Psychosocial Functioning of Hospitalized Chinese Adolescents and Their Families Susan Kools, PhD, RN Christine Kennedy, PhD, RN Sarah K.F. Kong, MPH, RN Jyu-Lin Chen, PhD(c), RN Linda Franck, PhD, RN Thomas K.S. Wong, PhD, RN The purpose of this study was to describe behavioral and emotional problems, social competence, and family functioning of hospitalized Chinese adolescents and to compare their psychosocial functioning with normative samples of Chinese adoles- cents and their families. A convenience sample of 103 hospitalized adolescent patients and their families participated. Families came from geographical areas in the Chinese Mainland (5 hospitals) and Hong Kong (2 hospitals). Parents completed a Chinese version of the Child Behavior Checklist for ages 4 to 18 years and the Family Assessment Device. Adolescents responded to a Chinese version of the Youth Self-Report. Youth in the Chinese Mainland and Hong Kong appear to be quite similar in many domains of behavioral functioning. Hospitalized adolescents in Hong Kong and the Chinese Mainland exhibited behavioral and emotional profiles that were qualitatively similar to the norms reported in community samples of Chinese and Chinese- American adolescents, albeit significantly lower than their healthy counterparts. This study examined, for the first time, the psychosocial functioning of hospitalized Chinese adolescents and their families. Our findings contribute to the cultural relevance of measuring adolescent and family responses to a known stressor and are useful for international comparisons by health care providers and researchers. © 2004 Elsevier Inc. All rights reserved. A DOLESCENT MENTAL HEALTH has re- cently become a priority area for researchers and health care professionals in Hong Kong and the Chinese Mainland (Liu et al., 2000; Shek, 1997). In 1999 researchers at Chinese University surveyed 26,111 Hong Kong adolescents (aged 10-19 years) and found that 14% reported that emotional health problems affected their daily ac- tivities; furthermore, 47% of 4,140 adults surveyed in 6 major Chinese cities were “greatly concerned” about mental health problems experienced by young persons (Students hit emotional problems, 1999, November 25, Hong Kong Standard; Survey shows mental health vital issue, 1999, November 12, Shanghai Star). Epidemiologic studies in both Hong Kong and the Chinese Mainland suggest that adolescence may be a period of particular vulner- ability to psychopathology (Shek, 1996). The rise in psychosocial problems of youth is attributed to extremely high academic stress, in- cluding heavy schoolwork loads, fear of failure, major competition for academic placements, and family pressure to excel in education (Bagley & Mallick, 1995; Crystal et al., 1994; Hui, 2000; Shek, 1996). Furthermore, although families in Hong Kong and the Chinese Mainland differ in the value they place on family piety, interdependence, conformity, and child respect for and submission to elders, families in both areas are having more intergenerational conflicts, and these conflicts may contribute to the increase in adolescent mental health problems (e.g., anxiety, depression and sui- From the Department of Family Health Care Nursing, Uni- versity of California, San Francisco, CA; Department of Nurs- ing and Health Sciences, The Hong Kong Polytechnic Univer- sity, Kowloon, Hong Kong; and Great Ormond Street Hospital for Children NHS Trust, London, England. This study was funded by the University of California Pacific Rim Research Program. Address correspondence and reprint requests to Susan Kools, PhD, RN, University of California, San Francisco, De- partment of Family Health Care Nursing, 2 Koret Way, Box 0606, San Francisco, CA 94143. © 2004 Elsevier Inc. All rights reserved. 0882-5963/04/1902-0000$30.00/0 doi:10.1016/S0882-5963(03)00142-8 95 Journal of Pediatric Nursing, Vol 19, No 2 (April), 2004