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Publisher: Hong Kong Academy of Medicine Press
Date: 04-12-2019
DOI: 10.12809/HKMJ198073
Abstract: Dementia is one of the most costly, disabling diseases associated with ageing, yet it remains underdiagnosed in primary care. In this article, we present the comprehensive approach illustrated with a classical case for diagnosing dementia which can be applied by healthcare professionals in primary care. This diagnostic approach includes history taking and physical examination, cognitive testing, informant interviews, neuropsychological testing, neuroimaging, and the utility of cerebrospinal fluid biomarkers. For the differential diagnosis of cognitive impairment, the differences and similarities among normal ageing, mild cognitive impairment, depression, and delirium are highlighted. As primary care physicians are playing an increasingly prominent role in the caring of elderly patients in an ageing population, their role in the diagnosis of dementia should be strengthened in order to provide a quality care for patients with dementia.
Publisher: Wiley
Date: 02-12-2015
DOI: 10.1111/GGI.12655
Abstract: The present study aims to describe the prevalence of potential elder abuse, and to examine correlates of abuse screening items among Chinese community-dwelling older adults. We analyzed the data of 3435 older persons aged ≥60 years who had first applied for the long-term care services in Hong Kong and completed the screening tool (Minimum Data Set-Home Care) in 2006. For each of the five abuse screening items ("fearful of a family member/caregiver," "unexplained injuries/broken bones/burns," "physically restrained," "unusually poor hygiene" and "neglected/abused/mistreated"), we examined its relationship with four types of factors: older person, perpetrator, relationship and environment. The rates of in idual abuse screening items ranged from 3.9% for physically restrained to 0.03% for unexplained injures/broken bones/burns. Physically restrained was positively associated with activities of daily living impairments, instrumental activities of daily living impairments, perceived poor health, physically abusive behavior and caregiver mental health. Unusually poor hygiene was positively associated with socially inappropriate behavior and actively resisted care. "Fearful of a family member/caregiver" was positively associated with perceived poor health, conflicting relationship and mental health, and negatively with care activities. Neglected/abused/mistreated was positively associated with age and informal care, and negatively with care activities. We identified a number of associated factors of different abuse screening items among older adults. Our findings could inform healthcare practitioners in identifying those older persons who might be at higher risk of abuse, and provide a knowledge base on which to develop effective preventive measures in the Chinese population. Geriatr Gerontol Int 2017 17: 150-160.
Publisher: Wiley
Date: 03-10-2020
DOI: 10.1111/JAN.14557
Publisher: Informa UK Limited
Date: 07-2011
Publisher: Informa UK Limited
Date: 11-2003
DOI: 10.1080/716100368
Publisher: JMIR Publications Inc.
Date: 30-04-0100
DOI: 10.2196/24084
Publisher: Oxford University Press (OUP)
Date: 25-11-2019
Abstract: few studies had investigated seasonal pattern of recurrent falls. to examine seasonal pattern of both single and recurrent falls amongst community-dwelling older adults first applying for long-term care (LTC) services. a cohort of 89,100 community-dwelling Hong Kong older adults aged 65 and over first applying for LTC services from 2005 to 2014 was obtained. Logistic regression models were used to examine seasonal pattern in single and recurrent falls, whilst controlling for gender, age and year. amongst 89,100 older adults, about 32% fell in past 90 days. Amongst the fallers, 34% fell recurrently. In 2014, the incidences of all fall, single fall and recurrent fall were 1.95, 0.80 and 1.15 per person-years, respectively. For single falls, the 90-day fall risk was highest during November to February with an odds ratio (OR) of 1.29 (95% confidence interval [CI] 1.19–1.41), compared with the lowest one during July to October. For recurrent falls, the highest OR for 90-day risk was highest during November to February (1.46, 95% CI 1.31–1.64) as well. single and recurrent falls both peaked during winter months. Interventions, such as implementing educational publicity and sending reminder to older adults in fall season, may be considered.
Publisher: MDPI AG
Date: 09-05-2022
DOI: 10.3390/HEALTHCARE10050870
Abstract: Painting is a well-known method for alleviating stress, but it is uncertain whether family caregivers can use an electronic painting platform at home for this purpose. Aim. The aim in this study was to assess the feasibility and acceptability of having family caregivers of persons with dementia (FCPWD) draw electronic paintings using a mobile app, and to assess the preliminary effect of the intervention on their well-being. Methods. This was a two-phase feasibility and acceptability study, with qualitative interviews conducted in Phase 1 and qualitative interviews and a quantitative survey conducted in Phase 2. Caregiving burden, depressive symptoms, self-rated health, and social support were measured before and after the intervention. Participants were asked to draw electronic paintings at any time they liked, and to share the paintings with friends or relatives if they wished. Result. The recruitment rate in Phase 2 was 87.5% (28 out of 32), with 78.6% participants (22 out 28) completing all activities in 8 weeks. The FCPWD regarded the e-painting app as an appropriate channel for expressing their emotions. They found the layout of the app to be easy to use and were satisfied with it. A total of 116 pictures were produced. Log-in frequency was significantly correlated with the sharing of paintings with friends or relatives (r = 0.72, p 0.001). Conclusion. FCPWD considered the e-painting mobile app to be a feasible and acceptable technology-based psychosocial platform. A further investigation with a larger s le in a full-scale randomized controlled trial is warranted.
Publisher: Informa UK Limited
Date: 11-2013
DOI: 10.1080/13607863.2013.768211
Abstract: This study examined the frequency and predictors of hospitalization and emergency room (ER) use among residents with Alzheimer's disease at admission and after 1 year in a long-term care facility. This secondary analysis used data collected with the Chinese version of the Residential Assessment Instrument Minimum Data Set 2.0 during the Hong Kong Longitudinal Study on Long-Term Care Facility Residents. A s le of 169 residents with Alzheimer's disease who were newly admitted between 2005 and 2010 was included in the analysis. Mixed-effects modeling was adopted to assess the associations between risk factors and the frequency of hospitalization and ER use. At admission, 27 (15.98%) respondents had been hospitalized and 19 (11.24%) required ER services during the previous 90 days. At admission, polypharmacy (β = .081, p < .01) and use of psychotropic drugs (β = ‑.506, p < .05) were significantly associated with frequency of hospitalization. At 1-year follow-up, cognitive impairment (β = .088, p < .05) and polypharmacy (β = .058, p < .001) had significant positive associations with frequency of hospitalization, as well as use of ER services (β = .084, p < .01 β = .077, p < .001, respectively). Use of psychotropic drugs had a negative association with frequency of ER use at both time points. Practitioners should periodically observe cognitive ability, polypharmacy, and use of psychotropic drugs among long-term care residents with Alzheimer's disease.
Publisher: MDPI AG
Date: 15-05-2020
Abstract: Findings of the association between hot weather and suicide in a subtropical city such as Hong Kong are inconsistent. This study aimed to revisit the association by identifying meteorological risk factors for older-adult suicides in Hong Kong using a time-series approach. A retrospective study was conducted on older-adult (aged ≥65) suicide deaths in Hong Kong from 1976 to 2014. Suicides were classified into those involving violent methods and those involving nonviolent methods. Meteorological data, including ambient temperature, were retrieved. Transfer function time-series models were fitted. In total, 7314 older-adult suicide deaths involving violent methods and 630 involving nonviolent methods were recorded. For violent-method suicides, a monthly average daily minimum ambient temperature was determined to best predict the monthly rate, and a daily maximum ambient temperature of 30.3 °C was considered the threshold. For suicide deaths involving nonviolent methods, the number of days in a month for which the daily maximum ambient temperature exceeded 32.7 °C could best predict the monthly rate. Higher ambient temperature was associated with more older-adult suicide deaths, both from violent and nonviolent methods. Weather-focused preventive measures for older-adult suicides are necessary, such as the provision of more public air-conditioned areas where older adults can shelter from extreme hot weather.
