The health literacy of Hong Kong Chinese parents with a healthy preschool child in seasonal influenza prevention and their health promotion strategies at the household level

University of Technology Sydney. Faculty of Health.[Background] Seasonal influenza is a public health concern in Hong Kong. The virus is easily transmitted from person-to-person through droplet and direct contact. Yearly influenza epidemics can seriously affect all age groups particularly those with immature or compromised immune systems such as young children and old people with chronic illness. A Hong Kong preparedness plan and response activities for community prevention of influenza epidemics have been developed. However, compliance rates remain low. Many health behaviours are learned during childhood through parental modeling, guidance, supervision, reminders and repeated practice. Therefore, improving the health literacy of parents through supportive activities is critical. [Methods] Mixed methods research employing a multiple-case study approach was used to gain a multifaceted understanding of parents’ health literacy, culture influences and parental-child teaching regarding seasonal influenza prevention and related health promotion strategies. Twenty Hong Kong Chinese parents with a healthy three-to-five year old child from three kindergartens were recruited. A qualitative thematic analysis was employed and quantitative survey data were examined descriptively. These data were integrated and comprehensive comparisons were made across cases to identify commonalities and differences. [Results] Hong Kong Chinese parents demonstrated different levels of functional, interactive and critical health literacy to prevent seasonal influenza. Parents used various social connections including family and community members, social media, the internet and television to access and exchange health information. Cultural values and norms influenced parents’ functional health literacy in seasonal influenza prevention. In this study, parents applied five major cultural health prevention practices to prevent and manage influenza. These are: sharing beds with family members or a domestic helper when the child is ill; boiling white vinegar to kill air-born germs to ensure a healthy environment; diet therapy to enhance health; self-prescribed Chinese medication to manage child’s cold symptoms; and the co-use of Western and traditional Chinese medication to avoid influenza infection. This study also identified five approaches Hong Kong Chinese parents used to teach their children healthy practices including ways to prevent influenza. These approaches included: processes parents used to teach personal hygiene; parent-child interactions during teaching; approaches to managing children’s health behaviours; enhancing children’s healthy practices; and parents’ perspective of the role of the nurse in health promotion. The findings indicate that there is scope to better support parents to apply interactive approaches to help their children establish healthy behaviours. [Conclusion] This study has provided a comprehensive understanding of parental health literacy and the teaching approaches used by selected Hong Kong parents to protect their children against seasonal influenza that may be transferrable to other Hong Kong settings. The findings highlight the need for community nurses to play a central role in increasing parents’ health literacy. Pluralistic health systems need to review seasonal influenza preparedness plans to better engage families to support and comply with health advice before the onset of an epidemic. Positive parent-child interaction and teaching should be integrated into health promotion programmes to enhance children’s understanding and compliance with healthy practices

A Descriptive and Phenomenological Exploration of the Spiritual Needs of Chinese Children Hospitalized with Cancer

Spiritual well-being is the fourth dimension of health, as equally important as physical, mental, and social well-being. The shadow of death associated with cancer triggers children to explore their personal values, meanings, and life goals throughout the illness trajectory, enabling them to identify their unique spiritual needs. Chinese children are generally non-religious, unlike Western children, which affects their spiritual needs. To address the literature gaps, we applied a qualitative, descriptive, phenomenological approach for exploring the spiritual needs of Chinese children hospitalized with cancer. Purposive sampling was conducted in two public hospitals with special wards for pediatric oncology patients in Hunan Province, China. Consequently, 22 children, hospitalized with cancer, were recruited and individually interviewed using a semi-structured interview format. We conducted a thematic analysis of the interview transcripts. Four important themes were identified: the need for self-exploration, inner needs, need for a connection with others, and need for a connection with gods, supernatural powers, and fictional characters. We found that culture significantly influenced the spiritual needs of Chinese children with cancer. Hope was a key factor motivating the children to continue cancer treatment. To address their unique spiritual needs, culturally specific interventions should be developed and incorporated into their care to enhance their spiritual well-being

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. © 2014 WU et al.; licensee BioMed Central Ltd.Link_to_subscribed_fulltex