Cecilia Chan

• Professor Emeritus at The University of Hong Kong

Objectives: Research considered patient outcomes primarily over caregivers in end-of-life care settings. The importance of family caregivers (FCs) in end-of-life care draws growing awareness, evidenced by an increasing number of evaluations of caregiver-targeted interventions. Little is known of FCs’ collateral benefits in patient-oriented home-bas...

Generativity has been increasingly recognized as an important component of healthy aging. Although the desire to be generative is influenced by societal and cultural expectations, the relative influence of its driving factors by retirement status, a significant life-course transition, is underexplored. This study examined how later-life generativit...

This study examined the moderating mechanisms of generative concerns (perception of making contributions to others) between generative civic activities and mental health among middle-aged and older adults. A total of 1,109 community-dwelling adults aged over 45 were recruited through an online survey. Generative civic activities (political particip...

Objective: Living the final days of life being cared for at home is a preference expressed by many. The data on the effectiveness of home-based end-of-life care (EoLC) intervention to improve the holistic conditions of terminally ill patients are scanty. This study sought to evaluate a psychosocial home-based EoLC intervention for terminally ill p...

Objectives: This study examines associations between social isolation and depressive symptoms among Hong Kong Chinese adults aged 65 and older by investigating the distinct effects of individual indicators, cumulative index, and typologies of social isolation during the Covid-19 pandemic. Methods: We used a sample of 260 older adults from a cros...

In Hong Kong, the population of centenarians increased from about 3,000 in 2011 to over 10,000 in 2021. The growth of this population has led to challenges concerning how far family caregivers, who are usually older adults themselves, could care for their spouse or parents. In 2021, we launched the 2nd Hong Kong Centenarian Study and included the v...

The first centenarian study in Hong Kong was conducted in 2011 and examined the multidimensional health of adults aged 95 or older. The 2011 study found that, among a population of about 3,000 centenarians, a significant proportion enjoyed a high degree of autonomy in their daily functions in relatively good health. The study has been repeated in 2...

Successful aging (SA) was proposed by Robert J Havighurst in 1961 to capture how older adults add “lives onto (their) years.” While there is a consensus regarding the multidimensionality of the concept, the set of criteria that should be applied to older adults of advanced age remain controversial. Notwithstanding their inevitable decline in physic...

Objectives To determine the effectiveness of a simple, self-administrable moxibustion-cum-massage intervention for relieving chronic pain and improving psychological well-being for older adults in the community. Design A randomized controlled trial. Setting Seventy-eight participants with chronic pain were randomly assigned to the intervention an...

The strengths of drawing-based approaches for encouraging children's participation in health research and facilitating communication with them have been increasingly acknowledged in the medical literature. However, there is a lack of methodological discussion on drawing-based approaches suitable for researching children living with physical health...

The emotional consequences of infertility are well documented. However, relatively few studies have emphasized the dyadic emotional interaction within couples, despite infertility being a shared life event. This study adopted a dyadic (between two people) approach to explore the emotional complexity that infertile couples face. A descriptive qualit...

Hong Kong experienced the SARS pandemic in 2003. Seventeen years later, the Covid-19 pandemic now challenges Hong Kong and the world. This study aims to unveil the impact of the pandemic on health social workers. One hundred and sixty-six health care social workers in Hong Kong were recruited to join a cross-sectional online survey from November 20...

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 P...

Generativity has recently received increasing attention as a key contributor to healthy aging. Personal resources and social expectations are shown to influence the desire to be generative and that generativity affects later-life health. However, whether generativity has a mediating role in linking its driving factors and health, and how gender may...

Chinese people are typically family oriented with strong intergenerational obligations and often regard discussion of death as a taboo. Palliative social workers carefully assess the needs of patients as well as those of the extended family network in situations of critical and serious illness. It is important for social workers to be sensitive to...

Introduction Atopic dermatitis (AD) is the most common childhood inflammatory skin problem affecting 15%–30% of children. Although AD adversely impacts the psychosocial well-being of children and their parent caregivers, parents’ psychosocial well-being is seldom mentioned in most non-pharmacological education programmes. A family-based psychosocia...

The Second Edition of the Oxford Textbook of Palliative Social Work is a compendium of contextualized information relevant to the field of palliative care, which coheres the collective wisdom of more than 150 authors, reflecting expertise, evidence, and passion. Infused with patient and family narratives, learning exercises and resources, the T ext...

This study examines the 21‐year longitudinal impacts and predictive effects of family caregiver transition and the presence of family caregiving on the clinical status of persons with schizophrenia (PwSs) in a rural area of China. Using panel data derived from the Chengdu Mental Health Project (CMHP), 250 dyads of PwSs and their family caregivers w...

