advanced-Stage Melanoma at Presentation Following the Peak of the Pandemic: A COVID-19 Cancer Canary in a Coal Mine.

BACKGROUND: For melanoma patients, timely identification and tumor thickness are directly correlated with outcomes. COVID-19 impacted both patients' ability and desire to see physicians. We sought to identify whether the pandemic correlated with changes in melanoma thickness at presentation and subsequent treatment timeline. METHODS: Retrospective chart review was performed on patients who underwent surgery for melanoma in an academic center surgical oncology practice from May 2019 to September 2021. Patients were split into two cohorts: "pre-pandemic" from May 2019 to May 2020 and "pandemic," after May 2020, representing when these patients received their initial diagnostic biopsy. Demographic and melanoma-specific variables were recorded and analyzed. RESULTS: A total of 112 patients were identified: 51 patients from the "pre-pandemic" and 61 from the "pandemic" time period. The pandemic cohort more frequently presented with lesions greater than 1 mm thickness compared to pre-pandemic (68.8% v 49%, p = 0.033) and were found to have significantly more advanced T stage (p = 0.02) and overall stage disease (p = 0.022). Additionally, trends show that for pandemic patients more time passed from patient-reported lesion appearance/change to diagnostic biopsy (5.7 ± 2.0 v 7.1 ± 1.5 months, p = 0.581), but less time from biopsy to operation (42.9 ± 2.4 v 52.9 ± 5.0 days, p = 0.06). CONCLUSIONS: "Pandemic" patients presented with thicker melanoma lesions and more advanced-stage disease. These results may portend a dangerous trend toward later stage at presentation, for melanoma and other cancers with rapid growth patterns, that will emerge as the prolonged effects of the pandemic continue to impact patients' presentation for medical care.

The application of technology to improve cognition in older adults: A review and suggestions for future directions.

The rapidly increasing worldwide population of older adults, along with the increasing prevalence of cognitive impairment and dementia in this population, is a growing health-care problem. As such, advances in technology-based cognitive interventions and games are playing an increasingly key role in preserving and improving older adults' cognitive function, especially during the COVID-19 pandemic when opportunities for face-to-face activities or training are few. In this paper, we summarize from previous studies systematic reviews and meta-analyses on the various types of technology used in cognitive interventions (namely, computerized cognitive training, virtual-reality interventions and robot-assisted interventions) and the empirical evidence on the effects of these technologies on global and specific cognitive functions in healthy and clinical populations of older adults (e.g., older adults with mild cognitive impairment or dementia). We also describe older adults' perceptions, experiences and acceptance of these technologies. Finally, we discuss the limitations, challenges and future avenues of research in this field.

Psychological Wellbeing and Associated Factors Among Ethnic Minorities During the COVID-19 Pandemic.

This study assessed the psychological wellbeing and its associated factors amongst ethnic minorities during the coronavirus disease 2019 (COVID-19) pandemic. A total of 310 Hong Kong South Asians aged 41.3 (SD 13.7) years completed an anonymous online survey between July 2020 and February 2021. The results showed an overall moderate level of stress and high levels of depression, anxiety and post-traumatic stress disorder (PTSD) symptoms amongst South Asian minorities. Multivariable regression analyses suggested that being single/divorced, following Hinduism or other non-Muslim religions, having lower perceived knowledge of COVID-19 and having worried about losing job were significant predictors of higher levels of depression, anxiety and/or stress; additionally, being male, having a low monthly household income, having worried about losing job and healthcare collapse were significant predictors of a higher level of PTSD symptoms. The findings suggest an urgent need to alleviate the psychological impacts of the COVID-19 pandemic on ethnic minorities, specifically for those most vulnerable to these impacts.

A review of the prevalence, associated factors and interventions of psychological symptoms among cancer patients in the Chinese Mainland during the COVID-19 pandemic

The novel coronavirus disease 2019 (COVID-19) has placed tremendous pressure on public health systems across the world. Compared with the healthy population, cancer patients are more prone to developing psychological problems, including depression and anxiety, because of worries about cancer recurrence, cancer symptoms, treatment-related discomfort, a lack of social interaction and the impact on their financial well-being. This paper aimed to identify existing evidence on psychological symptoms and their associated factors among cancer patients in the Chinese Mainland during the COVID-19 pandemic, and on interventions to effectively manage these symptoms. Articles related to the prevalence, the risk factors and interventions of psychological symptoms among cancer patients in the Chinese Mainland during COVID-19 published between December 2019 and August 2020 were searched in two English (PubMed and Embase) and two Chinese (CNKI and Wan Fang Data) databases. A total of 180 studies were identified, and 18 studies were included in the review after removing duplicates and screening for relevancy. The results suggest that patients with cancer in the Chinese Mainland have suffered psychological pressure during COVID-19, with a high prevalence of psychological distress, depression and anxiety reported across most of the reviewed studies. Pandemic-related factors such as treatment discontinuation and worry about being infected are associated with these symptoms. Nurses may help to relieve these symptoms by identifying stressors, providing relevant information through mass and social media and referring patients to specialists for psychological support. However, evidence about treatments and interventions for these symptoms is limited, and additional research is warranted to identify effective interventions to promote resilience in this patient population.