Publisher: Wiley
Date: 18-05-2021
DOI: 10.1002/NUR.22143
Abstract: Caregiving appraisal is a key driver to moderating caregiving outcomes. The caregiving appraisal of informal caregivers of people with dementia requires increased attention. This study aimed to explore the feasibility and acceptability of an evidence‐based bibliotherapy protocol, and test the efficacy on improving caregiving appraisal. A two‐arm pilot randomized controlled trial was adopted. Sixty informal caregivers were randomized to either the intervention group, receiving eight weekly professional‐guided bibliotherapy sessions in addition to usual care or the usual care group. The professional‐guided bibliotherapy sessions were weekly sessions in which caregivers self‐read the designated chapter and then received telephone coaching. Caregiving appraisal, coping, psychological well‐being, positive aspects of caregiving, knowledge of dementia, and attitude toward dementia were assessed both at baseline and immediately after the intervention. Assessors were blinded to group allocation. In idual interviews among 10 participants from the intervention group were conducted to explorecaregivers' acceptance of the intervention. Descriptive statistics, χ 2 test, Mann–Whitney U test, independent t test, generalized estimating equation, and content analysis were used for data analysis. This study pioneered the use of bibliotherapy among informal caregivers of people with dementia. The participant recruitment rate was 69.8%. The attrition rate of the intervention group was 20%. Bibliotherapy had a significant time‐by‐group interaction effect on caregiving appraisal ( p 0.001), coping ( p = 0.003), positive aspects of caregiving ( p = 0.001), knowledge of dementia ( p = 0.017), and attitude toward dementia ( p 0.001). The effect on psychological well‐being, however, was only significant on the personal growth subscale ( p = 0.025). The acceptability was also confirmed. No adverse event was documented.
Publisher: MDPI AG
Date: 22-12-2022
DOI: 10.3390/HEALTHCARE11010039
Abstract: Background: Social robots have the potential to bring benefits to aged care. However, it is uncertain whether placing these robots in older people’s home is acceptable and whether human-robot interactions would occur or not. Methods: Four case studies were conducted to understand the experiences of older adults and family caregivers when humanoid social robot Ka Ka was placed in homes for two weeks. Results: Four older adults and three family caregivers were involved. Older adults interacted with the social robot Ka Ka every day during the study period. ‘Talking to Ka Ka’, ‘listening to music’, ‘using the calendar reminder’, and ‘listening to the weather report’ were the most commonly used features. Qualitative data reported the strengths of Ka Ka, such as providing emotional support to older adults living alone, ersifying their daily activities, and enhancing family relationships. The voice from Ka Ka (female, soft, and pleasing to the ear) was considered as ‘bringing a pleasant feeling’ to older adults. Conclusions: In order to support aging-in-place and fill the gaps of the intensified shortage of health and social manpower, it is of prime importance to develop reliable and age-friendly AI-based robotic services that meet the needs and preferences of older adults and caregivers.
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.JAMDA.2019.01.123
Abstract: To support person-centered, residential long-term care internationally, a consortium of researchers in medicine, nursing, behavioral, and social sciences from 21 geographically and economically erse countries have launched the WE-THRIVE consortium to develop a common data infrastructure. WE-THRIVE aims to identify measurement domains that are internationally relevant, including in low-, middle-, and high-income countries, prioritize concepts to operationalize domains, and specify a set of data elements to measure concepts that can be used across studies for data sharing and comparisons. This article reports findings from consortium meetings at the 2016 meeting of the Gerontological Society of America and the 2017 meeting of the International Association of Gerontology and Geriatrics, to identify domains and prioritize concepts, following best practices to identify common data elements (CDEs) that were developed through the US National Institutes of Health/National Institute of Nursing Research's CDEs initiative. Four domains were identified, including organizational context, workforce and staffing, person-centered care, and care outcomes. Using a nominal group process, WE-THRIVE prioritized 21 concepts across the 4 domains. Several concepts showed similarity to existing measurement structures, whereas others differed. Conceptual similarity (convergence eg, concepts in the care outcomes domain of functional level and harm-free care) provides further support of the critical foundational work in LTC measurement endorsed and implemented by regulatory bodies. Different concepts ( ergence eg, concepts in the person-centered care domain of knowing the person and what matters most to the person) highlights current gaps in measurement efforts and is consistent with WE-THRIVE's focus on supporting resilience and thriving for residents, family, and staff. In alignment with the World Health Organization's call for comparative measurement work for health systems change, WE-THRIVE's work to date highlights the benefits of engaging with erse LTC researchers, including those in low-, middle-, and high-income countries, to develop a measurement infrastructure that integrates the aspirations of person-centered LTC.
Publisher: Springer Science and Business Media LLC
Date: 02-06-2018
DOI: 10.1007/S00127-018-1538-6
Abstract: Depression literacy refers to the ability to recognize depression and make informed decisions about its treatment. To date, relatively little research has been done to examine depression literacy in the Western Pacific region. Given the pervasiveness of depression and the need to enhance mental health care in this region, it is important to gain a better understanding of depression literacy and health-seeking behaviors in this part of the world. This mixed-methods study utilized a convergent parallel design to examine depression literacy and the associated health-seeking attitudes among urban adults from three countries-Cambodia, Philippines, and Fiji. A total of 455 adults completed a quantitative survey on depression knowledge, attitudes, and professional help seeking. Separately, 56 interviewees from 6 focus groups provided qualitative data on their impression and knowledge of depression and mental illness within the context of their local communities. Overall, results showed that depression knowledge was comparatively lower in this region. Controlling for differences across countries, higher knowledge was significantly associated with more positive attitudes towards mental illness (B = - 0.28, p = 0.025) and professional help seeking (B = 0.20, p < 0.001). Financial stability, such as employment, was also a salient factor for help seeking. This study was the first to provide a baseline understanding on depression literacy and highlights the need to increase public knowledge on depression in the Western Pacific. Culturally congruent recommendations on enhancing depression literacy in this region, such as anti-stigma c aigns, use of financial incentives, and family-based approach in health education, are discussed.
Publisher: MDPI AG
Date: 27-11-2022
Abstract: The health and well-being of school leaders during the COVID-19 pandemic have been largely neglected compared to the health and well-being of students and teachers. This study assessed the magnitude of perceived stress and well-being and the associated factors, including number of working hours, work-related sense of coherence (work-SoC), perceived stress, self-endangering work behaviour, secondary burnout symptoms, and satisfaction with work, among school leaders in Hong Kong, China during the COVID-19 pandemic. This cross-sectional, survey-based study collected demographic data and mental health measurements from 259 eligible school leaders in Hong Kong from April 2021 to February 2022. Pearson’s correlation analyses, multilinear regression models, and independent-s les Student’s t-tests were performed. The findings revealed that school leaders’ perceived stress was negatively correlated with their well-being (r = −0.544, p 0.01) and work-related SoC (r = −0.327, p 0.01) but positively correlated with their extensification of work (r = 0.473, p 0.01), exhaustion related to work situations (r = 0.559, p 0.01), and psychosomatic complaints (r = 0.439, p 0.01). In a model that adjusted for gender and age, student leaders with higher subjective well-being scores had a lower level of perceived stress (B = −0.031 95% confidence interval [CI], −0.59, −0.02 p = 0.034), whereas leaders in schools with a larger student population had a higher level of perceived stress (B = 0.002 95% CI, 0.000, 0.003 p = 0.030). School leaders with a higher likelihood of performing the self-endangering work behaviour of ‘intensification of work’ had higher perceived stress levels (B = 1.497 95% CI, 0.717, 2.278 p 0.001). School leaders with a higher work-related SoC (B = 4.20 95% CI, 1.290, 7.106 p = 0.005) had a higher level of well-being. School leaders with higher levels of perceived stress (B = −0.734 95% CI, −1.423, −0.044 p = 0.037), a higher likelihood of performing the self-endangering work behaviour of ‘extensification of work’ (B = −4.846 95% CI, −8.543, −1.149 p = 0.010), and a higher score for exhaustion related to work (B = −10.449 95% CI, −13.864, −7.033 p = 0.000) showed lower levels of well-being. The finding of a high incidence of stress among school leadership justifies the need for more societal attention to the well-being of school leaders in Hong Kong. It is important that policies and initiatives are designed to enhance the well-being of school leaders and that they are supported in leading the management of schools and coping with stress in school settings.
