Continued smoking among patients with chronic diseases detrimentally affects their health and treatment outcomes. However, a majority of smokers with chronic diseases appear to have no intention to ...quit. Understanding the needs and concerns of this population is a crucial step in facilitating the design of an appropriate smoking cessation intervention. This study aimed to understand the risk perception, behaviours, attitudes, and experiences related to smoking and smoking cessation among patients with chronic diseases, including cardiovascular diseases, chronic respiratory diseases, and/or diabetes in Hong Kong. Individual semi-structured interviews with smokers with chronic diseases (n = 30) were conducted from May to July 2021. The methods and results are reported according to the COREQ. Four themes were generated: (1) perceptions of the association between chronic diseases and smoking/smoking cessation; (2) perceptions of the health/disease status; (3) quitting smoking is not the first priority; and (4) perceived barriers to quitting smoking. This study addressed a gap in the literature by gathering data concerning the perspectives of smokers with chronic diseases on smoking and smoking cessation. The deficit of knowledge among smokers with chronic diseases warrants the reinforcement of health education targeting this population. Our findings indicate the need for further efforts in designing appropriate smoking cessation interventions targeting smokers with chronic diseases, which will match the needs and concerns identified in this study.
Purpose
To collate evidence and evaluate the effects of physical activity interventions on physical activity level among pediatric cancer survivors who had completed active cancer treatment.
Methods
...Relevant published studies were identified in May 2020 via five databases and reference checking. Searches were limited to randomized controlled trials or controlled clinical trials, published in English involving pediatric cancer survivors aged 18 years or below. Interventions were related to promote physical activity among the survivors. Included studies were assessed using the revised version of the Cochrane’s Risk of Bias Tool.
Results
Eight randomized controlled trials (620 pediatric cancer survivors and 53 caregivers of pediatric cancer survivors) were included. All studies investigated interventions for pediatric cancer survivors to increase their physical activity level. The interventions used varied across the eight included studies: three mHealth—medical and public health practice supported by mobile devices; two eHealth—the use of information and communication technologies to improve health care; two adventure-based training; and one educational program. Measures of physical activity level also varied: five used various objective measurements (i.e., accelerometer, pedometer, multisensory activity monitor); three used different self-reported questionnaires. Owing to high variability of the interventions and measures, it was impossible to perform meta-analysis. Overall, eHealth and mHealth interventions showed effectiveness and feasibility to promote physical activity among pediatric cancer survivors.
Conclusions
eHealth and mHealth interventions appear to be increasingly important strategies to promote physical activity among pediatric cancer survivors.
Implications for Cancer Survivors
Future larger-scale studies using a core-set of assessment tools are warranted to further promote regular physical activity in pediatric cancer survivors.
Aims
To systematically summarize seminal studies on the design and effectiveness of smoking cessation interventions targeted at patients with chronic diseases through a critical appraisal of the ...literature.
Design
A systematic review.
Data Sources
This review included literature identified through a search of six databases up to June 2020.
Review Methods
This review was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions. The literature search was limited to English‐language articles on the effectiveness of smoking cessation interventions for smokers who were aged ≥18 years and diagnosed with chronic diseases. Data were extracted using the Cochrane Data collection form for intervention reviews of randomized controlled trials and non‐randomized controlled trials. The articles were subjected to a quality assessment.
Results
Ten relevant articles were identified. The designs of the interventions were highly heterogeneous, and only six articles reported a significant increase in smoking abstinence among patients with chronic diseases. In the target population, an intervention delivered by healthcare professionals on an intensive schedule was shown to more effectively induce smoking cessation, compared with minimal counselling. However, methodological flaws were identified in most of the included studies.
Conclusion
The findings of this review suggest that additional efforts are needed to design smoking cessation interventions for patients with chronic diseases and that further examination of the effectiveness and feasibility of these interventions is warranted.
Impact
What problem did the study address?
This review evaluated the effectiveness of smoking cessation interventions targeted at patients with chronic diseases.
What were the main findings?
An intervention with an intensive schedule that was delivered by healthcare professionals was shown to more effectively induce smoking cessation in patients with chronic diseases, compared with minimal counselling.
More attention and resources should be directed towards smokers with no intention to quit, especially those with chronic diseases.
There is an urgent need for generic smoking cessation interventions that use novel approaches to address the unique needs of this population and to integrate such evidence‐based interventions into routine care.
Where and on whom will the research have impact?
The findings of this review may guide nurses, who play a prominent role in raising the issue of smoking cessation with patients, to design appropriate smoking cessation interventions for patients with chronic diseases.
