University Students' Vaccination Intention after the Fifth Wave of the COVID-19 Outbreak in Hong Kong: Inspiration from a Health Belief Model.

The fifth wave of COVID-19, driven by the Omicron variant, started to surge in Hong Kong in December 2021. Previous studies have shown that younger adults, compared to older adults, are vulnerable to increased risks of side effects after vaccination. However, little is known about the COVID-19 vaccination behavior among younger adults, especially university students, in Hong Kong. Therefore, the present online survey study aimed to investigate the predictors of COVID-19 vaccination intention among university students in Hong Kong using the Health Belief Model (HBM) as a framework. Two other potential predictors, the previous influenza vaccine uptake frequency and the Hong Kong SAR government vaccination lottery program, were also examined. The intention to receive another dose of the COVID-19 vaccine was low (36.4%). Multivariate binomial logistic regression analysis showed that, after controlling for demographic and baseline characteristics, the perceived susceptibility (OR = 2.98, CI = 1.18-7.53) and previous influenza vaccine uptake frequency (OR = 1.54, CI = 1.08-2.19) significantly and positively predicted the COVID-19 vaccination intention. However, the government vaccination lottery program (i.e., wining prizes for being vaccinated) (OR = 0.87, CI = 0.34-2.26) was not a significant motivator of COVID-19 vaccination. Future public health campaigns should focus on the individual susceptibility to COVID-19 and past influenza vaccination history to promote increased vaccination uptake among university students.

Comparative analysis of symptom burdens and influential factors among diverse terminally-ill patients.

BACKGROUND: The suffering experienced by terminally-ill patients encompasses physiological, psychosocial and spiritual dimensions. While previous studies have investigated symptom burden intensity for specific disease groups, such as cancer or heart failure patients, a research gap exists in understanding major distressing symptoms among diverse terminally-ill patients. This study assessed symptom burden intensity and explored its influential factors among diverse patient disease groups. METHODS: This cross-sectional study utilized the baseline Integrated Palliative care Outcome Scale (IPOS) assessment data. The study participants were terminally-ill patients enrolled in an end-of-life care (EoLC) intervention in Hong Kong. Statistical methods including relative importance index (RII), one-way analysis of variance (ANOVA), and generalized linear regression (GLR) were employed. RESULTS: Final sample consisted of 1,549 terminally-ill patients (mean age =77.4 years, SD =11.6). The five top-rated distressing symptoms among these patients, revealed by the RII analysis, were poor mobility (RII =64.4%), family anxiety (RII =63.5%), sharing feelings with family/friends (RII =61.4%), weakness/lack of energy (RII =58.1%), and hardly feeling at peace (RII =50.7%). One-way ANOVA showed significant differences among the eight disease groups in perceived physical and emotional symptom burden intensity (P<0.05). Analysis of RII symptom scores for each disease group revealed that poor mobility was rated as the most distressing symptom (RII =85.1-62.9%) by patients with motor neurone disease, Parkinson's disease, heart failure, dementia, end-stage renal disease and other serious diseases (including stroke, hematological disease, multiple sclerosis and liver diseases). Perceived family anxiety (RII =66.1%) and shortness of breath (RII =63.8%) were the most distressing symptoms for cancer patients and those with chronic obstructive pulmonary disease, respectively. GLR analysis showed that illness type is the most significant factor influencing the perceived burden intensity in terms of the IPOS total and subscale scores of physical symptoms, emotional symptoms and communication/practical issues. Demographic characteristics such as age, gender, marital status and co-residing status were also identified as influential factors of various symptom categories. However, patients' educational level and relationship with primary caregiver did not significantly influence any perceived symptom burden. CONCLUSIONS: This study provides valuable insights into the symptom burdens experienced by diverse patient disease groups at end-stage of life. The findings highlight the major distressing symptoms of poor mobility, family anxiety, and shortness of breath. Addressing these symptoms is crucial in improving the quality of care for terminally-ill patients. Furthermore, the study identifies influential factors that can affect the perceived intensity of symptom burden, primarily the main type of terminal illness and patient's age. Tailored care support and improved clinical care should be implemented, particularly for high-risk groups such as patients with non-cancer terminal illnesses and older aged patients. These findings contribute to existing literature and emphasize the need for comprehensive and individualized care in EoLC.

