Hong-gu He
Email Address
nurhhg@nus.edu.sg
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Publication Preliminary effects of a mobile interactive supervised therapy intervention on people living with HIV: Pilot randomized controlled trial(JMIR Publications Inc., 2020) Pang, Y.; Molton, J.S.; Ooi, W.T.; Paton, N.I.; He, H.-G.; MEDICINE; DEPARTMENT OF COMPUTER SCIENCE; ALICE LEE CENTRE FOR NURSING STUDIESBackground: As people living with HIV infection require lifelong treatment, nonadherence to medication will reduce their chance of maintaining viral suppression and increase the risk of developing drug resistance and HIV transmission. Objective: This study aimed to evaluate the efficacy of a mobile app, Mobile Interactive Supervised Therapy (MIST), for improving adherence to oral HIV medications among HIV-infected adults in Singapore. Methods: We conducted a two-group pilot randomized controlled trial (RCT) with a process evaluation, in which 40 HIV-infected participants with once-daily medication regimes were recruited from a public tertiary hospital in Singapore and randomly assigned equally to either the intervention (receiving MIST and routine care) or control (receiving routine care only) groups. The intervention lasted for 2 months. The outcome of antiretroviral therapy (ART) adherence was measured by a 7-day recall self-report (SR), pill count (PC), an electronic medical device-Medication Event Monitoring System (MEMS)-and a mobile app-MIST (for the intervention group only). In total, 20 participants from the intervention group were interviewed at the end of the intervention to assess the acceptability of MIST. Data were collected at baseline and at 1-month and 2-month postintervention. Results: All participants had excellent medication adherence at baseline (median 100, IQR 100-100). The use of MIST did not result in a significant improvement in ART adherence when measured by the SR, PC, and MEMS, as compared with the control group at 1-month (P values >.99, .86, and .74, respectively) and 2-month (P values=.80, .84, and .82, respectively) postintervention. ART adherence also did not improve in each group over the same period. MIST was perceived to be a beneficial tool based on the process evaluation results. Conclusions: Although MIST did not enhance medication adherence to HIV treatments, mainly owing to the ceiling effect, it was perceived to be beneficial among the participants of this study. Our process evaluation provided useful data to further develop MIST for bigger and long-term mobile phone app-assisted intervention RCTs in the future. Trial Registration: ClinicalTrials.gov NCT03794648; https://clinicaltrials.gov/ct2/show/NCT03794648. © 2020 Journal of Medical Internet Research. All rights reserved.Publication The efficacy of wechat-based parenting training on the psychological well-being of mothers with children with autism during the COVID-19 pandemic: Quasi-experimental study(JMIR Publications Inc., 2021-02-10) Liu, Guihua; Wang, Shuo; Liao, Jinhua; Ou, Ping; Huang, Longsheng; Xie, Namei; He, Yingshuang; Lin, Jinling; He, Hong-Gu; Hu, Rongfang; ALICE LEE CENTRE FOR NURSING STUDIESBackground: During the COVID-19 pandemic, special education schools for children in most areas of China were closed between the end of January and the beginning of June in 2020. The sudden interruption in schooling and the pandemic itself caused parents to be anxious and even to panic. Mobile-based parenting skills education has been demonstrated to be an effective method for improving the psychological well-being of mothers with children with autism. However, whether it can improve the psychological states of mothers in the context of the COVID-19 pandemic is a subject that should be urgently investigated. Objective: The aim of this study is to evaluate the efficacy of WeChat-based parenting training on anxiety, depression, parenting stress, and hope in mothers with children with autism, as well as the feasibility of the program during the COVID-19 pandemic. Methods: This was a quasi-experimental trial. A total of 125 mothers with preschool children with autism were recruited in January 2020. The participants were assigned to the control group (n=60), in which they received routine care, or the intervention group (n=65), in which they received the 12-week WeChat-based parenting training plus routine care, according to their preferences. Anxiety, depression, parenting stress, hope, satisfaction, and adherence to the intervention were measured at three timepoints: baseline (T0), postintervention (T1), and a 20-week follow-up (T2). Results: In total, 109 mothers completed the T1 assessment and 104 mothers completed the T2 assessment. The results of the linear mixed model analysis showed statistically significant group × time interaction effects for the intervention on anxiety (F=14.219, P<.001), depression (F=26.563, P<.001), parenting stress (F=68.572, P<.001), and hope (F=197.608, P<.001). Of all mothers in the intervention group, 90.4% (48.8/54) reported that they were extremely satisfied with the WeChat-based parenting training. In total, 40.0% (26/65) logged their progress in home training each week and 61.5% (40/65) logged their progress more than 80% of the time for all 20 weeks. Conclusions: The WeChat-based parenting training is acceptable and appears to be an effective approach for reducing anxiety, depression, and parenting stress, as well as increasing hope in mothers with children with autism during the global COVID-19 pandemic. Future studies with rigorous designs and longer follow-up periods are needed to further detect the effectiveness of the WeChat-based parenting training. © Guihua Liu, Shuo Wang, Jinhua Liao, Ping Ou, Longsheng Huang, Namei Xie, Yingshuang He, Jinling Lin, Hong-Gu He, Rongfang Hu.Publication A randomized controlled trial of the effectiveness of a postnatal psychoeducation programme on outcomes of primiparas: Study protocol(John Wiley & Sons Ltd, 2015-01) Shorey, Shefaly; Chan, Wai Chi Sally; Chong, Yap Seng; He, Hong-Gu; NURSING/ALICE LEE CTR FOR NURSING STUD; OBSTETRICS & GYNAECOLOGYPublication A randomized controlled trial of the effectiveness of a postnatal psychoeducation programme on self-efficacy, social support and postnatal depression among primiparas(Wiley-Blackwell Publishing, 2015-06) Shorey, Shefaly; Chan, Wai Chi Sally; Chong, Yap Seng; He, Hong-Gu; NURSING/ALICE LEE CTR FOR NURSING STUD; OBSTETRICS & GYNAECOLOGYPublication Frontline nurses’ burnout, anxiety, depression, and fear statuses and their associated factors during the COVID-19 outbreak in Wuhan, China: A large-scale cross-sectional study(Lancet Publishing Group, 2020) Hu, D.; Kong, Y.; Li, W.; Han, Q.; Zhang, X.; Zhu, L.X.; Wan, S.W.; Liu, Z.; Shen, Q.; Yang, J.; He, H.-G.; Zhu, J.; ALICE LEE CENTRE FOR NURSING STUDIESBackground: During the Coronavirus Disease 2019 (COVID-19) pandemic, frontline nurses face enormous mental health challenges. Epidemiological data on the mental health statuses of frontline nurses are still limited. The aim of this study was to examine mental health (burnout, anxiety, depression, and fear) and their associated factors among frontline nurses who were caring for COVID-19 patients in Wuhan, China. Methods: A large-scale cross-sectional, descriptive, correlational study design was used. A total of 2,014 eligible frontline nurses from two hospitals in Wuhan, China, participated in the study. Besides sociodemographic and background data, a set of valid and reliable instruments were used to measure outcomes of burnout, anxiety, depression, fear, skin lesion, self-efficacy, resilience, and social support via the online survey in February 2020. Findings: On average, the participants had a moderate level of burnout and a high level of fear. About half of the nurses reported moderate and high work burnout, as shown in emotional exhaustion (n = 1,218, 60.5%), depersonalization (n = 853, 42.3%), and personal accomplishment (n = 1,219, 60.6%). The findings showed that 288 (14.3%), 217 (10.7%), and 1,837 (91.2%) nurses reported moderate and high levels of anxiety, depression, and fear, respectively. The majority of the nurses (n = 1,910, 94.8%) had one or more skin lesions, and 1,950 (96.8%) nurses expressed their frontline work willingness. Mental health outcomes were statistically positively correlated with skin lesion and negatively correlated with self-efficacy, resilience, social support, and frontline work willingness. Interpretation: The frontline nurses experienced a variety of mental health challenges, especially burnout and fear, which warrant attention and support from policymakers. Future interventions at the national and organisational levels are needed to improve mental health during this pandemic by preventing and managing skin lesions, building self-efficacy and resilience, providing sufficient social support, and ensuring frontline work willingness. © 2020 The Author(s)Publication Becoming a confident and happy first-time mother: Postnatal psychoeducation intervention booklet for first-time mothers. Booklet for first-time mothers.