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Aim: Cognitive assessment services were found to be beneficial to older people with cognitive complaints but information is limited on adherence to the recommendations provided. This study aimed to identify predictors of clients' adherence to nursing recommendations after attending a community‐based nurse‐led cognitive assessment service in Hong Kong. Methods: A cross‐sectional design was adopted. We analysed a dataset routinely collected from clients attending the services between January 2012 and January 2018. Multiple regression analyses were conducted to identify predictors (demographics, functional health status and cognitive performance) of the clients' adherence. Their satisfaction with the services was also examined. Results: Two hundred and twenty‐three clients attended the clinic. Of the 133 who completed the telephone follow‐up at the 6 months postconsultation, 44.1% did not adhere to the recommendations. Clients with a higher Clinical Dementia Rating (OR = 4.17), lower Clock Drawing Test score (OR = 1.13) and lower education level (OR = 0.91) were found to be less likely to adhere to the nursing recommendations. Ninety‐six percent (190/198) were satisfied with the overall services. Conclusion: Cognitive assessment services in nurse‐led clinics could provide a self‐referred service for older people with cognitive complaints. However, low adherence to nursing recommendations was found among clients with poorer cognitive functions and lower education levels. Summary statement: What is already known about this topic: Community‐based nurse‐led cognitive assessment services were found to be beneficial to older people with cognitive complaints by providing clients with timely screening, assessment, education and advice.Nonadherence to the recommendations of health‐care professionals could pose significant risks to the clients' health.There has been limited research on clients' adherence to the recommendations of nurses at community‐based cognitive assessment services. What this paper adds: About 44.1% of clients receiving a cognitive assessment did not adhere to the nursing recommendations. Those with poorer cognitive functions and lower education levels were found to be less likely to be adherent.About 96% of clients attending the community‐based cognitive assessment services in a nurse‐led clinic expressed satisfaction with them. The implications of this paper: Community‐based cognitive assessment clinics should develop appropriate strategies to improve clients' adherence, especially those with poor cognitive functions and lower education levels.Future research should investigate why clients with poor cognitive functions and lower education levels are less likely to adhere to nursing recommendations. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Family‐involved interventions can result in better outcomes than traditional mental health care for both service users and their families.Nurses' attitudes towards family involvement can affect family participation in care.Earlier studies on psychiatric nurses' attitudes towards family involvement in care report ambiguous findings. Hong Kong's unique integrated cultures may influence Hong Kong psychiatric nurses' attitudes towards family involvement in nursing care. What the paper adds to existing knowledge?: The majority of psychiatric nurses had positive views on family involvement in care in Hong Kong.Four variables (i.e. gender, clinical experience, nature of working unit and family nursing training) of psychiatric nurses are associated with their attitudes towards family involvement in care in Hong Kong. What are the implications for practice?: Policy makers should develop strategies to increase psychiatric nurses' awareness of the importance of family involvement in patient care.Nurse educators help to design family nursing training to enhance psychiatric nurses' competence in collaborating with families of people suffering from mental disorders. Introduction: In Hong Kong, involving the family in nursing care is still optional and mainly depends on nurses' attitudes and the willingness of the family. Hong Kong psychiatric nurses' attitudes towards family involvement in nursing care may be influenced by the unique integrated Eastern and Western cultures, however earlier studies report ambiguous findings. Aims: This study aimed to assess Hong Kong psychiatric registered nurses' attitudes towards family involvement in care and its associated factors. Methods: This study is a cross‐sectional descriptive online survey with convenience sampling based on the Families' Importance in Nursing Care‐Nurses' Attitudes (FINC‐NA) instrument. Results: Most of the psychiatric nurses had supportive attitudes towards family involvement in care. Females with more clinical experience, working in a rehabilitation‐related unit and having attended a family nursing education course were associated with positive attitudes towards family involvement in care. Discussion: The supportive attitude of psychiatric nurses may be explained by the shift of mental health nursing care from hospital care to community care in recent decades. Implications for practice: Mental health nurse education and training in Hong Kong could place more emphasis on building family work skills, particularly for newly qualified nurses and those working in acute inpatient settings. [ABSTRACT FROM AUTHOR]

Aims: To explore the feasibility and effects of the programme based on information‐motivation‐behavioural skills (IMB) model (IMB programme) on adherence to inhalation therapy and other health outcomes in chronic obstructive pulmonary disease (COPD) patients. Background: Poor adherence to inhalation therapy is common among COPD patients. The IMB model is supported by previous studies as useful in promoting adherence to health behaviours. Methods: This pilot randomized controlled trial randomized 35 COPD patients to receive either the IMB‐based programme or usual care. The 4‐week IMB programme consisted of a face‐to‐face and two telephone sessions to empower patients with skills and knowledge on using inhalation therapy and support their goal attainment for treatment compliance. Outcome evaluation including adherence to inhalation therapy, inhalation techniques, disease impact, and quality of life was conducted at baseline and at 6 weeks after randomization. Feasibility of the IMB programme was evaluated by a satisfaction survey and implementation experience. Results: Thirty patients completed the study, with an attrition rate of 14.3%. The intervention group (n = 15) had significant improvements in inhalation adherence, inhalation techniques, and quality of life than the control group over the evaluation period. Patient satisfaction survey results and observations on programme implementation suggested the feasibility of the IMB programme. Conclusion: A IMB model is a feasible and potentially effective intervention for improving COPD patients' adherence to inhalation therapy. SUMMARY STATEMENT: What is already known about this topic? Information‐motivation‐behavioural skills (IMB) models have produced positive effects on adherence behaviour in patients with acquired immune deficiency syndrome, coronary heart disease, and diabetes. What this paper adds? No study has evaluated the effects of the IMB model on an intervention for adherence behaviour in patients with chronic obstructive pulmonary disease (COPD).The pilot randomized controlled trial (RCT) showed that the IMB model used in the intervention was effective in improving COPD patients' adherence to inhalation regimen and techniques.The pilot study found that the IMB intervention programme was feasible for implementation in outpatient settings and was highly accepted by COPD patients. The implications of this paper: This programme may be effective in improving COPD patients' adherence to inhalation regimen and inhalation techniques.The programme is feasible and acceptable.There is need to conduct an adequately powered multisite RCT to provide stringent outcome evaluation of the IMB intervention programme. [Correction added on 28 January 2020: 'The implications of this paper' section has been amended.] [ABSTRACT FROM AUTHOR]

Accessible Summary: What is already known about this topic?: Individuals with severe mental illness (SMI) have elevated risks for physical health problems and low screening rates.No previous studies have compared the physical health promotion needs of people with SMI using the same screening tool across different international settings. What this paper adds to existing knowledge?: It appears feasible to use the HIP to profile and compare physical health‐related risks in people with SMI across different international settings.The HIP tool identified significant differences in areas of risk across the four countries. What are the implications for practice?: The HIP could be used to identify unique clusters of health promotion needs in different countries.Use of HIP health checks may support implementation of individualized interventions. Introduction: To date, no studies have contrasted physical health profiles of people with severe mental illness (SMI) in different countries. Aim: To evaluate feasibility of using the Health Improvement Profile (HIP) to compare and contrast physical health and health behaviours of people with SMI from four countries. Method: An observational feasibility study using secondary analysis of pooled health state and lifestyle data. Physical health checks using modified versions of HIP were administered in four countries. Results: Findings suggest feasibility of HIP screening to profile and compare physical health and health behaviours of people with SMI across international settings. High overall numbers of risk items (red flags) were identified in all but the Thailand sample. Despite some commonalities, there were important differences in health profiles across countries. Discussion: This is the first study to demonstrate feasibility of the HIP to compare health risks in individuals with SMI across countries. Future multi‐national HIP studies should recruit a fully powered stratified random sample of people with SMI that is representative of each setting. Implications for practice: It appears feasible to utilize the HIP to identify specific areas of health risk in different countries, which may help to better focus nursing interventions and use of resources. [ABSTRACT FROM AUTHOR]

