Perceptions, behaviours and attitudes towards smoking held by the male partners of Chinese pregnant women:a qualitative study

Abstract Background Direct associations of tobacco exposure during pregnancy with pregnancy complications and adverse birth outcomes have been proven. Previous studies suggest that expecting a child provides a valuable opportunity to promote behavioural changes, such as smoking cessation, among the male partners of pregnant women. Thorough understandings of Chinese expectant fathers’ smoking behaviour during the transition to fatherhood is a prerequisite to the development of appropriate interventions to facilitate smoking cessation. This study aimed to explore the perceptions, behaviours and attitudes related to smoking among male partners of pregnant women in China. Methods A descriptive phenomenological approach was adopted. A purposive sample of expectant fathers aged 18 years or older who had a tobacco use history within the past year were recruited at obstetrics and gynaecology clinics and invited to participate in one-to-one, 20–30-min semi-structured interviews. The data analysis followed Colaizzi’s descriptive phenomenological method. Results Twenty-five expectant fathers were interviewed. Four themes were generated: 1) the benefits of smoking and respondents’ misperceptions of the impact of smoking and SHS and neglectful attitude of the impact of smoking, which were given as the major reasons for continuing to smoke; 2) factors contributing to smoking cessation, including concern for the potential health impact of continued smoking on the pregnant partner and baby, the role of being father, and the encouragement to quit from family members; and 3) perceived barriers to smoking cessation, including withdrawal symptoms or cigarette cravings, absence of smoking cessation support, and increasing stress. Conclusion This study provides a comprehensive understanding of the perception, behaviours, and attitudes related to smoking among Chinese expectant fathers. The findings of this study can guide healthcare professionals and policymakers in combining the distribution of educational information about the hazards of SHS for maternal and neonatal health with smoking cessation assistance for expectant fathers through policy initiatives and other types of incentives and programmes targeted to enhance smoking cessation among this population. Trial registration Prospectively registered at clinicaltrial.org ( NCT03401021 ) on 8 Jan 2018

Adaptation and Psychometric Evaluation of the Chinese Counseling Competencies Scale-Revised

Objectives: This study conducted a linguistic and psychometric evaluation of the Chinese Counseling Competencies Scale-Revised (CCS-R).Methods: The Chinese CCS-R was created from the original English version using a standard forward-backward translation process. The psychometric properties of the Chinese CCS-R were examined in a cohort of 208 counselors-in-training by two independent raters. Fifty-three counselors-in-training were asked to undergo another counseling performance evaluation for the test-retest. The confirmatory factor analysis (CFA) was conducted for the Chinese CCS-R, followed by internal consistency, test-retest reliability, inter-rater reliability, convergent validity, and concurrent validity.Results: The results of the CFA supported the factorial validity of the Chinese CCS-R, with adequate construct replicability. The scale had a McDonald's omega of 0.876, and intraclass correlation coefficients of 0.63 and 0.90 for test-retest reliability and inter-rater reliability, respectively. Significantly positive correlations were observed between the Chinese CCS-R score and scores of performance checklist (Pearson's γ = 0.781), indicating a large convergent validity, and knowledge on drug abuse (Pearson's γ = 0.833), indicating a moderate concurrent validity.Conclusion: The results support that the Chinese CCS-R is a valid and reliable measure of the counseling competencies.Practice implication: The CCS-R provides trainers with a reliable tool to evaluate counseling students' competencies and to facilitate discussions with trainees about their areas for growth

Brief advice and active referral for smoking cessation services among community smokers: a study protocol for randomized controlled trial

Abstract Background Most smokers do not use smoking cessation (SC) services although it increases successful quits. Passive referral providing SC information to smokers is commonly used in SC studies. Little was known about active referral in the community setting. This study aims to motivate community smokers to quit by brief SC advice using a validated AWARD model (Ask, Warn, Advise, Refer and Do-it-again) that adjunct with active referral of smokers to various SC services in Hong Kong. Methods/Design This is a single-blinded, parallel three-armed cluster randomized controlled trial (RCT) with two treatment groups of (1) brief SC advice using the AWARD model, active referral to SC services plus a referral card and a health warning leaflet (active referral group) and (2) brief SC advice using AWARD model and health warning leaflet (brief advice group) and a control group receives general very brief advice with a self-help booklet. A total of 1291 smokers will be recruited from 66 clusters (recruitment sessions) with 22 will be allocated to each of the two intervention and one control groups. SC ambassadors will be trained for delivering the interventions and conducting telephone follow-up. The primary outcomes are self-reported 7-days point prevalence (PP) abstinence at 3 and 6 months follow-up. Intention-to-treat principle and multi-level regressions will be used for data analysis. Discussion This is the first RCT on assessing a model combining brief advice and active referral to SC services among community smokers. The results will inform the practices of SC services and intervention studies. Trial registration NCT02539875 (ClinicalTrials.gov registry; registered retrospectively on 22 July 2015

