Utilization of the Youth Quitline as an opportunity for an undergraduate nursing students to deliver smoking cessation counseling as their clinical placement: An implementation of a service-learning model.

BACKGROUND: Smoking is an important modifiable risk factor of morbidities and mortality. Although healthcare professionals play an important role in smoking cessation, their adoption of such practices is relatively low because of inadequate training. To address this issue, we incorporated a service-learning model to operate the Youth Quitline. Undergraduate nursing students were trained and received supervision while delivering smoking cessation counseling through the Youth Quitline as their clinical placement. OBJECTIVES: We evaluated the effectiveness of the placement by assessing students' knowledge, attitudes and practices regarding smoking cessation and tobacco control. DESIGN: One-group pretest-posttest design. SETTING: Youth Quitline. PARTICIPANTS: A total of 61 third-year students in a mental health nursing program. METHODS: Students were required to complete 80 h at the Youth Quitline. The 80 h were divided into 20 sessions; students used four sessions to approach and recruit youth smokers in the community, then provided them with telephone counseling for the rest of the time. Prior to the placement, students attended a 2-day workshop. The outcomes were changes in students' knowledge, attitudes and practices regarding smoking cessation and tobacco control 3 months after the placement compared with baseline. RESULTS: From January-June 2021, students conducted 105 outreach activities to identify 3142 smokers in the community, and provided telephone counseling for 336 smokers via Youth Quitline. Compared with baseline, significant improvements were observed in students' knowledge, attitudes and practices regarding smoking cessation and tobacco control at 3-month follow-up. CONCLUSIONS: The clinical placement improved students' knowledge, attitudes and practices regarding smoking cessation and tobacco control, enhancing their competency in providing support to assist smokers to quit in their future practice. Incorporating the service-learning model in existing community-based services can provide additional venues for nursing students to practice. This is particularly important because many venues have restricted access during the COVID-19 pandemic.

The association of peer pressure and peer affiliation with the health risk behaviors of secondary school students in Hong Kong.

OBJECTIVE: The aim of this study was to explore the relationship between peer pressure and the health risk behaviors of secondary school students. STUDY DESIGN: Cross-sectional study using a self-completed questionnaire. METHODS: Secondary school students in Year 3 were the target population of this study. Information was solicited from students on their perceptions of peer pressure using a questionnaire employing the Peer Pressure Inventory and their involvement in risk behaviors using a modified global school-based student health survey. RESULTS: A total of 840 secondary students from Hong Kong completed the questionnaires. The prevalence of secondary students who had ever smoked was 6.4%, consumed alcohol 39.2%, ever used drugs 0.5%, were sexually active 3.9%, and involved in bullying 20.5%. A higher proportion of secondary students involved in risk behaviors were affiliated with peers who were involved in the same activities: smoking (48.9%), drinking alcohol (86.5%), using drugs (18.2%), engaged in sexual activity (34.5%), and bullying (82.6%). The perception of peer conformity and peer involvement was found to be significantly correlated with the students' health risk behaviors, particularly with regard to smoking, drinking alcohol, and bullying. A logistic regression analysis showed that having friends who are involved in the same risk behaviors is the single most important factor associated with the participation of secondary students in those specific risk behaviors. CONCLUSIONS: The results of this study provided a better understanding of the association between peer pressure and the adoption of health behaviors. The development of effective peer-led prevention programs to reduce the uptake of health risk behaviors should therefore be promoted to prevent adolescents from developing serious health problems.

A community-wide school health project for the promotion of smoke-free homes.

BACKGROUND: A community-wide school health project for the promotion of smoke-free homes was launched in June 2010 with the aim of promoting the benefits of smoke-free homes to all school-aged children (aged 6-18), and indirectly to their parents and family members. The 1-year project included health talks on a smoke-free life; the distribution of educational leaflets; slogan and visual art competitions; and a health fair held in June 2011. Two sets of questionnaires were developed to solicit a resolution and action from the participants regarding the establishment of a smoke-free home, and their decision to stay smoke-free. This is a paper to report on the activities of this project, the attempts to reach out to school-aged children, and their indications of agreement with, support for, and commitment to promoting smoke-free homes. RESULTS: The project reached an estimated 12,800 school-aged children in Hong Kong. A large proportion of those received educational leaflets (69.6-88.2 %). Of those who participated in the health fair, 69.7-87.6 % agreed to promote the concept of smoke-free homes to friends and family. More primary than secondary students pledged to not take up smoking (90.8 vs 85.8 %). About 82 % of those who had experimented with smoking pledged to stop. A small proportion of them reported already having established a smoke-free policy at home (14.9 %), placed a 'No Smoking' sign at home (16.4 %), informed visitors of their smoke-free policy at home (12.9 %), and asked visitors to dispose of lit cigarettes before entering their home (15.9 %). DISCUSSION: This community-wide school health project on the benefits of smoke-free homes reached a large number of students, and indirectly to family members, and home visitors. Public health efforts of this kind should be continued to reach younger generations and the general public.