A review of the prevalence, associated factors and interventions of psychological symptoms among cancer patients in the Chinese Mainland during the COVID-19 pandemic.

The novel coronavirus disease 2019 (COVID-19) has placed tremendous pressure on public health systems across the world. Compared with the healthy population, cancer patients are more prone to developing psychological problems, including depression and anxiety, because of worries about cancer recurrence, cancer symptoms, treatment-related discomfort, a lack of social interaction and the impact on their financial well-being. This paper aimed to identify existing evidence on psychological symptoms and their associated factors among cancer patients in the Chinese Mainland during the COVID-19 pandemic, and on interventions to effectively manage these symptoms. Articles related to the prevalence, the risk factors and interventions of psychological symptoms among cancer patients in the Chinese Mainland during COVID-19 published between December 2019 and August 2020 were searched in two English (PubMed and Embase) and two Chinese (CNKI and Wan Fang Data) databases. A total of 180 studies were identified, and 18 studies were included in the review after removing duplicates and screening for relevancy. The results suggest that patients with cancer in the Chinese Mainland have suffered psychological pressure during COVID-19, with a high prevalence of psychological distress, depression and anxiety reported across most of the reviewed studies. Pandemic-related factors such as treatment discontinuation and worry about being infected are associated with these symptoms. Nurses may help to relieve these symptoms by identifying stressors, providing relevant information through mass and social media and referring patients to specialists for psychological support. However, evidence about treatments and interventions for these symptoms is limited, and additional research is warranted to identify effective interventions to promote resilience in this patient population.

Knowledge, Attitudes and Practices Towards COVID-19 Amongst Ethnic Minorities in Hong Kong.

This study assessed the knowledge, attitudes and practices (KAP) towards coronavirus disease 2019 (COVID-19) among South Asians in Hong Kong and examined the factors that affect KAP towards COVID-19 in this population. This cross-sectional descriptive study recruited participants with assistance from South Asian community centres and organisations. A total of 352 participants completed questionnaires to assess their level of KAP towards COVID-19. The mean knowledge score was 5.38/10, indicating a relatively low knowledge level. The participants expressed certain misconceptions regarding the prevention of COVID-19 infection. They perceived a mild risk related to the disease, had positive attitudes regarding its prevention and often implemented recommended disease-preventive measures, such as maintaining social distance (88.1%) and wearing masks in public (94.3%). Participants who were male, had a secondary school education or lower and who perceived a lower risk of being infected and lower self-efficacy were less likely to implement preventive measures. Culturally and linguistically appropriate health education could be developed to increase the knowledge of South Asians, especially those with lower education levels, about COVID-19 and to encourage them to implement the necessary preventive measures.

A Review of Psychological Issues among Patients and Healthcare Staff during Two Major Coronavirus Disease Outbreaks in China: Contributory Factors and Management Strategies

Outbreaks of severe acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19) have affected populations worldwide. Our literature review summarises the studies reporting psychological issues among healthcare staff and infected patients in mainland China, Hong Kong, and Taiwan during these two outbreaks and the potential strategies for addressing these issues. Our review shows that patients and healthcare staff presented similar psychological symptoms, including anxiety, fear, distress, and depression, which may lead to stress-related complications such as insomnia. In patients, these psychological impairments can be contributed to by being quarantined, perceptions of threats to life, and uncertainty about health status. Quarantine is also a factor for distress among healthcare staff, together with their heavy workload, the fear that they and their families would become infected, witnessing their patients"poor and deteriorating conditions, and the requirement to wear protective gear. Strategies that are needed to address these factors include providing counselling services, implementing mindfulness-based therapies and optimism interventions, and providing telecommunication facilities for patients to communicate with their families. Healthcare staff should also be provided with these services, together with appropriate and flexible work shift arrangements and morale boosting. These strategies would improve not only the mental well-being of patients and healthcare staff, but also the self-efficacy and competence of the staff to provide quality healthcare services.