照顧者實用資訊手冊

手冊源起 香港面對人口高齡化，醫療和福利系統無可避免面臨持續的挑戰。照顧者因壓力問題而引發的家庭悲劇時有發生，反映照顧者自身亦極需要社會的重視和支援。 現時照顧者人數眾多，當中不乏配偶、父母、子女、女婿、媳婦，對長者照顧及社會無酬的付出，確實值得社會的認同和肯定。然而，儘管本港為長者及照顧者提供不少支援服務，由於不同的原因，照顧者似乎未有善用現有的服務，常常需要一力承擔所有照顧的責任，這無疑增加了他們的壓力。 照顧者需求多樣性 照顧者有不同種類，所需要的服務或支援亦有所不同。例如：「新手照顧者」剛開始接觸照顧工作，需要盡快提升日常護理和相關的疾病知識，以及獲得合適的離院/復康服務支援。「隱蔽照顧者」一直承擔照顧工作但沒有接受任何支援，因此，他們需要的是服務提供者/鄰里的主動接觸，並被轉介合適的照顧服務，以分擔他們部分照顧工作。「高危照顧者」幾乎長時間被照顧的工作佔據了其生活，他們需要的是喘息空間和暫託服務，甚至可能是情緒支援。即使「資深的照顧者」也可能需要喘息或暫託的支援服務去減輕壓力；而結束了照顧工作的「畢業照顧者」，無論是情緒的支援，還是重新規劃財務與就業的安排，都有非常實際的需求。基於照顧者的不同需要，照顧者的支援和服務也是多樣化，如何讓不同種類的照顧者能夠輕易了解現有的社區支援服務、可考慮甚麼因素選取相關服務、如何獲取所需的支援包括申領經濟支援或預早準備長期護理開支、如何自強增值等，都是這本手冊希望解答的問題。 手冊的目的 編製這本手冊的目的就是要減少照顧者四處尋找資訊的麻煩，提供一個整全且易於瀏覽的資訊來源。本手冊主要有兩大目標：其一，幫助照顧者認識不同的服務和資源，積極尋求援助；其二是一站式提供豐富的資訊服務，提升照顧者的能力和平衡身心健康。 手冊的意義 此手冊的社會意義是期望提高大眾對照顧者需要的關注，並引導更多的行動以支援照顧者。如果您的親友是照顧者，又或您認識的朋友甚至鄰居正面對照顧家人的困難，您可以主動伸出援手，又或利用這本手冊作為啟示，向他們介紹相關的服務。 另外，這本手冊可以視作為支援照顧者的工具，讓照顧者明白在承擔照顧家人的重任時並不需要孤軍奮戰，也可以善用社區提供的各種資源和服務。 手冊架構 本手冊由四個主要部分組成，每部分都專注於特定的主題，旨在提供照顧者的全方位支援和資訊，幫助他們在面對挑戰時能夠有所依賴，並從中獲得力量： 第一部分主要提供基礎知識，其中包括不同種類的照顧者的介紹、四種長者常見疾病（包括認知障礙、中風、老年抑鬱和癌症）的病徵說明、以及照顧者可能面臨的壓力與「喘息服務」的重要性。第二部分專注介紹長者常用的社區及健康服務。我們按照地區將服務機構進行了分類，羅列「認知障礙、中風、老年抑鬱、癌症」常用的服務機構，此外，我們還提供家居安全、樂齡科技租賃服務，以及財務支援等相關建議。第三部分將焦點重新放回照顧者身上，提供了支援照顧者的社福機構介紹、照顧者同路人的心得分享，以及照顧者的培訓資訊，旨在幫助照顧者在面對困難時能自強不息。最後，在本手冊的結尾部分，我們特別邀請了四位專家學者就照顧者政策提出見解和建議，為加強照顧者支援服務提供新思路。 如果按持份者來分類，手冊的四個部分的重點如下： 第一部分：照顧者的基礎知識 ◎ 針對預備照顧者、新手以及隱蔽照顧者，讓他們了解照顧者的角色和需要；照顧體弱長者的基礎知識，並提供應對壓力的建議，包括自我照顧和喘息服務等。 第二部分：照顧者支援 ◎ 針對所有護老者，提供長者常用的社區服務、健康服務和支援計劃，包括暫託、住宿、護送及陪診、善別支援、情緒支援、復康用品津貼及租賃的支援計劃，以及財務策劃師提供的理財貼士。 第三部分：照顧者自強 ◎ 針對照顧者，資訊包括不同的照顧者支援組織、同路人和畢業照顧者的經驗心得、培訓課程，以及實用的電子資訊平台推介。 第四部分：對照顧者支援政策的看法和展望 ◎ 針對服務提供者、政策倡議者及制定者，提供專家學者對照顧者服務及政策的未來發展方向的看法和建議，以期引發更多關於「如何為照顧者提供更好支持」的討論。 給讀者的使用指引 本手冊內容十分豐富，讀者可以先瀏覽目錄，選擇與您相關的部分進行細讀。對於新手照顧者或剛接觸/關注護老服務的人士(例如：學生、社區人士)，我們建議您可以參考手冊第24-33頁「給照顧者的智慧錦囊」的個案，了解不同照顧者可能面對的情境，這可能會給您一點概念，讓您可以考慮尋求哪些支援服務，又或您身邊照顧者朋友有哪些需要，以及如何協助他們獲取所需要的支援。我們深知閱讀本手冊時，您可能會遇到一些不明白的地方，請不必感到困惑。您可以嘗試找身邊的朋友、鄰居或社會服務機構的工作人員一起閱讀，或者向本中心的職員進行查詢。 此外，為方便讀者可以隨時隨地閱讀而不需要攜帶整本手冊，我們為本手冊設立了一個專屬網頁，免費下載整本手冊或某些章節內容。 希望您在閱讀的過程中能找到有用的資訊，並能從中獲得實際的幫助。https://commons.ln.edu.hk/apias_guide/1009/thumbnail.jp

