Mandarin Version Research Articles

Psychometric Assessment of the Mandarin Version of the Decisional Conflict Scale with Pregnant Women Making Prenatal Test Decisions.

PurposeWomen with high-risk pregnancies are often required to make choices about further prenatal testing for Down syndrome, but the decisional conflict they face is poorly understood. This study aimed to test the validity and reliability of the Mandarin version of the decisional conflict scale (M-DCS) in Chinese women with high-risk pregnancies making choices about further prenatal testing for Down syndrome.Patients and MethodsA methodological study was conducted to determine the psychometric properties of the M-DCS, specially, reliability and content, construct, and concurrent validity. The convenience sample comprised 240 pregnant women with high risk for Down syndrome attending the out-patient clinic of the study hospital in Guangzhou, China.ResultsThe five-factor model of M-DCS was supported by confirmatory factor analysis with a satisfactory fit to the data (RMSEA <0.08, RMR <0.05, GFI, CFI, NFI, and IFI all >0.90, except AGFI=0.88 PNFI = 0.76). The internal consistency of the M-DCS was high, with Cronbach’s α of 0.94.ConclusionThe reliability and validity (content, construct, and concurrent) of the M-DCS were all demonstrated as good. This instrument is an important tool for researchers and health-care providers working with women with high-risk pregnancies who need to make choices about further prenatal testing for Down syndrome.

The Chinese Mandarin Version of the Crisis Triage Rating Scale for Taiwanese with Mental Illness to Compulsory Hospitalization.

Background: A controversial issue of the need to protect human rights and ensure public safety still remains a conflict in Taiwan. The purpose of this study was to translate the Crisis Triage Rating Scale to Chinese Mandarin (CMCTRS). Method: A cross-sectional design with convenient sampling was employed in this study. The CMCTRS was tested on 302 Taiwanese individuals with mental illness who were admitted to the emergency room (ER) of a psychiatric center. A higher score indicated a greater need for mandatory psychiatric admission. Psychiatrists rated the patients’ status according to three scale criteria and six action plans of recommendations. Results: Five specialists evaluated the content validity index to be 0.8. A total of 210 participants (69.5%) were deemed suitable for compulsory hospitalization or admission for observation in ER. The optimal cut-off score was 8, with a Youden Index of 1.46, a sensitivity of 0.748, and a specificity of 0.712 in deciding the need for hospitalization or observation. Conclusions: The CMCTRS exhibited an acceptable criterion validity with psychiatrists in a population of 302 patients at the ER of a psychiatric center. A cut-off point of 8 is recommended for determining hospitalization or a minimum 24 h stay at emergency for observation.

How can learning effects be measured in Balint groups? Validation of a Balint group questionnaire in China

BackgroundBalint groups aim to reflect doctor-patient relationships on the basis of personal cases. This study reports the validation of a questionnaire aimed at the identification of learning processes among Balint group participants in China.MethodsThis multicenter cross-sectional study was conducted during Balint group sessions in Beijing, Guangzhou and Shanghai. A heterogeneous sample of different professional groups was intended to adequately capture the reality of Balint work in China. After a Balint group session, the participants were asked to complete the Mandarin version of the Balint group session questionnaire (BGQ-C) and the group questionnaire (GQ), an internationally validated instrument to assess central dimensions of therapeutic relationships during group processes.ResultsQuestionnaires from n = 806 participants from 55 Chinese Balint groups, predominantly comprising individuals with a medical background, were analyzed. Most participants were female (74.6%), and the average age was 34.2 years old (SD = 9.4). The results indicated good to very good reliability (Cronbach’s α = .70 to .86; retest rs = .430 to .697). The verification of the construct validity of the BGQ-C showed satisfying convergent (rs = .465 to .574) and discriminant validity (rs = -.117 to -.209). The model was tested with a confirmatory factor analysis of a three-factor model (standardized root mean square residual = .025; comparative fit index = .977; Tucker-Lewis index = .971). The 3 empirically identified scales resulted in good model fit with the theoretical dimensions of Balint work postulated in the literature: “reflection of transference dynamics in the doctor-patient relationship”, “emotional and cognitive learning” and “case mirroring in the dynamic of the group”. Due to the high correlations between the factors, a single-factor model was possible. A group comparison between the German and Chinese samples showed different loadings across cultures.ConclusionsThe BGQ-C is a quick-to-complete, item-based measuring instrument that allows the relevant dimensions of Balint group work to be recorded. This study suggests good psychometric properties of the Chinese version. Nevertheless, it must be assumed that the composition of constructs in the two countries is different.

