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woo h. & twinn s. (2004) Journal of Advanced Nursing 45(6), 595–602 Health needs of Hong Kong Chinese pregnant adolescents The outcomes of adolescent pregnancy have been associated with health risks such as obstetric complications and depression, and educational risks such as school dropout and reduced employment opportunities. These outcomes arise from a range of needs including perceived health needs, which are the focus of this paper. This paper reports a study to identify the perceived needs of Hong Kong Chinese adolescents following confirmation of an unintended pregnancy. An exploratory qualitative approach was used with a purposive sample of 10 Hong Kong Chinese pregnant adolescents. The study was undertaken during their stay in a non-government organization maternal shelter. Semi-structured interviews were used to explore adolescents’ perceptions of their psychological, social and health needs and the extent to which each of these needs was met. Six major categories were identified within the context of need, of which three were related to health needs: acceptance of the pregnancy; psychological reactions to the pregnancy; and use of contraception and health advice. The findings contribute to an understanding of the perceived health needs of Chinese adolescents, in particular those that are culturally determined. Implications for nursing practice indicate the significance of comprehensive health assessments and health promotion strategies to help adolescents increase their knowledge about sexual health and contraception. [ABSTRACT FROM AUTHOR]

Students’ perceptions of the effectiveness of mentors in an undergraduate nursing programme in Hong Kong Aim of the paper. This paper reports the results of a multiple-phase study on a mentoring scheme for nursing students in one of the universities in Hong Kong. Using a qualitative approach, students’ perceptions of the various roles of mentors were collected, and this information was used as the basis to design a tool for subsequent evaluation of the mentoring scheme. Background. The nursing department in one of the universities in Hong Kong initiated and developed the idea of an ‘Honorary Clinical Instructors’ scheme (HCI scheme) for the supervision of the pre-registration nurses. The scheme was examined in a local context, where the Chinese culture dominated, so that a standardized protocol that takes into account the potential cultural dimensions could be established. Design. The mentoring roles outlined by the English National Board (ENB) for Nursing, Midwifery, Health Visiting were used as a framework to identify undergraduate nursing students’ perception of the effectiveness of mentors. Information gathered from interviews with Year 2 students (n=12) and Year 3 students (n=10) was used as the basis to design a questionnaire for subsequent programme evaluation. An evaluation questionnaire based on the interviewing results was developed for further evaluation of the mentoring scheme. Findings. After the mentoring scheme was evaluated in semester one, a series of strategies were designed to improve the preparation of mentors and the implementation of the scheme. The strategies were identified as effective by the significant differences in the perceptions students had towards the mentoring scheme in semester one and semester two (t189=–4·80, P < 0·001), with semester two (n=81) having a mean score difference of 8·69 higher than in semester one (n=110). Conclusions. It was concluded that the... [ABSTRACT FROM AUTHOR]

Hong Kong returned to the sovereignty of the People's Republic of China in July 1997. In the past, Hong Kong has been greatly influenced by the British system of nurses' training, which was very different from that in mainland China. As Hong Kong is now a part of China again, there is an increased opportunity for the exchange of experience and ideas among nurse educators. The First China-Hong Kong Nursing Education Conference has provided opportunities for the authors to gain a deeper understanding of the development of nursing education in China and Hong Kong. The authors believe that it is also important for China and Hong Kong to increase networking with the international nursing community. This paper has been written largely based on the information gathered from papers presented in the Conference and the discussion with nurse educators who attended the Conference, together with a review of literature. This paper focuses on comparing the history and present development of basic nursing education in both places. The future direction for the development of nursing education in these two places will also be discussed. [ABSTRACT FROM AUTHOR]

Title. Nurses’ perceptions of preoperative teaching for ambulatory surgical patients. Aim. This paper is a report of a study to examine nurses’ perceptions of the importance of providing preoperative information to ambulatory surgical patients, and factors that might influence their provision of such teaching. Background. Ambulatory surgery is now widespread and creates a challenge for nurses to provide preoperative teaching in the limited contact time they have with patients. Although nurses act as key educators in patient teaching, little is known about their perceptions of the importance of preoperative teaching, or about current practice in the provision of such teaching for ambulatory surgical patients. Methods. A self-administered questionnaire including demographics and the Preoperative Teaching Questionnaire was completed by 91 of the 169 eligible nurses (response rate 53·8%) working in day-surgery units, operating theatres or outpatient clinics providing ambulatory surgery services in two public hospitals in Hong Kong in 2005. Results. A discrepancy between nurses’ perceptions and practice in relation to the provision of preoperative information was found. Limited teaching aids, tight operation schedules and language barriers affected the delivery of preoperative information to ambulatory surgical patients. Conclusion. The results highlight the importance of reviewing current preoperative teaching methods and improving the effectiveness of such teaching to enhance the quality of care for ambulatory surgical patients. [ABSTRACT FROM AUTHOR]