Background Physical activity (PA) has been positively associated with health-related quality of life (HRQoL) among cancer patients and family caregivers. However, there has been no relevant research for patient-caregiver dyads. Methods Path analysis, based on the actor–partner interdependence model (APIM), was used to examine the relationship betw...

Background Affiliate stigma of family caregivers may severely influence family caregiving, early treatment, and recovery of people with mental illness (PMI), and it may be impacted by the knowledge of mental illness and contact with PMI. However, little is known about the correlation between affiliate stigma of family caregivers of PMI and contact...

Depressed people are prone to sleep disturbance, which may in return perpetuate the depression. Both depression and sleep disturbance influence proinflammatory cytokines interleukin (IL) 6 and 1β. Thus interventions for depression should consider the effect on sleep disturbance, and vice versa. Integrative Body-Mind-Spirit (IBMS) and Qigong interve...

Post-traumatic growth (PTG) emerges from highly stressful situations. The coronavirus (COVID) pandemic may qualify as one. This study investigated the PTG among Hong Kong citizens during the first outbreak in spring 2020, shortly after a large-scale social movement subsided. A longitudinal online survey was launched during the peak (Time 1) and the...

Purpose This study aimed to (1) explore the prevalence and relevant influencing factors of different mental disorders 5 years after the Lushan earthquake in Ya’an, China. Methods An epidemiological mental health survey was conducted to identify the prevalence of mental disorders in general population in Ya’an. A multi-stage, group-matching random...

Women with polycystic ovary syndrome (PCOS) suffer significant psychological distress, which may activate the hypothalamus-pituitary-ovary axis and further affect their physiological state. They often experience elevated levels of testosterone and triglycerides. Considering reports of psychological distress among women with PCOS, this study aimed t...

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 b...

During COVID-19 pandemic, people experienced lockdown and associated distress. As face-to-face intervention was unfeasible, an 8-week Strength-based Online Community Intervention (SOCI) was developed and evaluated with a quasi-experimental design in Hubei Province, China from February to April 2020. Participants (N = 150) self-elected to join eithe...

The emphasis of risk has been recognized as a crucial component to effective and successful policy compliance amidst a crisis. Yet, during the COVID-19 pandemic, when the impact of risk may fluctuate with the severity of the prolonged pandemic, and that the public consider not only public health factors when they choose but also whether to follow a...

Studies have shown individuals with chronic illnesses tend to experience poorer mental health compared to their counterparts without a chronic illness under the COVID-19 pandemic. The pervasive disruption on daily lifestyles due to social distancing could be a contributing factor. In this study, we collaborated with local patient support groups to...

Background: Chlamydia is common amongst the sexually active population in Hong Kong. As most cases are asymptomatic, partner notification may be helpful in controlling chlamydia. This study examined attitudes towards partner notification for chlamydia among Hong Kong Chinese youths in order to inform a culturally appropriate, patient-empowering se...

The emphasis of risk has been recognized as a crucial component to effective and successful policy compliance amidst crisis. Yet, during the COVID-19 pandemic, when the dreadfulness of the risk may fluctuate with the severity of the prolonged pandemic, and the nature of public health policy is not confined purely to public health concerns, perceive...

Background It remains unknown what the impacts of multiple dimensions of contact (e.g. level, quantity and quality) are on the stigma of mental illness. Aims To explore the relationship between the multiple dimensions of contact and stigma of mental illness among family members (FM), mental health workers (MHW) and community residents (CR) in Hong...

Background Although poverty associated with severe mental illness (SMI) has been documented in many studies, little long-term evidence of social drift exists. This study aimed to unravel the poverty transitions among persons with SMI in a fast change community in China. Methods Two mental health surveys, using the International Classification of D...

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...

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 PCO...

This is a reflection of my personal journal of my engagement in research on social worker practice to being out change in society. Through my 40 years of social work practice, I have used touching stories, case studies, pre–post intervention outcome studies, randomized control trials, and eventually moving into using biomarkers as outcome measures...

Objectives Families facing end-stage nonmalignant chronic diseases (NMCDs) are presented with similar symptom burdens and need for psycho-social–spiritual support as their counterparts with advanced cancers. However, NMCD patients tend to face more variable disease trajectories, and thus may require different anticipatory supports, delivered in fam...

PurposeHousehold poverty associated with schizophrenia has been long described. However, the mechanisms by which schizophrenia may have influenced the economic status of a household in rural communities are still unclear. This study aimed to test an integrated model of schizophrenia, social support and caregiving burden on household poverty in a ru...