The resulting improvements in patients’ health would not only benefit patients themselves but also reduce the burden of chronic diseases on healthcare systems.
Objective
To examine the interrelationships among resilience, self‐esteem, and depressive symptoms and determine whether resilience was a factor associated with quality of life for Hong Kong Chinese ...children with cancer.
Methods
We used a cross‐sectional study design. Participants were 138 Hong Kong Chinese children (aged 7–14 years) who were admitted to the pediatric oncology units of an acute public hospital. The resilience, depressive symptoms, self‐esteem, and quality of life of participating children were assessed. The primary outcome was the association between resilience and quality of life in children with cancer.
Results
In total, 72 boys and 66 girls were recruited for this study (mean age 10.6 years). The mean levels of resilience, depressive symptoms, self‐esteem, and quality of life were 23.4, 30.0, 23.0, and 63.6, respectively. There was a statistically significant strong positive correlation between resilience and quality of life (r = 0.60, p < 0.01), indicating that greater resilience was associated with better quality of life. Children with cancer from single‐parent families, those diagnosed with a brain tumor, and those who received multiple treatments reported significantly lower levels of resilience, self‐esteem, and quality of life, and greater depressive symptoms than other children (all p's < 0.001). Results of a multiple regression analysis revealed that resilience (p < 0.001) was a strong factor associated with quality of life among children with cancer.
Conclusions
It is essential that healthcare professionals implement interventions to boost the resilience of children with cancer, thereby enhancing their quality of life.
Evidence shows that resilience is crucial to maintain psychological well-being and quality of life in the face of stress and adversity. However, the relationships between resilience and psychological ...well-being and factors associated with quality of life in Hong Kong Chinese parents of children with cancer are underexplored. This study aimed to examine the interrelationships among resilience, ways of coping, psychological well-being, and quality of life among Chinese parents of children with cancer, and identify factors associated with their quality of life. A cross-sectional study was conducted with 119 Chinese parents of children with cancer at the Hong Kong Children's Hospital between January 2020 and March 2022. Parents' resilience level, ways of coping, depressive symptoms, state anxiety scores, perceived social support, and quality of life were assessed. Participating parents (
= 119) included 98 mothers (82.4%) and 11 parents were from single-parent families (9.2%). Almost half (47.9%) of the parents were potentially at risk for depression. The results showed that participants from single-parent families reported statistically significantly lower levels of resilience (
< 0.001), more depressive symptoms (
< 0.001), and poorer quality of life (
< 0.001) than those who lived with their partners (married). In addition, parents who adopted problem-focused coping strategies reported statistically significantly higher levels of resilience (
< 0.001), fewer depressive symptoms (
< 0.001), and better quality of life (
< 0.001) than those who adopted emotion-focused coping strategies. A multiple regression analysis revealed that resilience (
< 0.001) was associated with quality of life among parents of children with cancer. This study provides further support that resilience is an important factor associated with quality of life in parents of children with cancer. Assessing resilience in parents is an important prerequisite for designing appropriate interventions to increase their resilience and enhance their quality of life.
Caring for children with cancer can be a stressful experience for parents and may have negative effects on their physical and psychological well-being. Although evidence has shown that resilience is ...associated with positive psychological well-being, few interventions have been specifically designed to enhance the resilience of parents of children with cancer.
The aim of this study is to examine the effectiveness of a mobile device-based resilience training program in reducing depressive symptoms and enhancing resilience and quality of life (QoL) in parents of children with cancer.
Parents of children diagnosed with cancer were recruited from the pediatric oncology wards of 3 tertiary hospitals in China. The participants were randomly assigned to either the experimental group (52/103, 50.5%) to undergo an 8-week mobile device-based resilience training program or to the control group (51/103, 49.5%) to receive an 8-week program of placebo information. The study outcomes included resilience, depressive symptoms, and QoL, as measured by the Connor-Davidson Resilience Scale, the Self-Rating Depression Scale, and the Short Form of the 6-Dimension Health Survey, respectively. All data were collected at baseline and at 2 and 6 months of follow-up. The data analysis followed the intention-to-treat principle. A generalized estimating equation was used to examine the effects of the intervention.