Publisher: Wiley
Date: 08-2023
DOI: 10.1002/GPS.5982
Abstract: Age‐related hearing loss (ARHL) is the third leading cause of years lived with disability. Connections among ARHL, depressive symptoms, social engagement and cognitive status are increasingly reported but the underlying mechanisms leading to these relationships are largely unknown. Exploring these mechanisms is a worthy goal, especially in older adults. This study aimed to examine the mediating effect of social engagement and depressive symptoms on the relationship between ARHL and cognitive status. Structural equation modeling (SEM) with path analysis were performed with data from a cross‐sectional study conducted in 11 community centers in 2021, which assessed older adults' intrinsic and sensory capacities using the WHO ICOPE framework. Demographic information, health profile, a binary measure of hearing capacity, depressive symptoms, social engagement, and cognitive status of participants were gathered. A total of 304 participants were included. ARHL was positively associated with depressive symptoms ( β = 0.18, p = 0.009) and negatively related to social engagement ( β = −0.13, p = 0.026). Social engagement was positively associated with cognitive status ( β = 0.17, p = 0.005) and negatively associated with depressive symptoms ( β = −0.23, p 0.001). Greater depressive symptoms were negatively associated with the participants' cognition ( β = −0.13, p = 0.009). Both social engagement ( β = −0.02, p = 0.029) and depressive symptoms ( β = −0.02, p = 0.032) mediated the negative associations between ARHL and cognitive status. Addressing hearing loss, depressive symptoms, and enhancing social engagement should be investigated as a potential means of minimizing cognitive decline. Well‐designed studies are needed to comprehensively inform the clinical practice development, particularly large prospective studies that will facilitate further elucidate possible causal mechanisms behind these observed associations.
Publisher: Wiley
Date: 13-12-2018
DOI: 10.1111/PHN.12573
Abstract: This paper provides an overview of the status of dementia care in Mainland China under the framework of the three-tier long-term care system proposed by the Chinese government, and gives the direction for service development. Official documents, annual reports of related associations, and studies conducted in Mainland China from 2006 to 2017, published both in English and Chinese were reviewed. With the establishment of the three-tier long-term care system, the Government has invested a lot in long-term care, and improvements have been made. However, specific areas of dementia care still face challenges. Strategies in improving the long-term care services have been achieved. These included training for informal caregivers at home settings, increased investment in community health centers, and increased institutional placements, etc. However, these are not enough to fulfill the needs of people with dementia and their caregivers. Multiple levels of training and interaction within the framework of the three-tier long-term care system as well as more research are recommended for improving dementia care.
Publisher: SAGE Publications
Date: 09-2008
Abstract: This study describes the establishment, promotion, and preliminary findings of a peer-led smoking cessation quitline for Chinese youth smokers in Hong Kong. The Youth Quitline targeted Chinese smokers aged 12 to 25, who smoked at least one cigarette in the past 30 days and were willing to leave telephone numbers for follow up. The protocol was translated from the California Smoker's Helpline and we provided toll-free telephone counseling based on motivational intervention with multiple follow-up sessions for smokers who called the service. By intention-to-treat analysis, 55% reported at least one quit attempt, and the quit rate was 22.1% (self-reported 7-day point prevalence) or 17.5% (self-reported 30-day point prevalence). The Hong Kong Youth Quitline, along with enforcement of the antismoking legislation for both youth and adults, advocacy to de-normalize smoking in the society, and appropriate publicity, could help to promote quitting among youth smokers in Hong Kong.
Publisher: JMIR Publications Inc.
Date: 23-10-2019
Abstract: ocial network sites (SNSs) are widely exploited in health education and communication by the general public, including patients with various conditions. Nevertheless, there is an absence of evidence evaluating SNSs in connecting health professionals for professional purposes. his pilot randomized controlled trial was designed to evaluate the feasibility of an intervention aiming to investigate the effects of a continuous professional education program utilizing Facebook to obtain knowledge on dementia and care for patients with dementia. ighty health professionals from Hong Kong were recruited for participation in the study and randomized at a 1:1 ratio by a block randomization method to the intervention group (n=40) and control group (n=40). The intervention was an 8-week educational program developed to deliver updated knowledge on dementia care from a multidisciplinary perspective, either by Facebook (intervention group) or by email (control group) from October 2018 to January 2019. The primary outcomes were the effects of the intervention, measured by differences in the means of changes in pre- and postintervention scores of knowledge assessments from the 25-item Dementia Knowledge Assessment Scale (DKAS) and formative evaluation of 20 multiple choice questions. Other outcome measurements included participant compliance, participant engagement in Facebook, satisfaction, and self-perceived uses of Facebook for continuing professional education programs. ignificantly more intervention group participants (n=35) completed the study than the control group (n=25) ( i P /i & .001). The overall retention rate was 75% (60/80). The mean of changes in scores in the intervention group were significant in all assessments ( i P /i & .001). A significant difference in the mean of changes in scores between the two groups was identified in the DKAS subscale Communication and Behavior (95% CI 0.4-3.3, i P /i =.02). There was no significant difference in the total DKAS scores, scores of other DKAS subscales, and multiple choice questions. Participant compliance was significantly higher in the intervention group than in the control group ( i P /i & .001). The mean numbers of participants accessing the learning materials were 31.5 (SD 3.9) and 17.6 (SD 5.2) in the intervention and control group, respectively. Polls attracted the highest level of participant engagement, followed by videos. Intervention group participants scored significantly higher in favoring the use of Facebook for the continuing education program ( i P /i =.03). Overall, participants were satisfied with the interventions (mean score 4 of a total of 5, SD 0.6). he significantly higher retention rate, together with the high levels of participant compliance and engagement, demonstrate that Facebook is a promising tool for professional education. Education delivered through Facebook was significantly more effective at improving participants’ knowledge of how people with dementia communicate and behave. Participants demonstrated positive attitudes toward utilizing Facebook for professional learning. These findings provide evidence for the feasibility of using Facebook as an intervention delivery tool in a manner that can be rolled out into practical settings.
Publisher: Wiley
Date: 29-06-2016
Abstract: The aim of the present study was to develop a simple nomogram that can be used to predict the risk of diabetes mellitus (DM) in the asymptomatic non-diabetic subjects based on non-laboratory- and laboratory-based risk algorithms. Anthropometric data, plasma fasting glucose, full lipid profile, exercise habits, and family history of DM were collected from Chinese non-diabetic subjects aged 18-70 years. Logistic regression analysis was performed on a random s le of 2518 subjects to construct non-laboratory- and laboratory-based risk assessment algorithms for detection of undiagnosed DM both algorithms were validated on data of the remaining s le (n = 839). The Hosmer-Lemeshow test and area under the receiver operating characteristic (ROC) curve (AUC) were used to assess the calibration and discrimination of the DM risk algorithms. Of 3357 subjects recruited, 271 (8.1%) had undiagnosed DM defined by fasting glucose ≥7.0 mmol/L or 2-h post-load plasma glucose ≥11.1 mmol/L after an oral glucose tolerance test. The non-laboratory-based risk algorithm, with scores ranging from 0 to 33, included age, body mass index, family history of DM, regular exercise, and uncontrolled blood pressure the laboratory-based risk algorithm, with scores ranging from 0 to 37, added triglyceride level to the risk factors. Both algorithms demonstrated acceptable calibration (Hosmer-Lemeshow test: P = 0.229 and P = 0.483) and discrimination (AUC 0.709 and 0.711) for detection of undiagnosed DM. A simple-to-use nomogram for detecting undiagnosed DM has been developed using validated non-laboratory-based and laboratory-based risk algorithms.
Publisher: Research Square Platform LLC
Date: 12-12-2019
Abstract: Background: As population ageing and dementia incidence continue to increase worldwide, health systems are urged to empower the public to address factors related to dementia. This study aims to assess Macau citizens’ knowledge of dementia, attitudes towards persons with dementia, and help-seeking behaviours and intention toward dementia.Methods: This is a mixed-methods study with both quantitative (cross-sectional survey) and qualitative components (focus group interviews). The Alzheimer’s Disease Knowledge Scale (ADKS) and Dementia Attitude Scale (DAS) were utilized in the quantitative data collection, whereas focus group interviews were employed to gather context-specific understanding of dementia in the local setting. Descriptive statistics and Chi-square tests were used to analyze quantitative data, while content analysis was used for qualitative data.Results: The overall level of knowledge on dementia was low (ADKS mean total score = 17.38, SD = 3.31), with the least amount of knowledge in the caregiving domain. Meanwhile, attitudes toward persons with dementia was generally positive (mean [SD] = 89.07 [11.99]). Many of the focus group participants were also uncertain regarding the availability of dementia services in the region. The general public was interested to obtain dementia information through social media.Conclusions: Efforts should be made to build up dementia literacy in Macau, especially in terms of caregiving. Information about dementia could be disseminated in social media and by healthcare professionals.
