Children's mobile-gaming preferences, online risks, and mental health.

This study examined the relationships between children's mobile gaming preferences, online risks, and mental health. Data were obtained from a sample of 2,702 third and fourth grade students from 16 elementary schools in Taiwan and 9 schools in China. A self-administered questionnaire was used. The mental state of the children who participated in the study was assessed using the Strengths and Difficulties Questionnaire (SDQ), while mobile gaming addiction was assessed using the short form of the Internet Gaming Disorders Scale (IGDS9-SF). The results showed that about 54% of children played mobile games with others (multi-player), while 31% played mobile games alone, and 15% did not play mobile games. Multiple logistic regression results indicated that behaviors such as participating in multi-player games, playing violent games, a poor parent-child relationship, and living in a rural area were associated with a greater risk of mobile gaming addiction. Involvement in multi-player games, playing violent games, mobile gaming addiction, and exposure to mobile violence/pornography were associated with greater risks of cyber aggression/victimization. Multiple regression results showed that being a multi-player, playing violent games, mobile gaming addiction, exposure to violence/pornography, exposure to cyber aggression/victimization, and having a poor parent-child relationship were associated with emotional and behavioral problems.

Excessive Gaming and Online Energy-Drink Marketing Exposure Associated with Energy-Drink Consumption among Adolescents.

In this study, we examined excessive online gaming by adolescents and the resultant effects of their exposure to the online marketing of energy drinks and alcohol, and whether marketing literacy could serve as a mitigating factor. This cross-sectional study was conducted in 2020. Data were obtained from a sample of 2613 seventh-grade students from 30 middle schools in Taiwan. A self-administered questionnaire was conducted. The results showed that nearly 18% of the adolescent respondents had used energy drinks, while 75% reported seeing energy-drink advertisements on the internet in the past year. Multiple regression results indicated that factors such as being male, reporting excessive gaming, being exposed to higher levels of online energy-drink marketing, and reporting alcohol use were positively associated with energy-drink consumption. A higher level of online energy-drink marketing-affective literacy, however, was negatively associated with energy-drink consumption. In conclusion, factors that predicted energy-drink consumption among adolescents included excessive gaming and exposure to online energy-drink marketing, but marketing-affective literacy tended to lessen the impact of such advertising.

Smartphone addiction and victimization predicts sleep problems and depression among children.

BACKGROUND: In this study we examined the phenomena of smartphone addiction, online harassment, and school bullying/victimization to predict the prospective influence these could have on the onset and persistence of sleep problems and depression among children. METHODS: Responses from 2155 fifth-grade children recruited from 30 primary schools in Taipei were assessed, and a follow-up was performed in the 6th grade. Self-administered questionnaires were collected for each year. FINDINGS: Children who reported smartphone addictions, online harassment, and school bullying/victimization coupled with an increase in those factors were more likely to experience the onset and persistence of sleep problems. In addition, children who reported smartphone addiction, online harassment, school bullying/victimization, and poor sleep quality were more likely to experience the onset and persistence of depression. IMPLICATIONS: School nurses or pediatric nurses should be able to assess children's Internet use and risks to understand potential influences on sleep quality and mental status and provide recommendations for children, parents and schools.

A survey of PM2.5 preventive behavioral intention and related factors among community elderly in Northern Taiwan.

ABSTRACT: Population aging and air pollution are global concerns. The purpose of this study is to explore the relationship among particulate matter with a diameter of 2.5 µm or less (PM2.5) knowledge, PM2.5 preventive attitude, and PM2.5 preventive behavioral intention in the elderly.A cross-sectional survey design was applied in this study, including usage intention and snowball sampling. A total of 617 elderly people aged over 65 participated, and the collected data were quantitatively analyzed.The results showed that the mean score of PM2.5 knowledge of the elderly was 10.34 (79.53%) with the standard deviation (SD) of 3.42, the mean score of PM2.5 preventive attitude was 4.58 (91.60%) with SD of 0.49, and the mean score of PM2.5 preventive behavioral intention was 4.72 (94.40%) with SD of 0.40. Elderly people's characteristics regarding PM2.5 knowledge and PM2.5 preventive attitude explained 22% (adjusted R2 = 0.22, F = 30.44, P < .001) of the variance in PM2.5 preventive behavioral intention.It is concluded that we found no difference in PM2.5 knowledge, PM2.5 preventive attitude, or PM2.5 preventive behavioral intention among the elderly with or without chronic diseases. In our opinion, health education regarding the threat of PM2.5 to the health of the elderly should be strengthened, to enhance their knowledge, preventive attitude, and preventive behavioral intention of PM2.5.

Factors associated with patients' decision on colorectal cancer screening.