AIM: This paper is a report of a survey to explore Hong Kong nurses' disaster preparedness. BACKGROUND: Increasingly frequent global disasters are posing threats to human health and life. The World Health Organization has called for countries to have detailed plans at all levels in order to be prepared for disasters that may arise. METHOD: A questionnaire was distributed to convenience samples of practising Registered Nurses studying in Master's degree programmes at a Hong Kong university in 2007. Results. Of a possible 174, 164 questionnaires were returned (Response rate 94%). Almost all nurses (97.6%) considered the government health department to be the organization most involved in disastrous situations. The majority (84.8%) were aware of the existence of a protocol on disaster management at their workplace. About one-third would respond in accordance with protocol (38.4%) or rely on directions from their immediate supervisors (34.8%) if a disaster occurred. Almost all the nurses (97%) considered themselves not adequately prepared for disasters. They recognized that a protocol for disaster management (85.4%) and training and drills for disasters (both 84.1%) are useful tools. CONCLUSION: Nurses in Hong Kong are not adequately prepared for disasters, but are aware of the need for such preparation. Disaster management training should be included in the basic education of nurses. [ABSTRACT FROM AUTHOR]

Title. Women’s experience of internal radiation treatment for uterine cervical cancer Aim. This paper is a report of a study to explore the experiences of women undergoing internal radiation for cervical cancer. Background. Cervical cancer continues to be one of the most common cancers and one of the leading causes of cancer deaths globally. Women’s experiences of undergoing internal radiation for cervical cancer remain relatively unexplored, in particular in Hong Kong. Better understanding of the experiences of this specific group could inform the provision of supportive care services and provide useful information to be included in education programmes for them. Method. A phenomenological approach was adopted and unstructured telephone interviews were carried out with eight participants between July and October 2004. The interviews were audio-taped and analysed using the procedures described by Giorgi, 1985 . Findings. Three themes were identified from the data: (1) isolation versus social intercourse, (2) unbearable symptom distress versus endurance and coping and (3) growth from the experience. The most distressing aspects of undergoing internal cervical irradiation reported by the patients were the experience of isolation and various physical and psychological symptoms. Specific provisions in the physical environment, psychological support provided by healthcare professionals, family and fellow patients and a positive attitude helped them to cope. They also felt that they became stronger through their hardship and suffering. Conclusion. The findings highlight the importance of adequate preparation of patients, carers and friends before the procedure, more sensitive support during the procedure and debriefing afterwards. There might also be benefits in delivering therapy to two women in adjacent beds to enable them to support each other. [ABSTRACT FROM AUTHOR]

AIM: This paper reports a study to examine the effectiveness of a 12-session mutual support group for Chinese families caring for a relative with schizophrenia compared with a psycho-educational group and routine family support services in Hong Kong. BACKGROUND: Schizophrenia is a disruptive and distressing illness for patients and their families. With the current trend of community care for mental illness, there is evidence that family intervention reduces patient relapse and re-hospitalization, satisfies the health needs of families and enhances their coping capabilities. METHODS: A randomized controlled trial was conducted from May 2002 to June 2003 with 96 Chinese families of a relative with schizophrenia selected from two psychiatric outpatient clinics in Hong Kong. Families were randomly assigned to receive mutual support (n = 32), psycho-education (n = 33) or standard care only (n = 31). The interventions were delivered at outpatient clinics over a 6-month period. Pre- and post- (1 week and 6 months) testing took place and families' functioning, mental health service utilization, patients' level of functioning and duration of re-hospitalization were measured. RESULTS: At both post-test periods, family caregivers and patients in the mutual support group reported statistically significant improvements on family and patients' level of functioning, when compared with their counterparts in the psycho-education and standard care groups. CONCLUSIONS: The findings support the use of mutual support groups as an effective modality of family intervention in a Chinese population caring for a family member with schizophrenia to improve both family and patient functioning. [ABSTRACT FROM AUTHOR]