Aims This article discusses the ways researchers may become open to manifold interpretations of lived experience through thematic analysis that follows the tradition of hermeneutic phenomenology. Background Martin Heidegger's thinking about historical contexts of understandings and the notions of 'alētheia' and 'techne' disclose what he called meaning of lived experience, as the 'unchanging Being of changing beings'. While these notions remain central to hermeneutic phenomenological research, novice phenomenologists usually face the problem of how to incorporate these philosophical tenets into thematic analysis. Design Discussion paper. Data sources This discussion paper is based on our experiences of hermeneutic analysis supported by the writings of Heidegger. Literature reviewed for this paper ranges from 1927 - 2014. We draw on data from a study of foreign domestic helpers in Hong Kong to demonstrate how 'dwelling' in the language of participants' 'ek-sistence' supported us in a process of thematic analysis. Data were collected from December 2013 - February 2016. Implications for Nursing Nurses doing hermeneutic phenomenology have to develop self-awareness of one's own 'taken-for-granted' thinking to disclose the unspoken meanings hidden in the language of participants. Understanding the philosophical tenets of hermeneutic phenomenology allows nurses to preserve possibilities of interpretations in thinking. In so doing, methods of thematic analysis can uncover and present the structure of the meaning of lived experience. Conclusion We provide our readers with vicarious experience of how to begin cultivating thinking that is aligned with hermeneutic phenomenological philosophical tenets to conduct thematic analysis. [ABSTRACT FROM AUTHOR]

mcinnes e., seers k. & tutton l. (2011) Older people's views in relation to risk of falling and need for intervention: a meta-ethnography. Journal of Advanced Nursing 67(12), 2525-2536. Abstract Aim. This paper is a report of a meta-ethnography of qualitative studies of older peoples' views on risk of falling and need for intervention. Background. Falls and falls-related injuries in older people are worldwide problems. A conceptual understanding of older people's views about falls risk and need for intervention is useful for understanding factors likely to impact on acceptance of risk and recommended interventions. Data Sources. Seven electronic databases were searched 1999-2009. Reference lists of included articles were screened for eligible papers. Review Methods. Assessment of quality was carried out. Themes and concepts were extracted using a meta-ethnographic approach to compare similarities and differences across the retrieved studies. A line of argument was developed to produce an explanatory framework of the extracted themes and concepts. Results. Eleven relevant qualitative research articles of reasonable quality were identified. Six key concepts were identified: beyond personal control; rationalizing; salience; life-change and identity; taking control and self-management. A line of argument synthesis describes how older people approach self-appraisal of falls risk and intervention need, and how they cope and adapt to falls risk and intervention need. Conclusion. In response to having an elevated risk status and perceived associations with frailty and impact on an independent life-style, some prefer to adapt to this reality by taking control and implementing self-management strategies. Healthcare professionals should take into account beliefs about risk and negotiate choices for intervention, recognizing that some individuals prefer to drive the decision-making process to preserve identity as a competent and independent person. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Many Western countries have abandoned the wearing of nurse uniforms on inpatient mental health wards. The adoption of a non‐uniform policy in Hong Kong was recently introduced in select rehabilitation units to align with the philosophy of the recovery model. What the paper adds to existing knowledge?: The findings suggest that nurses perceived wearing non‐uniform might help to reduce the self‐stigma of service users and develop better self‐esteem.The perceived potential benefits of the introduction of a non‐uniform policy seemed to outweigh the perceived drawbacks. What are the implications for practice?: The results further acknowledge the potential positive effects of nurses wearing non‐uniform on facilitating psychiatric service users' recovery process. However, further research on service users' perspectives is required.The wearing of non‐uniform may be considered to be extended to other psychiatric wards in Hong Kong and other similar Asian settings in order to potentially help promote patient's recovery and to reduce emotional distance between staff and service users. Introduction: A non‐uniform policy was recently adopted in selected Hong Kong rehabilitation wards to align with the philosophy of the recovery model. The change in policy is relatively novel in Asia, where no previous studies have reported how this may influence nursing care and service users' recovery. Aim: To explore Hong Kong Mental Health Nurses' views about wearing non‐uniform within an inpatient rehabilitation unit in regard to facilitating service users' recovery process. Method: A qualitative descriptive study was conducted, utilizing individual in‐depth semi‐structured research interviews. Results: A total of 12 interviews were conducted with nurse participants. The analysis process identified 3 main themes and 9 subthemes. Main themes were "building up rapport with service users," "non‐uniform helps deinstitutionalization" and "different approaches to maximize the benefit and to minimize the risk." Discussion: Despite some concerns, the majority of nurse participants positively viewed the policy of wearing non‐uniform and felt it was potentially beneficial to service users' recovery process. Implications for practice: Nurses perceived that wearing non‐uniform may facilitate meaningful therapeutic engagement, and may help to reduce the self‐stigma and develop the self‐esteem of service users. Other inpatient units in Hong Kong and similar Asian settings might consider adopting the policy. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Mindful yoga combines yoga techniques with the mindfulness‐based stress reduction approach.Previous studies on mindful yoga have reported improvements in depression for working‐age adults, but no studies have been conducted with older people. What the paper adds to existing knowledge?: Mindful yoga may be a safe and acceptable intervention to improve the mental and physical health of older adults with depression.The beneficial therapeutic ingredients of mindful yoga, included calmness, being non‐judgmental, letting go and seizing the day. What are the implications for practice?: Single‐sex mindful yoga groups may be more acceptable for some people.Well‐conducted feasibility studies comparing mindful yoga with an alternative group‐based approach are necessary. Introduction: Mindful yoga combines yoga techniques with the mindfulness‐based stress reduction approach. Previous studies on mindful yoga have reported improvements in depression for working‐age adults, but no studies have been conducted with older people. Aims: To explore the experiences of older adults with depression participating in a mindful yoga group to establish whether the approach has potential as a future intervention for this client group. Method: This study adopted a qualitative descriptive method and used inductive content analysis. Eighteen in‐depth individual interviews were conducted with nine participants (each participant had one interview following the programme and another four weeks later). Results: Six main themes emerged: "improved physical status," "actively involved in the community," "positive psychological effects," "perceived therapeutic ingredients," "facilitators of practising mindful yoga" and "barriers to practising mindful yoga.". Discussion: Most participants reported benefitting from the programme. Two male participants expressed that exercises were too challenging and more suited to women, suggesting single‐sex groups may be more acceptable. Implications for practice: Mindful yoga may be an acceptable/useful intervention for older adults with depression, but future studies are required to establish its feasibility and potential efficacy. [ABSTRACT FROM AUTHOR]

Postnatal depression ( PND) affects 10-15% of postnatal women worldwide, yet it is poorly recognized and managed. Among the psychological interventions, which are used to manage PND, cognitive-behavioural therapy was found to be effective and promising. In the past decade, research efforts have focused on developing effective antenatal interventions to prevent PND. Strong antenatal predictors such as antenatal depressive symptoms have been identified for targeted early intervention or prevention to help reduce the risk of developing depression after childbirth. However, the findings regarding effectiveness of antenatal preventive interventions have been inconsistent. Based on the reports of previous studies, a brief group antenatal intervention using cognitive-behavioural approach is necessary, particularly one with sensitivity for Chinese woman. This paper reports the details of a nurse-led cognitive-behavioural programme developed and tested in, and for use with a sample of Hong Kong pregnant women. The trial run showed that the programme was feasible to be implemented and well received by the participants. [ABSTRACT FROM AUTHOR]

