The study investigated the level of behavioral intention to consult doctors for flu symptoms (BICDFS) during the Coronavirus Disease 2019 (COVID-19) pandemic and examined its associations with illness representations of COVID-19 and fear of COVID-19 during clinic visits in a general Chinese adult population.
A random telephone survey was conducted among 300 residents in Hong Kong, China in April 2020 when the second wave of COVID-19 was just ended in the region. The participants were asked about their intention to consult doctors if they had mild or severe flu symptoms in the next week (from 1 = definitely no to 5 = definitely yes). Illness representations of COVID-19 were measured by the Chinese version of the Brief Illness Perception Questionnaire (BIPQ). The fear of COVID-19 during clinic visits were assessed by two single items. Linear regression adjusted for background variables and hierarchical strategies were employed.
Of the participants, 52.3 and 92.0% showed an intention to consult doctors for mild and severe flu symptoms, respectively. Adjusted for background factors, COVID-19-related cognitive representations (consequences: standardized b = 0.15, p = 0.010; understanding: standardized b = 0.21, p = 0.001) and emotional representations (concern: standardized b = 0.17, p = 0.001; negative emotions: standardized b = 0.19, p = 0.001) were positively associated with BICDFS. In the hierarchical model, independent significant factors of BICDFS included understanding (standardized b = 0.16, p = 0.013) and negative emotions (standardized b = 0.17, p = 0.008). The fear-related variables showed non-significant associations with the BICDFS.
Promotion of care-seeking behaviors for flu symptoms during the COVID-19 pandemic should consider improving people\'s understanding of COVID-19 and providing advice on related coping strategies for emotional responses to COVID-19.

BACKGROUND: The common-sense model of illness suggests that mental representations of health threats may affect one\'s behavioral reactions to them and health status. Internet gaming disorder is a newly defined mental disorder. Illness representations of internet gaming disorder may affect one\'s risk of internet gaming disorder. In turn, symptoms of internet gaming disorder may affect one\'s perceptions of the disorder.
OBJECTIVE: This study aimed to investigate the relationships between illness representations and symptoms of internet gaming disorder in college students.
METHODS: A 1-year longitudinal study was conducted with a convenience sample of Chinese college students (n=591; 342/591, 57.9% female).
RESULTS: Of the participants, 10.1% (60/591) and 9.1% (54/591) were classified as having probable internet gaming disorder at baseline (T1) and follow-up (T2), respectively. The correlations between some dimensions of illness representations regarding internet gaming disorder (ie, consequence, timeline, personal control, treatment control, and concern) at T1 and symptoms of internet gaming disorder at T2 and between symptoms of internet gaming disorder at T1 and the dimensions of illness representations at T2 (ie, consequence, timeline, personal control, and emotional response) were statistically significant. The cross-lagged model fit the data well ((χ2/df=2.28, comparative fit index=.95, root mean square error of approximation=.06) and showed that internet gaming disorder at T1 was positively associated with unfavorable illness representations at T2.
CONCLUSIONS: Individuals with more severe symptoms of internet gaming disorder had more pessimistic perceptions about the disorder. Such cognitive perceptions may affect one\'s emotional and behavioral reactions towards the disorder (eg, greater levels of depression and low self-control intention) and should be modified by educational programs and psychological interventions.

OBJECTIVE: The aim of the study is to explore the illness perceptions of Chinese women with breast cancer and relationships with their socio-demographic and clinical characteristics.
METHODS: A descriptive, correlational, and exploratory design was used. The Chinese version of the Revised Illness Perception Questionnaire was modified and used to collect data.
RESULTS: Of the 16 common symptoms of breast cancer, the participants recognized only 2.81 symptoms, on average. Of the 6 causal factors, \"uncontrollable factors\" had the highest mean score, while \"behavioural factors\" received the lowest score. Most of the participants knew little about the disease, perceived that this illness is cyclic in nature and would not last for a long time, believed that the illness could have serious consequences but could be controlled, and reported having negative emotional responses to this illness. Most of the dimensions of illness perception were significantly correlated with one another. Furthermore, some socio-demographic and clinical characteristics were confirmed to be predictors of illness perceptions.
CONCLUSIONS: These findings suggest that illness perceptions should be regarded as a whole to guide the coping process of Chinese women with breast cancer and provide new clinical information to support care for this group.

Illness representations play a significant role on mental health across various health conditions. The present study explores the associations between illness representations of HIV and mental health (suicidal ideation and depression), and the mediation effects of emotional representations on the associations between cognitive representations and mental health among men who have sex with men who were newly diagnosed with HIV (ND-MSM) in China. A total of 225 ND-MSM were recruited from a non-governmental organisation and were invited to complete a cross-sectional survey. Results showed that 48.0% had suicidal ideation since HIV diagnosis and 48.4% scored higher than the cut-off for mild depression or above. Stepwise regression analyses showed that higher levels of emotional representations of HIV and lower levels of treatment control were associated with both suicidal ideation and depression. Emotional representations were shown to mediate the associations between some cognitive representations variables and mental health. Findings suggest that both cognitive and emotional representations of HIV were important factors of mental health among ND-MSM. Interventions to promote the mental health of ND-MSM are warranted and should seek to improve their cognitive and emotional representations of HIV.

BACKGROUND: The Illness Perception Questionnaire-Revised (IPQ-R) has commonly been used to measure illness representations of various diseases. The present study examined whether the original factor structure of the IPQ-R could be confirmed or a new structure could be established on substance dependence among injecting drug users (IDU) in China.
METHODS: A total of 257 IDU completed the 38-item IPQ-R on substance dependence.
RESULTS: Results of confirmatory factor analysis (CFA) showed that the 7-factor structure as proposed by the original IPQ-R reported poor goodness-of-fit statistics. Although removal of 12 items improved the model fit, the goodness-of-fit statistics were still below acceptable standards. Furthermore, factors obtained from the exploratory factor analysis (EFA) of the IPQ-R were not interpretable.
CONCLUSIONS: The CFA found that the original IPQ-R factor structure fit the data poorly. Factors derived from EFA were also not interpretable. Use of the IPQ-R for assessment of illness representations of substance dependence among IDU in China is cautioned until further validation.

This study examined illness representations of new influenza Human Swine Influenza A (H1N1) and association with H1N1 preventive behaviors among 300 Chinese adults using a population-based randomized telephone survey. Results showed that relatively few participants thought H1N1 would have serious consequences (12%-15.7%) and few showed negative emotional responses toward H1N1 (9%-24.7%). The majority of the participants thought H1N1 could be controlled by treatment (70.4%-72.7%). Multiple logistic regression analyses showed that treatment control (odds ratio = 1.78) and psychological attribution (odds ratio = .75) were associated with intention to take up influenza vaccination. Emotional representations were associated with lower likelihood of wearing face mask (odds ratio = .77) and hand washing (odds ratio = .67). Results confirm that illness representation variables are associated with H1N1 preventive behaviors.