Publisher: Wiley
Date: 14-12-2020
DOI: 10.1111/JNU.12616
Publisher: SAGE Publications
Date: 2019
Abstract: To support the development of internationally comparable common data elements (CDEs) that can be used to measure essential aspects of long-term care (LTC) across low-, middle-, and high-income countries, a group of researchers in medicine, nursing, behavioral, and social sciences from 21 different countries have joined forces and launched the Worldwide Elements to Harmonize Research in LTC Living Environments (WE-THRIVE) initiative. This initiative aims to develop a common data infrastructure for international use across the domains of organizational context, workforce and staffing, person-centered care, and care outcomes, as these are critical to LTC quality, experiences, and outcomes. This article reports measurement recommendations for the care outcomes domain, focusing on previously prioritized care outcomes concepts of well-being, quality of life (QoL), and personhood for residents in LTC. Through literature review and expert ranking, we recommend nine measures of well-being, QoL, and personhood, as a basis for developing CDEs for long-term care outcomes across countries. Data in LTC have often included deficit-oriented measures while important, reductions do not necessarily mean that residents are concurrently experiencing well-being. Enhancing measurement efforts with the inclusion of these positive LTC outcomes across countries would facilitate international LTC research and align with global shifts toward healthy aging and person-centered LTC models.
Publisher: Informa UK Limited
Date: 22-01-2019
Publisher: MDPI AG
Date: 02-10-2022
Abstract: Background: Hypertension comorbid with metabolic syndrome could increase the development of adverse cardiovascular events. Educational interventions were effective to improve outcomes in patients. Methods: This was a secondary data analysis of participants with hypertension. The original randomized controlled trial aimed to examine the effect of app and booklet versus control among in iduals diagnosed with metabolic syndrome living in the community. A 30-min health education was provided to each participant. In addition to the education, the app group received a mobile app while the booklet group received a booklet. Data were collected at baseline, week 4, week 12, and week 24. Intention-to-treat principle was followed, and generalized estimating equations was employed for data analysis. Results: A total of 118 participants with hypertension and metabolic syndrome were extracted from the three-arm trial data. The s le size was 36, 42, and 40 in the app group, booklet group, and control group, respectively. Compared to the control group, the app group showed a significant reduction on body weight and waist circumference at week 24, while the total exercise and self-efficacy for exercise were increased at week 12 and week 24 but no significant findings were observed in the booklet group. Conclusions: The educational intervention supported with app was superior to the booklet support on the outcomes of body weight, waist circumference, total exercise, and self-efficacy for exercise among patients with hypertension and metabolic syndrome in the community.
Publisher: SAGE Publications
Date: 12-2018
Abstract: This study aims to investigate the effect of two interventions (verbal advice and comic books) on health literacy and medication compliance among older adults living in 15 public estates in Hong Kong. This is a two-phase multi-site quasi-experimental study with a pre-and-post design with four measurement points (T1–T4). In both phases, the two interventions were conducted by trained medical/nursing harmacy students. Two home visits were carried out in each phase. After the baseline measurement at Time 1 (T1), students verbally advised the older adult participants on how to read, understand, and interpret information on drug labels and how to store drugs properly. A post-assessment was conducted at T2. One year later, another pre-assessment was conducted at T3, and then students used a comic book to educate the older adults. A post-assessment was carried out at T4 after the use of the comic book. Health literacy was measured using the 24-item Chinese Health Literacy Scale for Chronic Care and medication compliance was measured using the Medication Compliance, Knowledge and Storage scale. Generalised Linear Mixed Models were used. A total of 165 subjects were included. The majority (60.6%) were female, aged from 67 to 96. About half (47.3%) had received no formal education. Controlling for age and cognition, there was a significant increase in health literacy after the use of the comic book (coefficient = 2.742, p = 0.001). There was also a significant improvement in medication compliance (total score) (coefficient = −1.018, p 0.001), reduced knowledge deficiency (coefficient = −0.236, p 0.05), and reduced storage problems (coefficient = −0.293, p = 0.001) after using comic books. Comic books are a good strategy to improve the health literacy level and medication compliance of community-dwelling older adults.
Publisher: Springer International Publishing
Date: 2019
Publisher: MDPI AG
Date: 08-11-2022
Abstract: School teachers have faced many challenges due to the coronavirus disease-2019 (COVID-19) pandemic and public health-related containment measures. Recent studies have demonstrated high levels of stress and mental health issues among school teachers. To better understand teacher well-being and inform practices to support them in the face of the ongoing pandemic, we aimed to assess perceived stress, well-being and associated factors among school teachers in Hong Kong, China. For this cross-sectional study, we employed a self-reported questionnaire to assess teacher well-being as an indicator of mental health. Drawing on quantitative data obtained from 336 teachers in Hong Kong from April 2021 to February 2022, we assessed workloads, work-related sense of coherence, perceived stress, secondary burnout symptoms (i.e. intensification of work and exhaustion related to work situation), self-endangering work behaviours and satisfaction with work. Bivariate and multivariate analyses were performed to examine the associations between well-being, demographic and work characteristics. A high percentage (87.6%) of teachers had high levels of perceived stress, which was positively associated with extensification of work (r = 0.571, p 0.01), intensification of work (r = 0.640, p 0.01) and exhaustion related to work situation (r = 0.554, p 0.01). A multilinear regression model adjusted for age and gender was computed to detect predictors of teachers’ well-being index values (F(12, 296) = 41.405, p 0.001, R2 = 0.627). A higher WHO-5 score was associated with (1) higher teaching hours (B = 0.235, 95% CI = 0.093, 0.413, p = 0.002) (2) higher work-related sense of coherence (B = 2.490, 95% CI = 0.209, 4.770, p = 0.032) (3) higher work satisfaction (B = 5.410, 95% CI = 2.979, 7.841, p 0.001) (4) lower level of exhaustion related to work situations (B = −9.677, 95% CI = −12.279, −7.075, p 0.001) and (5) lower level of psychosomatic complaints (B = −4.167, 95% CI = −6.739, −7.075, p = 0.002). These findings highlight the critical need to allocate more attention and resources to improve the mental health of school teachers in Hong Kong. The findings can also inform the development of psychological and organisational interventions and support mechanisms for teachers during the prolonged COVID-19 pandemic and in preparation for future stressful scenarios. Safeguarding the well-being and mental health of teachers is important for improving the quality of teaching and learning environments and the mental health of school students.
Publisher: Oxford University Press (OUP)
Date: 12-05-2011
DOI: 10.1093/NTR/NTR086
Abstract: The smoking patterns of youth remain unknown after they have received smoking cessation counseling. This study aims to examine the quitting trajectories of Chinese youth smokers after they have received quitline services and to examine factors to predict their quitting trajectories. A total of 402 Chinese youth smokers (aged 12-25 years) called a quitline and participated in telephone follow-ups at 1 week, 1 month, and 3 and 6 months after initial telephone counseling. Finite mixture modeling was employed to examine the quitting trajectories by the SAS Proc Traj group-based modeling procedure. Hierarchical multinomial logistic regression was used to compare the baseline intention to quit smoking, prosmoking attitudes, social influences, self-efficacy to quit, smoking profile, quitting history, and demographic characteristics among the trajectory groups. Three distinct quitting trajectory groups were identified: quitters, reducers, and persistent smokers. Both quitters and reducers dramatically reduced the level of their cigarette consumption immediately after initial counseling. Youth smokers who were intended to quit at baseline, perceived confidence to quit, and perceived importance of quitting were more likely to have successfully quit smoking at six-month follow-up. Those who had prosmoking attitudes were less likely to quit smoking. The findings reveal the profiles of youth smokers who can quit successfully and can guide the development of better and relevant interventions based on the psychosocial characteristics of youth smokers. Short-term goals such as an abrupt quit attempt or immediately reducing cigarette consumption by half may be the key to help youth smokers quit successfully.
Publisher: Oxford University Press (OUP)
Date: 17-04-2014
Abstract: Although domestic helpers increasingly play a role in elder care in many societies, there is a lack of research on their influence on caregiver distress. This study aimed to examine the influence of domestic helpers on the relationship between stressors (the care needs of frail elders and spousal provision of care) and spousal caregivers' psychological distress. This study was a secondary analysis of cross-sectional data collected between 2007 and 2009 from 6,442 Hong Kong adults aged 60 or older who were applying for government-subsidized long-term care services and whose spouses were their primary caregivers. Among the spousal caregivers, 73.04% were women, 44.16% felt distressed, and 5.73% were assisted by domestic helpers. According to logistic regression analysis, spousal caregivers who provided personal care related to activities of daily living were more likely to be distressed if they were not assisted by domestic helpers. The findings suggest that domestic help may moderate the effect of stressors on spousal caregivers. Domestic helpers provide support not just to frail older adults but also to spousal caregivers. Further studies are recommended to explore the precise effect of domestic help on family caregivers, care receivers, and the caregiving process.