Hong Kong's linked exchange rate system (LERS) has been in operation since 1983, during which time many other fixed exchange rate systems have succumbed to shocks and/or speculative attacks. This paper investigates how market participants assessed changes made to the LERS by using the tools of modern finance to extract information from financial asset prices about market expectations. These changes have been characterized as making the system less discretionary over time. We find that decreasing the discretionary element of the LERS led to an increase in credibility of the arrangement. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Warwick-Edinburgh Mental Well-being Scale (WEMWBS) which is a measurement of mental health and well-being, was translated into Chinese to assess the reliability and validity in a sample of undergraduate nursing trainees in Wenzhou. What this paper adds to existing knowledge? Currently, there is no a reliable assessment tool to systematically evaluate mental well-being in mainland China. Therefore, we undertook the translation and cultural adaptation of the WEMWBS and tested the scale's reliability and validity. The reliability and validity of the Chinese version of the Short Warwick-Edinburgh Mental Well-being Scale have been demonstrated in Hong Kong, but the WEMWBS has not been validated in mainland China in either clinical or non-clinical settings. What are the implications for practice? It might provide a reliable quantitative tool to evaluate mental well-being in non-clinical settings, which has important implications for mental health nursing. In future,it might be a reliable quantitative tool for evaluating mental well-being in other population such as hospitalized patients to improve their life quality. Abstract Introduction There is growing interest worldwide in the evaluation of positive mental health and wellbeing. Aim This study was to translate the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) into Chinese and assess the reliability and validity of this scale in a sample of undergraduate nursing trainees. Methods A forward and backward translation protocol was used to translate the scale into Chinese. The psychometric properties of the C-WEMWBS, such as internal consistency reliability, test-retest reliability and factorial validity, were analysed. Results All 14 items of the initial C-WEMWBS were rated as conceptually equivalent to those of the original version. Confirmatory factor analysis indicated the emergence of a single factor. The psychometric properties of the C-WEMWBS were satisfactory, with an internal consistency reliability of .94 and a test-retest reliability of .83. The item-total correlations ranged from .66 to .83. There was a moderate relationship ( r = .52) between the C-WEMWBS and the WHO-5. Implications for practice This was the first Chinese version of the WEMWBS to be developed and psychometrically assessed with a sample of undergraduate nursing trainees. It provides a reliable quantitative tool to evaluate mental well-being in non-clinical settings, which has important implications for mental health nursing. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to describe and discuss the recruitment strategies used in a research study of cervical cancer screening among South Asian women, the challenges encountered and the lessons learnt from the experience. Background Ethnic minority populations face different barriers to participating in research studies. Strategies have been developed to recruit this population to health-related research in Western countries, but there is little information about such research in the Asian region. Design Discussion paper. Data sources The discussion is based on our previous experience. The source of this experience is the recruitment strategies used, their results and the challenges encountered during the process. Implications for nursing Culturally, relevant strategies and maintaining good relationships with stakeholders improved participant recruitment. Familiarity with South Asians' traditional calendar - when cultural and religious festivals are held every year - would aid the setting up of appropriate schedules for participant recruitment, either before or after the periods when they cannot be reached, such as Ramadan. South Asian women are often busy with childcare and housework. This is their major responsibility in the family and any failure to fulfil such duties is a source of stress and may foster feelings of guilt. A better understanding of their daily routines is therefore important. Such information enables the establishment of daily meeting schedules to increase the success rate of recruitment. Conclusion Recruitment is a tedious process, but appropriate planning and taking account of cultural and religious practices and daily schedules will help to improve its rate of success. [ABSTRACT FROM AUTHOR]

Aims: To explore the impact of the coronavirus disease 2019 pandemic on the healthrelated quality of life (HRQoL) of breast cancer survivors. Design: We utilized a qualitative descriptive approach to facilitate interviews among 25 participants, all of whom are survivors of breast cancer and have received treatment in Hong Kong within the preceding 3 years. Methods: Content analysis was performed to understand how patients' HRQoL views and experiences changed during coronavirus disease 2019 pandemic. Results: The results included six themes delineating the impact of the coronavirus disease 2019 pandemic: (i) survivor sensitivities in pandemic times, (ii) coping and conditioning in pandemic times, (iii) transforming work and home dynamics in pandemic times, (iv) cognitive resilience and adaptation to the COVID-19 protective measures, (v) social resilience in pandemic times and (vi) healthcare adaptation and coping in pandemic times. Conclusion: This study provides insights into the experiences and challenges of breast cancer survivors during the coronavirus disease 2019 pandemic. Some survivors had new physical and psychological symptoms, including fear and anxiety, isolation, pain, lymphoedema and burnout, which potentially have long-term impact upon HRQoL. Implications for the profession and/or patient care: This study highlights the unique challenges faced by breast cancer survivors during the coronavirus disease 2019 pandemic, including accessing healthcare services and the impact of social isolation. Healthcare providers should consider the holistic needs of breast cancer survivors in the provision of health care and develop supportive interventions, including telehealth services and online support groups, to address these challenges and improve their HRQoL. Impact: Surgery aimed at treating breast cancer or reducing its risk generally influences the appearance of breast areas and donor sites. The continuing effects of these changes on body image and HRQoL are well-reported, although studies have ineffectively examined the initial experiences of women regarding their postoperative appearance, particularly during the pandemic. Reporting method: The checklist of consolidated criteria for reporting qualitative research (COREQ) was utilized. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Frailty and multimorbidity are common in later life. A higher level of frailty is associated with a higher risk of adverse physical and psychological health situations., Older adults with pain have been reported to be lonelier and more depressed, as well as less happy and less satisfied with their life as compared to those without pain., In view of the high prevalence of pain among older adults and the reversibility of frailty, it is important to explore the relationship between pain, frailty and psychological parameters in order to devise patient-centred interventions., What this paper adds to existing knowledge? Frailty index is positively correlated with the presence of pain, and associated with gender, functional mobility and loneliness., Among these significant variables, loneliness was the factor that contributed the most to the frailty index., What are the implications for practice? It is essential to put the focus of healthcare on both the physical and psychological aspects of well-being., All nurses are advised to improve the management of pain in older people in order to lower the levels of pain, frailty and psychological distress among this population., Nursing care should address the loneliness level especially the problem of social loneliness among older adults particularly those living in nursing homes., Abstract Introduction In view of the high prevalence of pain among older adults and the reversibility of frailty, it is important to explore the relationship between pain, frailty and psychological parameters in order to devise patient-centred interventions. Aim To examine the levels of frailty, pain and psychological parameters among older adults living in Hong Kong nursing homes, and the cross-sectional relationships among these items. Methods A cross-sectional study was conducted among 178 residents from six nursing homes. Frailty, pain, mobility, happiness, loneliness and life satisfaction of participants were assessed using validated questionnaires. Results A multiple linear regression ( R2 = 0.338, P < 0.05) showed that the frailty index was associated with loneliness, functional mobility and gender. Among these significant variables, loneliness was the factor that contributed the most to the frailty index. Discussion It is essential to put the focus of healthcare on both the physical and psychological aspects of well-being. Findings suggest that apart from improving mobility and reducing pain, loneliness could be a target of psychosocial interventions to reduce frailty and improve quality of life. Implications for practice It is advised that nursing care should address loneliness, especially the problem of social loneliness among older adults particularly those living in nursing homes. [ABSTRACT FROM AUTHOR]

Aim This paper aims to describe the research protocol that will be used to determine the effectiveness of a health-social partnership intervention programme among community-dwelling older adults. Background Ageing in place is a preferred option for overcoming challenges of the increasing prevalence of chronic diseases and the risk for hospitalization associated with the ageing population. Nevertheless, our knowledge of how to implement this concept is limited. The integrated efforts of health and social services may help to enable older adults to live with a sense of control over their daily life and to be independent to the fullest extent possible in the community. Design This is a randomized, controlled trial. Methods Participants are community-dwelling older adults referred from a community centre. Sample size calculation was based on power analysis. The intervention group will receive the programme with the standard protocols guided by a comprehensive assessment-intervention-evaluation framework. Home visits and telephones follow-up will be employed as means of conducting the interventions and monitoring their progress. The customary care group will receive placebo social calls. The duration of the interventions will be 3 months. The study was funded by the School of Nursing in Hong Kong. Research Ethics Committee approval was obtained in September 2014. Discussion The results of this research are expected to enable older adults to stay in the community with optimal health and well-being. Health and social sciences are integrated into the practice in this research protocol. The scarce literature on this topic means that this study can also provide an opportunity to bridge the caring gap among older adults. [ABSTRACT FROM AUTHOR]

Aims This paper tests the mediating effect of institutional peer support on the relationship between physical declines and depressive symptoms among nursing home residents. Background As the number of older adults living in nursing homes increases, peer support received from other residents in the institutions is critical to the psychological well-being of residents who face physical declines and reduction in family support. This study tested whether institutional peer support would account for the detrimental effect of physical declines on depressive symptoms of Chinese older people residing in nursing homes. Design A cross-sectional design was used. Method The study was conducted between January-March 2009 by convenience sampling. The sample consisted of 187 nursing home residents, with 54 men and 133 women. Interviews were conducted by an experienced research assistant, and responses on physical abilities and institutional peer support were collected. Geriatric Depression Scale was used to assess depressive symptoms of each participant. Results Participants with poor physical abilities reported more depressive symptoms. Institutional peer support was negatively correlated with physical declines and depressive symptoms. Results of the regression analysis showed that the effect of physical declines on depressive symptoms was no longer significant when the influence of institutional peer support was statistically controlled, indicating a full mediation of institutional peer support on depression of older people. Conclusion Findings of this study reveal that institutional peer support positively contributes to the psychological well-being of nursing home residents. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a descriptive study of Chinese abdominal surgical patients' and nurses' perceptions of discharge information needs. Background. Discharge from hospital poses a potential threat to surgical patients' lives because they have to cope in daily life with the consequences of the illness and surgery. Recent studies indicate that nurses often underestimate or inappropriately perceive patients' discharge information needs. Few studies have examined the discharge information needs of patients who have undergone abdominal surgery, and research in Asian populations is particularly scarce. Methods. A descriptive qualitative study was conducted in 2008. Semi-structured interviews were performed with a convenience sample of 16 patients who had undergone an abdominal surgery and their 16 nurses in a regional general hospital in Hong Kong. Results. Results of content analysis indicated that to both the surgical patients and their nurses, three similar categories of information needs on discharge were health concerns upon discharge, addressing patients' information needs, and obstacles that hindered information seeking. Specific needs related to finance, knowledge of illness, psychological support and role of diet and traditional Chinese medicine perceived as important by the patients were underestimated by the surgical nurses and revealed important issues in providing holistic and culture-specific nursing care for surgical patients upon discharge. Conclusion. Surgical patients' information needs on finance, illness condition, psychological support and cultural practices were found not to be accurately and adequately understood by their nurses. Nurses should give culturally specific and appropriate predischarge education in terms of promotion of recovery from surgery, health maintenance practice and psychological support. [ABSTRACT FROM AUTHOR]

