1.Mental health awareness and stigmatization: A cross-sectional study of knowledge, attitudes, and perceptions among medical students at a Philippine medical school
Christine R. Sy ; Jose Ronilo G. Juangco
Health Sciences Journal 2025;14(1):36-42
INTRODUCTION
Mental health plays a crucial role in overall well-being, yet stigma and misconceptions persist, even among future healthcare professionals. This study assessed medical students’ knowledge, attitudes, and perceptions (KAP) regarding mental health and explored their association with sociodemographic characteristics.
METHODSWe conducted an analytical cross-sectional study among 270 medical students at a private Philippine university from September to October 2023. Participants completed a validated questionnaire. Descriptive statistics, Spearman’s correlation, and odds ratios were calculated.
RESULTSMost respondents exhibited high knowledge (80.7%), positive attitudes (90.4%), and favorable perceptions (95.6%) toward mental health. Students who had not interacted with individuals with mental illness were 2.87 times more likely to display negative attitudes (OR = 2.87, 95% CI: 1.19–6.90, p = 0.015). Attitude and perception showed a moderate positive correlation (r = 0.409, p < 0.001), while knowledge and perception demonstrated a weak negative correlation (r = -0.129, p = 0.034).
CONCLUSIONThese medical students generally possessed good knowledge, positive attitudes, and perceptions regarding mental health. Academic progression and real-life exposure positively influence attitudes, highlighting the need for experiential learning to reduce stigma and promote empathy in medical training.
Human ; Mental Health ; Knowledge ; Attitude ; Perception ; Philippines
2.Knowledge of COVID-19 and associated factors among kidney transplant recipients and donors in Singapore.
Ian Tatt LIEW ; Yeli WANG ; Terence KEE ; Ping Sing TEE ; Rupesh Madhukar SHIRORE ; Sobhana THANGARAJU ; Quan Yao HO ; York Moi LU ; Jin Hua YONG ; Fiona FOO ; Eleanor NG ; Xia HE ; Constance LEE ; Shannon BAEY ; Marjorie FOO ; Tazeen Hasan JAFAR
Singapore medical journal 2025;66(2):81-90
BACKGROUND:
Effective interventions during the coronavirus disease 2019 (COVID-19) pandemic require an understanding of patients' knowledge and perceptions that influence their behaviour. Our study assessed knowledge of COVID-19 among kidney transplant recipients and donors, hitherto unevaluated.
METHODS:
We conducted a cross-sectional survey among 325 kidney transplant recipients and 172 donors between 1 May 2020 and 30 June 2020. The survey questionnaire assessed knowledge levels of COVID-19, sociodemographic data, health status, psychosocial impact of COVID-19 and precautionary behaviours during the pandemic.
RESULTS:
The mean COVID-19 knowledge score of the study population was 7.5 (standard deviation: 2.2) out of 10. The mean score was significantly higher among kidney recipients compared to kidney donors (7.9 [1.9] vs. 6.7 [2.6]; P <0.001). Younger age (21-49 vs. ≥50 years) and higher education (diploma and higher vs. secondary and lower) were associated with significantly higher knowledge scores in donors, but not among recipients ( P -interactions ≤0.01). In both kidney recipients and donors, financial concerns and/or social isolation were associated with lower knowledge levels.
CONCLUSIONS
Concerted efforts are needed to improve COVID-19 knowledge in kidney transplant recipients and donors, particularly older donors, donors with lower education and patients with financial concerns or feelings of social isolation. Intensive patient education may mitigate the impact of education levels on COVID-19 knowledge levels.
Humans
;
COVID-19/epidemiology*
;
Kidney Transplantation
;
Middle Aged
;
Singapore/epidemiology*
;
Male
;
Female
;
Adult
;
Cross-Sectional Studies
;
Health Knowledge, Attitudes, Practice
;
Transplant Recipients/psychology*
;
Surveys and Questionnaires
;
Tissue Donors/psychology*
;
SARS-CoV-2
;
Young Adult
;
Aged
;
Pandemics
3.Pandemic-related health literacy: a systematic review of literature in COVID-19, SARS and MERS pandemics.