Publisher: Wiley
Date: 21-08-2019
DOI: 10.1002/GPS.5197
Abstract: To examine levels of knowledge about dementia and attitudes towards dementia in low- and middle-income countries (LMICs), identify sources to turn to for help, and explore the relationship between knowledge and attitudes. This mixed methods study with both quantitative (a cross-sectional survey) and qualitative (focus group interviews) components was conducted in Cambodia, the Philippines, and Fiji in 2017-18. A survey was completed by the citizens of the three countries, and two focus group interviews were conducted in each country to generate a context-specific understanding of dementia literacy within the local LMIC setting. The quantitative component utilized the Alzheimer's Disease Knowledge Scale and the Dementia Attitude Scale, while knowledge, attitudes, and views on seeking help for dementia was discussed in the focus group interviews (qualitative component). A total of 476 participants completed the survey. Another 54 participants (39 females and 15 males) were invited to join six focus group interviews to express their views on dementia. Positive attitudes were noted despite the level of dementia knowledge was low. Families and religious figures were viewed as the sources for help. Controlling for demographics, country-specific predictors of positive attitudes towards dementia were found. The involvement of family members and religious leaders in dementia education could enhance the recognition of dementia. Specific kinds of dementia knowledge should be targeted to educate the public in different countries.
Publisher: Informa UK Limited
Date: 04-2022
DOI: 10.2147/RMHP.S355554
Publisher: Wiley
Date: 10-03-2023
DOI: 10.1111/JNU.12883
Abstract: The research aimed to examine the effect of a lifestyle intervention program using mobile application versus booklet for adults with metabolic syndrome in Hong Kong. The outcomes comprised body weight (primary outcome), exercise amount, improvement of cardiometabolic risk factors, cardiovascular endurance, perceived stress scale, and exercise self‐efficacy. A three‐arm randomized controlled trial namely App group, Booklet group, and control group was adopted. Two hundred sixty‐four adults with metabolic syndrome were recruited from community centers from 2019 to December 2021. Inclusion criteria are those adults with metabolic syndrome, able to use a smart phone. All participants received a 30‐min health talk. App group additionally received a mobile application, while Booklet group received a booklet, and the control group received a placebo booklet. Data were collected at baseline, Weeks 4, 12, and 24. SPSS and generalized estimating equations (GEE) model were employed for data analysis. Attrition rates were minimal, ranged from 2.65% to 6.44%. Both app and booklet group showed significant improvement in outcomes (exercise amount, waist circumference) when compared to control group. However, statistically significant and superior results were observed in app group, including body weight, exercise amount, waist circumference, body mass index, and systolic blood pressure when compared to booklet group. The lifestyle intervention supported with app was found to be superior to the booklet support for reducing body weight and maintaining exercise. The lifestyle intervention program using mobile application support could be used widely for adults with metabolic syndrome in the community. Suggest nurses may incorporate this program in their health promotion strategies focusing on a healthy lifestyle to reduce the risk of progression to metabolic syndrome.
Publisher: Springer Science and Business Media LLC
Date: 13-05-2014
Publisher: Oxford University Press (OUP)
Date: 09-06-2022
Abstract: Integrating mental activities with physical exercises (e.g., dual-tasking) may potentially improve cognition in older adults and people with mild cognitive impairment (MCI). This study investigated the preliminary efficacy of a new intervention called dual-task Zumba Gold (DTZ) on people with MCI to guide an adequately-powered full-scale trial. This is a 2-arm pilot randomized controlled trial with 60 people with MCI assigned to a 12-week DTZ intervention or control group (health education). We hypothesized that DTZ would facilitate significant improvements in global cognition (primary outcome) and other psychological hysical measures at postintervention (T1) and 6-week follow-up (T2). Generalized estimating equations with an intention-to-treat approach were used to evaluate intervention effects. Postintervention qualitative interviews explored the participants’ program perceptions. Fifty-one participants completed the study, with no adverse events reported. DTZ participants showed significant improvements in global cognition (p & .001, d = 0.75–0.78), executive function (p & .001, d = 0.28–0.33), immediate recall (p & .001, d = 0.50–0.54), delayed recall (p = .003, d = 0.66–0.71), quality of life (p = .027, d = 0.59–0.63), and mobility (p = .005, d = 0.53–0.56) at T1 and T2. There were nonsignificant changes in working memory, depressive symptoms, blood pressure, body mass index, and waist circumference. Participants conveyed intervention acceptability, including challenges/barriers, enablers, and future recommendations. DTZ is a potentially feasible intervention for people with MCI that may improve cognition, quality of life, and mobility. A full-scale trial is recommended for confirmatory evaluation. NCT04788238
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 31-01-2012
DOI: 10.7314/APJCP.2012.13.1.283
Abstract: To explore the participation rates for breast and colorectal cancer screening and identify associated correlates among elderly women. Logistic regressions were conducted using data collected in 2006 from 1,533 elderly women aged 60 years or above who had completed a screening instrument, the Minimum Data Set-Home Care, while applying for long-term care services at the first time in Hong Kong. The participation rates for breast and colorectal cancer screening among frail older Chinese women were 3.7% and 10.8% respectively. Cognitive status was inversely associated with the likelihood of participation in screening (breast: OR = 0.66, 95%CI = 0.47-0.94 colon: OR = 0.81, 95%CI = 0.66-0.99), as was educational level with the likelihood of participation in breast cancer screening (no formal education: OR = 0.20, 95%CI = 0.06-0.61, some primary education: OR = 0.31, 95%CI = 0.10-1.00). The delivery of cancer preventive health services to frail older women is less than ideal. Cognitive status and educational level were important factors in cancer screening behaviour. Tailor-made strategic promotion programmes targeting older women with low cognitive status and educational levels are needed to enhance awareness and acceptance within this vulnerable group.
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.ARCHGER.2014.10.005
Abstract: To test whether health literacy is associated with sunlight exposure behavior, we interviewed 648 Chinese adults aged 65 years or older. Using the information-motivation-behavioral skills model and structural equation modeling, we tested whether health literacy was associated with the complex relationships among knowledge about vitamin D, attitudes toward sunlight exposure, doctor recommendations regarding sunlight exposure, and sunlight exposure behavior. Health literacy was directly associated with sunlight exposure (β=.20, p<.01). Indirect relationships also existed between knowledge and sunlight exposure through health literacy (β=.46, p<.001) and between attitudes and sunlight exposure through health literacy (β=-.12, p<.05). The model had good fit (χ(2)/df=2.79 RMSEA=.053, p=.346 CFI=.95 TLI=.92). Health literacy should be considered when educating older adults about vitamin D supplements and sunlight exposure. Providing relevant knowledge or making doctor recommendations might not be effective. Training should focus on in iduals with low health literacy who may be less likely to receive sunlight exposure.
Publisher: Oxford University Press (OUP)
Date: 28-11-2012
Abstract: negative mood is an important construct when assessing the health of older persons. The profile of mood states questionnaire is commonly used to measure mood however, it might not be suitable for older adults with low education level and those who are not originated North American. to examine a negative mood scale formed by nine items in the Mood Section of the Minimum Data Set-Home Care of the Resident Assessment Instrument. a secondary analysis of data from 3,523 older persons aged 60 or over who had first applied for the long-term care services in Hong Kong and completed the screening tool in 2006. Exploratory and confirmatory factor analyses were used to test the factor structure and multiple-group confirmatory factor analysis to test the gender invariance of the Negative Mood Scale in the Minimum Data Set-Home Care. Its reliability using Cronbach's alpha was examined. both a three-factor model at the first level and a one-factor model at the second level provided excellent fits to the overall data, and held equally well for both males and females, and two randomly split s les. Multiple-group confirmatory factor analyses revealed both genders demonstrating an equivalent pattern of factor loadings. Cronbach's alpha value was acceptable for the overall data (0.66). the Negative Mood Scale is a reliable and valid scale and both genders responded to it using the same framework and metric, suggesting it could be used to measure negative mood in Chinese community-dwelling older adults. Further testing of the instrument is needed.