Aim. This paper reports a study to examine the effectiveness of a 6-month dementia care programme for Chinese families living with and caring for a relative with dementia, compared with routine family support services in Hong Kong. Background. Recognizing the adverse psychosocial health effects inherent in dementia care, different psychosocial interventions provided preliminary evidence of their effectiveness in improving family members' knowledge and skills in caregiving and delaying dementia sufferers' illness deterioration and institutionalization. Little is known about the effects of such interventions for family caregivers' psychosocial health conditions, particularly in non-Western populations. Methods. A randomized controlled trial was conducted with 92 Chinese families of a relative with dementia in two dementia care centres in Hong Kong. They were randomly selected from a dementia client list and then randomly assigned to receive either the dementia family care programme (n = 46), or routine care only (n = 46). Clients' symptoms and institutionalization, and caregivers' quality of life, burden and social support at recruitment, 1 week, and 12 and 18 months following intervention were measured and compared between the study groups using repeated measures MANOVAs followed by Helmert's contrast tests. Data was collected over a period of 24 months, between September 2007 and August 2009. Results. Results of the MANOVAs and contrast tests indicated that at 18-month follow-up, participants in the family programme reported significantly greater improvements in clients' symptoms and institutionalization rates, and caregivers' quality of life and burden, when compared with their counterparts in the routine care group. Conclusion. These findings provide evidence that the dementia care family programme can improve the psychosocial functioning of both clients with dementia and their family caregivers in a Chinese population. Further research is recommended to investigate whether this intervention can also apply to families with different socioeconomic backgrounds and across cultures. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study to illuminate the experience of family members whose relatives survived the resuscitation in an accident and emergency department, and their preferences with regard to being present. Background. Family presence during resuscitation can offer benefits to both patient and family members, and large healthcare organizations support and recommend offering the option for their presence. However, many staff believe that this is too distressing or traumatic for families and that they would interfere with the resuscitation process. Methods. An interpretive phenomenological approach was used to collect data in 2007-2008 with 18 family members of patients who survived life-sustaining interventions in an accident and emergency department in Hong Kong. Audiorecorded interviews were transcribed verbatim for thematic analysis and verified with the participants in second interviews. Findings. None of the family members was present in resuscitation room during the life-sustaining interventions, and five entered the room after the patients' condition was stable. The majority indicated a strong preference to be present if given the option. Three interrelated themes emerged: (i) emotional connectedness, (ii) knowing the patient, and (iii) perceived (in)appropriateness, with 10 subthemes representing affective, rational and contextual determinants of family presence preferences. The interplay of these determinants and how they contributed to strong or weak preference for family presence was analysed. Conclusion. Variations among the contributing determinants to each family member's preference to be present were revealed. Appropriate nursing interventions, policy and guidelines should be developed to meet individualized needs during such critical and life-threatening moments in accident and emergency departments. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study of the effect of music on the quality of life of community-dwelling older Chinese people in Hong Kong. Background. Older people's quality of life can be improved by preparing for the transition into old age. Listening to music, as a vehicle for feeling, can facilitate the non-verbal expression of emotion, reaching people's inner feelings without being threatening, and it can be a tool for emotional catharsis. Method. A randomized controlled trial design was conducted from in 2007 in a community centre in Hong Kong. A total of 66 older people (31 in music group and 35 in control group), aged from 65 to 90 years were randomly assigned to undergo either a 30-minute music intervention or a rest period for 4 weeks; quality of life outcomes were then measured. Results. Quality of life improved weekly in the music group, indicating a cumulative dose effect, and a statistically significantly better quality of life was found over time in each sub-score for those in the music group compared with the controls. However, in the music group, there were no statistically significant improvements of quality of life in each sub-score over the 4 weeks. Conclusion. Being engaged in music activities can help a person to connect with their life experiences and with other people, and to be more stimulated. Music is a non-invasive, simple and inexpensive therapeutic method of improving quality of life in community-dwelling elders. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a study comparing children with smoking parents and those with non-smoking parents, in terms of knowledge and attitude towards smoking and the influence of parents and peers on smoking initiation. Background. Adolescence is a developmental stage when smoking habits are likely to start. Adolescents are most influenced by the smoking habits of their parents and friends. Method. A cross-section study was conducted with students aged 13-15 years in two schools in 2008, using a questionnaire that collected information on the smoking habits of their parents and peers, knowledge and attitude towards smoking, initiation and inclination towards smoking. Chi-square tests and binary logistic regression were used to analyse the data. Results. A total of 257 of 575 (44.7%) students had smoking parent(s), and 25.4% reported having peers who smoked. Children with non-smoking parents were more likely than those with smoking parents to consider 'smoking as disgusting' (67.3% vs. 45.9%), and to know that 'smoking is addictive' (80.5% vs. 70.4%) and 'harmful to health' (81.8% vs. 67.7%). More of those with smoking parents had tried smoking than those with non-smoking parents (13.2% vs. 3.8%). Conclusion. Preventive programmes should involve smoking parents to increase their awareness of the impact their smoking has on their children. Interventions should include problem-solving skills for children to deal with daily stresses and thus eradicate the potential risk of smoking initiation. [ABSTRACT FROM AUTHOR]

Aim and objectives. This paper aims to explore the factors that affect Hong Kong intensive care unit nurses in providing oral care. Background. The literature shows that evidence-based oral care prevents ventilator-associated pneumonia. Nevertheless, not all intensive care unit nurses provide such care. Although several studies have been undertaken to identify factors that affecting the provision of oral care, none of these studies looked at the situation in Hong Kong. Design. An exploratory qualitative design was adopted, with audio-taped interviews. Methods. A convenience sample of 10 registered nurses with 3-14 years of intensive care unit working experience was recruited from the intensive care unit of one regional hospital in Hong Kong. Transcribed interviews were analysed by means of content analysis. Results. The participants' descriptions of their oral care practices covered oral health assessment, cleansing the oral cavity and care of the surrounding areas. Findings revealed the following significant factors that influenced intensive care unit nurses in providing oral care: their perceptions of the purpose of oral care; their fears about providing it; the priority of oral care; and inadequate support for oral care. Conclusions. The findings indicate that nurses' oral care practices were not evidence based. Factors that affected the provision of oral care were consistent with those found in previous studies. Relevance to clinical practice. Study findings indicate that present oral care training should be revised. The findings also highlight the influence of ward culture on nurses' priorities in providing oral care. Appropriate materials, adequate staffing levels and the establishment of an evidence-based oral care protocol may facilitate the provision of oral care in the intensive care unit. [ABSTRACT FROM AUTHOR]

yu d.s.f.(2010) Insomnia Severity Index: psychometric properties with Chinese community-dwelling older people. Journal of Advanced Nursing 66(10), 2350–2359. Aim. This paper is a report of a study to evaluate the psychometric properties of the Chinese version of the Insomnia Severity Index. Background. Despite the high prevalence of insomnia in older people and its detrimental impact on well-being and healthcare costs, this problem is almost always undetected and consequently under-treated. The Insomnia Severity Index is psychometrically sound in measuring perceived insomnia severity. However, it has had very limited application in non-White populations. Methods. An instrument validation study was carried out between October 2008 and April 2009. The Insomnia Severity Index was translated into Chinese using Brislin’s model and administered to a convenience sample of 585 older Chinese people recruited from three community centres for elders. Other instruments were also administered, including the Chinese version of the Pittsburgh Sleep Quality Index and the Geriatric Depression Scale. Results. Cronbach’s alpha of the Chinese version of the Insomnia Severity Index was 0·81, with item-to-total correlations in the range of 0·34–0·67. Construct validity was supported by its moderate relationship with the Chinese Pittsburgh Sleep Quality Index and sleep efficiency. The Chinese version of the Insomnia Severity Index also indicated more severe level of insomnia in older people who reported depressed mood on the Geriatric Depression Scale. Discriminant validity was supported as the Chinese version of the Insomnia Severity Index could discriminate poorer sleepers from normal sleepers. Exploratory factor analysis identified a two-factor structure for the Chinese version of the Insomnia Severity Index in measuring the severity and impacts of insomnia on the Chinese older people. Conclusion. The Chinese version of the Insomnia Severity Index is a culturally-relevant and psychometrically-sound instrument for assessing severity and impact of insomnia in Chinese community-dwelling older people. Nurses can use this tool to assess older people’s perceptions of insomnia. [ABSTRACT FROM AUTHOR]

