Cervical cancer screening: knowledge, health perception and attendance rate among Hong Kong Chinese women

Sharron SK Leung1, Ivy Leung21School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong; 2Quality Healthcare Medical Services, Hong KongPurpose: Cervical cancer screening has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. However, cervical screening attendance rates are still far from satisfactory in many countries. Strategies, health promotion and education programs need to be developed with clear evidence of the causes and factors relating to the low attendance rate. The study aims to assess the prediction of cervical screening attendance rate by Chinese women’s knowledge about cervical cancer and cervical screening as well as their perception of health.Patients and methods: A survey with self-reported questionnaires was conducted on 385 Chinese women recruited from a community clinic in Hong Kong. Participants were Chinese women, Hong Kong residents, aged 18–65 years, able to read Chinese or English, and were not pregnant.Results: Women aged 37 years or less, with at least tertiary education, who perceived having control over their own health and had better knowledge on risk factors, were more likely to attend cervical cancer screening. Many participants had adequate general knowledge but were unable to identify correct answers on the risk factors.Conclusion: Health promotion efforts need to focus on increasing women’s knowledge on risk factors and enhancing their perceived health control by providing more information on the link between screening and early detection with lower incidence rates and mortality from cervical cancer.Keywords: cervical screening attendance, cervical cancer, health perception and knowledge, perceived health control, Chines

Study protocol for "Moving bright, eating smart"- a phase 2 clinical trial on the acceptability and feasibility of a diet and physical activity intervention to prevent recurrence in colorectal cancer survivors

Background: Colorectal cancer is the second most common cancer and cancer-killer in Hong Kong with an alarming increasing incidence in recent years. The latest World Cancer Research Fund report concluded that foods low in fibre, and high in red and processed meat cause colorectal cancer whereas physical activity protects againstcolon cancer. Yet, the influence of these lifestyle factors on cancer outcome is largely unknown even though cancer survivors are eager for lifestyle modifications. Observational studies suggested that low intake of a Western-pattern diet and high physical activity level reduced colorectal cancer mortality. The Theory of PlannedBehaviour and the Health Action Process Approach have guided the design of intervention models targeting a wide range of health-related behaviours.Methods/design: We aim to demonstrate the feasibility of two behavioural interventions intended to improve colorectal cancer outcome and which are designed to increase physical activity level and reduce consumption of a Western-pattern diet. This three year study will be a multicentre, randomised controlled trial in a 2x2 factorialdesign comparing the “Moving Bright, Eating Smart” (physical activity and diet) programme against usual care. Subjects will be recruited over a 12-month period, undertake intervention for 12 months and followed up for a further 12 months. Baseline, interim and three post-intervention assessments will be conducted. Two hundred and twenty-two colorectal cancer patients who completed curative treatment without evidence of recurrence will be recruited into the study. Primary outcome measure will be whether physical activity and dietary targets are met at the end of the 12-month intervention. Secondary outcome measures include the magnitude andmechanism of behavioural change, the degree and determinants of compliance, and the additional health benefits and side effects of the intervention.Discussion: The results of this study will establish the feasibility of targeting the two behaviours (diet and physical activity) and demonstrate the magnitude of behaviour change. The information will facilitate the design of a further larger phase III randomised controlled trial with colorectal cancer outcome as the study endpoint to determine whether this intervention model would reduce colorectal cancer recurrence and mortality

Physical activity intervention in cancer survivors : a systematic review and meta-analysis of randomized controlled trials

Proffered paper session: Information, patients and the public/ Survivorship and end of life careBackground The aim was to systematically review all published randomized controlled trials (RCTs) which tested the effect of a physical activity intervention in adult cancer survivors after the main cancer treatment. Method Relevant RCTs were located by: (1) systematic searching of electronic databases (PUBMED and Google Scholar) using cancer-related and exercise-related search terms; and (2) scanning the references of retrieved RCTs and relevant reviews. All relevant RCTs were retrieved and assessed to determine if they met the selection criteria. Data extraction was independently performed by two investigators and followed by a discussion to reach consensus. The main outcome measures were cancer outcome (survival and recurrence), quality of life (QoL), body composition and functional capacity. Results A total of 2,447 citations were identified of which 170 potentially relevant ones were examined in detail. Forty-five papers met the selection criteria of which 41 reported data on at least one relevant outcome. These encompassed 18 papers not included in previously published reviews. Twenty-six papers (63.4%) were on breast cancers and the remaining papers were on other cancers. There was a paucity of published data on the effects of physical activity interventions on cancer outcome. Various instruments were used to assess the other outcomes (QoL and functional capacity) limiting the pooling of data for meta-analysis. Estimates of the effects of physical activity interventions on QoL, body composition and functional capacity were determined. Potential determinants of the effect heterogeneity across studies were evaluated. Conclusion Moderately-strong-to-strong evidence was found for a positive effect of physical activity interventions on QoL of adult cancer survivors following main cancer treatment. Clinically meaningful associations were identified between such interventions and improved functional capacity. The observed heterogeneity in study design and outcome parameters highlighted the need for the development of a standardized protocol to facilitate meta-analysis on the effects of physical activity in cancer survivors. Acknowledgements This study has been supported by WCRF UK, WCRF International and WCRF Hong Kong