AIM: This paper reports a study to translate the Childbirth Self-efficacy Inventory into Chinese and examine its reliability and validity among pregnant Chinese women in Hong Kong. BACKGROUND: Self-efficacy for childbirth has been emerged as an important psychological construct in childbearing care. A reliable and valid self-efficacy measure for pregnant women is crucial to the understanding of their psychological preparation, as well as the development of an appropriate childbirth education programme. METHODS: Two experienced midwives undertook translation of the Childbirth Self-efficacy Inventory into Chinese, and another two experienced midwives independently conducted back translation. An expert panel of six healthcare professionals and 10 pregnant women examined the face and content validity of the translated instrument. A convenience sample of 148 pregnant Chinese women of not <36 weeks of gestation, and attending a regional teaching hospital in Hong Kong, were invited to complete the translated inventory and a demographic data sheet. RESULTS: The Childbirth Self-efficacy Inventory indicated high internal consistency. Principal components analysis supported the fact that each of the efficacy and outcome expectancy subscales is uni-dimensional. Neither scores in the efficacy nor outcome expectancy subscales suggested any statistically significant relationships with parity, age, education and attendance at childbirth education classes. No statistically significant differences in efficacy and outcome expectancy scores were found between the active phase (when contractions are not more than 5 minutes apart) and second stage (when pushing out the baby) of labour. CONCLUSION: The study provides initial support for the reliability and validity of the Childbirth Self-efficacy Inventory. Although its sensitivity in differentiating between the two stages of labour was not evident, the distinguishing role of its expectancy subscales has been identified. [ABSTRACT FROM AUTHOR]

AIM: The aim of this paper is to report a study of the lived experience of postpartum stress among depressed Hong Kong Chinese mothers. BACKGROUND: Research consistently relates postpartum stress to the mood and well-being of mothers during the postpartum period. While several studies have used questionnaires to assess the stress levels of mothers or have identified stressors by asking them to list stressful events, the existing literature lacks in-depth information on the lived experience of postpartum stress from the perspective of the depressed mother. METHODS: The study adopted a phenomenological approach with a purposive sample of 11 depressed Hong Kong Chinese mothers at around the sixth postpartum month. In-depth interviews were conducted in Cantonese and focused on the stress the mothers experienced during the postpartum period up to the time of the interview. The data were collected in 2000. RESULTS: Living in a metropolitan city under the mixed and sometimes conflicting influences of cultures from the East and the West, Hong Kong Chinese mothers face a unique set of challenges which, if not properly managed, may cause stress and/or depression in the postpartum period. We identified five major postpartum stress themes amongst this group of women: parenting competence, the expectation-experience gap, baby-minder arrangements, childcare demands, and conflict with culture and tradition. CONCLUSIONS: Health care staff should give anticipatory guidance to mothers and their spouses about the culturally prescribed set of rules that proved stressful. Antenatal education classes need to enhanced, and support is needed to help this population of women manage and overcome the challenges in the postpartum period. [ABSTRACT FROM AUTHOR]

AIM: This paper reports a study to examine the relationship between patient satisfaction and triage nursing care in order to assist nurses in defining more clearly their roles, and ultimately to improve the quality of care delivered to emergency patients. BACKGROUND: Patient satisfaction is considered an important indicator of quality care from the perspective of the consumer and has been widely studied in many settings. However, few studies have examined patient satisfaction with emergency nursing services in the particular area of triage. METHODS: A descriptive, correlational study was conducted in 2001 in one urban acute hospital in Hong Kong using Consumer Emergency Care Satisfaction Scale (CECSS), and patient and nurse demographic data were also collected. Following a power calculation, systematic sampling was carried out, and the final sample consisted of 56 urgent, semi-urgent and non-urgent patients triaged. The response rate was 61%. RESULTS: The majority of the participants were satisfied with their triage nursing care and teaching. However, difficulties were encountered during the data collection process, resulting in a relatively low response rate. Correlational analyses revealed that patient satisfaction with triage nursing care was statistically significantly correlated with age and the type of nursing intervention received. Older people were more satisfied with the teaching offered by triage nurses and patients who had received specific nursing interventions gave more positive ratings on the teaching subscale of the CECSS. There were no statistically significant relationships between patient satisfaction with triage nursing care and nurse characteristics, including gender, work experiences and educational level. CONCLUSIONS: Patients were generally satisfied with the care provided by the triage nurses. Measuring patient satisfaction with triage nursing care remains a major challenge for health care providers in emergency care settings. [ABSTRACT FROM AUTHOR]