chow s.k.y. & wong f.k.y. (2010) Health-related quality of life in patients undergoing peritoneal dialysis: effects of a nurse-led case management programme. Journal of Advanced Nursing 66(8), 1780–1792. Title. Health-related quality of life in patients undergoing peritoneal dialysis: effects of a nurse-led case management programme. Aim. This paper is a report of an examination of the effectiveness of a nurse-led case management programme in improving the quality of life of peritoneal dialysis patients in Hong Kong. Background. Patients with end-stage renal failure need integrated health care to maintain a desirable quality of life. Studies suggest that transitional care using a nurse case management model has a positive effect for patients suffering from chronic diseases, but the results have not been conclusive. Method. Eighty-five patients participated in the study in 2005, 43 in the study group and 42 in the control group. Patients in the control group received routine hospital discharge services. Study group patients received a comprehensive education programme prior to discharge and standardized, 6-week nurse-initiated telephone follow-up. Kidney disease quality of life was measured for each patient at three time intervals: before the intervention, at completion of the 6-week intervention and 6 weeks after completion of the programme. Results. Repeated measures analysis of variance, general linear model was carried out. Statistically significant within-group effects were found for symptoms/problems, effects of kidney disease, sleep, role-physical, pain, emotional wellbeing and social function. Statistically significant interaction effects were demonstrated for staff encouragement, patient satisfaction, sleep and social function. Conclusion. The nurse-led case management programme can be applied effectively to patients receiving peritoneal dialysis. The new model of care is particularly useful for enhancing patients’ wellbeing in the transition from hospital to home. [ABSTRACT FROM AUTHOR]

Title. Coping behaviour checklist for Chinese children: development and psychometric testing. Aim. This paper is a report of development and psychometric testing of the coping behaviour checklist for Chinese children. Background. An understanding of the coping behaviour of children is an essential prerequisite for the design of an appropriate psychological intervention to enhance children’s ability to cope with stressful medical procedures and hospitalization. Review of literature reveals that there is lack of child-sensitive measurement tools in the Chinese culture for assessing coping behaviours of children with good psychometric properties. Methods. An instrument development and validation study was conducted. Phase 1 was designed to develop a checklist of coping behaviour for Chinese children, while in phase 2 the psychometric properties of the new scale were tested. A total of 168 (phase 1) and 236 (phase 2) children between the ages of 7 and 12 years, were invited to participate in this study in 2008 and 2009, respectively; 228 completed both phases of data collection. Results. On the basis of the results of qualitative interview data, the coping behaviour checklist for Chinese children was developed. The newly developed scale had adequate internal consistency reliability and test–retest reliability, high content validity and appropriate construct validity. Confirmatory factor analysis further added evidence of the construct validity of the scale. Conclusion. The instrument can be used to identify the coping behaviour of Hong Kong Chinese children aged between 7 and 12 years. Knowing the coping behaviour of children in advance can help nurses to shape and design appropriate psychological interventions that can help children better cope with stressful medical procedures and hospitalization. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study conducted to examine self-reported adherence to a therapeutic regimen for continuous ambulatory peritoneal dialysis. Background. Studies of patients’ adherence during dialysis have primarily focused on haemodialysis and have frequently yielded inconsistent results, which are attributed to the inconsistent tools used to measure adherence. Levels of adherence to all four components of the therapeutic regimen (i.e. dietary and fluid restrictions, medication, and the dialysis regimen) among patients receiving peritoneal dialysis have not been examined, especially from a patient perspective. Methods. A total population sample was used. A cross-sectional survey was carried out by face-to-face interviews in 2005 in one renal clinic in Hong Kong. A total of 173 patients undergoing peritoneal dialysis (56% of the total population) participated in the study. Results. Patients perceived themselves as more adherent to medication (83%; 95% confidence interval 77–88%) and dialysis (93%; 95% confidence interval 88–96%) prescriptions than to fluid (64%; 95% confidence interval 56–71%) and dietary (38%; 95% confidence interval 30–45%) restrictions. Those who were male, younger or had received dialysis for 1–3 years saw themselves as more non-adherent compared with other patients. Conclusion. Healthcare professionals should take cultural issues into consideration when setting dietary and fluid restriction guidelines. Additional attention and support are required for patients who identify themselves as more non-adherent. To help patients live with end-stage renal disease and its treatment, qualitative research is required to understand how they go through the dynamic process of adherence. [ABSTRACT FROM AUTHOR]

mok e., wong f. & wong d. (2010) The meaning of spirituality and spiritual care among the Hong Kong Chinese terminally ill. Journal of Advanced Nursing 66(2), 360–370. Title. The meaning of spirituality and spiritual care among the Hong Kong Chinese terminally ill. Aim. This paper is a report of a study conducted to explore the phenomenon of spirituality and spiritual care among terminally ill Chinese patients. Background. Meeting a patient’s spiritual needs is a fundamental part of holistic nursing care. In the Western literature, spirituality is related to connectedness, faith, and hope. Contemporary scholars in the West suggest that spirituality is a broader term than religion. Method. Phenomenological interviews were conducted with a convenience sample of 15 terminally ill Chinese patients in 2007. Findings. Participants found the term spirituality an abstract concept and described it as a unique personal belief which gives strength and relates to meaning of life. Spirituality is integrated with the body and mind and is a multidimensional concept. The acceptance of death as a process in life and ‘letting go’ leads to serenity and peace of mind. Other important themes include how the meaning of life is derived through relationships and connectedness, self-reflection of responsibilities, and obligations fulfilled. Inner spiritual well-being is attained from having faith and knowing possibilities in life and after death. Participants did not expect nurses to provide spiritual care, but when quality interpersonal care was given it gave them strength and spiritually supportive. Conclusion. If healthcare professionals can provide a compassionate and loving environment that facilitates acceptance and hope, the spiritual life of patients is enhanced. For dying individuals to experience love and for them to be understood as valuable even when no longer economically productive are both experiences of healing. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to examine and compare decision‐making preferences on end‐of‐life care for older people in Japan, the Hong Kong SAR and South Korea. Background: Cultural values and beliefs influence decision‐making on end‐of‐life care. Design: A cross‐sectional design was adopted. Methods: Community‐dwelling people aged ≥65 with additional requirements were recruited in 2016–2017 in the three regions. Their decision‐making preferences on end‐of‐life care were assessed using Pang et al.'s questionnaire. These preferences and their sociodemographic and personal experience variables were compared and analysed using univariate and multiple logistic regressions. The STROBE checklist was followed. Results: This study involved 415 participants. In all three regions, the most preferred decision maker and person with whom to discuss end‐of‐life care issues was a family member. Participants in the Hong Kong SAR were less likely to select a family member as their preferred decision maker than those in Japan (adjusted odds ratio = 0.129). Koreans were less likely to discuss end‐of‐life care issues with medical professionals than people in Japan (adjusted odds ratio = 0.278). More than 70% of the participants in each region indicated that they would not prefer to leave an advance directive to decide their end‐of‐life care. Conclusion: Older Asians prefer to make their own decisions after consulting others. Family members play an important role in helping older people plan their preferred end‐of‐life care arrangements, even acting as decision makers when older people become incapable of deciding for themselves. Relevance to clinical practice: Sufficient information should be provided to older people and their families for the older people to determine their preferred care. Helping families to understand and support the planned care and advance directives is a strategy for maximising family compliance with the care. Continuous efforts should be made to promote advance care planning and advance directives. [ABSTRACT FROM AUTHOR]