ABSTRACT: Cancer prevention and control are critical public health concerns. However, the screening uptake and referral rate for colorectal cancer (CRC) in Taiwan remain low. This study focused on the factors influencing whether a patient with a CRC diagnosis chooses to undergo referral follow-up.A cross-sectional research and used the Health Belief Model was method applied in this study. Variables such as demographic factors, CRC diagnosis-related knowledge factors, and health belief factors were employed to investigate the decisive factors that affect the health behavior of patients diagnosed with CRC who test positive on the fecal occult blood test. Study identified prospective participants in Daliao District, Kaohsiung City, Taiwan aged 50 to 75 years. A structured questionnaire was administered to the individuals, and 200 responded. The questionnaires of 100 who went for a referral group and 80 who did not a nonreferral group were analyzed. The questionnaire was reliable and valid, as determined through an expert evaluation and pretest, respectively.Among the 200 participants, T test indicated that those who underwent a referral were significantly more likely to be younger (Age [Mean ±â€ŠSD] n: 62.7, 7.1%; Unreferred group: n: 65.1, 7.0%; Referred group: n:60.7, 6.6%; P ≤ .001), be more educated (P = .002), exercise more (P < .05), and have more family members with cancer (P = .001) or CRC (P < .05). Participants who underwent a referral also had significantly more knowledge (P < .001). Furthermore, those who underwent a referral had significantly perceived greater susceptibility (P < .05), greater benefits (P = .002), and lower barriers (P < .001) of screening; they also received greater encouragement to do so from sources (e.g., clinicians or the media) around them (P = .009).Age, education level, number of family members with cancer or CRC, exercise habits, knowledge of CRC, perceived susceptibility, perceived benefits, perceived barriers, and encouragement from others influence referral behavior. Government policy should focus on older patients and health education, especially in the mass media. Hospitals should also ensure the ease of referrals to lower perceived barriers.

Soliciting organ donations by medical personnel and organ donation coordinators: A factor analysis.

The literature on organ donation in Taiwan lacks a discussion of the roles of medical staff, organ donors, and transplant coordinators in organ donation. The biggest plight of organ donation is lack of the organ donations. When we probed the possibilities of not finish the organ donation procedure, such as religions, traditions and cultural belief, disease cognitions, and the failure of persuasion or the loss of organ donors. There are lots of research literature shown that the attitude of medical personnel would influence the willingness of organ donation or persuasion. This study considered such personnel and their participation in organ donation, specifically analyzing factors influencing their effectiveness. Snowball sampling was adopted to recruit medical staff, organ donors, and transplant coordinators for an online survey. The results revealed that some participants were unclear as to how to initiate the organ donation process and what practical operations are involved. Even with the necessary qualifications, some participants remained passive when soliciting organ donations in clinical practice. Organ donation coordinators with experience in caring for organ donors who attended organ donation courses performed well in soliciting organ donations. The researchers recommend that training courses on clinical planning and organ donation are incorporated into intensive care training and that they serve as the basis for counsellors soliciting organ donations to increase nurses' willingness to solicit organ donations.

Using the health belief model to explore nursing students' relationships between COVID-19 knowledge, health beliefs, cues to action, self-efficacy, and behavioral intention: A cross-sectional survey study.

ABSTRACT: Nursing educators should equip nursing students with sufficient knowledge about coronavirus disease 2019 (COVID-19), perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy, and behavioral intention in order to prevent the spread of COVID-19.The purpose of this study was to use the health belief model to elucidate nursing students' relationships between knowledge about COVID-19, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy, and behavioral intention.A cross-sectional survey design was adopted and purposive sampling was utilized. A total of 361 nursing students participated in the study. Quantitative analysis was employed for all data analysis.The findings showed that the nursing students had the following mean scores on knowledge of COVID-19 9.43 [standard deviation (SD)1.19], perceived susceptibility 19.41 (SD2.68), perceived severity 20.31 (SD 4.09), perceived benefits 26.52 (SD 4.08), perceived barriers 15.17 (SD5.88), cues to action 3.30 (SD1.70), self-efficacy 17.68 (SD2.83), and behavioral intention 18.46 (SD2.33). Nursing students' demographic background, knowledge of COVID-19, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy explained 58.1% of the variance in behavioral intention (R2 = 0.581, F = 29.775, P < .001).Nursing educators can increase nursing students' knowledge of COVID-19, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy as effective means of health promotion to improve their behavioral intention to prevent the spread of COVID-19.

The effectiveness of a health promotion intervention on the meaning of life, positive beliefs, and well-being among undergraduate nursing students: One-group experimental study.

Nursing educators have a responsibility to value undergraduate nursing students' physical, psychological, spiritual, and social health promotion.The purpose of the study was to examine the effectiveness of a health promotion intervention concerning meaning of life, positive beliefs, and well-being among undergraduate nursing students in a health promotion curriculum.The study was adopted a pretest, posttest, and post post-test design in 1-group experimental study with a purposive sample of 112 undergraduate nursing students who attended in a health promotion curriculum and voluntarily completed a reliable 3-part questionnaire (content validity index = 0.95; Cronbach's αs = meaning of life, 0.97; positive beliefs, 0.94; and well-being 0.96).Undergraduate nursing students showed significant (all P < .001) improvements on the meaning of life, positive beliefs, and well-being immediately after the intervention, which were sustained over time.Nursing educators should incorporate these variables into the health promotion curriculum to enhance undergraduate nursing students' physical, psychological, spiritual, and social health promotion.