Jun Jie Benjamin SENG ; Cheng Teng YEAM ; Caleb Weihao HUANG ; Ngiap Chuan TAN ; Lian Leng LOW
Singapore medical journal 2025;66(5):244-255
INTRODUCTION:
Health literacy plays an essential role in one's ability to acquire and understand critical medical information in the coronavirus disease 2019 (COVID-19) infodemic and in other pandemics. We aimed to summarise the assessment, levels and determinants of pandemic-related health literacy and its associated clinical outcomes.
METHODS:
A systematic review was performed in Medline ® , Embase ® , PsycINFO ® , CINAHL ® and four major preprint servers. Observational and interventional studies that evaluated health literacy related to the novel COVID-19, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) were included. Items used in health literacy instruments were grouped under the themes of knowledge, attitudes and practices. Determinants of health literacy were grouped into five domains: sociodemographic, medical, psychological/psychiatric, health systems-related and others.
RESULTS:
Of the 2,065 articles screened, 70 articles were included. Of these, 21, 17 and 32 studies evaluated health literacy related to COVID-19, SARS and MERS, respectively. The rates of low pandemic health literacy ranged from 4.3% to 57.9% among medical-related populations and from 4.0% to 82.5% among nonmedical populations. Knowledge about the symptoms and transmission of infection, worry about infection, and practices related to mask usage and hand hygiene were most frequently evaluated. Sociodemographic determinants of health literacy were most frequently studied, among which higher education level, older age and female gender were found to be associated with better health literacy. No studies evaluated the outcomes associated with health literacy.
CONCLUSION
The level of pandemic-related health literacy is suboptimal. Healthcare administrators need to be aware of health literacy determinants when formulating policies in pandemics.
Humans
;
Health Literacy
;
COVID-19/epidemiology*
;
Severe Acute Respiratory Syndrome/epidemiology*
;
Health Knowledge, Attitudes, Practice
;
Pandemics
;
SARS-CoV-2
;
Coronavirus Infections/epidemiology*
;
Middle East Respiratory Syndrome Coronavirus
;
Female
;
Male
4.Awareness and attitudes of elderly Southeast Asian adults towards telehealth during the COVID-19 pandemic: a qualitative study.
Ryan Eyn Kidd MAN ; Aricia Xin Yi HO ; Ester Pei Xuan LEE ; Eva Katie Diana FENWICK ; Amudha ARAVINDHAN ; Kam Chun HO ; Gavin Siew Wei TAN ; Daniel Shu Wei TING ; Tien Yin WONG ; Khung Keong YEO ; Su-Yen GOH ; Preeti GUPTA ; Ecosse Luc LAMOUREUX
Singapore medical journal 2025;66(5):256-264
INTRODUCTION:
We aimed to understand the awareness and attitudes of elderly Southeast Asians towards telehealth services during the coronavirus disease 2019 (COVID-19) pandemic in this study.
METHODS:
In this qualitative study, 78 individuals from Singapore (51.3% female, mean age 73.0 ± 7.6 years) were interviewed via telephone between 13 May 2020 and 9 June 2020 during Singapore's first COVID-19 'circuit breaker'. Participants were asked to describe their understanding of telehealth, their experience of and willingness to utilise these services, and the barriers and facilitators underlying their decision. Transcripts were analysed using thematic analysis, guided by the United Theory of Acceptance Use of Technology framework.
RESULTS:
Of the 78 participants, 24 (30.8%) were able to describe the range of telehealth services available and 15 (19.2%) had previously utilised these services. Conversely, 14 (17.9%) participants thought that telehealth comprised solely home medication delivery and 50 (51.3%) participants did not know about telehealth. Despite the advantages offered by telehealth services, participants preferred in-person consultations due to a perceived lack of human interaction and accuracy of diagnoses, poor digital literacy and a lack of access to telehealth-capable devices.
CONCLUSION
Our results showed poor overall awareness of the range of telehealth services available among elderly Asian individuals, with many harbouring erroneous views regarding their use. These data suggest that public health education campaigns are needed to improve awareness of and correct negative perceptions towards telehealth services in elderly Asians.
Humans
;
COVID-19/epidemiology*
;
Female
;
Telemedicine
;
Aged
;
Male
;
Singapore/epidemiology*
;
Qualitative Research
;
Health Knowledge, Attitudes, Practice
;
SARS-CoV-2
;
Aged, 80 and over
;
Middle Aged
;
Pandemics
;
Awareness
;
Asian People
;
Southeast Asian People
5.Public knowledge, awareness and perception of gut microbiome and faecal microbiota transplantation in Singapore: a survey study.