Background Although knowledge is a crucial component in contact theory delineating how prejudice changes toward out-groups with stigmatized conditions, little is known about the mediating role of knowledge on contact, stigmatizing attitudes, and behaviors toward mental illness. Aim This study aimed to examine the mechanism underlie contact and sti...

COVID-19 has brought tremendous and abrupt threats to various aspects of our daily lives, from school and work to interpersonal relationships. Self-compassion is put forth as a salutogenic perspective on oneself that buffers the adverse mental health impacts of these threats. During the peak of a local outbreak in Hong Kong in Spring 2020, 761 part...

Background Self-stigma exerts a range of adversities for persons with severe mental illness (SMI), however, little is known about the association between peer contact, social support and self-stigma. Aims This study aimed to explore the mediating role of social support on the relationship between peer contact and self-stigma among persons with SMI...

Background: Alcohol dependence is associated with alcohol-related problems and persistent vulnerability to relapse. Despite newer medications, frequent relapses continue to occur. Hence, there is a need to look at holistic approaches to deal with this problem. Objective: Evaluate the effectiveness of nurse-led body-mind-spirit (BMS)-based relaps...

Background: Little is known about poverty trends in people with severe mental illness (SMI) over a long time span, especially under conditions of fast socioeconomic development. Aims: This study aims to unravel changes in household poverty levels among people with SMI in a fast-changing rural community in China. Method: Two mental health surve...

Background It is unknown whether and how poverty influences the long-term outcome of persons with severe mental illness (SMI). Aims To explore the change of poverty status in persons with SMI from 1994 to 2015 and examine the impact of poverty status on patients’ outcome in rural China. Method Two mental health surveys using identical methods and...

PurposeThis study explored the role of perceived severity of the pandemic, post-traumatic stress and sense of coherence in the development of post-traumatic growth from exposure to COVID-19 among Hong Kong citizens. MethodsA longitudinal online survey was launched during the first local outbreak in Spring 2020. Time 1 was collected at the peak of t...

COVID-19 has brought tremendous and abrupt threats to various aspects of our daily lives, from school and work to interpersonal relationships. Self-compassion is put forth as a salutogenic perspective on oneself that buffers the adverse mental health impacts of these threats. During the peak of a local outbreak in Hong Kong in Spring 2020, 761 part...

Present study examined effectiveness of Integrative Body Mind Spirit (I-BMS) intervention among individuals with alcohol dependence. A 2-group single blind RCT design was used, comparing I-BMS to treatment as usual (TAU) on drinking and psychological outcomes. One hundred participants diagnosed with alcohol dependent syndrome were randomly assigned...

At the beginning of the pandemic, the world has likened COVID-19 to SARS which devastated Hong Kong in 2003. Based on the results of a survey conducted between March and April 2020 with 761 Hong Kong adult residents, we summarised three lessons on the coping of Hong Kong people: (i) Establish adequate personal vigilance, (ii) Brace for a mental hea...

Background Little research effort has been devoted to examining the role of patient enablement in alleviating health anxiety in primary care. In this study, we examined the role of patient enablement as a moderator in the relationship between health anxiety, psychological distress, and treatment seeking in traditional Chinese medicine (TCM). Metho...

Childhood sexual abuse (CSA) has been shown to predict the coupling of depression and inflammation in adulthood. Trust within intimate relationships, a core element in marital relations, has been shown to predict positive physical and mental health outcomes, but the mediating role of trust in partners in the association between CSA and inflammation...

This chapter is a review on how the Integrative Body-Mind-Spirit (IBMS) intervention model is being developed through a process of serving and learning from patients and survivors on what helped them through their trajectory of illness or experience. It includes moving from simple pre-/post-measures to randomized controlled trial, generating IBMS m...

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 mar...

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 w...

Objective The symptomatology of atopic dermatitis (AD) imposes heavy physical, psychological, and social burdens on children, yet their psychosocial needs have been commonly ignored in AD management. Evidence of the psychosocial effects of psychosocial interventions on childhood AD is thin. The present study aimed to examine the effects of a custom...

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...

Abstract Background: Maternal psychopathology can be an important factor associated with psychological adjustment of children. However, there is limited research on long-term impacts of maternal posttraumatic stress disorder (PTSD) on children’s mental health. This study examined how PTSD trajectories of women exposed to the 2008 Wenchuan earthquak...

Atopic dermatitis (AD) imposes significant physical and psychosocial burdens on affected children. However, little has been done to learn from the subjective experiences, perspectives and emotions of children living with AD. Their voices are not heard in healthcare settings. This study aims to share these children's voices and provide a deep unders...