Simulated directed-learning in life-education intervention on the meaning of life, positive beliefs, and well-being among nursing students: A Quasi-experimental study.

Nursing educators have the responsibility to equip nursing students with knowledge about the meaning of life, positive beliefs, and well-being in order to enhance their physical, psychological, spiritual, and social health education and promotion. The purpose of this study was to explore nursing students' simulated directed-learning in a life-education intervention on the meaning of life, positive beliefs, and well-being in regard to immediate and delayed effects in improving physical, psychological, spiritual, and social health education and promotion.The method of this study was constituted a quasi-experimental design with experimental and control groups for pre-test, post-test, and post-post-test. Purposive sampling and non-random distribution were used in the study. Assigned to the experimental group, 54 participants were third-year nursing students enrolled in a health education course with simulated directed-learning in a life-education intervention. Assigned to the control group, 56 participants were third-year nursing students enrolled in a caring care course without simulated directed-learning in a life-education intervention. A 56-item questionnaire was utilized, and the content validity index (CVI) was 0.95, as determined by seven expert scholars. The reliability of the questionnaire (n = 45) on Cronbach's α were: meaning of life 0.96, positive beliefs 0.95, and well-being 0.96. The statistical package SPSS 23.0 was used to analyze all of the data in the study. Frequencies, percentages, pre-test mean and SD, post-test mean and SD, post-post-test mean and SD, chi-squared test, t test, and generalized estimating equation (GEE) were employed for data analysis.Nursing students in the experimental group compared with the control group exhibited significant differences in meaning of life on the pre-post-test (ß = 16.40, P < .001) and pre-post post-test (ß = 25.94, P < .001), positive beliefs on the pre-post-test (ß = 5.64, P < .01) and pre-post post-test (ß = 9.21, P < .001), and well-being on the pre-post-test (ß = 14.33, P < .001) and pre-post post-test (ß = 23.68, P < .001).Nursing students in the experimental group showed a significant improvement in the simulated directed-learning with a life-education intervention on meaning of life, positive beliefs, and well-being in the immediate and delayed effects that enhanced their physical, psychological, spiritual, and social health education and promotion.

Nursing students' relationships among meaning in life, well-being, and positive beliefs: A cross-sectional survey study.

Nursing educators have a core responsibility to develop nursing students' health promotion. The purpose of this study was to explore nursing students regarding their relationships among meaning in life, well-being, and positive beliefs. A cross-sectional survey design was adopted in this study. Purposive sampling was used. A total of 219 nursing students participated in the study. Quantitative analysis was utilized for the data analyses. The study found that nursing students had the following mean scores on the meaning in life, 4.33 (86.60%) standard deviation (SD) 0.79; well-being, 4.23 (84.60%) SD 0.78; and positive beliefs, 4.32 (86.40%) SD 0.75. The nursing students' characteristics, meaning in life, and well-being explained 79% of the variance in positive beliefs (adjusted R = 0.79, F = 114.57, P < .001). Nursing educators can promote meaning in life and well-being to nursing students as an effective way to increase their positive beliefs.

The Theory of Planned Behavior to Predict Protective Behavioral Intentions against PM2.5 in Parents of Young Children from Urban and Rural Beijing, China.

Smog and air pollution have fast become significant environmental problems and are attributed to rapid global industrialization and urbanization. Emissions of fine particulate matter with an aerodynamic diameter of ≤2.5 µm (PM2.5) increase smog and air pollution, with strong impacts on human health. Children are particularly vulnerable. While increasing studies are being conducted on the behaviors leading to PM2.5 toxicity from the perspective of environmental toxicants, there is a lack of research on factors influencing anti-PM2.5 behavioral intentions. Thus, this study aims to narrow this gap by adapting the theory of planned behavior framework to investigate the effects of attitude, subjective norms, and perceived behavioral control on protective behavioral intentions against PM2.5. In total, 1277 online questionnaires were collected from parents of young children living in urban and rural areas of Beijing, and the data was analyzed using correlation, regression, and path analyses. Results revealed that there were significant differences between parents from urban and rural areas in terms of attitude (t = 4.727 > 1.96, p < 0.001), subjective norms (t = 5.529 > 1.96, p < 0.001), perceived behavioral control (t = 6.155 > 1.96, p < 0.001), and anti-PM2.5 behavioral intentions (t = 6.838 > 1.96, p < 0.001). Path analysis revealed that parents from urban and rural areas had different behavioral intention paths. For urban parents, the findings indicated that subjective norms (ß = 0.73, t = 21.84 > 3.29) and perceived behavioral control (γ = 0.22, t = 6.12 > 3.29) had direct impacts on anti-PM2.5 behavioral intentions. In contrast, the attitudes (γ = 0.39, t = 3.74 > 3.29) and subjective norms (ß = 0.60, t = 8.55 > 3.29) of rural parents were found to directly influence anti-PM2.5 behavioral intentions.