Social Work - Research Publications
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ItemNo Preview AvailableExtroversion Fosters Career Competence among Adolescents in Hong Kong(Springer Science and Business Media LLC, 2022-06)Adolescents often feel helpless about planning their career in highly competitive societies such as Hong Kong. Relatively limited research has been conducted to examine whether being extrovert can influence adolescents’ career-related knowledge and career decision self-efficacy (CDSE). Methods: This cross-sectional study explored the relationship between extroversion, career knowledge and CDSE among 535 Hong Kong high school students based on Social Cognitive Career Theory and Trait and Factor Theory. Descriptive data analysis, correlation tests and structural equation modelling were used. Results: Study respondents displayed a low level of career knowledge and CDSE. Extroversion had a directly positive effect on CDSE (β = 0.219, p < 0.001), while career knowledge significantly mediated the relationship between extroversion and CDSE (β = 0.185, p < 0.001). Conclusions: This study provided a model to understand high school adolescents’ career decision self-efficacy, and empirically supported career training interventions to enhance adolescents’ self-efficacy and confidence in being more outgoing.
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ItemNo Preview AvailableObjectification and ambiguity of body image in women with Polycystic Ovary Syndrome: A mixed-method study.(Elsevier BV, 2022-08-01)BACKGROUND: The manifestations of Polycystic Ovary Syndrome (PCOS), including acne, hirsutism, obesity, uncertain fertility, etc., can make women anxious, worried, or even depressed with their appearance and body. However, little relevant research has been conducted in the Chinese context. This mixed-method study aimed to understand how women with PCOS in China perceive their bodies and to examine the association between body image and depression. METHODS: First, 101 PCOS patients participated in a survey using the Body Surveillance subscale of the Objectified Body Consciousness Scale, the Short-form Mishel Uncertainty in Illness Scale, the Appearance Anxiety Scale, and the Beck Depression Inventory-II, which measured participants' self-objectification, illness ambiguity, appearance anxiety, and depression, respectively. Second, fifteen women joined face-to-face semi-structured in-depth interviews, investigating their illness ambiguity, objectified experience, and behaviors to pursue beauty. RESULTS: Results indicated a high level of self-objectification, illness ambiguity, appearance anxiety, and depression among women with PCOS in China and supported the significant associations among the outcomes. Qualitative findings presented a body image of the precarious body, indiscernible identity, and distraught mind. LIMITATIONS: A convenient sampling method was used. The generalization of the study results needs further validation. Future longitudinal studies are necessary to clarify the causal relationships among outcomes. CONCLUSIONS: This study presented women's body image with PCOS and found the negative impact of body image on their depression levels. This study was of both theoretical and practical significance. Appropriate mind-body therapies were suggested for them.
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ItemNo Preview AvailableEfficacy of Integrative Body-Mind-Spirit Group Intervention for Parents of Children With Eczema: A Randomized, Wait-List Controlled Clinical Trial(SAGE Publications, 2020-09)Objectives: This randomized controlled trial evaluated the effects of a psychosocial intervention developed based on the Integrative Body-Mind-Spirit (IBMS) model that aimed to enhance the well-being of parents of children with eczema. Methods: Ninety-one families were randomly allocated to either the six-session intervention group (n = 48) or the wait-list control group (n = 43) and completed the randomized trial. For both groups, a range of psychosocial outcome measures were taken before the intervention (T0), postintervention (T1), and 6 weeks after the intervention (T2). Results: Relative to the control group, the intervention group was significantly improved over time in their levels of perceived stress, depression, and a number of holistic well-being measures, including nonattachment, afflictive ideation, and general vitality. Discussion: The results provided empirical support for an IBMS-informed psychosocial intervention in reducing stress and depression and enhancing well-being among parents of children with eczema.