Reliability and Validity of the Mandarin Version of the Voice-Related Quality of Life (MV-RQOL) Measure

The reliability and validity of the Voice-Related Quality of Life (V-RQOL) measure has been conducted in languages other than Mandarin. Therefore, this study aims to analyze the reliability and validity of the Mandarin version of the V-RQOL (MV-RQOL) questionnaire. The MV-RQOL was completed by a total of 57 participants, including 27 individuals with voice disorders (VD) and 30 individuals without voice disorders (NVD). Statistical analyses were carried out to evaluate the validity, reliability, reproducibility, and the Receiver Operating Characteristic (ROC) curve was also derived. Statistical analyses demonstrated the MV-RQOL has strong internal consistency. The test-retest reliability was found to be high as well. There was a significant difference between the groups with and without voice disorders. The NVD group had higher scores compared with the VD group for the overall MV-RQOL score and for the 2 domains. In addition, the scores between males and females showed no significant differences. A significant difference was found between the MV-RQOL scores of individuals who defined their voices as good and very good, and those who defined their voices as poor and fair. Area under the curve value from ROC curve was found to be 0.994. The optimal cutoff value was found to be 85.00, with sensitivity of 96.7% and specificity of 96.3%. Based on the results, it can be suggested that the MV-RQOL measure is a reliable and valid self-assessment tool, that discriminates well between patients with and without voice disorders, in the Taiwanese population.

The Relationship Between Hearing Loss and Cognitive Impairment in a Chinese Elderly Population: The Baseline Analysis.

Objectives: The objective of the study was to investigate the association between untreated age-related hearing loss and cognitive impairment in Mandarin-speaking older adults living in China.Methods: Older adults (293; 111 males, M = 70.33 ± 4.90 years; 182 females, M = 69.02 ± 4.08 years) were recruited. All participants completed a pure tone audiometric hearing assessment, Hearing Impairment-Montreal Cognitive Assessment Test (HI-MoCA), and a computerized neuropsychology test battery (CANTAB). The Mandarin version of the De Jong Gierveld Loneliness Scale was used to measure the loneliness, and the Mandarin version of the 21-item Depression Anxiety Stress Scale (DASS-21) was used to measure the current severity of a range of symptoms common to depression, stress, and anxiety of the participants.Results: A multiple stepwise regression analysis showed that the average of four mid-frequency thresholds in the better ear was related to CANTAB Paired Associates Learning (β = 0.20, p = 0.002), and the global cognitive function score (HI-MoCA) (β = −0.25, p < 0.001). The average of three high frequencies in the better ear was significantly associated with CANTAB Delayed Matching to Sample (β = −0.16, p = 0.008), and Spatial Working Memory (β = 0.17, p = 0.003).Conclusion: The results revealed a significant relationship between age-related hearing loss and cognitive impairment in Mandarin-speaking older adults. These research outcomes have clinical implications specifically for hearing health care professionals in China and other populations that speak a tonal language, especially when providing hearing rehabilitation.

Validation of the Committed Action Questionnaire-8 and Its Mediating Role Between Experiential Avoidance and Life Satisfaction Among Chinese University Students.

