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The article comments on "Nurses as providers of support for mothers of premature infants," a paper by E. Mok and S.F. Leung which was published in the 2006 issue. The study explored the supportive behavior of nurses as experienced by mothers of premature infants in Hong Kong, China. The findings on parents' perceived and received support needs in a neonatal unit are discussed.

AIM: This paper described a case study of a randomised controlled trial with the aim to illuminate how the intervention described takes into account the important methodological considerations for enhancing the efficacy of psychoeducational interventions for paediatric patients. BACKGROUND: Many nursing intervention studies commit a Type II error despite the fact that the intervention is effective. Lack of attention given to the threats of validity of an intervention study may lead to inaccurate inference about the efficacy of the intervention study, thereby precluding any definitive conclusions being drawn. DESIGN: A case study of a randomised controlled trial was described. METHOD: Two hundred and three Hong Kong Chinese children, admitted for elective surgery, were invited to participate in the study. By using a simple complete randomisation method, 97 children were assigned to the experimental group and received therapeutic play intervention and 106 children were assigned to the control group and received routine information preparation. RESULTS: Children received preoperative therapeutic play intervention experienced lower anxiety levels, fewer negative emotions and lower heart rates and mean arterial blood pressures. CONCLUSION: This case study illustrates that the more a measure is sensitive to differentiate between the experimental and control groups, the greater the likelihood of documenting intervention efficacy. Besides, the timing of measuring a dependent variable that matches with peak response to an intervention is crucial in evaluating the efficacy of an intervention. Additionally, outcome measures that are sensitive enough to differentiate between the experimental and control groups are extremely important to ensure greater accuracy in evaluating the efficacy of psychoeducational interventions. RELEVANCE TO CLINICAL PRACTICE: It is anticipated that designing an effective psychoeducational intervention research design can facilitate the development of holistic and quality care in preparing children for hospitalisation. [ABSTRACT FROM AUTHOR]

Aims. To investigate nursing students’ knowledge, attitude and readiness to work for clients with sexual health concerns and to identify strategies to help students develop as they take up their role in sexual health-related care. Background. There is an increasing global demand for improving sexual health. A better understanding of nursing students’ attitude and readiness to work for clients with sexual health concerns is the beginning of this endeavour. The need to explore strategies for developing competent health care practitioners is timely. Design. A cross-sectional survey. Methods. Nursing students ( n = 377) studying in pre- and postregistration programmes were surveyed at a university in Hong Kong using a questionnaire with open- and closed-ended questions about their knowledge, attitude and self-perception on readiness to work for clients with sexual health concerns. Results. Students’ knowledge of sexual health was satisfactory. They were positive in acknowledging the nursing role in sexual health care, but hesitant in taking up an active role in practice. Students’ readiness to participate in related activities was below satisfactory. Their perception of inadequate knowledge, feelings of anxiety, worries about colleagues’ and clients’ possible adverse responses and inadequate exemplars were major factors affecting their readiness. This paper also highlighted some important learning areas and strategies that could help in enhancing students’ knowledge and confidence in sexual health care practices. Conclusion. Improving the educational programme and clinical practice for nursing students is necessary but may not be adequate. Valuing the affective aspect of education, formal recognition of this extended role and advancing related education to a postexperience level would also benefit the development of sexual health care. Relevance to clinical practice. Preparing more mentors as exemplars, inviting clinicians and managers as partners in sexual health-related care would help nursing students to work efficiently for clients with sexual health concerns. [ABSTRACT FROM AUTHOR]

lau py&chan cwh (2005) Journal of Clinical Nursing14, 28–34SARS (Severe Acute Respiratory Syndrome): reflective practice of a nurse managerThis paper describes the reflective practice of a nurse manager in Hong Kong in supporting frontline nurses to overcome the crisis of SARS.SARS infection was a crisis for everyone in endemic areas because of its threat to physical and emotional health. Hong Kong was the second leading endemic area in the world. Inadequate supplies of protective devices and the death of a nurse infected with SARS triggered nurses’ negative emotions.A model of structured reflection was adopted to examine one's practice. A problem-solving model for crisis intervention was integrated into the reflective stage of structured reflection.Promotion of nurses’ safety and emotional stability were the major goals in handling the crisis. Strategies were employed including self-awareness, empowerment and team building, information sharing, provision of personal protective equipment and emotional support for frontline nurses.SARS infection threatens the physical and emotional health of nurses. From a positive perspective, such a crisis created an opportunity to learn and grow in terms of ethical, personal and aesthetic arenas.SARS epidemic raised worldwide attention and challenged the Hong Kong's health care system. Reflective practice is useful to guide and examine nurses’ professional action during the crisis, and to put the experience into a learning perspective. [ABSTRACT FROM AUTHOR]