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ItemNo Preview AvailableComparing dyadic cognitive behavioral therapy (CBT) with dyadic integrative body-mind-spirit intervention (I-BMS) for Chinese family caregivers of lung cancer patients: a randomized controlled trial(SPRINGER, 2020-03)PURPOSE: The study adopted a randomized controlled trial to compare the effect of culturally compatible psychosocial interventions on multiple aspects of quality of life (QoL) for family caregivers of lung cancer patients. METHODS: 157 Chinese informal caregivers of lung cancer patients were recruited together with the family members for whom they were providing care, and randomly assigned to either integrative body-mind-spirit intervention (I-BMS) or cognitive behavioral therapy (CBT). Patient-caregiver dyads attended the same arm of intervention in separate groups for 8 weeks. Assessments of generic QoL, anxiety, depression, perceived stress, insomnia, and caregiving burden were measured before intervention (T0), within 1-week (T1), 8-week (T2), and 16-week (T3) post-intervention. RESULTS: Adopting the intention-to-treat analysis, family caregivers in receipt of both I-BMS and CBT exhibited a statistically significant improvement in generic QoL immediately following intervention and at follow-up assessments, with moderate effect size. Improvement of insomnia was found at T1 for both modes, which deteriorated at follow-up; both modes reduced anxiety and perceived stress at follow-up. No intervention effect was observed in depression and domains of caregiving burden. There was no significant interaction effect between intervention type and time. No main or interaction effect between sample background variables and intervention type was found to predict symptomatic changes at T1 and T3. CONCLUSIONS: Culturally attuned I-BMS and CBT exhibited equivalent effectiveness in improving psychological distress and generic QoL for family caregivers of lung cancer patients. To improve the evaluation of outcomes, future study could benefit from incorporating a usual care control.
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ItemNo Preview AvailableComparing the efficacy of integrative body-mind-spirit intervention with cognitive behavioral therapy in patient-caregiver parallel groups for lung cancer patients using a randomized controlled trial(ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2020-07-03)Purposes/objectives: This paper reports the comparative efficacies of integrative body-mind-spirit intervention (I-BMS) and cognitive behavioral therapy (CBT) in patient-caregiver parallel groups for Chinese patients with lung cancer.Design: Randomized controlled trial (RCT).Methods: One hundred and fifty-seven patient-caregiver dyads with no marked functional impairment were randomized into one of the two interventions with eight weekly patient-caregiver parallel groups. Assessments were conducted at baseline, within one, eight- and sixteen-weeks post-intervention. Effects of treatment group across time were analyzed by multilevel modeling.Findings: CBT led to greater reduction in emotional vulnerability than I-BMS. I-BMS resulted in greater increase in overall QoL and spiritual self-care, and more reduction in depression than CBT. Patients in both interventions experienced improvement in physical, emotional and spiritual, except social, domains of QoL.Conclusion: I-BMS was more efficacious for diverse domains of QoL, and CBT was more effective for emotional well-being, despite the relatively small between-group effect sizes.Implications for psychosocial providers/policy: (1) With the expanding repertoire of psychosocial interventions for families facing lung cancer, it has become imperative to investigate the comparative efficacies of empirically supported and culturally adapted interventions. (2) Our findings show that I-BMS was more effective for diverse domains of QoL, while CBT was more efficacious with emotional well-being, although both interventions led to significant improvements in physical, emotional and spiritual domains of patient QoL. (3) Patient-caregiver parallel groups have been shown to be effective for enhancing QoL of Chinese lung cancer patients. (4) Care professionals are encouraged to dispense interventions based on the idiosyncratic needs and preferences of the patients to maximize the treatment effects.