BACKGROUND: Breastfeeding initiation rates have been steadily rising in Hong Kong, but most employed women wean prior to returning to work. While health care providers promote breastfeeding, women receive little support from employers. A few health care facilities offer some workplace breastfeeding support, but little is known about the specific types and amount of support that are offered. AIMS: This paper reports a study whose aim was to describe workplace supports available to breastfeeding women employed by hospitals that provide maternity services in Hong Kong, and to determine if differences in workplace supports exist based on the hospitals' numbers of employees or funding source. METHODS: In late 2001, a cross-sectional survey was completed by nurse managers or lactation consultants most knowledgeable about supports to breastfeeding employees in 19 hospitals. FINDINGS: The number of workplace breastfeeding supports or Breastfeeding Support Score (M = 7.47; sd = 3.37) varied considerably. Mean Breastfeeding Support Score for government-funded hospitals was significantly higher (t = 2.31; P = 0.03) than for private hospitals. Of the 14 hospitals that had a designated space for using a breast pump, only five (26.3%) had a private room with a door that locked. Only two hospitals (11.1%) allowed employees to take breaks as needed to use a pump; employees in 10 (55.6%) had to use their meal and regular break times. Hospitals having a hospital-wide committee that addressed workplace breastfeeding issues had a more supportive environment for breastfeeding employees. Although all surveyed hospitals returned the questionnaire, the sample size was small. It was difficult to ensure accuracy and to differentiate subtle variations in the services provided using a self-report survey. CONCLUSIONS: Facilitating continued breastfeeding after employees' return to work requires that employers understand the needs of breastfeeding employees. Policy at the level of the employer and government is an essential component of creating a supportive environment. [ABSTRACT FROM AUTHOR]

kong s.k.f. & lee d.t.f. (2004) Journal of Advanced Nursing 46(4), 369–379 Factors influencing decision to breastfeed The low prevalence and short duration of breastfeeding in international studies have highlighted the need for more investigations into the problems. International studies have identified certain factors that affect breastfeeding intentions. Due to insufficient published studies on the local breastfeeding situation, this study specifically investigated factors influencing the breastfeeding decision among primipara women in Hong Kong. The aim of this paper is to report a study investigating the personal, social, cultural, facilities and environmental and other factors contributing to women's decisions to breastfeed, and to exploring first-time mothers’ knowledge of breastfeeding and its influence on their breastfeeding intentions. Three private and 10 public hospitals in Hong Kong participated in the study. Both quantitative and qualitative data were collected through questionnaires and subsequently by in-depth interviews with 230 first-time mothers 24–48 hours after delivery. The results indicated that personal, cultural, social, and environmental factors are common influencing factors in the decision to breastfeed. Mother's knowledge and attitudes, followed by husband's support, were identified as important in influencing infant feeding choice. Expected local cultural differences were also identified. Acknowledgement of the influencing factors could lead to appropriate management of the promotion of breastfeeding. Further research into husband's role, recognition and support for infant feeding and the issue of ‘inadequate breast milk’ is necessary for a successful breastfeeding campaign. Some other interesting findings typical of the local culture, such as family communication and living environment relating to breastfeeding, are also discussed. The study has identified the influencing factors that affect women's decision to breastfeed. Recommendations are made for health care professionals and the community to create a more baby-friendly atmosphere and environment for the promotion of breastfeeding. [ABSTRACT FROM AUTHOR]

BACKGROUND: Developmental action inquiry (DAI) was chosen as the change strategy for introducing problem-based learning (PBL) in a pre-registration nursing programme. The central task was to transform the tutor and student participants to become collaborators in this curriculum reconstruction project. AIM: This paper expounds the way in which the action inquiry was constructed and in light of students' feedback analysis, the way in which PBL has made a difference in student learning was evaluated. DESIGN: Taking into consideration the change context and different group characteristics, the DAI was conducted in terms of two dynamically interlinked circles that formed partnerships between PBL core group members and tutors, and between tutors and students in coconstructing knowledge useful for PBL curriculum development. FINDINGS: The findings of the student evaluation questionnaire reveal that the majority of students felt PBL made a difference to their expectations of self, the student group and the teacher role in creating a facilitative environment to enhance learning. However, there was a significant difference among individual student group responses. The students' positive and negative PBL experience in self-learning, tutor-student interaction, and group-learning were identified as crucial factors contributing to these group variations. CONCLUSION: The evaluation findings show that a paradigm shift from teacher-centred to student-centred learning, from valuing self-learning to co-operative group-learning, and from theory-based to practice-based learning occurred among the students. DAI was found to be an effective change strategy for transforming participants to become collaborators in searching for useful knowledge and coconstructing the PBL learning context. [ABSTRACT FROM AUTHOR]