Background: Committed action is one of the core processes of psychological flexibility derived from acceptance and commitment therapy. It has not been widely investigated in mainland China as appropriate measures are lacking. The current study aimed to validate a Chinese (Mandarin) version of the Committed Action Questionnaire (CAQ-8) in a non-clinical college sample and to explore whether committed action would have a mediating effect in the association between experiential avoidance (EA) and life satisfaction.Methods: We translated the CAQ-8 into Chinese (Mandarin). A total of 913 Chinese undergraduates completed a set of questionnaires measuring committed action, EA, mindful awareness, anxiety, depression, stress, and life satisfaction. For test–retest reliability, 167 respondents completed the CAQ-8 again 4 weeks later.Results: The entire scale of CAQ-8 (Mandarin) and two subscales showed adequate internal consistency and acceptable test–retest reliability. Confirmatory factor analyses confirmed the two-factor structure and the convergent and criterion validity were acceptable. Committed action was correlated with less EA, more mindful awareness, less depressive symptoms, less anxiety, less stress, and more life satisfaction. In bootstrap mediation analyses, committed action partially mediated the association between EA and life satisfaction.Conclusion: The results suggest that the CAQ-8 (Mandarin) is a brief, psychometrically sound instrument to investigate committed action in Chinese populations, and the relationship between EA and life satisfaction was partially explained by committed action. This study provides new information about the usefulness of CAQ-8 and supports the assumption that committed action may be considered a promising factors for improving life satisfaction who have involved in EA among an educated non-clinical population.

Development and validation of a mandarin version of demoralization scale for adolescents and young adults

The impact of demoralization among the general population has received little attention due to the lack of an appropriate measurement. Three studies involving 1,143 high school and undergraduate students in Taiwan were thus conducted to develop and validate a tool to assess demoralization. A pool of 50 items was first developed and administered to high school students. Exploratory factor analysis results supported a 5-factor solution with 15 items (Study 1). Study 2 compared the potential models using confirmatory factor analysis and found the 5-factor second-order model with 15 items the best fit model. The 15-item Mandarin version of Demoralization Scale (DS-M-15) was also found to have good internal consistency, test–retest reliability, and (concurrent and predictive) validity in a sample of undergraduate students (Study 3). Taken together, the converging findings show that the DS-M-15 is a promising tool for assessing demoralization among Chinese adolescents and emerging adults.

Nurse-led exercise and cognitive-behavioral care against nurse-led usual care between and after chemotherapy cycles in Han Chinese women of ovarian cancer with moderate to severe levels of cancer-related fatigue: A retrospective analysis of the effectiveness.

Women with ovarian cancer are reported to fatigue over time. Moderate to severe levels of cancer-related fatigue is fluent in Han Chinese patients with cancer. Comprehensive Cancer Network guidelines are recommending exercise and cognitive behavioral therapy to reduce cancer-related fatigue. Exercise is an easy, cost-effective, and non-pharmacological approach. The objective of the study was to evaluate the effectiveness of nurse-led exercise and cognitive-behavioral care against nurse-led usual care in Han Chinese women of ovarian cancer regarding cancer-related fatigue, depressive symptoms, and sleep quality.Han Chinese women with moderate to severe levels of cancer-related fatigue have received 30 minutes, 5 times/week nurse-led exercise and 60 min/week cognitive-behavioral care (EC cohort, n = 118) or nurse-led usual care regarding educations and recommendations only (UC cohort, n = 126) or have not received nurse-led exercise, cognitive-behavioral care, educations, and recommendations (NC cohort, n = 145) between and after chemotherapy cycles. The Piper Fatigue Scale, the Zung Self-rating Depression Scale, and Pittsburgh Sleep Quality Index questionnaires were evaluated at the start and the end of non-pharmacological treatment.At the end of treatment as compared to the start of treatment, only women of EC cohort had decrease Piper Fatigue Scale (5.40 ± 1.49/woman vs 6.06 ± 1.49/woman, P < .0001, q = 4.973) and Zung Self-rating Depression Scale score (48.67 ± 4.24/woman vs 49.93 ± 4.29/woman, P = .001, q = 3.449). Also, at the end of treatment, as compared to the start of treatment, only women of EC cohort have increased Pittsburgh Sleep Quality Index score (14.76 ± 2.18/woman vs 13.94 ± 2.90/woman, P = .045, q = 3.523). Only exercise and cognitive-behavioral care were successful in a decrease in the numbers of women with depression (the Mandarin Chinese version of the Zung Self-rating Depression Scale score >53, 32 vs 16, P = .015).Nurse-led exercise and cognitive-behavioral care can help Han Chinese women with ovarian cancer to decrease cancer-related fatigue and depression. Also, it can improve the quality of sleep.Evidence Level: 4.Technical Efficacy: Stage 5.