The participants were mostly female (72/103, 69.9%), and their mean age was 33.6 (SD 5.2) years. The participants in the experimental group showed significantly higher levels of resilience (mean 67.96, SD 15.8 vs mean 58.27, SD 19.0; P<.001) and lower levels of depressive symptoms (mean 40.17, SD 9.9 vs mean 46.04, SD 10.9; P<.001) than those in the control group at 6 months of follow-up. The intervention showed statistically significant effects in improving resilience (β=6.082; P=.01) and decreasing depressive symptoms (β=-2.772; P=.04) relative to the control group. The QoL score in the experimental group was higher than that in the control group at 6 months of follow-up (mean 0.79, SD 0.2 vs mean 0.76, SD 0.3; P=.07); however, no statistically significant intervention effect was detected (β=.020; P=.38).
The mobile device-based resilience training program effectively enhanced resilience and alleviated depressive symptoms in parents of children with cancer. It is highly recommended that health care professionals incorporate this resilience training program when providing psychological care to parents of children with cancer.
Clinical.Trials.gov NCT04038242; http://clinicaltrials.gov/ct2/show/NCT04038242.
This study analyzed archived data from a previous large-scale survey study on multiple health-risk behaviors among Chinese adults in Hong Kong between 21 June and 31 August 2021. In addition, this ...study examined participants' perceptions of the risks associated with their behaviors, their attitudes toward adopting healthy behaviors, and the impact of COVID-19 on their health-risk behaviors. A total of 4605 participants who had at least one health-risk behavior were included in the analysis. The results showed that about half of the participants were unaware that non-communicable diseases (NCDs) can be caused by health-risk behaviors such as tobacco use, harmful use of alcohol, physical inactivity, and an unhealthy diet. More than half of the participants did not have regular body checkups or monitor their physical health at home. Many participants paid more attention to their health due to the COVID-19 pandemic, but few made changes to their unhealthy habits or adopted a healthier lifestyle. Of the 704 smokers, 60.9% did not realize that smoking increases the risk of transmitting COVID-19 to others. Only 32.2% and 11.9% smokers had the intention to quit smoking and reduced their cigarette consumption, respectively. Additionally, 13.6% reported that their daily cigarette consumption had increased, and 78.8% changed their smoking behavior during the pandemic. Healthcare professionals must educate the public about the association between health-risk behaviors and NCDs and between COVID-19 and NCDs. The government should formulate a long-term plan to strengthen the primary healthcare system and address the challenges posed by the rising prevalence of NCDs.
A previous study reported that smoking outside the home and away from the infants or pregnant women (thirdhand smoke) does not completely protect a smoker’s home from environmental tobacco smoke ...contamination and infants or pregnant women from exposure to it 4. A systematic review of 9 qualitative studies published before 2014, summarizing the barriers to and facilitators of smoking cessation by male smokers during their partners’ pregnancy, found that most expectant fathers were aware of the adverse health effects of smoking but did not recognize that they extended to pregnant women and fetuses 11. Using video as a medium to convey information, we expected that smoking expectant fathers who received the intervention would increase their understanding of smoking hazards during pregnancy and postpartum and hence become more motivated to quit smoking. Because of the shifts in masculinity associated with impending fatherhood, expectant fathers’ responsibilities as providers and role models for children increases, which may increase their willingness to quit smoking 8. Expectant fathers were excluded if they were unable to provide informed consent or receive counseling because of impaired mental status, cognitive impairment, or communication barriers identified from their medical records or if they had participated in other smoking cessation programs or services.
Purpose
Musical training has been found to promote psychological well-being and quality of life among pediatric brain tumor survivors. Yet, the essential elements of musical training that influence ...its efficacy remain unknown. This study aimed to examine the lived experience of engaging in the musical training program from the perspectives of pediatric brain tumor survivors, their parents, and interveners.
Methods
We employed a descriptive phenomenological approach. Twenty pediatric brain tumor survivors (aged 8–15 years) who had undergone musical training in a previous trial were selected, along with their parents (13 mothers and 7 fathers) and 7 interveners, to participate in individual semi-structured interviews. Data analysis was conducted according to Colaizzi’s descriptive phenomenology method.
Results
Five main themes emerged from the interviews: overcoming difficulties encountered during the initial phase of the musical training program, improved psychological and emotional well-being, facilitation of participation in musical training program, appreciation of the benefits of joining the musical training program, and expectation of future musical training program. The musical training program improved the psychological and emotional well-being of pediatric brain tumor survivors by promoting positive mood, facilitating emotional management and expression, and enhancing self-confidence. In addition, learning in a supportive environment is crucial in facilitating survivors to overcome adversity during their learning process.
Conclusion
This study addressed a literature gap by exploring how a musical training program promoted psychological well-being among pediatric brain tumor survivors. The study findings inform the importance of tailoring musical training program based on survivors’ learning abilities and needs.
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