Spouses' experience of caregiving for cancer patients: a literature review.

BACKGROUND: The spouse is generally the primary informal caregiver for cancer patients. Many studies have explored the experience of caregiving for cancer patients, but it is unclear whether there are gender differences in the spousal caring experience for cancer patients. AIM: This review describes the recent published research on the stress process of spousal caregiving experience for cancer patients, and aims to identify any gender differences in the caregiving experience. METHODS: Electronic, manual and author's searches were conducted. Articles included were published in English and Chinese, from January 2000 to March 2012. Study population is couples coping with cancer. Focus is on caregiving experience for spouse with cancer, and findings include both male and female spousal caregivers in quantitative studies. The databases searched included MEDLINE, CINAHL, Science Citation Index Expanded, Scopus, PsycINFO and the China Academic Journal Full-text Database. The key search terms used were 'cancer' or 'oncology' or 'carcinoma' AND 'caregiver' or 'caregiving' or 'carer' AND 'gender differences' or 'gender' AND 'spouse' or 'couple' or 'partner'. Spousal caregiving experiences of cancer patients were explored by adopting the 'stress process' of the Cancer Family Caregiving Experience Model from the gender perspective. RESULTS: Twenty-five articles were identified and included in this review. It was revealed that female spousal caregivers perceived higher level negative experience in caregiving, such as lower mental health, lower physical health, poorer health-related quality of life, lower life satisfaction and decreased marital satisfaction than male spousal caregivers. However, female spousal caregivers are more likely to experience personal growth than male spousal caregivers. CONCLUSION: This review identified that female spousal caregivers for cancer patients had higher levels of negative experience in caregiving. A better understanding of the spousal caregiving experience will provide healthcare professionals with the information needed to develop interventions to support and prepare spousal caregivers to care for their loved ones with cancer.

Building life-long learning capacity in undergraduate nursing freshmen within an integrative and small group learning context.

BACKGROUND: Life-long learning involves the development of skills in critical thinking (CT), effective group process (GP), and self-directedness (SDL). Recent studies have shown that small group learning with active interactions is effective in enabling students to develop themselves as independent learners beyond graduation. With a view to integrative learning, the purpose of this study was to evaluate life-long learning outcomes through the work of small group teaching and learning for a class of undergraduate nursing freshmen during one academic year. METHODS: A mixed-methods approach was used to evaluate the CT, GP and SDL of 99 freshmen with a self-assessment questionnaire before and after their learning activities in three nursing courses, and to identify themes from a total of six focus group interviews with the students and teachers. RESULTS: The CT, GP and SDL results obtained from self-assessment did not indicate significant differences. Four themes emerged from the qualitative analysis. DISCUSSION: Many factors contributed to the results on life-long learning skill development of students in this study. The qualitative analysis provided good insights for future teaching and learning development. CONCLUSIONS: With a developmental perspective, life-long learning may be better developed and evaluated over a longer period of time in the nursing program.

The application of family-nursing assessment skills: from classroom to hospital ward among final-year nursing undergraduates in Hong Kong.

BACKGROUND: There is little research on nursing students' application of family health assessment in clinical practice. OBJECTIVE: To examine the effect of an elective course, Family in Health and Illness (FHI), on year 4 nursing students' family health assessment and practice. METHODS: A quasi-experimental design was used. One hundred and twenty students completed pre- and post-course questionnaires, after taking FHI (n=49) or a course in Women's Health (WH; n=71) in a baccalaureate nursing program in Hong Kong. Students rated their interest in family assessment and appraised their own confidence and competence in practicing family nursing before the courses commenced, immediately after, and three months post course completion. In addition, their perceived ease of applying family assessment in practice was measured. RESULTS: Students who had taken FHI reported significantly higher interest than those who had not immediately after the course and three months later. The perceived ease of functional assessment immediate after the course was the only predictor of confidence and competence in practicing family nursing (B=0.76, 95% CI=1.37-8.23, p=0.011) at the 3-month follow-up after controlling for age and baseline measures. Level of interest (B=0.44, 95% CI=4.55-0.13, p=0.040) was an additional predictor of nurse-patient relationship at the 3-month follow-up. CONCLUSION: Educational input to nursing students may foster their interest and confidence in working with families in clinical settings. Further studies are needed to examine the factors impeding actual application of family nursing assessment.