A methodological study on the combination of qualitative and quantitative methods in cognitive interviewing for cross-cultural adaptation.

AimThe aim of this study is to explore the use of the Questionnaire Appraisal System with a combination of qualitative and quantitative methods in cognitive interviewing for cross‐cultural adaptation.DesignThis is a descriptive methodological study.MethodsUsing the Mandarin version of the Post‐Stroke Checklist as an example, cognitive interviews were conducted with 27 stroke survivors in Guangzhou between November 2020 and February 2021. The Questionnaire Appraisal System was applied as a codebook in focus group discussions to perform quantitative data collections and quantitative content analysis.ResultsThirty‐eight problems were proposed in focus group discussions and identified all but four of the 30 questions that emerged in the cognitive interviews. A new item was added to the Questionnaire Appraisal System for better categorization. Four categories and six subcategories of problems in the checklist were revealed.

Easy to Read Health Education Material Improves Oral Health Literacy of Older Adults in Rural Community-Based Care Centers: A Quasi-Experimental Study.

Health education increases older adults’ health knowledge and affects their health outcomes. Older adults have physical changes with aging, such as blurred vision and cognitive decline. Therefore, health education materials must be legible in their case. This study, following the “easy (EZ) to read” concept, designed oral health education material and tested the learning effectiveness of older adults in rural community-based care centers in central Taiwan. Three of the communities were provided EZ to read health education material (n = 72), while three were given general text material (n = 57) as the control group. We collected pre-test and post-test scores using the Mandarin version of the oral health literacy adult questionnaire (MOHL-AQ). The demographic background of the EZ to read and general text groups showed no significant difference (p > 0.05). Analysis of covariance (ANCOVA) showed that the EZ to read material significantly improved total scores of oral health literacy (p < 0.001). The chi-square test showed a significant improvement in oral health literacy levels (p < 0.001). We suggest applying EZ to read concepts to widen the field of older adult education and to reduce illegibility-induced health knowledge disparities.

Inpatient Dignity Scale: Mandarin translation and psychometric characteristics evaluation

AimThe aim of this paper was to translate the English version of the Inpatient Dignity Scale into Mandarin and to test the psychometric properties of the Mandarin version of the Inpatient Dignity Scale.DesignThis research is a cross‐sectional survey, using convenience sampling.MethodsThe English version of the Inpatient Dignity Scale was translated into Mandarin Chinese. From June–August 2020, 736 inpatients from 50 tertiary hospitals in Guangzhou were recruited to assess the psychometric attributes of the Inpatient Dignity Scale.ResultsThe Mandarin version of the Inpatient Dignity Scale consists of expectation and satisfaction subscales. It differs from the English language version, as the expectation subscale includes three dimensions and the satisfaction subscale includes two dimensions. The total Cronbach alpha coefficient of the expectation subscale and the satisfaction subscale were .820 and .965, respectively, and the split‐half reliability of the expectation subscale and the satisfaction subscale were 0.740 and 0.928, respectively, indicating good internal consistency and effectiveness. Known‐groups validity was established, as 70% of the hypotheses were supported.

Association of Postpartum Pain Sensitivity and Postpartum Depression: A Prospective Observational Study.