thompson d.r., lopez v., lee d. & twinn s. (2004) Journal of Clinical Nursing 13, 131–135 SARS – a perspective from a school of nursing in Hong Kong Severe acute respiratory syndrome (SARS) is a new infectious disease with significant morbidity and mortality that has had a major impact on health and health care services worldwide. Hong Kong has had a significant number of cases and deaths. Nurses, at the vanguard of the clinical health care team, have been particularly affected by it. The outbreak prompted the health authorities to implement a series of public health measures and hospital policies, including a guideline for the diagnosis and management of patients with SARS. This paper aims at providing an overview of what is known about SARS and the impact it has had in Hong Kong and to highlight from the perspective of a school of nursing the major clinical, educational and public health implications. The lack of understanding and uncertainty about the disease led to significant variation in the provision of information, contributing to the confusion and anxiety in the community. Therefore, there is a need to revise the nursing curriculum, to provide continuing education to all health care professionals, particularly with regard to infection control measures, and to revisit the range of public health policies to ensure the health of the community is protected by these policies. There also has been a reaffirmation of the importance of health promotion that highlights the importance of the partnership between nurses, health policy makers and public health personnel. It is evident that the organization and delivery of clinical practice, teaching and health promotion have to be flexible and responsive to a changing health scenario. Nurses must play a crucial role in the prevention, detection and containment of SARS. They will need to implement and ensure strict adherence to infection control measures and, in some circumstances, isolation and quarantine may be warranted. Attention to the psychological state of patients and family members should not be overlooked. Paramount is education of patients, families and members of the public at large. [ABSTRACT FROM AUTHOR]

* The significance of primary health care to the health of individuals and communities has been well established but the development of primary health care and nursing practice within the context of primary health care remains varied in different countries and settings.* This paper focuses on developments in nursing practice in primary health care in Hong Kong, using three community-based research projects to identify the opportunities and challenges created for nurses working in these settings. The projects were established in response to identified health needs and to target cancer education, HIV/AIDS and chronic health problems.* Opportunities include the development of professional autonomy, innovative approaches to clinical practice, and developing skills in working with a diverse range of professionals and communities. Challenges include managing uncertainty and the development of evaluation systems to demonstrate health gains from nursing interventions. [ABSTRACT FROM AUTHOR]

Aim. To describe and understand the experiences of Chinese family members of terminally ill patients during the end of life process in a palliative care unit. Background. Palliative care aims to provide care to dying patients and their family members. Skillful interventions are necessary to help family members cope with the impending death of the patient and maintain their emotional equilibrium. Hence, it is important to understand the experiences of family members of palliative care. Design. A phenomenological study was conducted. Data were collected by semi-structured interviews. We interviewed a purposive sample of 20 family members of terminally ill patients in a palliative care unit in Hong Kong. The data were analysed following Colaizzi's phenomenological methodology. Results. Family members experienced anticipatory grief, with reactions that included anger, unease, sadness and helplessness. This was particularly acute when the patient was first admitted to the palliative care unit. However, the family members quickly accepted the reality and committed themselves to the care of the patient, seeking informational and emotional support from the nurses. The families wanted to be assured that the patient had been offered good care and suffered no pain. It was considered important to be with the patient during the dying process. Conclusion. This study demonstrated that Chinese family members were committed to the care of the patients in the palliative care unit. Cultural beliefs played a part in influencing family emotions and concerns. Relevance to clinical practice. This study offers a direction for family interventions that acknowledge the reactions of family members to the admission of a patient to a palliative care unit. It highlights that families need active informational and emotional support from nurses. [ABSTRACT FROM AUTHOR]