Background Little is known about the relationship between changes of family structure for people with severe mental illness (SMI) and treatment status of SMI during a period of sustained rapid socioeconomic development. This study aimed to explore the relationship between changes of family structure and treatment status of people with SMI in a 21-y...

The present study examined a set of longitudinal, dyadic data obtained from a dyadic intervention study and used the actor-partner interdependence model (APIM) to analyze if there are significant predictive relationships between the anxiety levels of children with eczema and that of their parent caregivers. The levels of anxiety of children with ec...

This study was performed to compare the treatment status between older (≥65 years) and younger adults (18-64 years) with severe mental illness (SMI) and explore factors associated with treatment status in rural China. Persons with SMI were identified in one mental health survey in 2015 in 6 townships of Xinjin County, Chengdu, China. Logistic regre...

Background Little is known about the impacts of schizophrenia on different types of caregiving burden. Aim This study aims to examine how the severity of schizophrenia, social functioning and aggressive behavior are associated with caregiving burden across different kinship types. Method The analytic sample included 300 dyads of persons with schi...

Purpose Internalized stigma, an adverse psychological process, severely impedes the lives of people diagnosed with schizophrenia and restricts them from social integration and recovery. The aim of this study was to empirically evaluate an integrative model of relationship between internalized stigma and patients’ recovery-related outcomes among peo...

Assessing the psychological effects on children and adolescents of suffering atopic dermatitis (AD) is essential, when planning successful management. This study aimed to systematically review the literature regarding risk of mental disorders in children and adolescents with, or without, AD; and to explore confounders. We identified potentially rel...

Objective Forgiveness includes processes that involve a decision to stop bitterness and thoughts of revenge (i.e., decisional forgiveness), which further motivates the forgiver towards the restoration of positive emotions (i.e., emotional forgiveness). Using stress and coping framework, this study investigated intrapersonal and interpersonal facili...

Study question: Do sense of meaning and acceptance mediate the relationships between gratitude and infertility-related stress among women undergoing IVF? Summary answer: Among women undergoing IVF, the negative relationships between gratitude and infertility-related stress are explained by a general sense of meaningfulness and acceptance of life...

To enhance the academic achievements of Yi ethnic minority youths in rural school settings, the authors examined the effect of classmate support and the meditating role of ethnic identity in promoting their academic motivation. Cross-sectional survey data were collected from Yi youths sponsored by a philanthropic organization to attend local school...

Background: Studies on mental health following disasters have primarily focused on posttraumatic stress disorder (PTSD), yet severe, enduring and disabling grief (i.e., complicated grief, CG) also appears relevant. Objective: The present study examines symptom profiles of PTSD and CG among bereaved Sichuan earthquake survivors one year after the di...

Importance Qigong is a mind-body exercise that may be an effective self-care intervention for improving the well-being of women survivors of intimate partner violence. Objective To test whether a qigong intervention would increase telomerase activity and improve mental health in Chinese women who survived intimate partner violence. Design, Settin...

Chronic fatigue syndrome (CFS) is often overlooked, has unclear etiology and no effective cure except some symptomatic treatments. Additionally, most people with CFS do not seek medical attention. Qigong exercise, an ancient Eastern body-mind-spirit practice, has been long practiced in Chinese communities and may powerfully trigger the self-healing...

Purpose: Eczema is a pediatric skin disease that affects the psychosocial well-being of both children and their parent caregivers. This paper outlines a protocol for an experimental study that evaluates the effectiveness of a psychosocial empowerment program for children with eczema and their parent caregivers. Method: A multi-center randomized...

Although stress has been widely acknowledged to link to psychosomatic dysfunctioning, the underlying mechanism that transmits the impact is not adequately investigated. This study examined self-compassion as a potential mediator that may explain the pathway from stress to depressive and somatic symptoms. Data in the present study were drawn from a...

Background Little is known about the relationship between poverty and outcomes of severe mental illness (SMI) during a period of sustained rapid socioeconomic development. This study explored the relationship between poverty and outcomes of people with SMI in a 21-year longitudinal study in a rural area of China. Methods Epidemiological surveys of...

This study aims to examine the relationship between the duration of untreated psychosis (DUP) and 14-year outcomes of schizophrenia in a Chinese rural area. Participants with schizophrenia (n=510) were identified in an epidemiological investigation of 123 572 people aged 15 years and older in 1994 and followed up in 2008 in Xinjin, Chengdu, China....

Background Based on the cognitive theory, anxiety arising from the awareness of death and dying may activate dysfunctional attitudes, which may then reduce quality of life. This study examined the interdependence and the mediating role of dysfunctional attitudes on the relationship between death anxiety and quality of life among patients with lung...