IntroductionPostpartum depression (PPD) is a severe psychiatric disorder that negatively affects postnatal mothers worldwide. The aim of the study is to investigate the association between postpartum pain sensitivity and PPD as well as to identify the other potential risk factors for PPD and their interconnections.MethodsThe current study was a prospective observational clinical study that enrolled 210 singleton pregnant women in a tertiary referral hospital from January to December 2020. Postpartum pain sensitivity was assessed by the Mandarin Chinese version of the Pain Sensitivity Questionnaire (PSQ), and PSQ-C-total and PSQ-C-minor scores were collected. PPD was screened by self-reporting Edinburgh Postnatal Depression Scale (EPDS), and EPDS total score was recorded. The association between postpartum pain sensitivity and PPD, as well as the risk factors and their interconnections, was analyzed by using a combination of stratified, bivariate, correlation, receiver-operating characteristic (ROC) curve, multivariate logistic regression, and path analysis.ResultsOverall, 87 of 210 mothers (41.4%) screened positive for PPD. A positive correlation between PSQ-C-total (r = 0.67) or PSQ-C-minor (r = 0.62) and EPDS scores was identified. PSQ-C-total [area under curve (AUC) 0.89, 95% CI 0.84–0.93; P < 0.0001] showed significantly higher diagnostic accuracy compared with PSQ-C-minor (AUC 0.85, 95% CI 0.80–0.90; P < 0.0001) in predicting EPDS scores ≥ 10 points. Multivariate logistic regression indicated that a high PSQ-C-total score [adjusted odds ratio (OR) 1.12, 95% CI 1.08–1.51; P < 0.001] and gestational diabetes (adjusted OR 2.68, 95% CI 0.96–7.47; P = 0.045) were independent risk factors, while breastfeeding (adjusted OR: 0.34, 95% CI 0.15–0.78; P = 0.007) and normal birth weight (adjusted OR 0.17, 95% CI 0.05–0.61; P = 0.0047) were independently associated with decreasing adjusted ORs for EPDS scores ≥ 10 points. The path analysis model indicated that PSQ-C-total scores and gestational diabetes showed bidirectional effects, while birth weight and breastfeeding only had a direct impact on EPDS scores ≥ 10 points.ConclusionIncreased postpartum pain sensitivity was closely associated with EPDS scores ≥ 10 points, and PSQ-C scores could be a reliable predictor. Moreover, gestational diabetes, low occurrence of breastfeeding, and low birth weight were the risk factors for EPDS scores ≥ 10 points.Trial RegistrationChiCTR.org.cn identifier, ChiCTR-2000033091.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40122-021-00325-1.

Investigation Regarding Early Cognitive Function of Women in the Postpartum Period and the Analysis of Influencing Factors.

ObjectiveThe present study aims to assess the cognitive function of healthy full-term puerperae and compare it with the cognitive function of healthy non-pregnant women in order to analyze possible influencing factors.MethodsThe study subjects were divided into two groups: the maternal (case) group (n = 80) and the control group (n = 30). A total of 50 healthy single-birth full-term primiparous women and 30 women undergoing a second pregnancy were assigned to the maternal group, while 30 non-pregnant women matched by general data were assigned to the control group. Subject cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) (Beijing version) and the Birmingham Cognitive Screen (BCoS) (Mandarin version); related influencing factors were analyzed.ResultsIn the maternal group, the results showed a MoCA score of 26.52 ± 2.13 points and a cognitive impairment incidence of 26% in primiparous women, along with a MoCA score of 25.83 ± 2.49 points and a cognitive impairment incidence of 36.7% in women undergoing a second pregnancy. All scores were lower in the maternal group than in the control group, which had a MoCA score of 27.47 ± 1.28 points and cognitive impairment incidence of 6.7% (p < 0.05). The differences in MoCA score and cognitive impairment incidence between the primiparous sub-group and the second pregnancy sub-group were not statistically significant (p > 0.05). The visual space and executive function MoCA scale scores were lower in the maternal group than in the control group (p < 0.01). Furthermore, the scores were lower in the maternal group than in the control group in the following BCoS items: instant story recall, total apple deletion number, auditory attention, rule conversion, and gesture imitation (p < 0.05).ConclusionWomen in the postpartum period may develop cognitive dysfunction; however, the difference in cognitive impairment incidence between the primiparous sub-group and the second pregnancy sub-group in this study was not statistically significant. The educational level, labor analgesia, and total labor time (min) were found to be influencing factors in the postpartum cognitive function decline (p < 0.05).

Processing of expressions by individuals with autistic traits: Empathy deficit or sensory hyper-reactivity?