Publisher: Informa UK Limited
Date: 02-11-2022
DOI: 10.1080/13557858.2022.2139818
Abstract: Research on dementia literacy in Chinese societies is still emerging, and this is especially the case among racially minoritized groups. The present study explored the knowledge, causal beliefs, and help-seeking behaviors of South Asian migrants in Hong Kong about dementia. It also investigated existing community barriers related to dementia knowledge and help-seeking. We conducted a qualitative study from a purposive s le of 38 older people and family caregivers from India, Pakistan, and Nepal who lived in Hong Kong. Focus groups and in idual in-depth interviews were used to gather information, while thematic analysis was employed to analyze the data. Five main themes were identified: normalization with stigmatization of dementia spiritual and psychosocial attributions of dementia familial responsibility despite potential caregiving burden uncertainties versus openness to professional care and barriers and opportunities in dementia literacy. Ethnic minorities recognized dementia as a disease of normal aging or a mental disorder. They also perceived spiritual and psychosocial factors as their main causes. While participants recognized the potential burden of dementia caregiving, families were their first point of help-seeking, as many of them expressed contrasting feelings of confidence or doubt toward professional services. Utilization of health education strategies, together with collaboration with community leaders, could address the barriers to dementia literacy. This is the first study to explore how ethnic minorities in Asia perceive dementia and its related help-seeking behaviors in their communities. South Asian migrants in Hong Kong have a limited understanding of dementia and may experience delays in obtaining relevant community services. While culture influenced their knowledge, health education may address their misperceptions and help-seeking behaviors toward dementia. Culture- and language-specific programs could also improve dementia knowledge and health service access.
Publisher: Wiley
Date: 06-05-2015
DOI: 10.1111/JOCN.12854
Abstract: To investigate the smoking behaviours, perceptions about quitting smoking and factors associated with intention to quit in patients with type 2 diabetes mellitus. Smoking causes type 2 diabetes mellitus. There has been limited research on the needs and concerns of smokers with type 2 diabetes mellitus about quitting smoking. The study used a qualitative design. Patients diagnosed with type 2 diabetes mellitus who had a history of smoking were recruited at the outpatient diabetic clinics of two major local hospitals in Hong Kong for a semi-structured interview (n = 42), guided by the theory of planned behaviour. At data saturation, 22 current smokers and 20 ex-smokers with type 2 diabetes mellitus were recruited. The current smokers reported they had not quit smoking because of satisfaction with present health status, and misconceptions about the association between diabetes and smoking, and the perceived hazards of quitting. In contrast, ex-smokers had a positive opinion about quitting smoking, accepted advice about quitting from health professionals and received more family support than current smokers. Psychological addiction and weight gain after cessation made quitting challenging. Satisfaction with health status, inadequate knowledge about the relationship between type 2 diabetes mellitus and smoking, and misconceptions about quitting smoking resulted in negative attitudes toward quitting by type 2 diabetes mellitus smokers. Smoking peers, psychological addiction and post-cessation weight gain hindered the quitting process. Education on the causal link between smoking, type 2 diabetes mellitus and its complications is important to raise health awareness and counter misconceptions about quitting smoking. Behavioural counselling with weight control strategies should be part of a comprehensive smoking cessation intervention for type 2 diabetes mellitus smokers.
Publisher: MDPI AG
Date: 17-10-2022
Abstract: Background: While a number of population preventive measures for COVID-19 exist that help to decrease the spread of the virus in the community, there are still many areas in preventative efforts that need improvement or refinement, particularly as new strains of the virus develop. Some of the key issues currently include incorrect and/or inconsistent use of face masks, low acceptance of early screening or vaccination for COVID-19, vaccine hesitance, and misinformation. This is particularly the case in some vulnerable populations, such as older people with chronic illnesses, ethnic minorities who may not speak the mainstream language well and children. The current protocol introduces a large programme of research through five interrelated studies that all focus on social and behavioural interventions to improve different aspects of community-related preventative indicators. Hence, the specific objectives of the overall programme are to (1) increase early testing for COVID-19 and promote the uptake of COVID-19 vaccines in the community (Study 1) (2) increase COVID-19-related health literacy and vaccine literacy and promote improved preventative measures in minority ethnic groups, chronically ill populations and caregivers (Study 2) (3) strengthen the public’s motivation to stay at home and avoid nonessential high-risk activities (Study 3) (4) decrease COVID-19 vaccine hesitancy (Study 4) and (5) enhance the adherence to COVID-19-related hygiene practices and the uptake of early testing in school children (Study 5). Methods: We will utilise a community-based participatory research (CBPR) approach in the proposed studies. All studies will incorporate an intervention development phase in conjunction with key community stakeholders, a feasibility study and an execution stage. A variety of self-reported and objective-based measures will be used to assess various outcomes, based on the focus of each study, in both the short- and long-term, including, for ex le, the 8-item self-reported eHealth Literacy Scale (eHEAL) and objective measures such as vaccine uptake. Discussion: Theory-driven interventions will address each study’s focus (e.g., social distancing, promotion of vaccine uptake, eHealth education, preventive measures and early detection). Improvements are expected to be seen in the outcomes of vulnerable and high-risk groups. Decreased infection rates are expected due to improved preventative behaviours and increased vaccine uptake. Long-term sustainability of the approach will be achieved through the CBPR model. The publication of this protocol can assist not only in sharing a large-scale and complex community-based design, but will also allow all to learn from this, so that we will have better insight in the future whether sharing of study designs can elicit timely research initiatives.
Publisher: Elsevier BV
Date: 09-2020
Publisher: SAGE Publications
Date: 22-05-2019
Publisher: Hindawi Limited
Date: 11-2022
DOI: 10.1111/HSC.14101
Abstract: As global population ageing persists, understanding older adults' capacity to navigate the financial and healthcare system is essential. This scoping review examines how the concept of financial health literacy (FHL) is described and measured in the existing literature, the factors that may affect it, and its potential outcomes in middle-aged and older adults. The review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) extension guidelines to synthesise the available evidence on this topic. We utilised electronic databases and hand searching to identify relevant literature published between 2010 and 2022. A total of 29 articles were included in this review. The results showed that FHL involved accessing, understanding and utilising financial information for planning/management of healthcare expenses and selecting appropriate health services. However, FHL is not particularly depicted as a concept in the current literature, as most studies investigated health literacy, financial literacy and health insurance literacy as separate domains that were interrelated to one another. No validated measurement tool was developed for FHL. We propose five domains to indicate the concept and measurement of FHL in middle-aged/older adults: money management, management of medical bills, understanding health insurance, deciding on appropriate health services, and planning for long-term care needs. Demographic variables, such as sex (females), advanced age, cognitive impairment, low education and income and racial and ethnic minorities, were found to be related to low FHL. The reviewed studies also showed that FHL was related to several outcomes, including healthcare decision-making, physical health and psychological well-being. Hence, future studies to develop and validate assessment tools of FHL, together with the involvement of vulnerable groups, are imperative to understanding the concept of FHL. This could also facilitate the development of appropriate interventions that could enhance this capacity in the ageing population.
Publisher: JMIR Publications Inc.
Date: 20-07-2017
Abstract: lthough much research has been done investigating the roles of social network sites (SNSs) in linking patients and health professionals, there is a lack of information about their uses, benefits, and limitations in connecting health professions only for professional communication. his review aimed to examine the utilization of SNSs for communication among health professionals in (1) frontline clinical practice, (2) professional networks, and (3) education and training to identify areas for future health communication research. his review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A systematic search of the literature published in the last 10 years (January 1, 2007, to March 1, 2017) was performed in March 2017, using the following electronic databases: MEDLINE via OvidSP, EMBASE, CINAHL Complete, and InfoSci-Journals. The searches were conducted using the following defined search terms: “social media” OR “social network” OR “social network site” OR “Facebook” OR “Twitter” OR “Linkedin” OR “Instagram” OR “Weibo” OR “Whatsapp” OR “Telegram” OR “WeChat” AND “health” OR “health profession.” f the 6977 papers retrieved, a total of 33 studies were included in this review. They were exploratory in nature, and the majority used surveys (n=25) and interviews (n=6). All retrieved studies stated that SNSs enhanced effective communication and information sharing. SNSs were used for supporting delivering of clinical services, making referrals, and sharing information. They were beneficial to network building and professional collaboration. SNSs were novel tools to enhance educational interactions among peers, students, instructors, and preceptors. The application of SNSs came with restraints in technical knowledge, concerns on data protection, privacy and liability, issues in professionalism, and data protection. NSs provide platforms facilitating efficient communication, interactions, and connections among health professionals in frontline clinical practice, professional networks, education, and training with limitations identified as technical knowledge, professionalism, and risks of data protection. The evolving use of SNSs necessitates robust research to explore the full potential and the relative effectiveness of SNSs in professional communication.