Lydia Wan Zhen LIM ; Kai Yee TOH ; Alex Richard COOK ; Jonathan Wei Jie LEE ; Jeremy Fung Yen LIM
Singapore medical journal 2025;66(8):439-448
INTRODUCTION:
Despite the exponential increase in microbiome research, knowledge and beliefs about the gut microbiome and faecal microbiota transplantation (FMT) remain unclear. The aim of this study was to identify the extent of knowledge, awareness and perception among the general public regarding the gut microbiome and FMT.
METHODS:
An online questionnaire on knowledge and beliefs about the gut microbiome and FMT was administered to 1831 participants. Data analysis software was used to generate descriptive statistics and explore associations between knowledge and sociodemographic variables.
RESULTS:
Even though only 33% of participants had heard of the gut microbiome, more than 92% had consumed probiotic drinks or supplements. While 85% had not heard of the FMT procedure, 72% of respondents would consider having FMT to treat Clostridioides difficile infection (CDI). Willingness to receive FMT depended mainly on recommendation from healthcare providers (77%). Knowledge and awareness regarding the gut microbiome and FMT were relatively low, despite most participants having prior gut health-related behaviours.
CONCLUSION
This study identified the public's perceptions of FMT and the potential barriers to its uptake. Insights from the study highlight the need for health education to enhance acceptance of FMT and the importance of using information supported by medical professionals to immunise the public against poorly validated science.
Humans
;
Fecal Microbiota Transplantation
;
Health Knowledge, Attitudes, Practice
;
Male
;
Female
;
Singapore
;
Gastrointestinal Microbiome
;
Surveys and Questionnaires
;
Adult
;
Middle Aged
;
Young Adult
;
Aged
;
Clostridium Infections/therapy*
;
Adolescent
6.Analysis of knowledge and related factors regarding hepatitis C prevention and treatment among female sex workers and men who have sex with men in the Xizang Autonomous Region.
Dorji WANGMO ; X Y ZHAO ; J SUN ; J PENG ; S R LI ; N PANG ; X D WU ; H Q GONG ; Y LI ; Y YANG
Chinese Journal of Epidemiology 2025;46(8):1417-1421
Objective: To investigate the knowledge of hepatitis C prevention and treatment and related factors among two groups of female sex workers (FSW) and men who have sex with men (MSM) in the Xizang Autonomous Region (Xizang) to provide a basis for the subsequent development of Hepatitis C publicity and education strategies. Methods: From August to September 2021, a special survey was conducted among 1 244 FSW and 234 MSM in 5 districts (counties) of 4 regions in Xizang. A one-on-one face-to-face questionnaire survey was adopted, and the χ² test and logistic regression were used to analyze the related factors of awareness of hepatitis C prevention and treatment among FSW and MSM. Results: The awareness rates of hepatitis C prevention and treatment knowledge among FSW and MSM were 35.0% (436/1 244) and 11.1% (26/234), respectively. Multivariate logistic regression analysis revealed that the positive related factors of FSW' awareness of hepatitis C prevention and treatment knowledge among those who had high school or technical secondary school education (aOR=4.72, 95%CI: 3.30-6.74) and college education or above (aOR=2.24, 95%CI: 1.58-3.18), those who experienced self-perceived risk of HCV infection (aOR=1.87, 95%CI: 1.43-2.45), negative related factors included married or cohabiting (aOR=0.58, 95%CI: 0.35-0.95), divorce or windowless (aOR=0.44, 95%CI: 0.27-0.72), no condom was used in the most recent commercial sexual activity (aOR=0.54, 95%CI: 0.43-0.69). The positive related factors of MSM's awareness of hepatitis C prevention and treatment knowledge were over 40 years old (aOR=8.65, 95%CI: 3.19-23.42) and having a self-perceived risk of HCV infection (aOR=6.25, 95%CI: 2.50-15.61). Conclusions: The awareness rate of hepatitis C prevention and treatment among FSW and MSM was relatively low in Xizang in 2021 and urgently needs to be improved. It is necessary to formulate targeted publicity strategies based on the characteristics of these two groups of people, increase publicity efforts, and expand the coverage of knowledge publicity to popularize key points about the clinical manifestations, treatment options, and transmission routes of hepatitis C, and carry out necessary warnings and education.
