Play interventions to reduce anxiety and negative emotions in hospitalized children

© 2016 LI et al. Background: Hospitalization is a stressful and threatening experience, which can be emotionally devastating to children. Hospital play interventions have been widely used to prepare children for invasive medical procedures and hospitalization. Nevertheless, there is an imperative need for rigorous empirical scrutiny of the effectiveness of hospital play interventions, in particular, using play activities to ease the psychological burden of hospitalized children. This study tested the effectiveness of play interventions to reduce anxiety and negative emotions in hospitalized children. Methods: A non-equivalent control group pre-test and post-test, between subjects design was conducted in the two largest acute-care public hospitals in Hong Kong. A total of 304 Chinese children (ages 3-12) admitted for treatments in these two hospitals were invited to participate in the study. Of the 304 paediatric patients, 154 received hospital play interventions and 150 received usual care. Results: Children who received the hospital play interventions exhibited fewer negative emotions and experienced lower levels of anxiety than those children who received usual care. Conclusion: This study addressed a gap in the literature by providing empirical evidence to support the effectiveness of play interventions in reducing anxiety and negative emotions in hospitalized children. Findings from this study emphasize the significance of incorporating hospital play interventions to provide holistic and quality care to ease the psychological burden of hospitalized children. Trial registration: ClinicalTrials.gov NCT02665403. Registered 22 January 2016.published_or_final_versio

Factors contributing to the psychological well-being for Hong Kong Chinese children from low-income families: A qualitative study

© 2016 The Author(s). Background: Despite compelling evidence demonstrating the negative impact of poverty and income disparity on children's psychological well-being, there has been a lack of qualitative information which addresses its contributing factors. This study aimed to shed light on this area by comparing the experiences toward daily life between children living in low- and high-income families. Methods: A qualitative study using a phenomenological approach was conducted from May 2012 to January 2013. A random sample of 42 children aged 10-13, with 25 from low- and 17 from high-income families were asked to voluntarily response to a demographic sheet and undergo individual semi-structured interviews which lasted about 25-30 min. Content analysis was used to analyze the data. Approval for the study was obtained from the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (reference UW 12-237). Results: The findings of this study revealed that the living environment, physical health, social life and ability to function at school of children from low-income families are severely impaired. Conclusions: It fills a gap in the literature by showing how poverty and income disparity affect the daily lives of children from low-income families on different levels. Also, adopting a sedentary lifestyle and unhealthy eating habits are possible factors mediating the effects of poverty and income disparity on the psychological well-being of children from low-income families. It is vital for healthcare professionals going beyond their normal roles to give advice on healthy lifestyles and behaviors by building multidisciplinary partnerships with schools and the community. Additionally, healthcare professionals should also target on these two possible factors to develop and implement appropriate interventions for promoting the psychological well-being among children living in poverty. Trial registration NCT02877719. 19 August 2016 retrospectively registeredpublished_or_final_versio

Genome-Wide Association Study of Hepatocellular Carcinoma in Southern Chinese Patients with Chronic Hepatitis B Virus Infection

One of the most relevant risk factors for hepatocellular carcinoma (HCC) development is chronic hepatitis B virus (HBV) infection, but only a fraction of chronic HBV carriers develop HCC, indicating that complex interactions among viral, environmental and genetic factors lead to HCC in HBV-infected patients. So far, host genetic factors have incompletely been characterized. Therefore, we performed a genome-wide association (GWA) study in a Southern Chinese cohort consisting of 95 HBV-infected HCC patients (cases) and 97 HBV-infected patients without HCC (controls) using the Illumina Human610-Quad BeadChips. The top single nucleotide polymorphisms (SNPs) were then validated in an independent cohort of 500 cases and 728 controls. 4 SNPs (rs12682266, rs7821974, rs2275959, rs1573266) at chromosome 8p12 showed consistent association in both the GWA and replication phases (ORcombined = 1.31–1.39; pcombined = 2.71×10−5–5.19×10−4; PARcombined = 26–31%). We found a 2.3-kb expressed sequence tag (EST) in the region using in-silico data mining and verified the existence of the full-length EST experimentally. The expression level of the EST was significantly reduced in human HCC tumors in comparison to the corresponding non-tumorous liver tissues (P<0.001). Results from sequence analysis and in-vitro protein translation study suggest that the transcript might function as a long non-coding RNA. In summary, our study suggests that variations at chromosome 8p12 may promote HCC in patients with HBV. Further functional studies of this region may help understand HBV-associated hepatocarcinogenesis