Aim. The present study aimed to investigate the stress and coping strategies of Hong Kong Chinese families during a critical illness and to examine the relationships between stress and coping. Background. Admissions to intensive care unit are usually an unanticipated event, which imposes stress on the family. Family's wellness is one of the significant factors affecting patient's well-beings. Much work has been conducted in Western societies. Stress and coping in Chinese families of critically ill patients have rarely been discussed. Method. Structured face-to-face interviews were conducted, using the Impact of Events Scale and the Family Crisis Oriented Personal Evaluation Scales. A convenience sample of 133 participants was recruited from a regional hospital in Hong Kong. Many were patients' children with age between 30 and 49. A total of 39.1% (n = 52) of the participants were males and 60.9% (n = 81) were females. Results. The participants experienced high level of stress (mean = 25.1, SD = 8.3). Higher level of stress were experienced by female (t = -4.6; d.f. = 1, 131; P = 0.00), those with lower educational attainment (F = 3.0; d.f. = 2, 130; P = 0.05) and those whose relatives were admitted to the intensive care unit unexpectedly (t = -2.2; d.f. = 1; P = 0.03). Patients' length of stay in the unit was significantly correlated with levels of stress (r = 0.5, P < 0.00). Level of stress had significant correlation with coping strategies utilization (r = 0.5, P < 0.00). Reframing strategies were frequently used whereas the passive appraisal strategies were least used. Family members used positive-coping strategies, which concurred with the Chinese stress-coping pattern 'fatalistic voluntarism'. Relevance to clinical practice. This study contributes to the understanding of Hong Kong Chinese families' stress and coping during a critical illness. Comprehensive assessments of family members' psychosocial needs are important to plan appropriate interventions to alleviate their stress and strengthen their coping skills. The findings will serve as guidance for nurses in delivering culturally sensitive and competent interventions. [ABSTRACT FROM AUTHOR]

Aims. The aim of this study was to identify the major stressors affecting Chinese adults whose partner had been admitted to an intensive care unit and to understand the major coping strategies employed to manage such stressors. Background. Recently a greater number of patients of higher acuity have been admitted to intensive care units and survive lengthy illnesses of an unpredictable course. Such critical illnesses have been identified as a major life event to family members of these patients. Little is known, however, about the stressors and coping mechanisms of Chinese adults whose critically ill partner is admitted to an intensive care unit. Methods. An exploratory qualitative design was selected to achieve the aims of the study. A purposive sample of 10 Chinese adults with a partner in an intensive care unit of a regional general hospital in Hong Kong participated in tape-recorded semi-structured interviews. Content analysis was employed to analyse the translated interviews. Findings. Categories of stressors included uncertainty, difficulties in communication, changes in roles and responsibilities, difficulties in decision making, financial strain as well as changes in relationships. Analysis identified a range of coping strategies which included seeking information, seeking support, reliance on cultural beliefs and practices, turning to religious beliefs, maintaining hope and acceptance of illness. Conclusions. The findings demonstrate the importance of cultural beliefs and practices in determining the coping mechanisms employed to manage the stressors identified by this sample of Chinese adults. Such findings indicate the use of both internal and external coping strategies in order to maintain equilibrium in the family. Relevance to clinical practice. Implications for nursing practice highlight the significance of seeking information throughout the critical period and also culturally appropriate support from healthcare professionals. [ABSTRACT FROM AUTHOR]

AIM: The present study aimed to describe the coping experiences of Chinese parents with children diagnosed as having cancer during the treatment stage. BACKGROUND: Cancer is the second major cause of death among children in Hong Kong, it claims the lives of 60-70 children per year. Childhood cancer has tremendous impact on the family, especially the parents. It is, therefore, important to understand parents' psychological functioning and coping experience. METHODS: A phenomenological approach was used. Data were collected by qualitative interviews and analysed following Colaizzi's phenomenological methodology. A purposive sample of nine parents whose children were diagnosed of having childhood cancer was recruited from a regional hospital in Hong Kong. RESULTS: Four themes emerged describing parents' coping experiences: shock and denial, establishing the meaning or the situation, confronting the reality and establishing a new perspective. The initial reactions of the parents to the diagnosis were shock, denial and worry. However, they quickly accepted the reality and regarded their child's illness as their 'fate' that they had to accept. They were committed to the care of the sick child and seek informational and emotional support to cope with the situation. All of them were able to identify positive aspects from the illness experience and establish hope for the future. Chinese cultural beliefs might help the parents cope positively and avoid negative emotions. CONCLUSION: This study found some commonalities of coping experience in both Western and Chinese culture. It adds knowledge to the coping experience of Chinese parents at the treatment phase of their children's illness and highlighted the need for emotional and information support for parents. RELEVANCE TO CLINICAL PRACTICE: Education programme and mutual support group would be helpful to parents. Nurses have to learn how different cultural groups and subcultural groups in the society cope to provide competent cultural care. [ABSTRACT FROM AUTHOR]