Humans
;
Male
;
Hepatitis C/therapy*
;
Health Knowledge, Attitudes, Practice
;
Surveys and Questionnaires
;
Sex Workers/psychology*
;
Homosexuality, Male
;
Female
;
Adult
;
China
;
Young Adult
;
Middle Aged
;
Logistic Models
7.Variations in management strategies for stable coronary artery disease in the Asia-Pacific region: Insights from a multinational survey.
Lucky CUENZA ; Satoshi HONDA ; Khi Yung FONG ; Mitsuaki SAWANO ; F Aaysha CADER ; Purich SURUNCHUPAKORN ; Wishnu Aditya WIDODO ; Mayank DALAKOTI ; Jeehoon KANG ; Misato CHIMURA ; Mohammed AL-OMARY ; Zhen-Vin LEE ; Novi Yanti SARI ; Thanawat SUESAT ; Tanveer AHMAD ; Jose Donato MAGNO ; Chen Ting TAN ; Badai Bhatara TIKSNADI ; Uditha HEWARATHNA ; Faisal HABIB ; Derek Pok Him LEE ; Jonathan YAP
Annals of the Academy of Medicine, Singapore 2025;54(5):283-295
INTRODUCTION:
Randomised controlled trials (RCTs) have informed guideline recommendations for the management of stable coronary artery disease (CAD). However, the real-world impact of contemporary guidelines and trials on practising physicians in the Asia-Pacific region remains uncertain. We aimed to evaluate the knowledge, attitudes and practices among cardiovascular physicians in the region regarding stable CAD management.
METHOD:
An anonymised cross-sectional electronic survey was administered to cardiovascular practitioners from the Asia Pacific, assessing 3 domains: 1) baseline knowledge on recent trials and society guideline, 2) attitudes towards stable CAD, and 3) case scenarios reflecting management preferences. Correlations among knowledge, attitudes and practice scores were assessed between physicians from developed and developing countries using Pearson correlation.
RESULTS:
Overall, 713 respondents from 21 countries completed the survey. The mean knowledge score was 2.90±1.18 (out of 4), with 37.3% of respondents answering all questions correctly, while 74.6% noted that guidelines have significant impact on their practice. Despite guidelines recommending optimal medical therapy, majority chose revascularisation (range 53.4- 90.6%) as the preferred strategy for the case scenarios. Practitioners from developed regions had higher knowledge scores and lower attitude scores compared to developing regions, while practice scores were similar in both groups. Weakly positive correlations were noted between knowledge, attitude and practice scores.
CONCLUSION
Variations exist in knowledge and attitudes towards guideline recommendations and correspondingly actual clinical practice in the Asia Pacific, with most practitioners choosing an upfront invasive strategy for the treatment of stable CAD. These differences reflect real-world disparities in guideline interpretation and clinical adoption.
Humans
;
Coronary Artery Disease/therapy*
;
Cross-Sectional Studies
;
Practice Patterns, Physicians'/statistics & numerical data*
;
Asia
;
Health Knowledge, Attitudes, Practice
;
Surveys and Questionnaires
;
Male
;
Practice Guidelines as Topic
;
Female
;
Attitude of Health Personnel
;
Middle Aged
;
Developing Countries
8.Fourth national survey of traditional Chinese medicine resources and protection of traditional knowledge of medication use among ethnic minorities.
Jiang-Wei DU ; Xiao-Bo ZHANG ; Jian-Zhi CUI ; Shao-Hua YANG ; Hai-Tao LI ; Zhi-Yong LI ; Lu-Qi HUANG
China Journal of Chinese Materia Medica 2025;50(9):2349-2355
Traditional Chinese medicine(TCM) resources are the essential material foundation for the development of TCM. The national survey of TCM resources serves as a periodic summary of these resources, ensuring the continuity, prosperity, and development of TCM in China. Since 1949, four national surveys of TCM resources have been conducted. The fourth survey incorporated an investigation into traditional knowledge related to TCM resources, including the traditional medicinal knowledge of Chinese ethnic minorities, with the goal of systematically exploring, preserving, and inheriting this knowledge. This manuscript provides an overview of the basic findings from the first three national surveys of TCM resources, while also clarifying the concepts, categories, forms, carriers, and acquisition pathways of traditional knowledge related to TCM resources. A preliminary summary of the findings from traditional knowledge investigations reported in current literature is also presented. Based on the fourth survey, this manuscript emphasizes the urgency of developing public medical knowledge through empirically-based investigations, the excavation, and compilation of traditional knowledge. It also outlines the potential for conducting "precise" investigations based on first-hand data obtained from the survey, as well as facilitating the discovery and evaluation of new medicines using traditional knowledge related to ethnic minority medicinal practices. This manuscript is expected to provide valuable insights for promoting the health and industrial development of ethnic minority populations in the post-"survey" phase.