Individuals with autistic traits display impaired social interaction and communication in everyday life, but the underlying cognitive neural mechanisms remain very unclear and still remain controversial. The mind-blindness hypothesis suggests that social difficulties in individuals with autistic traits are caused by empathy impairment in individuals; however, the intense world theory suggests that these social difficulties are caused by sensory hyper-reactivity and sensory overload, rather than empathy impairment. To further test these two theories, this study investigated event-related potentials (ERPs) to explore the cognitive neural processing of repetitive expressions in individuals with autistic traits. This study employed the Mandarin version of the autism-spectrum quotient (AQ) to assess autistic traits in 2,502 healthy adults. Two subset groups were used, e.g., the participants of a high-AQ group were randomly selected among the 10% of individuals with the highest AQ scores; similarly, the participants in the low-AQ group were randomly selected from the 10% of participants with the lowest AQ scores. In an experiment, three different facial expressions (positive, neutral, or negative) of the same person were presented successively and pseudo-randomly in each trial. Participants needed to define the expression of the face that was presented last. The results showed that compared with the low-AQ group, the high-AQ group exhibited higher P1 amplitudes induced by the second and third presented expressions, as well as higher P3 amplitudes induced by the third presented negative expressions. This indicates that individuals with autistic traits may experience overly strong perception, attention, and cognitive evaluation to repetitive expressions, particularly negative expressions. This result supports the intense world theory more strongly than the mind-blindness hypothesis.

Determining the factors associated with oral health-related quality of life in Chinese elders: Findings from the fourth national survey.

The purpose of this study was to assess the associations between the self-reported oral health-related quality of life (OHRQoL) of older Chinese people and their socio-economic status and oral health using data collected in the 4th National Oral Health Survey. After multistage stratified cluster sampling, 4332 adults aged 65-74years participated in the study. After a clinical examination, the participants completed a structured questionnaire. A Mandarin version of the General Oral Health Assessment Index (GOHAI) was included in the questionnaire. Clinical examinations were carried out using the criteria recommended by the World Health Organization. Multivariate analysis was used to evaluate the associations of the clinical and socio-demographic variables with the GOHAI scores of the participants. The weighted mean (SE) GOHAI score was 51.6 (0.0). Female sex and having more than 10 missing teeth, unrestored tooth spaces, more than 10 decayed teeth and a periodontal pocket ≥6mm were negatively associated with the GOHAI score, while having a higher education level and living in the Eastern region of China were positively associated with the GOHAI score. After adjustment for confounders, the OHRQoL of older Chinese individuals was mainly affected by untreated dental caries and the loss of teeth. Older Chinese individuals who were male, had a higher education level, were from the Eastern region, had no unrestored tooth spaces or deep periodontal pockets and had fewer decayed or missing teeth had higher GOHAI scores, indicating better OHRQoL.

Associated Factors of Oral Health-related Quality of Life in Chinese Adolescents Aged 12-15 Years.

Students aged 12 to 15 years were recruited using to a multistage stratified random sampling method. All the subjects received oral examination and completed a questionnaire. Information relating to OHRQoL was collected through a Mandarin version of the child oral impacts on daily performances (Child-OIDP) questionnaire. The relationship between the Child-OIDP scores and independent variables was assessed using a Mann-Whitney U-test, Kruskal-Wallis test and a multivariate Poisson regression. A total of 89,582 subjects were included in the analysis, of whom 76.6% reported oral impacts in the last 6 months. Eating was the most affected daily performance. The results of the regression analysis showed that factors associated with adolescents' OHRQoL included sex, location of residence, region, only child status, parents' level of education, frequency of sugar consumption, self-perception of general/oral health, dental appointments in the past 12 months, oral health knowledge status, age, decayed, missing and filled teeth (DMFT) index and number of teeth with gingival bleeding. Oral impacts were common among Chinese adolescents, although most were not so severe. Eating was the most commonly affected performance. Sex, location of residence, region, only child status, parents' level of education, frequency of sugar consumption, selfperception of general/oral health status, dental appointments in the previous 12 months, oral health knowledge status, age, DMFT index and number of teeth with gingival bleeding were found to be associated with OHRQoL.

Effects of preserving the bronchial artery on cough after thoracoscopic lobectomy.