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ItemNo Preview AvailableThe mental health of women with polycystic ovary syndrome: a systematic review and meta-analysis.(Springer, 2021-02)Polycystic ovary syndrome (PCOS) has been proposed to be associated with several mental health problems, including anxiety, depression, diminished sexual satisfaction, and lowered health-related quality of life, etc. A systematic review and meta-analysis of published literature was conducted comparing the mental health of women with and without PCOS. Ten English and Chinese databases were searched up to 12/31/2018. Random-effects models were introduced, and subgroup analysis, sensitivity test, and meta-regression were carried out to determine the source for heterogeneity among studies. Forty-six studies, including 30,989 participants (9265 women with PCOS and 25,638 controls), were qualified for review according to the inclusion criteria. Twenty-eight studies reported depression symptoms, 22 studies were on anxiety, 16 studies showed quality of life (QoL) status, 12 studies were about sexual dysfunction, five on emotional distress, four on binge eating, and four on somatization. Women with PCOS reported significantly higher depression (SMD = 0.64; 95% CI 0.50-0.78), anxiety (SMD = 0.63; 95% CI 0.50-0.77), lower QoL (SMD = - 0.55; 95% CI -0.69 to -0.40), and not significant sexual dysfunction (SMD = - 0.24; 95% CI - 0.49 to 0.01). Studies from different countries, adopting various diagnosis criteria, using diverse instruments, as well as in different years, have reported heterogenetic results. Women with PCOS in China reported a larger effect size of depression and anxiety than patients from other countries. The results of this study have indicated that women with PCOS suffer from depression, anxiety, and experience a lower quality of life, whereas their sexual function is not distinct from that of healthy women. Psychological health care interventions for women with PCOS were addressed.
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ItemThe Counterintuitive Relationship between Telomerase Activity and Childhood Emotional Abuse: Culture and Complexity(MDPI AG, 2021-02-08)BACKGROUND: A burgeoning literature has found relationships between telomere length, telomerase activity, and human health and longevity. Although some research links a history of childhood adversity with shortened telomere length, our review found no prior research on the relationship between child maltreatment history and telomerase activity in adulthood. We hypothesized a negative relationship between child maltreatment and telomerase activity and hypothesized that the association would be moderated by sex. METHODS: These relationships were tested on a sample of 262 Hong Kong Chinese adults (200 females versus 62 males) with mild to moderate depression. RESULTS: Counterintuitively, emotional abuse was positively associated with telomerase activity, while other maltreatment types were non-significant. The positive relationship between emotional abuse and telomerase activity was significantly moderated by the sex of the participant. CONCLUSIONS: We advance two possible explanations for this finding (1) a culturally informed resilience explanation and (2) a homeostatic complexity explanation. The two explanations are not mutually exclusive. This trial is registered under Hong Kong Clinical Trial Register number HKCTR-1929. SIGNIFICANCE STATEMENT: Emotional abuse was significantly positively associated with telomerase activity. There are at least two non-mutually exclusive explanations for the findings. Simply put, either (1) in the cultural context of Hong Kong emotional abuse was not a risk factor, and/or (2) the conceptualization of telomerase activity as a straightforward indicator of longevity is overly simplistic. The first story we might term a "resilience explanation" while the second we might call a "homeostatic complexity" story.
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ItemNo Preview AvailableInfant Access Program Evaluation( 2022-03-30)This project was commissioned by the Eastern Health Foundation to evaluate the implementation of the ‘Infant Access Program’ (IAP). The IAP seeks to improve access to specialist infant mental health services for children aged 0-5 years with mental health difficulties in the Maroondah City and Yarra Ranges local government areas. This report provides an overview of the evaluation method, key findings, and recommendations for future IAP research and program development to build the evidence base in infant mental health service provision. The program evaluation project used a mixed methods approach to evaluate the implementation of the Infant Access Program (IAP). The aims of the project were: - To identify existing models and programs designed to improve access to mental health services for children aged 0-5 years that have been implemented nationally and internationally in health and mental health sectors. - To evaluate if the IAP facilitates access to mental health services for children aged 0-5 years with mental health difficulties and their families. - To assess if the IAP is delivering mental health services to the target population: children at-risk of mental health difficulties. - To understand the experiences of clinicians who implemented the IAP. Findings: Despite the lack of specific research on this topic, the scoping review identified several broad themes for IAP to consider: (1) accessibility for at-risk populations (2) the importance of early detection of infants in need of mental health services and interventions; (3) the promotion of culturally responsive services and interventions; (4) ensuring the sustainability