Many courses aim to promote reflective thinking or reflection upon practice, but there is a scarcity of readily usable instruments to determine whether students engage in reflective thinking and, if so, to what extent. This paper reports the development and testing of such an instrument. To ensure validity, the constructs measured were derived from the extensive literature on reflective thinking, particularly the writing of Mezirow. A combination of the literature review and initial testing led to the development of a four-scale instrument measuring four constructs; habitual action, understanding, reflection and critical reflection. The final version of the instrument was tested with a sample of 303 students from eight classes of a health science faculty. The reliability of the scales was established by acceptable Cronbach alpha values. Confirmatory factor analysis showed a good fit to the proposed four-factor structure. Comparison of mean scores between the eight classes showed predicted significant differences on each of the four scales between undergraduate and postgraduate students.

Background: Smoking causes heart disease, the major cause of death in China and Hong Kong. Stress is one major trigger of smoking and relapse, and understanding stress among smoking cardiac patients can therefore help in designing effective interventions to motivate them to quit. The objective of this study was to examine the psychometric properties of the Perceived Stress Scale (PSS), and to compare the appropriateness of the three versions of the scale (PSS-14, PSS-10, and PSS-4) among Chinese cardiac patients who were also smokers. Methods: From March 2002 to December 2004, 1860 cardiac patients who smoked were recruited at the cardiac outpatient clinics of ten acute hospitals in Hong Kong, and 1800 questionnaires were analysed. Participants completed a questionnaire including the PSS, nicotine dependence and certain demographic variables. The psychometric properties of the PSS were investigated: construct validity using confirmatory factor analysis, reliability using Cronbach's alpha and concurrent validity by examining the relationship with smoking- and health-related variables. Results: For all the three versions of the PSS, confirmatory factor analyses corroborated the 2-factor structure of the scale, with the positive and negative factors correlating significantly and negatively to a moderate extent (r < -0.5), and high Cronbach's alpha values for the two subscales (alpha > 0.5). All the correlations of the two subscales and the smoking- and health-related variables were statistically significant and in the expected directions although of small magnitudes, except daily cigarette consumption. Conclusions: The findings confirmed the satisfactory psychometric properties of all three Chinese versions of PSS. We recommend the use of PSS-10 for research which focuses on the two components of perceived stress, as it shows a higher reliability; and the use of PSS-4 if such partition is not essential and space for multiple measures is limited.

An outbreak in Wuhan, China in late 2019 of a highly infectious new coronary pneumonia (COVID-19) led to the imposition of countrywide confinement measures from January to March 2020. This is a longitudinal study on changes in the mental health status of a college population before and after their COVID-19 confinement for the first two weeks, focusing on states of psychological distress, depression, anxiety and affectivity. The influence of possible stressors on their mental health were investigated, including inadequate supplies and fears of infection. Five hundred and fifty-five undergraduate students were recruited from Hebei Agricultural University in Baoding, China. The participants completed two online surveys—on anxiety and depression, and on positive and negative affect. One survey was conducted before the confinement and the other was conducted 15–17 days after the start of the confinement. Increases in negative affect and symptoms of anxiety and depression (p-values < 0.001) were observed after 2 weeks of confinement. Inadequate supplies of hand sanitizers, a higher year of study, and higher scores on anxiety and depression were common predictors of increased negative affect, anxiety, and depression across the confinement period. The results suggest that healthcare policymakers should carefully consider the appropriate confinement duration, and ensure adequate supplies of basic infection-control materials.

Introduction: The nine‐item Patient Health Questionnaire (PHQ‐9) is widely used to determine the severity of depression in adult populations, but its psychometric properties with regard to adolescents has been poorly explored. The present study aims to identify the factor structure and examine the measurement invariance of this instrument across genders and age groups in a Chinese adolescent sample.Methods: A large sample of Chinese schoolchildren completed the PHQ‐9 in a cross‐sectional survey in Hong Kong (N = 10 933). A confirmatory factor analysis (CFA) to test the factor structure and a multiple group CFA to test the gender and age invariances of the PHQ‐9 in adolescents were conducted. Cronbach alpha was used to assess the reliability of the questionnaire, and Pearson correlations with anxiety, self‐esteem, and perceived control were used to assess its construct validity.Results: The CFA results indicate that a one‐factor model with three pairs of item correlations fitted the PHQ‐9 data well, and measurement invariances by age and gender were supported. The PHQ‐9 also possesses adequate internal consistency (>.84) and is strongly correlated with anxiety (>.77), self‐esteem (<−.57), and perceived control (<−.56) in the expected directions in the overall sample and in the gender and age subsamples.Discussion: The results support the claim that the PHQ‐9 is a reliable and valid scale and can be used to assess and compare depressive severity across ages and genders during the period of adolescence.

An investigation was conducted into 3- or 4-year departmental sets of student feedback questionnaire data from one university. Only four out of 25 departments had significant changes to any of the six dimensions in the 3- or 4-year period, and three of these significant changes were falls. There is, therefore, no evidence that the use of the questionnaire was making any contribution to improving the overall quality of teaching and learning of the departments, at least as perceived by the students. If it was, there should have been evidence of rising values. The following reasons why the use of the questionnaire might not have been conducive to improving teaching quality are discussed. The possibility that teaching quality is inherently stable is rejected. It is possible that feedback from the questionnaire was not used effectively. Related to this is whether instructors perceived that the university rewarded good teaching, so felt there was an incentive to make use of the feedback. The emphasis of the system was on appraisal, which might negate any developmental effect. The standard questionnaire and the associated procedures may have lacked flexibility and been inappropriate for innovative forms of teaching. The study questions whether student feedback questionnaires are utilising resources effectively if they are administered in an environment similar to the university in question, which appears reasonably typical.