Evidence-based practice has been widely discussed in the literature, but it is not common or well adopted in nursing practice, both in Hong Kong and other countries. This article aims to examine the relationships between three important elements of evidence-based practice: systematic reviews, clinical guidelines and protocols. Current issues associated with evidence-based practice in Hong Kong are explored. Specific suggestions are given to researchers, practitioners, managers and academics so that the current situation can be advanced. [ABSTRACT FROM AUTHOR]

* Ten registered nurses working in a neonatal intensive care unit in Hong Kong were interviewed to explore their experiences of caring for infants whose disease is not responsive to curative treatment, their perceptions of palliative care, and factors influencing their care.* Eight categories emerged from the content analysis of the interviews: disbelieving; feeling ambivalent and helpless; protecting emotional self; providing optimal physical care to the infant; providing emotional support to the family; expressing empathy; lack of knowledge and counselling skills; and conflicting values in care.* The subtle cultural upbringing and socialization in nurse training and workplace environment also contributed to their moral distress.* Hospital and nurse administrators should consider different ways of facilitating palliative care in their acute care settings. For example, by culture-specific death education, peer support groups, bereavement teams, modification of departmental policies, and a supportive work environment.* Future research could include the identification of family needs and coping as well as ethical decision-making among nurses. [ABSTRACT FROM AUTHOR]

* The purpose of the study was to determine the stressors and coping methods of chronic haemodialysis patients in Hong Kong. Relationships among treatment-related stressors, coping methods and length of time on haemodialysis were explored.* Fifty subjects completed the Haemodialysis Stressor Scale (HSS) and Jalowiec Coping Scale (JCS).* Results revealed that limitation of fluid was the most frequently identified stressor, followed by limitation of food, itching, fatigue and cost.* The most common coping methods are 'accepted the situation because very little could be done', followed by 'told oneself not to worry because everything would work out fine' and 'told oneself that the problem was really not that important.' It was found that the traditional philosophies of the Chinese - Confucianism, Buddhism, and Taoism - share an approach to the understanding and management of life stressors as different from that adopted by Western philosophies.* The findings of this study can further facilitate nurse practitioners in providing support, information, and alternative solutions when assisting patients in coping with long-term haemodialysis. [ABSTRACT FROM AUTHOR]

The article examines the experiences of community-dwelling women in coping with urinary incontinence (UI) in Hong Kong, China. The study utilized a qualitative exploratory design and was performed in a nurse-led female incontinence clinic of an acute general hospital. The common themes emerged from the study were women's fears in coping with UI and strategies adopted to combat their urinary symptoms.

Responds to comments on the article about the article on the cultural influence on the experiences of women with postnatal depression in Hong Kong. Homogeneity of the sample population; Use of identification to ensure the appropriateness of the sample; Issue of subjectivity in interpreting qualitative data; Perception of husbands as uncaring and controlling in the majority of the sample population.

The article presents a commentary on the development of an instrument which measures the Chinese adolescent beliefs and attitudes towards substance abuse. It discusses the risks that can be associated with the use of the instrument. It questions the viability of the instrument in gathering valuable data that can be used to develop useful approaches for Hong Kong's young people.

Compares experiences of having a sick baby in neonatal intensive care among mothers with and without the right of abode in Hong Kong, China. Health status of illegal entrants; Demographic characteristics; Coping strategies used by women.

Investigates the perceptions and experiences of worries and concerns of insulin-treated type 2 diabetes patients in Hong Kong, China. Social stigma; Risk of losing jobs; Places used by diabetics to give themselves insulin injections.

Investigates the extent of fear of hypoglycaemia among diabetic patients in Hong Kong, China. Relationship between the fear of hypoglycaemia and the time since the patients' insulin treatment; Factors that contributed to the patients' fears; Implications of the study on clinical nursing practice.