of IMH services and programs; and (5) the integration of innovative interventions to improve existing practice models. A total of ten participants (CYMHS clinicians and EMCH nurses) consented into this evaluation. The participants provided mental health and nursing services to three local government areas in the Melbourne’s eastern region. During the implementation period (May – October 2021), two CYMHS clinicians and four EMCH nurses collected IAP activity data related to thirteen infants and young children and their families who were consulted or referred to the program. Following the Infant Access Program Evaluation implementation period, semi-structured qualitative focus groups were conducted with the ten CYMHS clinicians and EMCH nurses to gain an understanding of their experiences of implementing the IAP in practice. The analysis of the IAP activity data and focus group discussions demonstrate that the IAP does facilitate access to mental health services for children aged 0-5 years with mental health difficulties and their families. Access to specialist mental health support for most children and families was rapid, with most children meeting the CYMHS clinician at a first joint home visit only 14 days after the initial consultation with the EMCH nurse. This rapid response demonstrates the IAP is nimble and flexible in offering infant mental health services in a time sensitive manner. The program received referrals for infant mental health services for its intended target population: infants and children and their families experiencing known risk factors for poor mental health outcomes. Families with a range of complex psychosocial risk factors can often experience significant challenges in accessing specialist services such as infant mental health intervention for their child despite having concerns about their social and emotional development. The IAP managed the initial engagement with families by leveraging the existing relationship the family had with the EMCH nurse, however, there were challenges with maintaining engagement and delivering mental health interventions. Although the initial access to the IAP is a strength of the current design, further consideration is needed as to the ways in which to meaningfully engage with families of infants and children with mental health difficulties that are acceptable and sustainable. The IAP had the full support of all the CYMHS clinicians and EMCH nurses who were involved during the implementation phase of this evaluation. The experience of clinicians and nurses working in partnership, bringing skills sets of mental health clinicians and maternal child health together was considered a strength of the IAP design. The access and rapid response from the CYMHS clinicians to consult and meet with the families was also valued. This ensured a timely response to the needs of infants and children with mental health difficulties and capitalised on the readiness and willingness of families to engage with mental health services. The clinicians and nurses recognised the challenges of working with a population that is at-risk in our community. Establishing trust with the families was identified as the key to successful engagement with IAP. Creative ways of engaging families were also important, offering choice for when and where to meet the IAP clinician.
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ItemNo Preview AvailableFamily Violence and Abuse against Non-Parental Caregivers: An Australian Perspective(SAGE Publications Ltd, 2021)There has been significant discourse around the use of language in the context of domestic and family violence and inconsistencies in language present in policy, legislation, practice, and research. This has resulted in the lack of agreement on a definitive and overarching description of domestic and family violence (Tinning, 2010; Boxall et al., 2015). The Australian Government has adopted the United Nations (1993: 3) definition which states that violence against women is gender-based and results in or is likely to result in physical or psychological harm.
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ItemIdentifying the Patterns of Family Contact for Children in Care(ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2022-01-02)Contact between children in care and family members is complex and often emotionally difficult for all concerned. In the context of a wider Australian cross-jurisdictional intervention trial, focusing on contact between children in long-term care and their parents, a snapshot survey of 901 children in Victorian foster care and kinship care placements was undertaken. The aim was to determine which children had seen parents, siblings or extended family members within a 12-month period, and how practitioners explained lack of contact between children and their parents. The study found that most children had had contact with parents or other family members, though children in long-term care were less likely to have seen their parents than those where reunification was still a possibility. Practitioners’ views on why parental contact had not occurred for 18% of the sample illustrate the complexity of the issues involved in contact. IMPLICATIONS To support children’s best interests, professionals should be clear about the purpose of family contact and provide support appropriate to that purpose. With children in long-term care less likely to see their parents, professionals have a role in helping these parents adjust to a new role. Developing strategies to maintain meaningful connections between children in long-term care and their parents may be more effective for children’s best interests than the current emphasis on actual visits.