Publisher: BMJ
Date: 09-2023
Publisher: MDPI AG
Date: 20-08-2023
Abstract: The emergence of new coronavirus variants and evidence of waning immunity offered by COVID-19 vaccines draw attention to the need for regular vaccination. Vaccine hesitancy is one of the top ten threats to global health. There is a dearth of knowledge on people’s hesitancy to take regular COVID-19 vaccines. This study aimed to investigate the prevalence and determinants of hesitancy for regular COVID-19 vaccination. A population-based, random telephone survey was performed in Hong Kong in April 2022 (n = 1213). The age-standardized hesitancy rate for regular COVID-19 vaccines among Hong Kong adults was 39.4% (95% CI = 35.3–44.1%), exhibiting a sloping S-shape with age. Regression analyses revealed that females, young adults, self-perceived fair/bad health, low COVID-19 vaccine uptake, and believing there are better ways for prevention of infection were positive determinants of hesitancy for regular vaccination. Vaccine confidence, perceived severity and availability, trust in manufacturers and government, and civic duty inclination were negative determinants. Tailored vaccine promotions are needed for females, young adults, and people perceiving poor health and receiving fewer doses. Information on infection severity, vaccine availability, and trust in suppliers, products, and governments are key attitude-change facilitators to decrease hesitancy for regular COVID-19 vaccination and cope with future pandemics.
Publisher: JMIR Publications Inc.
Date: 07-07-2020
DOI: 10.2196/18095
Abstract: No study has comprehensively investigated the association between the usage of typical screen-based electronic media devices and sleep quality in a Chinese population with in iduals in a wide range of ages. This study aimed to understand the characteristics of television (TV) viewing, computer usage, and mobile phone usage in a representative Chinese population in Macau and to examine their roles in predicting the variations in sleep quality. This cross-sectional study was an analysis of 1500 Macau residents aged 15 to 90 years based on a community-based health needs assessment study entitled, “Healthy Living, Longer Lives.” Data collection was conducted in 7 districts of Macau from 2017 to 2018 through face-to-face interviews. The durations of daily TV viewing, computer usage, and mobile phone usage were recorded in a self-administered questionnaire. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality. The prevalence of TV, computer, and mobile phone usage was 78.4% (1176/1500), 51.6% (769/1490), and 85.5% (1276/1492), respectively. The average daily hours of usage were 1.75 (1.62), 1.53 (2.26), and 2.85 (2.47) hours, respectively. Females spent more time watching TV (P=.03) and using mobile phones (P=.02) and less time on the computer (P=.04) as compared to males. Older adults were more likely to watch TV while young people spent more time using the computer and mobile phones (P for all trends .001). The mean PSQI global score was 4.79 (2.80) among the participants. Females exhibited significantly higher PSQI scores than males (5.04 vs 4.49, respectively P .001). No linear association was observed between the PSQI score and the amount of time spent on the 3 electronic devices (P=.58 for PSQI-TV, P=.05 for PSQI-computer, and P=.52 for PSQI-mobile phone). Curve estimation showed significant quadratic curvilinear associations in PSQI-TV (P=.003) and PSQI-computer (P .001) among all the participants and in PSQI-mobile phone among youths (age, 15-24 years P=.04). After adjustment of the gender, age, body mass index, demographics, and lifestyle factors, more than 3 hours of TV viewing and 4 hours of computer usage or mobile phone usage was associated with 85% (95% CI 1.04-1.87 P=.008), 72% (95% CI 1.01-2.92 P=.045), and 53% (95% CI 1.06-2.22 P=.03) greater odds of having poor sleep quality (PSQI score ), respectively. The mobile phone was the most popular screen-based electronic device used in the Macau population, especially among young people. “J” shape associations were observed between sleep quality and the duration of TV viewing, computer usage, and mobile phone usage, indicating that the extreme use of screen-based electronic devices predicted poorer sleep status, whereas moderate use would be acceptable.
Publisher: Elsevier BV
Date: 2015
Publisher: Wiley
Date: 05-12-2011
DOI: 10.1111/J.1365-2648.2010.05529.X
Abstract: The aim of the study was to examine the factor structure of the Chinese General Self-Efficacy Scale and gender invariance in the structure. The General Self-Efficacy Scale was developed in 1981 and revised in 1995 to measure people's beliefs or expectations about their ability to perform tasks on their own across a wide range of demanding/novel situations. While the Chinese version of the General Self-Efficacy Scale has been examined for adolescents and adults from clinical populations, its psychometric properties for community-dwelling Chinese soon-to-be-aged adults, who are in a transitional stage from adulthood to later life, have not been tested. Females have consistently reported a lower general self-efficacy level than males, but it is unclear whether the difference is a result of response bias of the inventory by gender. A convenience s le of Chinese soon-to-be-aged adults (n = 695) in 28 non-government organizations in Hong Kong completed the survey from March to May 2005. Confirmatory factor analysis was used to test the factor structure and multiple-group confirmatory factor analysis to test the gender invariance of the Chinese version of the General Self-Efficacy Scale. The proposed factor structure of the Chinese version of the General Self-Efficacy Scale was an excellent fit to the overall data, and held equally well for both males and females, both genders demonstrating an equivalent pattern of factor loadings. The Cronbach alpha value was high (0·89). The Chinese version of the General Self-Efficacy is a reliable and valid scale and both genders responded to it using the same framework and metric, thus allowing it to be used with confidence in non-clinical Chinese soon-to-be-aged adult s les.
Publisher: JMIR Publications Inc.
Date: 15-01-2021
DOI: 10.2196/24097
Abstract: Digital communication technologies are playing an important role in the health communication strategies of governments and public health authorities during the COVID-19 pandemic. The internet and social media have become important sources of health-related information on COVID-19 and on protective behaviors. In addition, the COVID-19 infodemic is spreading faster than the coronavirus itself, which interferes with governmental health-related communication efforts. This jeopardizes national public health containment strategies. Therefore, digital health literacy is a key competence to navigate web-based COVID-19–related information and service environments. This study aimed to investigate university students’ digital health literacy and web-based information-seeking behaviors during the early stages of the COVID-19 pandemic in Germany. A cross-sectional study among 14,916 university students aged ≥18 years from 130 universities across all 16 federal states of Germany was conducted using a web-based survey. Along with sociodemographic characteristics (sex, age, subjective social status), the measures included five subscales from the Digital Health Literacy Instrument (DHLI), which was adapted to the specific context of the COVID-19 pandemic. Web-based information-seeking behavior was investigated by examining the web-based sources used by university students and the topics that the students searched for in connection with COVID-19. Data were analyzed using univariate and bivariate analyses. Across digital health literacy dimensions, the greatest difficulties could be found for assessing the reliability of health-related information (5964/14,103, 42.3%) and the ability to determine whether the information was written with a commercial interest (5489/14,097, 38.9%). Moreover, the respondents indicated that they most frequently have problems finding the information they are looking for (4282/14,098, 30.4%). When stratified according to sociodemographic characteristics, significant differences were found, with female university students reporting a lower DHLI for the dimensions of “information searching” and “evaluating reliability.” Search engines, news portals, and websites of public bodies were most often used by the respondents as sources to search for information on COVID-19 and related issues. Female students were found to use social media and health portals more frequently, while male students used Wikipedia and other web-based encyclopedias as well as YouTube more often. The use of social media was associated with a low ability to critically evaluate information, while the opposite was observed for the use of public websites. Although digital health literacy is well developed in university students, a significant proportion of students still face difficulties with certain abilities to evaluate information. There is a need to strengthen the digital health literacy capacities of university students using tailored interventions. Improving the quality of health-related information on the internet is also key.
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.JPEDS.2016.11.021
Abstract: To examine whether a family-based intervention targeting both smoking fathers and nonsmoking mothers in well-child health clinics is effective in increasing fathers' abstinence from cigarette smoking. This parallel 2-arm randomized controlled trial recruited a total of 1158 families with a daily-smoking father, a nonsmoking mother, and a child aged 0-18 months from the 22 maternal and child health centers in Hong Kong. The intervention group received the family-based intervention, including 6 nurse-led in idual face-to-face and telephone counseling sessions within 1 month after recruitment and a voluntary face-to-face family counseling session (FCS). The control group received a leaflet, a self-help booklet, and brief quitting advice only. Father-reported 7-day and 6-month abstinence, smoking reduction, quit attempts, mother-reported help and support, and child salivary cotinine level were assessed at 12 months. Generalized estimating equation models were used to compare these outcomes between the 2 study groups. Compared with the control group, the intervention group reported a greater prevalence of 7-day (13.7% vs 8.0% OR, 1.92 95% CI, 1.16-3.17 P < .01) and 6-month self-reported abstinence (13.4% vs. 7.5% OR, 2.10 95% CI, 1.30-3.40 P < .01). Within the intervention group, compared with receipt of in idual counseling only, participation in the FCS was associated with increases in fathers' self-reported abstinence (20.2% vs 12.3% P = .02), mothers' help (66.1% vs 43.8% P < .01), and support to the fathers (55.0% vs 45.4% P < .01). The family-based smoking cessation intervention for the families in the well-child healthcare setting was effective in increasing the fathers' self-reported abstinence. Additional participation in the FCS increased mothers' help and support to the fathers. Controlled-trials.com: ISRCTN99111655 Hkuctr.com: HKUCTR-465.