Spousal concordance in adverse childhood experiences and the association with depressive symptoms in middle-aged and older adults: findings across China, the US, and Europe

BackgroundAdverse childhood experiences (ACEs) are associated with higher depressive risks in adulthood. Whether respondents’ ACEs are associated with their own depressive symptoms in adulthood and whether this association extends to their spouses’ depressive symptoms remain unexplored.MethodsData were from China Health and Retirement Longitudinal Study (CHARLS), the Health and Retirement Study (HRS), and the Survey of Health, Ageing and Retirement in Europe (SHARE). ACEs were categorized into overall, intra-familial, and extra-familial ACEs. Correlations of couples’ ACEs were calculated using Cramer’s V and partial Spearman’s correlation. Associations of respondents’ ACEs with spousal depressive symptoms were assessed using logistic regression, and mediation analyses were conducted to explore the mediating role of respondents’ depressive symptoms.ResultsSignificant associations between husbands’ ACEs and wives’ depressive symptoms, with odds ratios (ORs) and 95% confidence intervals (CIs) of 2.09 (1.36–3.22) for 4 or more ACEs in CHARLS, and 1.25 (1.06–1.48) and 1.38 (1.06–1.79) for 2 or more ACEs in HRS and SHARE. However, wives’ ACEs were associated with husbands’ depressive symptoms only in CHARLS and SHARE. Findings in intra-familial and extra-familial ACEs were consistent with our main results. Additionally, respondents’ depressive symptoms mediated more than 20% of the effect of respondents’ ACEs on spousal depressive symptoms.ConclusionWe found that ACEs were significantly correlated between couples. Respondents’ ACEs were associated with spousal depressive symptoms, with respondents’ depressive symptoms mediating the association. The bidirectional implications of ACEs on depressive symptoms should be considered within household and effective interventions are warranted