Aim. This paper reports the second phase of a study that explored the perceptions and experience of Hong Kong Chinese insulin-treated clients who demonstrated fear of hypoglycaemia and worry about diabetes complications. Background. The first phase of the study, a descriptive survey (n = 120), identified 15% of respondents as simultaneously sustaining fears and worries associated with hypoglycaemia and diabetes complications. Although a small percentage, given the increasing number of clients using insulin treatment, this finding suggests a pocket of clients suffering from undesirable emotional health. However, a search of the literature identified few studies exploring Chinese clients' perceptions and experience in this area. Design. The second phase of the study employed a purposive sampling method and semi-structured interviews to collect data from 13 participants experiencing these fears and worries. Findings. Two researchers independently used content analysis to code and categorize data. Six categories identified were: the influence of perceptions of glycaemic control on emotion, hypo- and hyperglycaemia as a constant threat, keeping optimal glycaemic control or maintaining a working life, financial and psychological burden of blood glucose self-monitoring, being alone with the threat and finally distancing as the coping method. An overriding issue, a sense of losing control, emerged from the findings that described participants' perceptions and experience. This issue and two major health needs, developing self-efficacy and emotional support from nurses, were drawn from the findings for discussion. It is suggested that self-efficacy theory can be adopted as a conceptual framework to guide nursing practice for enhancing clients' capacity to exercise control over diabetes self-management. Conclusions. Findings obtained from the second phase of the study illuminated those from the first phase. Implications for nursing practice were identified, including facilitating both technical and psychosocial self-efficacy, assessing clients' total life situation, strengthening competence in counselling skills and forming alliances with clients. [ABSTRACT FROM AUTHOR]

AIMS: This paper describes the process by which the Chinese Dialysis Quality of Life Scale was developed, and the preliminary testing and psychometric evaluation of the scale in a sample of dialysis patients. BACKGROUND: Quality of life as a specific outcome variable has not been systematically and satisfactorily studied in Chinese dialysis patients in Hong Kong. A single global quality of life measure that is both reliable and valid for dialysis patients has yet to be developed. Without measurement tools, it is impossible to judge progress towards this goal. DESIGN: A list of key issues was first derived from an in-depth literature review, then verified by semi-structured interview on seven patients. The initial list of 87 items was then further refined through two rounds of content analysis. The remaining 50 items were finalized by pilot test on seven patients. Of the refined 40 items, face validity was assessed by a team including one professor and ten patients. The 40-item scale was further evaluated by stability, internal consistency and criterion validity with a convenience sample of 164 patients. The scale demonstrated high internal consistency and good test-retest reliability and criterion validity when used. CONCLUSIONS: The psychometric evaluations suggest that the instrument is worthy of further development. Continued validation of this scale on larger sample and Chinese population living outside Hong Kong has the potential to provide nurses with a valid assessment and treatment guide, and researchers with a valid measurement tool. [ABSTRACT FROM AUTHOR]

Aim. This paper examines the methodological issues arising from an evaluation of the effectiveness of a health education project undertaken to increase Hong Kong Chinese women's knowledge of the prevention of cervical cancer and the uptake of screening.Background. The significance of health promotion to the prevention of diseases currently affecting contemporary society has become increasingly recognized. Within the context of health promotion health education continues to provide an important preventive strategy. Indeed the leading causes of mortality such as coronary heart disease and cancer lend themselves well to health education interventions. However the evaluation of the effectiveness of health education remains complex and raises some important methodological issues.Design. The project used a health education intervention as the major preventive strategy and employed multiple methods of evaluation to assess its effectiveness. Outcome evaluation consisted of a confidential questionnaire administered at two points in time to measure changes in health-related behaviour and knowledge. It also included the collection of data from service providers to assess changes in the uptake of cervical cancer screening. Process evaluation involved the use of focus groups with randomly selected groups of women who had participated in the health education intervention and a diary kept by the project nurse.Findings. Methodological issues identified in the evaluation of the project included the extent to which changes in health-related knowledge and behaviour could be attributed to the intervention, the sensitivity of outcome measures and challenges in developing methods of process evaluation appropriate to the target population.Conclusions. The findings highlight the complexity of designing effective evaluation strategies for health education and the need to consider these issues in the development of both process and outcome evaluation. [ABSTRACT FROM AUTHOR]