A brief cognitive-behavioral stress management program for secondary school teachers.

OBJECTIVE: This study aimed to assess the efficacy of a brief cognitive-behavioral program that was designed to reduce the work-related stress levels of secondary school teachers. METHODS: A quasi-experimental design was used to compare the intervention groups with the wait-list control groups. Seventy teachers from the intervention groups and 54 from the control groups completed a set of validated scales at the baseline and 3-4 wk later. The scales included the Depression Anxiety Stress Scale, the Dysfunctional Attitude Scale-Form A, the Health-Promoting Lifestyle Profile II, and the Occupational Stress Inventory Revised Edition. RESULTS: After controlling for the baseline measures, the intervention groups had significantly lower role stress, personal strain and overall work-related stress 3-4 wk after the baseline measurements. The intervention groups also had significantly higher stress management behaviors, and less general stress and dysfunctional thoughts than the control groups (all p≤0.05). The levels of dysfunctional thoughts and stress management behaviors significantly predicted general stress after intervention and personal resource deficits. The level of dysfunctional thoughts also predicted the personal strain of work-related stresses (all p<0.05). CONCLUSIONS: The brief program reported in this study was efficacious in reducing the work-related stress of secondary teachers. Teachers experienced less work-related stress after the program, and they reported reduced dysfunctional thoughts and enhanced stress management behaviors. This program may be considered as an initial strategy for teachers to develop skills to cope with their work-related stress in the short term and could be incorporated with other strategies to achieve longer-term effects.

Household smoking practices of parents with young children, and predictors of poor household smoking practices.

OBJECTIVES: Household smoking practices of parents have a major impact on the health of their young children. This study examined the characteristics and household smoking practices of parents with children aged 4-5 years, and identified the predictive factors of poor household smoking practices among Chinese parents in Hong Kong. STUDY DESIGN: Cross-sectional survey. METHODS: Smoking parents with young children from a 1997 birth cohort were re-contacted for a telephone interview to assess their household smoking practices. RESULTS: Among 1149 smoking parents from 1049 families, 898 (85.6%) parents smoked at home. Of these, 339 (37.8%) parents reported smoking at home but not near (i.e. within 3 metres) their children, and 559 (62.2%) reported that they smoked at home without any restrictions. Logistic regression revealed that the predictors of poor household smoking practices were: smoking mother [odds ratio (OR) 4.92, P<0.001]; children born with normal birth weight (OR 2.62, P<0.05); having more than one child (OR 1.70, P=0.01); being a daily smoker (OR 18.96, P<0.0001); smoking >or= 11 cigarettes per day (OR 3.10, P<0.0001); having a higher Fagerstorm nicotine dependence score (OR 4.57-4.86, P<0.01); and having a smoking partner (OR 2.78, P<0.05). CONCLUSIONS: A high proportion of smoking parents with young children display poor smoking practices at home. It is of the utmost importance that community education and smoking cessation services are targeted at these smoking parents to promote smoke-free families.

The role of phospholipase D and phosphatidic acid in the mechanical activation of mTOR signaling in skeletal muscle.

Signaling by the mammalian target of rapamycin (mTOR) has been reported to be necessary for mechanical load-induced growth of skeletal muscle. The mechanisms involved in the mechanical activation of mTOR signaling are not known, but several studies indicate that a unique [phosphotidylinositol-3-kinase (PI3K)- and nutrient-independent] mechanism is involved. In this study, we have demonstrated that a regulatory pathway for mTOR signaling that involves phospholipase D (PLD) and the lipid second messenger phosphatidic acid (PA) plays a critical role in the mechanical activation of mTOR signaling. First, an elevation in PA concentration was sufficient for the activation of mTOR signaling. Second, the isozymes of PLD (PLD1 and PLD2) are localized to the z-band in skeletal muscle (a critical site of mechanical force transmission). Third, mechanical stimulation of skeletal muscle with intermittent passive stretch ex vivo induced PLD activation, PA accumulation, and mTOR signaling. Finally, pharmacological inhibition of PLD blocked the mechanically induced increase in PA and the activation of mTOR signaling. Combined, these results indicate that mechanical stimuli activate mTOR signaling through a PLD-dependent increase in PA. Furthermore, we showed that mTOR signaling was partially resistant to rapamycin in muscles subjected to mechanical stimulation. Because rapamycin and PA compete for binding to the FRB domain on mTOR, these results suggest that mechanical stimuli activate mTOR signaling through an enhanced binding of PA to the FRB domain on mTOR.