Physical activity for cancer survivors: meta-analysis of randomised controlled trials

Objective To systematically evaluate the effects of physical activity in adult patients after completion of main treatment related to cancer

A brief cognitive-behavioral psycho-education (B-CBE) program for managing stress and anxiety of main family caregivers of patients in the intensive care unit

© 2016 by the authors; licensee MDPI, Basel, Switzerland. Having a loved one in the intensive care unit (ICU) is a stressful event, which may cause a high level of anxiety to the family members. This could threaten their wellbeing and ability to support the patients in, or after discharge from, the ICU. To investigate the outcomes of a brief cognitive-behavioral psycho-education program (B-CBE) to manage stress and anxiety of the main family caregivers (MFCs), a pragmatic quasi-experimental study involving 45 participants (treatment group: 24; control group: 21) was conducted in an ICU. The Depression and Anxiety Stress Scale and the Critical Care Family Need Inventory were used to evaluate the primary outcomes on stress and anxiety, and satisfaction with family needs. The treatment group reported significantly better improvement in the information satisfaction score compared to the control group (p < 0.05; η 2 = 0.09). Overall main effects were observed on the stress (p < 0.01; η 2 = 0.20), anxiety (p < 0.01; η 2 = 0.18), depression (p < 0.05; η 2 = 0.13), support satisfaction (p < 0.05; η 2 = 0.13), and comfort satisfaction (p < 0.05; η 2 = 0.11) scores. The experience of this study suggest that MFCs are in great need of additional support like B-CBE to manage their stress and anxiety. Given the brevity of B-CBE, it is practical for critical care nurses to deliver and MFCs to take within the industrious context of an ICU. More studies are needed to investigate these types of brief psychological interventions.published_or_final_versio

Dietary and Physical Activity Interventions for Colorectal Cancer Survivors: A Randomized Controlled Trial

Abstract There has been evidence on the protective effects of diets high in fiber and low in red and processed meat (RPM), and physical activity (PA) against colorectal cancer (CRC) development, but that against CRC recurrence has been limited. This study evaluated the efficacy of a behavioral program comprising dietary and PA interventions in improving Chinese CRC survivors’ lifestyle. A 2 × 2 factorial randomized controlled trial of 223 CRC patients (82 females, mean age 65), randomly assigned to receive dietary, PA or both interventions, or usual care for 12 months, and assessed every 6 months for 24 months. Primary outcomes included two dietary and two PA targets. Secondary outcomes included changes in dietary consumptions and PA levels. Dietary interventions significantly increased the odds of achieving the targets of consuming less RPM at all time-points (OR 3.22–4.57, all p < 0.01) and refined grain (RG) at months 6 (OR 3.13, p = 0.002) and 24 (OR 2.19, p = 0.039), and reduced RPM (2.49–3.48 servings/week, all p < 0.01) and RG (0.31–0.5 servings/day, all p < 0.01) consumptions. Patients receiving PA interventions potentially spent more time on moderate-to-vigorous PA. This study demonstrated the efficacy of a behavioral program in improving dietary habits of Chinese CRC survivors

What Do We Know About Neuropsychological Aspects Of Schizophrenia?

Application of a neuropsychological perspective to the study of schizophrenia has established a number of important facts about this disorder. Some of the key findings from the existing literature are that, while neurocognitive impairment is present in most, if not all, persons with schizophrenia, there is both substantial interpatient heterogeneity and remarkable within-patient stability of cognitive function over the long-term course of the illness. Such findings have contributed to the firm establishment of neurobiologic models of schizophrenia, and thereby help to reduce the social stigma that was sometimes associated with purely psychogenic models popular during parts of the 20th century. Neuropsychological studies in recent decades have established the primacy of cognitive functions over psychopathologic symptoms as determinants of functional capacity and independence in everyday functioning. Although the cognitive benefits of both conventional and even second generation antipsychotic medications appear marginal at best, recognition of the primacy of cognitive deficits as determinants of functional disability in schizophrenia has catalyzed recent efforts to develop targeted treatments for the cognitive deficits of this disorder. Despite these accomplishments, however, some issues remain to be resolved. Efforts to firmly establish the specific neurocognitive/neuropathologic systems responsible for schizophrenia remain elusive, as do efforts to definitively demonstrate the specific cognitive deficits underlying specific forms of functional impairment. Further progress may be fostered by recent initiatives to integrate neuropsychological studies with experimental neuroscience, perhaps leading to measures of deficits in cognitive processes more clearly associated with specific, identifiable brain systems