BackgroundThe purpose of this prospective study was to explore the influence of both preoperative three‐dimensional (3D) reconstruction and intraoperative preservation of the bronchial artery (BA) on postoperative cough after thoracoscopic lobectomy.MethodsA total of 60 patients who had received a combination of thoracoscopic lobectomy and systematic lymph node dissection were included in this study. They were divided into two groups, namely the BA preservation group (Group A), and conventional surgical treatment group (Group B). In group A, we used Exoview software for 3D reconstruction of the BA before the operation and the BA was preserved during the operation. 3D reconstruction of the BA was not performed before surgery in group B. The incidence of postoperative cough, the Mandarin Chinese version of the Leicester cough questionnaire (LCQ‐MC), physiological, psychological and social dimensions and total score of the two groups were compared and analyzed.ResultsThe scores and total scores of LCQ‐MC in group B were lower than those in group A one and two months after surgery. There were significant differences between the two groups in physiological and psychological dimensions and total scores (p < 0.05), but there was no significant difference in social dimension between the two groups (p > 0.05). The incidence of postoperative cough in group A (16.7%) was lower than that in group B (30%), while the difference was not statistically significant (p = 0.222).ConclusionsPreoperative 3D reconstruction and intraoperative preservation of the BA can reduce the severity of postoperative cough.

A cross-cultural examination of implicit attitudes toward shyness in Canada and China

The goal of this research was to explore implicit and explicit attitudes about shyness in Canada and Mainland China. In Study 1, Canadian undergraduate students (N = 650) completed a newly developed online version of the Implicit Association Test (IAT) focused on shyness, as well as questionnaires about their own shyness and explicit beliefs about shyness. Results suggested that Canadian university students automatically associated shyness with negative words. In Study 2, Chinese undergraduate students (N = 290) completed a newly developed Mandarin Chinese online version of the IAT related to shyness, as well as questionnaires of their own shyness explicit beliefs about shyness. Results indicated that Chinese students also automatically associated shyness with negative words, but differences were observed in the pattern of association with participants’ own shyness. Results are discussed in terms of the implications of attitudes toward shyness in both cultures.

Health literacy and cancer screening behaviors among community-dwelling female adults in Taiwan

ABSTRACT This study was designed to explore the association among health literacy and cancer screening behaviors in Taiwanese females. A total of 353 community-dwelling females were recruited in this cross-sectional study from February to October 2015. Demographic, socioeconomic and personal behavior variables including physical activity, community activity, smoking, alcohol consumption, and betel nut chewing were recorded. Health literacy was evaluated using the Mandarin version of the European Health Literacy Survey Questionnaire. Data on screening behaviors for cervical, breast and colorectal cancers were confirmed by the Taiwanese National eHealth Database. Most respondents with inadequate or problematic general health literacy had no or irregular screening behaviors for cervical, breast and colorectal cancers. In multivariable regression analysis, women with inadequate health literacy were at a greater risk (Odds ratio = 5.71; 95% CI: 1.40–23.26) of having no previous Pap smear screening or >3 years screening interval regardless of education level. However, this association was not detected for breast or colorectal cancer. Women with inadequate health literacy were more likely to have irregular cervical cancer screening, however no associations among health literacy and breast or colorectal cancer were detected. The impact of health literacy on cancer screening behavior warrants further attention and research.

Reliability and validity of the Brief Assessment of Impaired Cognition (Chinese version) for stroke patients

Objective and accurate cognitive assessment scales are essential for guiding cognitive rehabilitation following stroke. The aim of this study was to evaluate the validity and reliability of the Mandarin Chinese version of the Brief Assessment of Impaired Cognition (BASIC) in stroke patients. The English version of the BASIC scale was translated into Mandarin Chinese, and 56 stroke patients at a stroke treatment center were enrolled in the study. The Mini-Mental State Examination (MMSE) and BASIC scale were used to evaluate the patients’ cognitive function, and content validity, structural validity, concurrent validity, internal consistency, interrater consistency and reliability and test-retest reliability were used to evaluate the test results. The correlation coefficients between each item of the BASIC scale and the total score were between 0.416 and 0.804 (p < 0.05). The total score on the BASIC scale was correlated with the total score on the MMSE (r = 0.479, p < 0.05). Four factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 74.932%. The factor loading of each item on the corresponding factor was > 0.5, indicating that the scale has good structural validity. Internal consistency was good (Cronbach’s α = 0.821), as were interrater (ICC > 0.95) and test-retest reliability (ICC = 0.815–0.941). Therefore, the Chinese version of the BASIC scale has good reliability and validity and can assist in screening for cognitive dysfunction or dementia in stroke patients.