Effectiveness of an integrated adventured-based training and health education programme in promoting the adoption and maintenance of regular physical activity among childhood cancer survivors

Background. Research indicates that increased survival rates are accompanied by an increase in associated physical and psychological problems. Whereas much of the attention has focused on the physiological care of childhood cancer survivors, the consequences of cancer and its treatments on psychological well-being remain relatively underexplored. Aims. The aims of the thesis were threefold: (1) describe the psychological well-being and quality of life; (2) assess the physical activity levels; and (3) examine the effectiveness of an integrated adventure-based training and health education program in promoting change in exercise behavior and enhancing physical activity, self-efficacy, and quality of life among Hong Kong Chinese childhood cancer survivors. Methods. Prior to the intervention study, the psychometric properties of two instruments (the Chinese Version of the Center for Epidemiologic Studies Depression Scale for Children and Coping Behaviour Checklist for Chinese Children) were evaluated and two descriptive studies were conducted to examine the psychological well-being, quality of life and physical activity level of Hong Kong Chinese childhood cancer survivors. A RCT, two-group pretest and repeated post-test, between-subjects design was then conducted in 71 childhood cancer survivors (aged 9-16-year olds). Thirty-four participants in the experimental group joined a four-day integrated adventure-based training and health education program. Thirty-seven participants in the control group received placebo intervention. Participants' exercise behavior, level of physical activity, self-efficacy, and quality of life were assessed at recruitment, and at three-, six-, and nine-month after the intervention. Results. The psychometric properties of the Center for Epidemiologic Studies Depression Scale and the Coping Behaviour Checklist for Chinese Children were confirmed. The first descriptive study showed that a significant number of children have high level of depression, low self-esteem, and undermined quality of life. The second descriptive study indicated that a significant decline in physical activity levels among childhood cancer survivors and most of them did not take physical exercise regularly. The intervention study revealed that participants in the experimental group reported statistically significant difference in physical activity stages of change, higher levels of physical activity, self-efficacy, and quality of life than those in the placebo control group from baseline to 9 months after starting the intervention. Conclusions. The two descriptive studies provided a thorough understanding of the psychological well-being and physical activity level of Hong Kong Chinese childhood cancer survivors. Most importantly, the intervention study addressed a gap in the literature by developing and evaluating the effectiveness of an integrated adventure-based training and health education program for promoting regular physical activity among childhood cancer survivors. In addition, this study demonstrated that it is feasible to implement such program in Hong Kong. The content, nature, and duration of the program appeared to be acceptable to the children and parents. Implications for practice. The study raises the awareness of regular physical activity in promoting physical and psychological well-being for childhood cancer survivors. Given the long-term health benefits, healthcare professionals should advocate regular exercising among childhood cancer survivors. This study also illustrates that the adventure-based training program is effective in promoting regular physical activity among childhood cancer survivors

Predisposing Factors to the Quality of Life of Childhood Cancer Survivors

The aim of this study was to examine the predisposing factors to the quality of life of Hong Kong Chinese childhood cancer survivors. A cross-sectional study was conducted with 153 survivors (9-16 years of age) during follow-up at the oncology outpatien

Effectiveness of an integrated adventure-based training and health education program in promoting regular physical activity among childhood cancer survivors

Background: There is growing concern about declining levels of physical activity in childhood cancer survivors. This study aimed to examine the effectiveness of an integrated adventure-based training and health education program in promoting changes in e

A descriptive study of the psychosocial well-being and quality of life of childhood cancer survivors in Hong Kong

BACKGROUND: Research indicates that increased survival rates are accompanied by an increase in associated psychosocial problems. Whereas much of the attention has focused on the physiological care of childhood cancer survivors, the consequences of cance