Humans
;
Medicine, Chinese Traditional
;
China/ethnology*
;
Minority Groups
;
Ethnicity
;
Drugs, Chinese Herbal/therapeutic use*
;
Health Knowledge, Attitudes, Practice/ethnology*
;
Surveys and Questionnaires
9.Medical researchers' knowledge and attitudes toward electronic informed consent in clinical research.
Xin TAN ; Ying WU ; Yuqiong ZHONG ; Xing LIU ; Xiaomin WANG
Journal of Central South University(Medical Sciences) 2025;50(2):290-300
OBJECTIVES:
Obtaining informed consent from research participants is an ethical and legal obligation for medical researchers in clinical studies. Electronic informed consent (eIC) is increasingly being adopted in clinical research worldwide. However, there is limited data on Chinese medical researchers' knowledge and attitudes toward eIC. This study aims to investigate their knowledge, attitudes, and influencing factors regarding eIC use in clinical research.
METHODS:
This cross-sectional study was conducted using stratified random sampling. From June to August 2022, medical researchers from 8 tertiary hospitals were surveyed via an online platform (Wenjuanxing). A self-developed eIC knowledge questionnaire and attitude scale were used to assess participants' understanding and perceptions of eIC. Univariate analysis was employed to explore factors influencing attitude scores and the correlation between knowledge and attitudes. A generalized linear model was used to analyze associations between demographic characteristics and attitude scores, including the frequency of difficulties in using smartphones or computers, preferred device for using eIC, and their interaction effects. Stratified analysis was further performed for significant interactions.
RESULTS:
A total of 399 valid questionnaires were collected. The mean accuracy rate on the eIC knowledge questionnaire was (94.88±15.50)%. Of the respondents, 74.9% had heard of eIC, and 84.5% preferred using mobile devices over computers to access eIC. The median attitude score was 3.41 (3.18, 3.76), indicating generally positive attitudes. Specifically, 81.7% found eIC more convenient than paper-based consent, 79.7% considered it more efficient, and 51.1% believed it could fully replace paper forms. However, 60.7% expressed concerns about data security and privacy, and 89.7% believed that relevant laws and regulations need improvement. Spearman correlation analysis showed a weak positive correlation between knowledge and attitude scores (r=0.171, P=0.001). Univariate analysis indicated that the frequency of difficulty using devices and preferred device for eIC were significantly associated with attitude scores (P<0.05). After adjusting for confounding factors, the generalized linear model demonstrated that participants who occasionally experienced had difficulty using devices had significantly lower attitude scores compared to those who never had difficulty (β=-0.040, 95% CI -0.071 to -0.009, P=0.012). Those who preferred using PCs had significantly lower attitude scores than those who preferred mobile devices (β=-0.066, 95% CI -0.108 to -0.023, P=0.002). Interaction analysis showed a significant interaction analysis showed a significant interaction between age and preferred device (P=0.011), particularly among participants aged ≥45-year (P<0.001). No other interactions were found to be significant (all P>0.05).
CONCLUSIONS
Medical researchers in China generally have a high level of knowledge and positive attitudes toward eIC, though concerns remain regarding data security and privacy. Future promotion of eIC in Chinese clinical research should be grounded in ethical considerations and address the specific needs of older users and mobile device users, while also enhancing researchers' competencies in using digital tools and eIC systems.
Humans
;
Cross-Sectional Studies
;
Informed Consent
;
Surveys and Questionnaires
;
Female
;
Male
;
Health Knowledge, Attitudes, Practice
;
Adult
;
Biomedical Research
;
Research Personnel/psychology*
;
Middle Aged
;
China
10.Current status and influencing factors of care burden in informal caregivers of patients with pressure injuries.