Aims: To describe a nurse‐led multicentre randomized controlled trial protocol developed to evaluate the effectiveness and cost‐effectiveness of a Chinese iSupport for Dementia program in Australia and Greater China including mainland China, Taiwan, Hong Kong and Macau. Design: A multicentre randomized controlled trial following the SPIRIT checklist. Methods: Participants in the study will be recruited from Australia and Greater China and will be randomly assigned to the intervention group or the usual care group. Interventions will include self‐learning of the iSupport program, virtual peer support and nurse program facilitator support for 6 months. Primary outcome measures will be the 12‐Item Short‐Form Health Survey. Secondary outcome measures will include: Revised Scale for Caregiving Self‐efficacy; Quality of Social Support Scale; Revised Memory and Behaviour Problem Checklist; the Quality of Life in Alzheimer's Disease‐Proxy; usages of care services; and cost‐effectiveness of the intervention. Outcomes will be measured at baseline, 6 months and 9 months from the baseline. Caregivers' experiences of the peer support will be explored. This project was funded by the National Foundation for Australia‐China Relations, Australian Government (Project ID: NFACR216). The total amount is $440,000 Australian dollars (or £ 236,231). Discussion: Approximately, 20% of people living with dementia in the world live in Australia and Greater China. Older Chinese are usually cared for by family caregivers at home due to the influence of Confucianism. However, free and online psychoeducation programs for this large cohort of caregivers are not available or accessible. The World Health Organization iSupport for Dementia is an evidence‐based online psychoeducation program for caregivers. Implementing a culturally adapted Chinese iSupport program will address this gap in supporting caregivers. Impact This study will provide research evidence on effectiveness and cost‐effectiveness of an online psychoeducation program for caregivers. Findings will inform policy and practice development. [ABSTRACT FROM AUTHOR]

Lee YM, Hung YK, Mo FKF, Ho WM. International Journal of Nursing Practice 2010; 16: 508-516 Comparison between ambulatory infusion mode and inpatient infusion mode from the perspective of quality of life among colorectal cancer patients receiving chemotherapy Folfox and Folfiri are active chemotherapy treatments used in advanced colorectal cancer. The total admission for these treatments has been significantly increasing in the study hospital. An ambulatory infusion programme was launched to address the problems of long waiting list and bed shortage. The study objective was to compare the quality of life between patients receiving the chemotherapy treatments in the ambulatory infusion group and the inpatient infusion group. The results showed that some demographic variables of education level, family role and employment status were determinants of the treatment mode. Patients in the ambulatory infusion group of social and global domains performed better than the inpatient group. However, the inpatient group had better quality of life of nauseated symptom at different stages. Some nursing educations should be reinforced to address the symptom management for patients receiving ambulatory infusion at home. The ambulatory infusion programme offered considerable quality of life benefits to colorectal cancer patients receiving chemotherapy. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives: To explore the experience of multiple concurrent symptoms over time and their impact on daily living in patients with end‐stage renal disease undergoing dialysis. Background: Patients undergoing dialysis experienced multiple concurrent symptoms because of the disease and treatment. Evidence suggests that these symptoms cluster around and have a significant impact on quality of life. However, the experience of this impact remained not clear. Design: A longitudinal descriptive qualitative study. Methods: Ten patients were purposely selected from the cohort of a longitudinal quantitative study in Hong Kong. A total of 28 face‐to‐face semi‐structured interviews were conducted between July 2017 and July 2018. Interviews were audiotaped, transcribed and analysed using a thematic analysis approach. Findings were reported following the COREQ checklist. Results: Four themes emerged from the data. The first theme "complex symptom experience" described a dynamic pattern of symptoms among patients. Although patients were unaware of the relationships among symptoms, a cluster of tiredness, breathlessness, dizziness and sleep disturbance was identified in the narratives of individual symptoms. The report of symptom experience and its change revealed a unique pattern of symptom perception. The three other themes illustrated the impact of multiple concurrent symptoms on daily living, namely "decreased physical functioning," "changes in social functioning" and "diet and fluid restrictions." Conclusions: Patients perceived dynamic and complex symptom experiences. This perception appears to be modulated by a number of factors. In addition, these experiences had negative and positive effects on patients' daily living. Relevance to clinical practice: Patients perceived unique impact of symptoms on daily living. Therefore, a nurse‐led person‐centred approach of care is warranted. In addition to routine symptom assessment, nurses need to capture the specific impact of symptoms on day‐to‐day life. Based on this assessment, symptom management interventions (e.g. health education, referral) can be tailor‐made and prioritised. [ABSTRACT FROM AUTHOR]

Aims and objectives: To assess nurses' perceptions of what constitutes optimal end‐of‐life (EOL) care in hospital and evaluate nurses' perceived barriers to EOL care delivery. Background: Care of dying patients is common in hospitals. However, little is known about the important elements of and barriers to optimal EOL care from key service providers' perspective, which is crucial for quality EOL care in hospital settings. Method: This is a cross‐sectional survey. Nurses practising in hospitals recruited by convenience sampling completed self‐report survey questionnaires. STROBE checklist was used in study reporting. Results: One hundred and‐seventy‐five nurses participated in the survey. The majority (70%) had experience in caring for dying patients. The five most highly perceived factors constituting optimal EOL care included the following: "families know and follow patient's EOL wishes"; "patients emotional concerns identified and managed well"; "patients participating in decision‐making"; "EOL care documents stored well and easily accessed"; and "provide private rooms and unlimited visiting hours for families of dying patients". Top five barriers were "doctors are too busy"; "nurses are too busy"; "insufficient private room/space"; "nurses have limited training in EOL care"; and "families have unrealistic expectations of patient's prognosis." Multivariate regression analysis identified that nurses without experience in caring for dying patients reported a significantly higher number of perceived barriers towards EOL care (p =.012). Those with postgraduate degree training reported significantly fewer perceived barriers (p =.007). Conclusion: Findings identified essential elements for optimal hospital EOL care not only involving patients and families in EOL decision and care, but also documentation and environmental issues in the healthcare system level and the needs for strengthening manpower and expertise at palliative care policy level. Relevance to clinical practice: This study revealed quantitative data to inform health service managers and policy makers in terms of training and service development/ re‐design for EOL care in hospital settings. [ABSTRACT FROM AUTHOR]

Aims and objectives: To test the effectiveness of a musical training programme in promoting happiness and quality of life of Hong Kong Chinese underprivileged preschool children. Background: The impact of poverty and income disparity on the psychological well‐being of children remains a profound global public health concern. There is substantial evidence that poverty and income disparity have many negative impacts on children's psychological well‐being, adversely affecting their quality of life. Methods: A nonequivalent, quasi‐experimental, two‐group, pretest and post‐test, between‐subjects design was conducted with 171 Hong Kong Chinese underprivileged preschool children (aged 3–6 years). Participants (n = 100) in the experimental group attended a weekly 1‐hr musical training lesson for 12 weeks conducted by the Music Children Foundation. Participants (n = 71) in the wait list control group received the same training after all data had been collected. Data collection for both groups was conducted at baseline and 12‐week follow‐up. The measured outcomes were happiness level and quality of life. A TREND checklist was completed. Results: Participants in the experimental group reported significantly higher levels of happiness (p = .002) and quality of life (p = .44) than those in the wait list control group. Conclusions: The present study indicates the effectiveness of a musical training programme in promoting happiness and quality of life of Hong Kong Chinese underprivileged preschool children. It also demonstrated the feasibility of implementing the programme in a community context. Relevance to clinical practice: This study aids to inform nurses the beneficial effect of the musical training programme in improving underprivileged children's psychological well‐being and quality of life. Indeed, community nurses may act as facilitators to promote the musical training programme to underprivileged children. The involvement of community nurses may greatly enhance the sustainability of the programme, thus making it to be a routine health promotion activity. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives: To examine the psychological well‐being and quality of life of Hong Kong Chinese adolescents with congenital heart disease. Background: Congenital heart disease (CHD) in adolescents is associated with having negative psychological impact and impairment to quality of life. A literature review revealed that most studies on the impact of CHD on the psychological well‐being and quality of life of adolescents to date have been conducted in Western populations. Method: A cross‐sectional design was employed. Adolescents aged 12–18 with CHD attending an outpatient clinic in an acute public hospital were invited to participate. Another similar age group of healthy Chinese adolescents was also invited to participate for comparison purposes. Subjects were asked to respond to the Chinese version of the Pediatric Quality of Life Inventory 4.0 Generic Core Scales, Center for Epidemiologic Studies Depression Scale for Children, Rosenberg Self‐Esteem Scale and a demographic sheet. A STROBE checklist was completed. Results: Adolescents with CHD exhibited more depressive symptoms, lower self‐esteem and poorer quality of life than their healthy counterparts. Disease severity might affect the self‐esteem, depressive symptoms and quality of life of adolescents with CHD. Disease severity, depressive symptoms, self‐esteem level and types of treatment received were associated with the quality of life of adolescents with CHD. Conclusions: Hong Kong Chinese adolescents suffering from CHD experience negative impacts on their psychological well‐being and quality of life. In this group, disease severity may affect psychological well‐being and quality of life. Specifically, quality of life of adolescents with CHD was associated with disease severity, depressive symptoms, self‐esteem level and the type of treatment received. Relevance to clinical practice: The findings contribute to clinical care guidelines and serve as a reference in developing nursing intervention to adolescents with CHD so as to uphold quality of care. Clinical trial registration: NCT03255850 (Clinical trial.gov). [ABSTRACT FROM AUTHOR]