(National University of Singapore & National University Hospital, 2016) He, HG; Shorey, S; Chan, WCS; Chong, YS; Luo, N; Chan, YH; Chow, A; Jiao, NN; Zhu, LX; Assoc Prof Hong-gu He; DEAN'S OFFICE (MEDICINE); ALICE LEE CENTRE FOR NURSING STUDIES; SAW SWEE HOCK SCHOOL OF PUBLIC HEALTH; OBSTETRICS & GYNAECOLOGYPublication Association between Probiotic Yogurt Intake and Gestational Diabetes Mellitus: A Case-Control Study(IRANIAN SCIENTIFIC SOCIETY MEDICAL ENTOMOLOGY, 2019-07-01) Chen, Xiaoqian; Jiang, Xiumin; Huang, Xinxin; He, Honggu; Zheng, Jing; Assoc Prof Hong-gu He; ALICE LEE CENTRE FOR NURSING STUDIESBackground: Gestational diabetes mellitus is one of the most frequent metabolic complications of pregnancy. Previous studies have reported that using either probiotic yogurt or a probiotic supplement reduces the incidence of gestational diabetes. However, the results were inconsistent. Thus, the aim of the present study was to investigate the association between gestational diabetes mellitus and probiotic yogurt intake during pregnancy and pre-pregnancy in Chinese women. Methods: This was a case-control study involving 123 cases with gestational diabetes mellitus and 126 controls matched for age and pre-pregnancy body mass index. Each participant was interviewed face-to-face using a structured questionnaire to collect socio-demographic characteristics, diet and exercise habits, as well as probiotic yogurt consumption (containing Lactobacillus acidophilus and Bifidobacterium) during pregnancy and prepregnancy. An unconditional logistic regression analysis was used to analyze the data. Results: Mothers in both groups had similar socio-demographic backgrounds. Probiotic yogurt intake during pregnancy was significantly higher in normal pregnant women than that in women with gestational diabetes mellitus (adjusted odds ratio: 0.292, 95% confidence interval: 0.148 - 0.577, P < 0.05). There were no significant differences in probiotic yogurt consumption before pregnancy between cases and controls. Conclusion: Probiotic yogurt intake before pregnancy was not associated with gestational diabetes mellitus, but probiotic yogurt consumption during pregnancy was effective in reducing the risk of gestational diabetes mellitus in Chinese women. The findings from the present study may have implications for the future care of pregnant Chinese women with gestational diabetes mellitus.Publication Patients' experiences of performing self-care of stomas in the initial postoperative period(Lippincott Williams and Wilkins, 2015) Lim, Siewhoon; Chan, Sally; He, Hong Gu; NURSING/ALICE LEE CTR FOR NURSING STUDPublication A systematic review and meta-analysis on the effectiveness of web-based psychosocial interventions on patients with colorectal cancer(Wiley-Blackwell, 2022-03-19) Wan, Su Wei; Chng, Yun Jia Devon; Lim, Siew Hoon; Chong, Choon Seng; Pikkarainen, Minna; He, Hong-gu; Assoc Prof Hong-gu He; SURGERY; ALICE LEE CENTRE FOR NURSING STUDIES; ANAESTHESIAAims: To synthesise the effectiveness of web-based psychosocial interventions on self-efficacy, anxiety, depression, quality of life (QoL), non-specific psychological and cancer-specific distress among patients with colorectal cancer. Design: A systematic review and meta-analysis. Data Sources: Six databases (PubMed, PsycINFO, Embase, Scopus, CINAHL and CNKI) were searched from inception to December 2021. Review methods: Experimental/quasi-experimental studies targeting patients with colorectal cancer for the improvement of aforementioned outcomes were included. Two reviewers screened and extracted the data, and assessed studies’ methodological quality using risk of bias tools. Meta-analyses and narrative syntheses were performed. Results: Nineteen studies consisting of 1,386 participants were identified. Cognitive-behavioral therapy delivered online was the most common trialed web-based psychosocial intervention. Meta-analyses revealed no positive effect for self-efficacy (SMD 0.93, 95% CI: 0.52 to 1.35, p < 0.01) and minimal benefit for QoL (MD 2.83, 95% CI: -3.72 to 5.98, p = 0.08) but significant positive effects for anxiety (MD -2.23, 95% CI: -3.31 to -1.14, p < 0.01) and depression (MD - 2.84, 95% CI: -4.09 to -1.59, p < 0.01) among colorectal cancer survivors in the intervention group as compared to the control group. Narrative synthesis suggested possible benefits in reducing distress. Conclusion: Web-based psychosocial interventions are promising alternatives to conventional delivery methods in reducing patients’ anxiety, depression and distress. However, evidence on self-efficacy and QoL remains inconsistent. More adequately powered, well-designed trials with targeted and theory-based interventions are required to ascertain findings. Impact: By highlighting the potential of web-based psychosocial in reducing anxiety and depression among colorectal cancer survivors, this review has put forth beneficial information supporting the use and acceptance of web-based care delivery in light of COVID-19 restrictions and nationwide lockdowns. Meanwhile, the paucity of empirical support reflects the necessity of more extensive research to test and improve other health outcomes.Publication A randomized controlled trial of the effectiveness of a postnatal psychoeducation programme on self-efficacy, social support and postnatal depression among primiparas(Blackwell Publishing, 2015) Shorey, S.; Chan, S.W.C.; Chong, Y.S.; He, H.-G.; OBSTETRICS & GYNAECOLOGY