Women's attendance for regular cervical screening has been identified as a significant factor in the prevention of cervical cancer. Evidence suggests, however, that both extrinsic and intrinsic factors influence women's attendance patterns for screening. Extrinsic factors, in particular the practitioner undertaking the screening procedure, have been shown to influence women's return rates for further screening. In Hong Kong, where uptake rates amongst Chinese women remain comparatively low, a study was undertaken to examine Chinese women's experiences and perceptions of cervical screening undertaken by either a female doctor or nurse. A multiple case study design using both qualitative and quantitative methods of data collection was employed. This paper reports the findings from the qualitative data obtained from 52 women participating in 12 focus group interviews held in the two case studies. Thematic analysis of the data demonstrated the importance of the caring nature, communication skills, experience and expertise of the practitioner to women's attendance pattern for screening. The experience and expertise of the practitioner, described by women as teaching, minimizing pain and discomfort and being considerate, were considered more influential to uptake rates than the professional discipline of the practitioner. Findings such as these indicate the importance of the influence of the practitioner in determining uptake rates for cervical screening amongst this population group. [ABSTRACT FROM AUTHOR]

This paper reports on a study of the implementation and evaluation of learning contracts in a clinical context for a group of students who were in their third year of study in a pre-registration bachelor of nursing degree programme in Hong Kong. A learning contract was implemented as a learning tool in the students' clinical placement in mental health nursing. An action research approach was used in this study. Data were collected from questionnaires and interviews with students and clinical instructors. Results showed that students and clinical instructors generally agreed that there was an increase in students' autonomy and motivation in learning with the use of a learning contract. It also increased the sharing between students and clinical instructors. The findings of the questionnaire and interviews supported each other. However, the lack of experience in using contract learning and the limited time in the clinical areas created difficulties for both students and clinical instructors. Despite the limitations, contract learning is considered beneficial to students' learning and has the potential to be used in clinical learning. [ABSTRACT FROM AUTHOR]

This paper reports the preliminary results of a study on the implementation of case management in the community psychiatric nursing service (CPNS). The purpose of the study is to compare the outcome of case management service with the conventional practice of CPNS in the care of chronic schizophrenic clients. The impact of case management service on clients' clinical status, functional level and satisfaction was measured. A matched, pre-post, case-control group design was used to compare case management and conventional care groups. A specific case management model based on the practice at Carondelet Saint Mary's Hospital and Health Centre in Tucson has been developed to care for the schizophrenic clients in the community. Subjects in the experimental group were cared for by CPNs using this case management model. Subjects in the control group were cared for by CPNs based on current practices in the CPNS. Pre- and post-measures were taken upon recruitment and at 5 months later. Findings showed that the experimental group had better outcome in terms of their mental status and functional level when compared with the control group. They were generally more satisfied with the service. When comparing case managers' role with that of conventional CPNs, case managers performed more in areas such as assessment, liaison, case discussion and life skills training. This study demonstrates that this particular model of case management can be effective in caring for clients with long-term mental health problems in Hong Kong. [ABSTRACT FROM AUTHOR]

Cervical cancer remains a cause of morbidity and mortality among women despite the efficacy of Pap smear screening. Uptake rates for Papanicolaou (Pap) smears among Hong Kong Chinese women remain low and evidence suggests that both intrinsic and extrinsic factors influence women's attendance for Pap smear screening, particularly the practitioner taking the smear. This study examined the experiences and perceptions of Hong Kong Chinese women of having a Pap smear taken by a female doctor or a female nurse using a case study design. A convenience sample of 50 women was selected from the two case study settings. Data collection involved a confidential structured interview, followed by focus group interviews with a sample of women participating in the structured interview. The findings relating to the technical quality and outcome of care provide the focus for this paper. Although women were highly satisfied with the care provided by both practitioners, women were more satisfied with the information given about the procedure by the nurse (P = 0.0130) and had more confidence in the nurse (P = 0.024). One of the five criteria used to assess the quality of smears demonstrated the doctor achieved a statistically significant higher number of smears containing the required percentage of endocervical cells (P = 0. 0180). Nevertheless, none of the smears taken by the nurse required repeating due to an inadequate specimen. These findings suggest, despite the need for audit of Pap smears, that appropriately qualified nurses can make an important contribution to the uptake of Pap smears among this population. [ABSTRACT FROM AUTHOR]