Aims and objectives: To evaluate (a) the perceived effects of the training provided to nurses under a standardised Connect, Ask, Respond and Empathise (CARE) protocol; (b) the ability to enhance the effectiveness of the ISBAR checklist; (c) any increase in nurses' spoken interactions and/or improved comprehension of the patient conditions upon the transfer of responsibility. Background: Nursing handover is a pivotal act of communication with effects on both patient safety and risk management. Previous studies of critical incidents have highlighted ineffective communication, including a lack of interaction and incomplete and unstructured handovers, as a major contributor to patient harm. Design: A pre‐ and post evaluation study involving a questionnaire survey before and after the 3‐hours training. Methods: Forty‐nine randomly selected bilingual nurses with no previous professional development experience in handover communication were trained according to the CARE protocol, and their perceptions of nursing handovers were assessed before and after training using questionnaire. The STROBE checklist is used (See File S1). Results: Training of the CARE protocol improved key areas of the handover process. All participating nurses exhibited significant improvements in their perceptions of effective handover from before to after training. Particularly, improvements were observed in the interactive frequency and quality and completeness of the presented patient information per handover. Conclusions: The nurses reported a deeper understanding of their perceptions of handover after a patient‐centred intervention, a better quality of interactions (e.g., querying and checking by incoming nurses), a greater focus when managing handovers and a more complete and comprehensive transfer of information between nurses. Relevance to clinical practice: CARE protocol‐based training yielded significant improvements in nursing handover practice. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives: To determine whether and how cognitive impairment interacts with therapy intensity to affect functional improvements in older stroke patients over an 8‐week postdischarge intervention delivered in a community setting. Background: Cognitive status is an important predictor of success of community‐based rehabilitation, but little has been known as to how cognitive impairment may affect outcomes through its interaction with the rehabilitation process. Design: A prospective follow‐up evaluation was conducted in Hong Kong of older stroke patients (n = 384) who were admitted to an 8‐week home‐based rehabilitation intervention after discharge in Hong Kong between 2012–2014. Methods: Cognitive screening was conducted among patients at the time of discharge from hospital. The intervention process was monitored, and individuals' therapy intensity was assessed and recorded by physical or occupational therapists independently in each therapy session. Outcomes were measured using the 10‐item Barthel ADL index at discharge and after the intervention. Results: Therapy intensity significantly moderated the relationship between cognitive impairment and functional recovery. Cognitively impaired stroke patients with moderate‐intensity rehabilitation reported significantly higher increase in functional performance than that of patients with low‐ and high‐intensity rehabilitation. In patients with no cognitive impairment, those who received high‐intensity treatment showed significantly more functional gains than that of patients being treated with less intensive rehabilitation. Conclusion: Cognitive impairment affected functional outcomes through its interaction with different levels of therapy intensity among poststroke older patients. Relevance to clinical practice: Increasing therapy intensity from moderate to high benefitted cognitively intact but not cognitively impaired patients. These results should inform decisions about community‐based rehabilitation and be used to identify the most cost‐effective service delivery model. [ABSTRACT FROM AUTHOR]

Aims: This study explored the impact of menopause on sexual health and marital relationships, the associated factors and the support needed among middle-aged and older women. Background: Although women experiencing menopause are more vulnerable to sexual health and marital problems, few studies have addressed this topic. Design: A mixed methods design was used, comprising primarily quantitative methods with a qualitative component to evaluate the impact of menopause on sexual health. Methods: Eligible women from community-based women centre in Hong Kong were recruited for a survey. The Female Sexual Function Index (FSFI) was used to evaluate sexual function and risk factors for developing sexual dysfunction. Purposively selected women were invited to participate in in-depth individual interviews to explore the impact of menopause on sexual health, the barriers encountered and the desired support. Findings: In total, 540 respondents completed the survey with response rate of 59.7% where 30 respondents participated in the in-depth individual interview. The prevalence of sexual dysfunction in the overall respondents and postmenopause were 85.1% and 91.2% respectively. Depression was found as a strong factor associated with sexual dysfunction. The qualitative data showed that menopause had a considerable negative impact on women's sexual lives. Vaginal dryness and low sexual desire were most commonly reported. Knowledge, financial support and family understanding were important to helping women manage menopause. Conclusion: This study gives further knowledge for healthcare providers and policy makers to develop appropriate strategies and deliver suitable services to improve the quality of sexual health of menopausal women. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study evaluates the clinical effectiveness of a multicomponent aroma‐massage with an acupressure treatment protocol and compared it to cognitive training for the management of behavioural and psychological symptoms of dementia. Background: Pharmacological interventions have been unsatisfactory in managing behavioural and psychological symptoms of dementia; thus, complementary and alternative medicine has been extensively researched to identify an adjunct safe and cost‐effective intervention. Design: This randomised clinical trial utilised a three‐arm parallel group design. Cognitive training was used as a conventional intervention to manage behavioural and psychological symptoms of dementia, whereas exercise was considered “treatment as usual” in this study; both were used as comparisons with the experimental protocol. There were three treatment groups: Group 1: aroma‐massage with acupressure + exercise, Group 2: cognitive training + exercise and Group 3: aroma‐massage with acupressure + cognitive training. Method: Sixty older adults were recruited and randomly assigned to the three groups (20 each). Using the 29‐item Chinese Version of the Cohen‐Mansfield Agitation Inventory, Neuropsychiatric Inventory, Mini‐mental State Examination and Barthel Index‐20, the outcome measures were assessed at preintervention, postintervention and the 3‐month follow‐up to assess behaviour, Activities of Daily Living, cognition, and behavioural and psychological symptoms of dementia severity and distress. Multiple comparisons performed through repeated measures were analysed to detect between‐group differences and within‐subject differences, as well as the interaction effects between groups and times. Results: The Group 1 and 3 participants showed a significant reduction in the severity and distress caused by behavioural and psychological symptoms of dementia, whereas Group 2 did not demonstrate similar effects. Conclusions: This clinical study suggests that aroma‐massage with acupressure is as effective as cognitive training and can enhance cognitive training in reducing the severity and distress of behavioural and psychological symptoms of dementia. Relevance to clinical practice: Aroma‐massage with acupressure may serve as an adjunct therapy to reduce behavioural and psychological symptoms of dementia. This therapy is safe, cost‐effective and can be implemented by caregivers and family members who are not professionally trained. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate room temperature and relative humidity affecting nurses’ comfort and protection in wearing N95 respirators during clinical bedside procedures. Background: N95 respirators are most commonly used to protect healthcare workers against airborne diseases. The elastic head straps required for tight‐fit may cause headache, facial pain and/or ear lobe discomfort. Although some past fit test results showed that these respirators are likely to fit comfortably, in reality, any discomfort from use may influence negatively their appeal and acceptability and thus lower their effectiveness to protect the wearers. Design: This study used a comparative study design to compare nurses’ comfort and protection in wearing N95 respirator during clinical nursing procedures. Method: The participants (84) were first‐year undergraduate nursing students from a university in Hong Kong. They were divided randomly into four groups (A, B, C and D), with 21 in each group. In this study, they performed the Personal Respirator Sampling Test (PRST), a self‐developed portable, real‐time fit test method based on the conventional fit test set‐up. After this, they were asked to complete a usability questionnaire, which was used to record their evaluations of the six perceptions of comfort of wearing N95 respirators. Results: The participants expressed being comfortable with the respirators at warm temperatures of 20 to 24°C. For those participants in Group A who had performed fit tests and fit checks, they did not feel hot nor had difficulties with breathing. However, they did feel tightness in the respirators and experienced discomfort on their ear lobes. Conclusion: Room temperature is the significant factor affecting the comfort in wearing N95 respirators. It is noteworthy that any discomforts from wearing respirators will negatively influence their appeal and proper use. Without doubt, comfortable fit makes healthcare workers more likely use respirators, hence complying with occupational health and safety regulations. Relevance to clinical practice: N95 respirator wearer's comfort is affected by room temperature. Wearer's comfort can affect his/her morale in performing bedside procedures in clinical practice. [ABSTRACT FROM AUTHOR]