Chunhong RUAN ; Lian MAO ; Jing LU ; Xuan YANG ; Chun SHENG ; Bo LI ; Lina GONG
Journal of Central South University(Medical Sciences) 2025;50(7):1234-1243
OBJECTIVES:
With the accelerating aging of the population and the rising prevalence of chronic diseases, the number of patients with pressure injuries (PIs) has increased markedly, prolonging the period of disease-related care. Informal caregivers play a critical role in the daily care of patients with pressure injuries, and their care burden has become increasingly prominent. This study aims to investigate the current status and influencing factors of care burden among informal caregivers of patients with PIs, providing evidence for targeted intervention strategies.
METHODS:
A total of 170 informal caregivers of patients with PIs were selected by convenience sampling from the Third Xiangya Hospital of Central South University. General demographic and clinical data of both patients and caregivers were collected. The Zarit Caregiver Burden Inventory (ZBI), Knowledge-Attitude-Practice Scale for Informal Caregivers of Patients with PIs, General Self-Efficacy Scale (GSES), and Family Caregiver Task Inventory (FCTI) were used to assess caregiving burden, knowledge-attitude-practice level, self-efficacy, and caregiving ability, respectively. Pearson correlation analysis was conducted to evaluate relationships among ZBI, Knowledge-Attitude-Practice Scale for Informal Caregivers of Patients with PIs, GSES, and FCTI scores. Stepwise multiple linear regression analysis was used to identify factors influencing caregiving.
RESULTS:
Among the 170 patients with pressure injuries, the age was (65.52±15.88) years; 118 (69.41%) were male and 52 (30.59%) were female. The duration of PIs was less than 1 month in 108 (63.53%) cases and 1 to 6 months in 40 cases (23.53%). Stage II injuries were predominant (135 cases, 79.41%). A total of 193 pressure injury sites were recorded, most commonly located at the sacrococcygeal region (127 sites, 65.80%), followed by the head (3 sites, 1.55%), shoulder and back (9 sites, 4.66%), feet (24 sites, 12.44%), and other regions (30 sites, 15.55%). Informal caregivers were 48.82% aged 46 to 59 years, 54.71% female, 41.77% primarily spouses and 47.06% children of the patients, and 77.06% lived with the patients. Caregivers who received assistance from others or had higher family per-capita monthly income reported significantly lower caregiver burden scores than those without assistance or with lower income (all P<0.001). The total ZBI score was 50.89±14.95, indicating a moderate burden. The total scores of the Knowledge-Attitude-Practice Scale for Informal Caregivers, GSES, and FCTI were 50.61±7.22, 26.03±7.11, and 14.76±8.70, respectively. Pearson correlation analysis revealed that ZBI scores were correlated with scores on the Knowledge-Attitude-Practice Scale for Informal Caregivers of Patients with PIs (r=-0.543, P<0.001), GSES scores (r=-0.545, P<0.001), and FCTI scores (r=0.800, P<0.001). The scores on Knowledge-Attitude-Practice Scale for Informal Caregivers of patients with PIs were correlated with GSES scores (r=0.500, P<0.001) and FCTI scores (r=-0.461, P<0.001); GSES scores was negatively correlated with FCTI scores (r=-0.415, P<0.001). Stepwise multiple linear regression analysis showed that assistance availability, family per-capita monthly income, total scores on the Knowledge-Attitude-Practice Scale for Informal Caregivers of Patients with PIs, total GSES score, and total FCTI score were the main influencing factors of caregiver burden, jointly explaining 79.38% of its variance.
CONCLUSIONS
The main factors influencing the caregiving burden of informal caregivers of patients with PIs include the availability of assistance, family per-capita monthly income, total score on the Knowledge-Attitude-Practice Scale for Informal Caregivers of PI patients, total score on the GSES, and total score on the FCTI. Developing targeted intervention strategies addressing these factors may help alleviate the caregiving burden among informal caregivers of patients with PIs.
Humans
;
Caregivers/psychology*
;
Pressure Ulcer/nursing*
;
Female
;
Male
;
Middle Aged
;
Cost of Illness
;
Adult
;
Aged
;
Surveys and Questionnaires
;
Health Knowledge, Attitudes, Practice
;
Self Efficacy
;
Caregiver Burden
;
China


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