Efficacy of the integrative Body-Mind-Spirit group intervention for improving quality of life in parent-child dyads adjusting to atopic dermatitis: protocol for a randomised controlled trial.

INTRODUCTION: Atopic dermatitis (AD) is the most common childhood inflammatory skin problem affecting 15%-30% of children. Although AD adversely impacts the psychosocial well-being of children and their parent caregivers, parents' psychosocial well-being is seldom mentioned in most non-pharmacological education programmes. A family-based psychosocial intervention, Integrative Body-Mind-Spirit (I-BMS) intervention, is examined. This study compares the efficacy of two versions of the I-BMS intervention (one delivered to both parents and children; one delivered to parents only) with a health education active control (delivered to parents only) in promoting adaptive emotional regulation and quality of life of children with AD and their parent caregivers. METHODS AND ANALYSIS: This is a three-arm, with equal randomisation, parallel randomised controlled trial. 192 parent-child dyads will be recruited through hospitals and non-governmental organisations in Hong Kong. Each dyad will complete an individual pre-group screening interview. Eligible dyads will be randomised in a ratio of 1:1:1 into one of the three arms. Each arm consists of six weekly sessions. A computer-generated list of random numbers will be used to perform randomisation. The primary outcomes are quality of life and emotional regulation. Assessments are administered at baseline, post-intervention and 6-week follow-up. Mixed factorial Analysis of Covariance (ANCOVAs) based on intention-to-treat principle will be conducted to examine the efficacy of the two I-BMS interventions. Structural equation modelling will be conducted to examine the parent-child interdependent effects of intervention. ETHICS AND DISSEMINATION: Ethics approval was obtained from the Human Research Ethics Committee of the University of Hong Kong (EA2001001) and the Institutional Review Board of the Hospital Authority of Hong Kong (UW 21-400, KC/KE-20-0360/FR-2, NTEC-2021-0408). Consent will be sought from participating parents and children. Parental consent for child participants will also be obtained. Findings will be presented in peer-reviewed journals and at conferences in medical dermatology, paediatrics and social work. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT04617977).

Treating depression with a smartphone-delivered self-help cognitive behavioral therapy for insomnia: study protocol for a parallel group randomized controlled trial.

BACKGROUND: Depression is a major public health concern. Emerging research has shown that cognitive behavioral therapy for insomnia (CBT-I) is effective in treating individuals with comorbid insomnia and depression. Traditional face-to-face CBT-I encounters many obstacles related to feasibility, accessibility, and help-seeking stigma. CBT-I delivered via smartphone application could be a potential solution. This paper reports a protocol designed to evaluate the efficacy of a self-help smartphone-based CBT-I, using a waitlist group as control, for people with major depression and insomnia. METHODS: A two-arm parallel randomized controlled trial is conducted in a target sample of 285 non-suicidal Hong Kong Chinese older than 17 years of age with major depression and insomnia. Participants complete an online rapid screening, followed by a telephone diagnostic interview. Those who meet the eligibility criteria are randomized in a ratio of 1:1 to receive either CBT-I immediately or to a waitlist control condition. The CBT-I consists of six weekly modules and is delivered through a smartphone application proACT-S. This smartphone app has been pilot tested and revamped to improve user experience. An online randomized algorithm is used to perform randomization to ensure allocation concealment. The primary outcomes are changes over the measurement points in sleep quality, insomnia severity, and depression severity. The secondary outcomes include changes over the measurement points in anxiety, subjective health, treatment expectancy, and acceptability of treatment. Assessments are administered at baseline, post-intervention, and 6-week follow-up. The recruitment is completed. Important adverse events, if any, are documented. Multilevel linear mixed model based on intention-to-treat principle will be conducted to examine the efficacy of the CBT-I intervention. DISCUSSION: It is expected that proACT-S is an efficacious brief sleep-focused self-help treatment for people with major depression and insomnia. If proven efficacious, due to its self-help nature, proACT-S may be applicable as a community-based early intervention, thereby reducing the burden of the public healthcare system in Hong Kong. TRIAL REGISTRATION: ClinicalTrials.gov NCT04228146 . Retrospectively registered on 14 January 2020.

Long-term displacement associated with health and stress among survivors of Typhoon Haiyan.