Aims and objectives To understand the challenges that clinicians face in communicating with patients and other clinicians within a Hong Kong trilingual emergency department. Background Effective communication has long been recognised as fundamental to the delivery of quality health care, especially in high-risk and time-constrained environments such as emergency departments. The issue of effective communication is particularly relevant in Hong Kong emergency departments, due to the high volume of patients and the linguistic complexity of this healthcare context. In Hong Kong, emergency department clinicians are native speakers of Chinese, but have received their medical training in English. The clinicians read and record virtually all of their medical documentation in English, yet they communicate verbally with patients in Cantonese and Mandarin. In addition, communication between clinicians occurs in spoken Cantonese, mixed with medical English. Thus, medical information is translated numerous times within one patient journey. This complex linguistic environment creates the potential for miscommunication. Design A mixed-methods design consisting of a quantitative survey with a sequential qualitative interview. Methods Data were collected in a survey from a purposive sample of 58 clinicians and analysed through descriptive statistics. Eighteen of the clinicians were then invited to take part in semi-structured interviews, the data from which were then subjected to a manifest content analysis. Results Nearly half of the clinicians surveyed believed that medical information may be omitted or altered through repeated translation in a trilingual emergency department. Eighty-three per cent of clinicians stated that there are communication problems at triage. Over 40% said that they have difficulties in documenting medical information. Around 50% believed that long work hours reduced their ability to communicate effectively with patients. In addition, 34% admitted that they rarely or never listen to patients during a consultation. Conclusion The findings reveal that the quality of communication in this Hong Kong emergency department is compromised by specific factors inherent in the linguistic complexity of Hong Kong emergency departments. These factors include the constant translation of medical information, inadequate documentation of medical information and significant professional and cultural pressures. Each of these issues increases the likelihood that healthcare communication will be difficult, incomplete or incorrect. This research provides empirical evidence for, and justifies the development of, an effective framework to enable clinicians to overcome communication challenges. Relevance to clinical practice The findings of this study may shed light on the unique conditions faced by clinicians, particularly in relation to communication, in the complex trilingual healthcare context of an emergency department similar to those in Hong Kong, and provide potential policy solutions for barriers to improve communication in such settings. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of this study was to assess a community-women health ambassadors programme and report the areas that were successful and those that required improvement. The objectives were to assess the feasibility, effectiveness, implementation and sustainability of the programme. Background Health promotion for the prevention of chronic diseases has always been the top priority in the health sector. To ensure that the relevant health messages are well received in local communities, a health promotion programme must be accessible, acceptable and culturally relevant. Design We conducted and evaluated a women health ambassador programme based on the lay health advisor model for health promotion in Hong Kong during November 2014 to February 2015. Health needs and the subsequent focus of the programme were determined by underprivileged Chinese women. Methods University health educators from different disciplines trained the women ( N = 80) to be health ambassadors through mini-lectures and training workshops. The trained women raised awareness about the importance of health within their families and social networks. The programme was evaluated through attendance rates, questionnaires and quizzes, changes in knowledge and behaviour, as well as qualitative discussion. Results While the majority of participants found the programme valuable and useful, retention rates were unideal. A statistically significant improvement was found in eating habits, but no significant change was identified for other knowledge and behaviour assessments. Conclusions The programme empowered underprivileged women to reflect on the importance of health, take responsibility for their own health and actively promote health to their families and personal communities. Relevance to clinical practice Our study supports that health promotion programmes based on the lay health advisor model are effective and encourage large-scale programmes of this nature. Our results also support that future health promotion efforts should deliver brief, clear and simple content as opposed to intricate information. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the effects of a home exercise programme on patients' perceptions of the barriers and benefits to exercise and adherence to the programme. Background Great efforts have been made to encourage dialysis patients to participate in rehabilitation regimens. The promotion of exercise in this population is still limited. Design This was a post hoc analysis of a randomised, two-group parallel study. Methods A total of 113 adult patients recruited from the haemodialysis units were randomised into two groups on a 1:1 ratio. Both groups received in-centre group exercise training weekly for 6 weeks. The intervention group patients were provided with an additional individualised nurse-led home exercise prescription and behavioural support for 12 weeks. The patients' perceptions of the barriers and benefits to exercise, adherence to the home exercise prescription and their exercise level at weeks 6 and 12 were evaluated. Results There was a significant between-group difference in the score on patient perceptions of the barriers and benefits to exercise, with the intervention group reporting a greater reduction in perceived barriers to exercise. Significant group differences were noted in exercise level upon the completion of the programme, with the intervention group reporting higher such levels. The average adherence rate to the negotiated exercise plans was 78.9%. The intervention group of patients did better at meeting or exceeding the minimum exercise goal than did the control group. Conclusion Home exercise prescriptions and behavioural support provided by trained nurses are effective at helping patients to remove barriers to engaging in exercise training. Relevance to clinical practice Physical exercise in a clinical arena should not be considered the exclusive domain of physical therapists; the team could collaborate with nurses to play a core role in making physical exercise for patients an essential practice of care in a multidisciplinary team. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the factors contributing to the low physical activity level for Hong Kong Chinese children hospitalised with cancer. Background Notwithstanding the fact that regular physical activity can ameliorate cancer-related fatigue and other adverse effect of cancer treatment on children's physical and psychological well-being, physical inactivity is a common problem among children undergoing cancer treatment. Understanding the factors that affect their physical activity level is an important step towards planning and evaluating an appropriate intervention that promotes the adoption and maintenance of regular physical activity. Design A phenomenological design was used in this qualitative study. Methods A purposive sample of 25 children with cancer was recruited in a paediatric oncology unit of an acute care public hospital in Hong Kong. They were asked to participate in a semistructured interview by their bedside lasting about 30 minutes. All the interviews were tape-recorded and immediately transcribed. Content analysis was used to analyse the qualitative data. Results The findings revealed that the patients' physical condition, misunderstanding about physical activity by children, parents and healthcare professionals, emotional disturbances and social influences are four important factors impeding children from engaging in regular physical activity during cancer treatment. Conclusion This study addresses a gap in the literature by identifying the factors that negatively influence the physical activity levels of Hong Kong Chinese children hospitalised with cancer. Relevance to clinical practice Understanding these factors, nurses can explore interventions that target on correcting the misunderstanding and providing relevant information about the importance of physical activity, eventually promoting the adoption and maintenance of regular physical activity and enhancing the quality of life. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the difficulties and strategies regarding guideline implementation among emergency nurses. Background Emerging infectious diseases remain an underlying source of global health concern. Guidelines for accident and emergency departments would require adjustments for infectious disease management. However, disparities between guidelines and nurses' practice are frequently reported, which undermines the implementation of these guidelines into practice. This article explores the experience of frontline emergency nurses regarding guideline implementation and provides an in-depth account of their strategies in bridging guideline-practice gaps. Design A qualitative descriptive design was used. Methods Semi-structured, face-to-face, individual interviews were conducted between November 2013-May 2014. A purposive sample of 12 frontline emergency nurses from five accident and emergency departments in Hong Kong were recruited. The audio-recorded interviews were transcribed verbatim and analysed with a qualitative content analysis approach. Results Four key categories associated with guideline-practice gaps emerged, including getting work done, adapting to accelerated infection control measures, compromising care standards and resolving competing clinical judgments across collaborating departments. The results illustrate that the guideline-practice gaps could be associated with inadequate provision of corresponding organisational supports after guidelines are established. Conclusions The nurses' experiences have uncovered the difficulties in the implementation of guidelines in emergency care settings and the corresponding strategies used to address these problems. The nurses' experiences reflect their endeavour in adjusting accordingly and adapting themselves to their circumstances in the face of unfeasible guidelines. Relevance to clinical practice It is important to customise guidelines to the needs of frontline nurses. Maintaining cross-departmental consensus on guideline interpretation and operation is also indicated as an important component for effective guideline implementation. [ABSTRACT FROM AUTHOR]

Nurses' knowledge regarding advance directives may affect their administration and completion in end-of-life care. Confidence among nurses is a barrier to the provision of quality end-of-life care. This study investigated nurses' knowledge of advance directives and perceived confidence in end-of-life care, in Hong Kong, Ireland, Israel, Italy and the USA using a cross-sectional descriptive design ( n = 1089). In all countries, older nurses and those who had more professional experience felt more confident managing patients' symptoms at end-of-life and more comfortable stopping preventive medications at end-of-life. Nurses in the USA reported that they have more knowledge and experience of advance directives compared with other countries. In addition, they reported the highest levels of confidence and comfort in dealing with end-of-life care. Although legislation for advance directives does not yet exist in Ireland, nurses reported high levels of confidence in end-of-life care. [ABSTRACT FROM AUTHOR]