Health care reform in Hong Kong in the 1990s has brought about dramatic change to the nursing discipline. This paper reports an ethnographic study which aimed at exploring the transformation of nursing in a regional hospital in Hong Kong during this period of reform. In the study, the restructuring of nursing work, its associated dynamics and resulting impacts upon the nursing profession were examined. A methodological triangulation approach to data collection encompassing interviews, participant observation and review of documents was used. The findings in this study suggest that the majority of nurses working in the case study hospital continue to be subject to medical dominance and are under management control. The emphasis on cost-effective care has however, fostered qualified nurses to claim more ownership of their professional judgement and autonomy. The health care reform has confirmed the status of two newly established groups of nurses, the nurse specialists and nurse managers. The development of the nursing profession is found to be closely connected to its work development. The preparation of the new generation of nurses, as revealed in this study, needs to emphasize the cognitive dimension of the professional competence. Some nurses need to be further educated in specialist practice and clinical management to maximize the contribution of nursing in health care delivery. [ABSTRACT FROM AUTHOR]

This study aims to investigate the daily mood states of public health nurses (PHNs) in managerial roles with children in Hong Kong, as a result of multiple role juggling (i.e. simultaneously attending to demands of different roles) using the experience sampling method. Convenience sampling was used to recruit 20 subjects. A watch was worn that beeped at six random times each day for 7 days as a signal to complete an experience sampling diary. PHNs on average responded to 34 signals (80%) to complete the experience sampling diaries. Two major findings provide the focus of this paper. First, results show that PHNs had minimal inter-role juggling between work and family as compared with previous studies in the United States. Cultural factors, sequentially dealing with family and work issues, having a domestic maid or a relative to see to household chores as well as strong spouse support are suggested as the reasons. These results have implications for nursing management and nursing practice. Second, the results also reveal PHNs as having an overall flat affect. It is suggested that PHNs may be using a ‘calm and detached’ coping style for occupational stress. This coping style has implications on the PHNs’ emotional health as well as nurse-client relationships. [ABSTRACT FROM AUTHOR]

Case management has been suggested as an innovative strategy which facilitates the linking of quality and cost-effective care. However, there is little consensus about what is actually being introduced under the name of case management. It is suggested that this absence of a clear understanding of case management has been an obstacle in moving forward case management practice and research. This paper presents a critical review of the confusion surrounding case management with an attempt to unravel issues relevant to the implementation of case management into community nursing practice in Hong Kong. It is concluded that there is a need for different definitions of case management as a result of the differences in the cultural and health care context in which it is being practised. Also, if case management programmes are to be advanced, there needs to be more co-ordinated effort in researching not only the expected outcomes but also the structures and processess of these programmes so that findings of similar case management programmes can be compared for ways of future improvement. [ABSTRACT FROM AUTHOR]

Cancer is a major health problem world-wide. Therefore, it is not surprising that cancer is identified as the top priority disease group for an improvement programme by the Hospital Authority in Hong Kong. Laser therapy for patients with nasopharyngeal carcinoma, for example, is evidence of the advancement of the scientific and technological developments for cancer treatment. Furthermore, the establishment of the Cancer Centre has provided ample opportunities for clinical practices and research studies. In response to the proclamation of the urgent need for the establishment of a cancer society in every country by Searle in 1990, the Oncology Care Society of Hong Kong, which aims to promote both cancer education and cancer research, was established in 1993. Adopted from the core curriculum of the European Oncology Nursing Society, the specialist course of cancer nursing care was first implemented in Hong Kong in 1993 and the nurse specialist is now a permanent part of nursing career structure in Hong Kong. This paper attempts to review the development of oncology nursing in Hong Kong according to these factors and to find ways to improve the current situation. [ABSTRACT FROM AUTHOR]