In the recent decades, expressive arts (EXA) has been used in end-of-life care (EOLC) for facilitating the quality of life of the patients and the caregivers. However, it may not be practical for every EOLC service to dispense EXA activities solely by extensively trained art therapy specialists. There is currently a lack of brief training for nonar...

Context: Parent-child book reading (PCBR) is effective at improving young children's language, literacy, brain, and cognitive development. The psychosocial effects of PCBR interventions are unclear. Objective: To systematically review and synthesize the effects of PCBR interventions on psychosocial functioning of children and parents. Data sour...

Compared to cancers at other sites, lung cancer often results in greater psychosocial distress to both the patients and their caregivers, due to the poor prognosis and survival rate, as well as the heavy symptom burden. In recent years, making protocols of proposed or on-going studies publicly available via clinical trial registries and/or peer-rev...

Objective: This study examined the differences in 14-year outcomes of persons with schizophrenia with and without family history of psychosis in a rural community in China. Methods: All participants with schizophrenia (n=510) aged 15 years and older were identified in a 1994 epidemiological investigation of 123,572 people and followed up in 2004...

The purpose of this study is to explore bereaved mothers’ 2-year experiences of losing their only child in the 2008 Sichuan earthquake. Taking an interpretative phenomenological approach, this study interviewed six bereaved mothers four times (6 months, 12 months, 18 months, and 24 months) in Dujiangyan area in Sichuan Province. The findings sugges...

Accepted manuscript: Sleep disturbances and depressive symptoms are closely associated with daytime dysfunctions; yet few studies have investigated their temporal relationship in a randomized controlled trial. We investigated the interrelationships among sleep, depressive symptoms, and daytime functioning following an integrative body-mind-spirit (...

Background Little is known about the change in long-term prevalence of mental disorders during a period of sustained rapid socioeconomic development. Here we explore the prevalence change of severe mental disorders in a 21-year longitudinal study in a rural area of China. Methods Epidemiological surveys of mental disorders were done in May, 1994,...

The primary goal of this study was to examine and describe the importance of childbearing as perceived by infertile women in the Chinese familial and social context. We adopted a qualitative descriptive method and conducted semi-structured interviews with female patients diagnosed with infertility. Participants were recruited at a high-volume ferti...

Chen, L., Fu, F., Sha, W., Chan, C. L. W., & Chow, A. Y.M., (2017). Mothers Coping with Bereavement in the 2008 China Earthquake: A Dual Process Model Analysis. OMEGA: Journal of Death and Dying. Advance online publication. This article was accidentally published twice Online First with different DOIs. The incorrect version of the article with DOI:...

Literature has established that migration processes have significant effects on the mental and psychological health of migrant children and adolescents. Yet, little is known of the effects of family dynamics and individual characteristics on rural-to-urban migrant adolescents’ psychological adjustment in the context of China. Using a cross-sectiona...

The purpose of this study is to explore the grief experiences of mothers after they lost their children in the 2008 China earthquake. Informed by the dual process model, this study conducted in-depth interviews to explore how six bereaved mothers coped with such grief over a 2-year period. Right after the earthquake, these mothers suffered from int...

Background Colorectal cancer imposes threats to patients’ well-being. Although most physical symptoms can be managed by medication, psychosocial stressors may complicate survival and hamper quality of life. Mindfulness and Qigong, two kinds of mind-body exercise rooted in Eastern health philosophy, has been found effective in symptoms management, i...

Background Advance care planning is a process of discussion that enables competent adults to express their wishes about end-of-life care through periods of decisional incapacity. Although a number of studies have documented social workers’ attitudes toward, knowledge about, and involvement in advance care planning, the information is fragmented. Th...

Providing choices on places to be cared during the end stage of life is considered as significant in achieving quality of death. In response to this pressing need, The Hong Kong Jockey Club Charities Trust initiated a Project in whicha Volunteer-Partnered End-of-Life Care (VPEoLC) Model was developed to support community-dwelling elders with advanc...

Background Life review interventions have been used to alleviate psycho-spiritual distress in people near the end of life. However, their effectiveness remains inconclusive. Aim To evaluate the effects of therapeutic life review on spiritual well-being, psychological distress, and quality of life in patients with terminal or advanced cancer. Desi...

The influence of marriage on the long-term outcomes of schizophrenia is largely unknown. This study was to examine the impact of marriage on the 14-year outcomes and identify the correlates of marriage among persons with schizophrenia in rural community. All study participants with schizophrenia (n = 510) were identified in 1994 in an epidemiologic...