Displacement from one's home after a natural disaster results not only in physical separation from significant others but also in profound disruptions of psychological and social resources such as community support and sense of belonging. Frequent displacement can exacerbate health and mental health problems brought by the disaster, especially among lower-income families in resource-scarce regions. OBJECTIVE: The present study examined the association among frequency of displacement after the disaster, health status, and psychological adjustments among survivors four years after the 2013 Super Typhoon Haiyan in the Philippines. METHOD: The study surveyed 345 typhoon survivors using randomized cluster samples in 13 towns in Eastern Philippines and assessed their physical and mental health status. RESULT: Path analysis revealed that, after controlling for age, gender, and traumatic exposure severity, frequency of displacement was a significant predictor for subjective health ratings and stress but not for posttraumatic stress symptoms, depression, and anxiety. CONCLUSION: These findings underscore the detrimental impact of long-term displacement on health outcomes following a disaster, especially in countries where public health resources are largely unavailable. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A well-slept teacher is a better teacher: A multi-respondent experience-sampling study on sleep, stress, and emotional transmission in the classroom.

The present study examined the impact of sleep, stress, and negative activating emotions of high-school teachers on their students' affective experience, academic motivation, and in-class satisfaction. It is hypothesized that teachers' sleep quality and stress have a positive influence on their own nervousness and irritability. With reference to the emotional crossover theory, teachers' nervousness and irritability are hypothesized to intensify students' nervousness and irritability and subsequently dampen their academic motivation and in-class satisfaction. Experience-sampling data were collected from 17 teachers and 437 students from two local high schools in Hong Kong across a 10-school-day period. Multilevel path analysis results revealed that teachers' stress was significantly associated with teachers' nervousness and irritability. Teachers' nervousness, rather than irritability, was subsequently associated with higher levels of nervousness and irritability among students, which, in turn, impaired their in-class satisfaction. There was also a significant negative association between students' irritability and their academic motivation. Results further showed that teachers' stress arising from poor sleep quality was a significant antecedent of the teacher-student emotional crossover, subsequently affecting students' academic motivation and in-class satisfaction. The findings highlight the detrimental effects of teachers' poor sleep and the resulting stress on students' academic and affective experience. Discussion focuses on how to improve teachers' sleep and manage their stress so as to enhance students' in-class emotions and academic motivation.

Do reincarnation beliefs protect older adult Chinese Buddhists against personal death anxiety?

The aim of this exploratory survey study was to develop and validate a Buddhist reincarnation beliefs scale and explore the relation between Buddhist reincarnation beliefs and personal death anxiety in 141 older adult Hong Kong Chinese Buddhists. Buddhist reincarnation beliefs were unrelated to personal death anxiety. This suggests that not all religious afterlife beliefs have death anxiety buffering power as proposed by Terror Management Theory, perhaps because Buddhists view reincarnation not as a solace but rather as a renewal of sufferings due to unwholesome karma. Future cross-religion comparison studies could investigate the efficacy of reincarnation beliefs as a personal death anxiety defense mechanism in a Hindu sample.

Mortality anxiety as a function of intrinsic religiosity and perceived purpose in life.

Fear of dying and death may be universal, but individuals differ in their emotional reactions to dying and death. The present study included a sample of 133 Chinese university students who were Christians. The authors tested a mediation model which posited that intrinsic religiosity, but not extrinsic religiosity, lowered anxiety toward the dying and death of self and someone close through fostering perceived purpose in life. Structural Equation Modeling results supported a partial mediating role of purpose in life. Moreover, participants were more anxious toward the dying and death of someone close than those of themselves. Discussion focuses on the protective role of intrinsic religiosity on dying and death anxiety.

General beliefs about the world as defensive mechanisms against death anxiety.

Death ideation and death anxiety represent the cognitive and affective dimensions of death attitudes, respectively. General beliefs about the world are proposed to be useful defensive mechanisms protecting persons against the death anxiety provoked by death ideation. SEM is employed to test the proposed mediation model, using a sample of 133 Hong Kong Chinese university students. Results showed that death ideation was significantly and inversely linked to belief in social cynicism, reward for application, and fate control. Moreover, higher levels of belief in fate control and lower levels of religiosity predicted greater death anxiety. Only belief in fate control partially mediated the relationship between death ideation and death anxiety. Discussion focused on how social axioms serve as useful defensive mechanisms against death anxiety.