Information needs, expectations, and treatment preference of patients considering spinal surgery: A case-control survey.

STUDY DESIGN: Case-control survey. OBJECTIVES: To explore intrapersonal factors associated with decision of patients with degenerative back pain for surgery. METHODS: From September 2018 to May 2019 patients were invited to complete a questionnaire. Patients who decided on (case) and declined surgery (control) were later confirmed from medical records. RESULTS: Seventy-five patients were recruited. Male patients (75.0%, p = 0.019), those who were married (78.7%, p = 0.0045), and had spousal care-givers (89.2%, p < 0.0001) were more likely to decide for surgery. All patients who decided on surgery expressed need for information on "the severity of their spine conditions" (p = 0.039). Those who decided on surgery did not have as the high expectation on "to sleep more comfortably" as those who declined (4.71 vs. 4.91, p = 0.022). The predictive factors for surgery decision by logistic regression analysis were: male gender (OR = 3.23, 95% CI: 1.19-8.77, p = 0.021); married (OR = 5.231, 95% CI: 1.87-14.61, p = 0.002); with available spousal care-giver (OR = 1.85, 95% CI: 0.198-3.89, p = 0.031); and those who preferred to treat/cure the spine disorder by pharmacological treatment (OR = 2.77, 95% CI: 1.02-7.50, p = 0.045). CONCLUSION: Patients who decided on surgery were likely to indicate need of medical information related to their condition. Patients were in hope of better relief of physical symptoms, especially related to sleep comfort. Patients would escalate their treatment from conservative to surgery when conservative treatments were no longer effective.

A systematic review on identifying risk factors associated with early sexual debut and coerced sex among adolescents and young people in communities.

AIMS AND OBJECTIVES: To review literature on identifying the risk factors associated with early sexual coerced debut with the aim to facilitate the healthcare workers' planning of relevant health services to improve intervention strategies for delaying of early coerced sexual debut or forced sexual debut (CSD/FSD) in the communities. BACKGROUND: Identifying the risk factors associated with coercion at first sex is crucial for developing appropriate sexual and reproductive health information and health promotion in response. However, current knowledge about the risk factors associated with coercion, sexual debut (SD) and delayed SD among young people is limited. Health information programmes are important during adolescence, when young people are developing their values and beliefs about sexual activity and sexual norms. However, little is known about those risk factors on initiation of early sexual debut to plan relevant interventions that can delay SD and prevent CSD/FSD in this population. DESIGN: A systematic review. METHODS: An extensive literature search using MEDLINE (PubMed), Nursing Journals (PubMed), Web of Science, PsychINFO and CINAHL. RESULTS: The search generated 39 published studies that met our inclusion and exclusion criteria. Thirty-two articles passed the quality appraisal and were selected. This review identified six domains of risk factors, categorised as: (1) the individual domain, (2) the family domain, (3) the partner/peer domain, (4) the school domain, (5) the community domain and (6) the cultural domain. These factors highlight the influences on sexual decision-making among adolescents and young people and the timing of their first sexual intercourse. CONCLUSION: It is important to use the outcome of this review's categorisation of identified risk factors to facilitate the healthcare workers and plan relevant sexual and reproductive health programmes more accessible to adolescents, especially young females and their parents. There is a need to evaluate the impact of these programmes that can delay SD and prevent CSD/FSD in this population. RELEVANCE TO CLINICAL PRACTICE: The results of this study could provide guidance on the planning of effective interventions for delaying of early CSD/FSD in the communities.

Parenting approaches and digital technology use of preschool age children in a Chinese community.

BACKGROUND: Young children are using digital technology (DT) devices anytime and anywhere, especially with the invention of smart phones and the replacement of desktop computers with digital tablets. Although research has shown that parents play an important role in fostering and supporting preschoolers' developing maturity and decisions about DT use, and in protecting them from potential risk due to excessive DT exposure, there have been limited studies conducted in Hong Kong focusing on parent-child DT use. This study had three objectives: 1) to explore parental use of DTs with their preschool children; 2) to identify the DT content that associated with child behavioral problems; and 3) to investigate the relationships between approaches adopted by parents to control children's DT use and related preschooler behavioral problems. METHODS: This exploratory quantitative study was conducted in Hong Kong with 202 parents or guardians of preschool children between the ages of 3 and 6 attending kindergarten. The questionnaire was focused on four aspects, including 1) participants' demographics; 2) pattern of DT use; 3) parenting approach to manage the child's DT use; and 4) child behavioral and health problems related to DT use. Multiple regression analysis was adopted as the main data analysis method for identifying the DT or parental approach-related predictors of the preschooler behavioral problems. RESULTS: In the multiple linear regression model, the 'restrictive approach score' was the only predictor among the three parental approaches (B:1.66, 95% CI: [0.21, 3.11], p < 0.05). Moreover, the viewing of antisocial behavior cartoons by children also significantly increased the tendency of children to have behavioral problem (B:3.84, 95% CI: [1.66, 6.02], p < 0.01). CONCLUSIONS: Since preschool children's cognitive and functional abilities are still in the developmental stage, parents play a crucial role in fostering appropriate and safe DT use. It is suggested that parents practice a combination of restrictive, instructive and co-using approaches, rather than a predominately restrictive approach, to facilitate their child's growth and development. Further studies are needed to explore the parent-child relationship and parents' self-efficacy when managing the parent-child DT use, to develop strategies to guide children in healthy DT use.