Publisher: Wiley
Date: 20-11-2019
DOI: 10.1111/JAN.14241
Abstract: To compare the effect of a lifestyle intervention programme using mobile application versus booklet for adults with metabolic syndrome (MetS) living in the community. A multisite randomized controlled trial with three parallel arms, namely metabolic syndrome app group, booklet group, and control group. The research study has been supported by the Health and Medical Research fund in Hong Kong in 2019. The protocol was approved by the study university and the selected community centres. Three hundred and sixty subjects will be recruited from community centres and randomized into either one arm. Inclusion criteria are those adult with MetS, able to use a smart phone. All participants received a 30-min health educational session. App group participants will receive a mobile application while booklet group participants will receive a specific booklet of MetS care and the control group receive a placebo booklet only. The primary outcomes comprises of body weight. The secondary outcomes include total physical exercise, cardiometablolic risk factors, cardiovascular endurance, self-efficacy for exercise, and stress level. Data will be collected at baseline, weeks 4, 12, and 24. SPSS and generalized estimating equations model will be employed for data analysis. Metabolic syndrome is a common health problem associated with the heightened risk of cardiovascular disease and the risks are potentially amenable to lifestyle intervention. The results will compare the relative effectiveness of a lifestyle intervention using an app versus a booklet on physical and psychological outcomes for adults with MetS. What problem will the study address? The results will inform the healthcare professional and nurses about the effective way for health promotion, to enhance patient's lifestyle modification and exercise sustainability that will be beneficial to the clients' health.
Publisher: JMIR Publications Inc.
Date: 06-03-2023
DOI: 10.2196/39989
Abstract: Immersive virtual reality (IVR) applications are gaining popularity in health care education. They provide an uninterrupted, scaled environment capable of simulating the full magnitude of sensory stimuli present in busy health care settings and increase students’ competence and confidence by providing them with accessible and repeatable learning opportunities in a fail-safe environment. This systematic review aimed to evaluate the effects of IVR teaching on the learning outcomes and experiences of undergraduate health care students compared with other teaching methods. MEDLINE, Embase, PubMed, and Scopus were searched (last search on May 2022) for randomized controlled trials (RCTs) or quasi-experimental studies published in English between January 2000 and March 2022. The inclusion criteria were studies involving undergraduate students majoring in health care, IVR teaching, and evaluations of students’ learning outcomes and experiences. The methodological validity of the studies was examined using the Joanna Briggs Institute standard critical appraisal instruments for RCTs or quasi-experimental studies. The findings were synthesized without a meta-analysis using vote counting as the synthesis metric. A binomial test with P .05 was used to test for statistical significance using SPSS (version 28 IBM Corp). The overall quality of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation tool. A total of 17 articles from 16 studies totaling 1787 participants conducted between 2007 and 2021 were included. The undergraduate students in the studies majored in medicine, nursing, rehabilitation, pharmacy, biomedicine, radiography, audiology, or stomatology. The IVR teaching domains included procedural training (13/16, 81%), anatomical knowledge (2/16, 12%), and orientation to the operating room setting (1/16, 6%). The quality of the 75% (12/16) of RCT studies was poor, with unclear descriptions of randomization, allocation concealment, and outcome assessor blinding procedures. The overall risk of bias was relatively low in the 25% (4/16) of quasi-experimental studies. A vote count showed that 60% (9/15 95% CI 16.3%-67.7% P=.61) of the studies identified similar learning outcomes between IVR teaching and other teaching approaches regardless of teaching domains. The vote count showed that 62% (8/13) of the studies favored using IVR as a teaching medium. The results of the binomial test (95% CI 34.9%-90% P=.59) did not show a statistically significant difference. Low-level evidence was identified based on the Grading of Recommendations Assessment, Development, and Evaluation tool. This review found that undergraduate students had positive learning outcomes and experiences after engaging with IVR teaching, although the effects may be similar to those of other forms of virtual reality or conventional teaching methods. Given the identification of risk of bias and low level of the overall evidence, more studies with a larger s le size and robust study design are required to evaluate the effects of IVR teaching. International prospective register of systematic reviews (PROSPERO) CRD42022313706 www.crd.york.ac.uk rospero/display_record.php?RecordID=313706
Publisher: Wiley
Date: 28-10-2022
DOI: 10.1111/JGS.18094
Abstract: Dementia is an emerging public health issue. Growing evidence emerged on the association between social integration and the risk of dementia. However, the magnitude of the association between different aspects of social integration and the risk of dementia is unclear. Five databases were systematically searched. Newcastle–Ottawa scale for assessing the quality of the reporting was used for quality appraisal. Longitudinal cohort studies examining the association between social integration and the risk of dementia were analyzed using random effects model. A series of sensitivity analyses was conducted to enhance the robustness of the findings. Forty publications generated from 32 studies/databases were included. The meta‐analysis showed that strong social engagement (overall RR = 0.81, 95% CI = 0.74–0.89, p 0.001) and frequent social contact (overall RR = 0.86, 95% CI = 0.76–0.97, p = 0.018) were positively associated with decreased risk of dementia. The influence of social support (overall RR = 0.92, 95% CI = 0.80–1.06, p = 0.238) and close social contact (overall RR = 0.74, 95% CI = 0.48–1.13, p = 0.167) was not significant. Loneliness was significantly associated with an increased risk of dementia (overall RR = 1.42, 95% CI = 1.26–1.60, p 0.001), whereas the influence of social isolation (overall RR = 1.58, 95% CI = 0.80–3.12, p = 0.192) was not significant. A larger social network size (RR = 0.75, 95% CI = 0.59–0.97, p = 0.028) was a promising influencing factor even though the number of studies was insufficient for a meta‐analysis. However, the heterogeneity among studies was generally high even though sensitivity analysis was conducted. Our findings reveal that high social engagement and frequent social contact are significantly associated with a lower risk of dementia, whereas loneliness is associated with a higher risk. The promising impact of large social network size is also identified. Substantial heterogeneity appeared in most of the analysis, making the inference tentative. Nevertheless, the sensitivity analysis provided valuable implications that enhancing social engagement and reducing loneliness may prevent or delay the onset of dementia among middle‐aged and older adults.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.JAMDA.2017.06.018
Abstract: Negative effects of restraint use have been well-documented. However, the prevalence of restraints use has been high in long-term care facilities in Hong Kong compared with other countries and this goes against the basic principles of ethical and compassionate care for older people. The present study aimed to review the change in the prevalence of physical and chemical restraint use in long-term care facilities (LTCFs) over a period of 11 years in Hong Kong and to identify the major factors associated with their use. This is an observational study with data obtained from the Hong Kong Longitudinal Study on LTCF Residents between 2005 and 2015. Trained assessors (nurses, social workers, and therapists) used the Minimum Data Set Resident Assessment Instrument to collect the data from 10 residential LTCFs. Physical restraint was defined as the use of any of the following: full bedside rails on all open sides of bed, other types of bedside rails used, trunk restraint, limb restraint, or the use of chair to prevent rising during the past 7 days. Chemical restraint was defined as the use of any of the following medications: antipsychotic, antianxiety, or hypnotic agents during past 7 days, excluding elder residents with a diagnosis of psychiatric illness. Annual prevalence of restraint use over 11 years and factors that were associated with the use of physical and chemical restraints. We analyzed the data for 2896 older people (978 male in iduals, mean age = 83.3 years). Between 2005 and 2015, the prevalence of restraint use was as follows: physical restraint use increased from 52.7% to 70.2% chemical restraint use increased from 15.9% to 21.78% and either physical or chemical restraint use increased from 57.9% to 75.7%. Physical restraint use was independently associated with older age, impaired activities of daily living or cognitive function, bowel and bladder incontinence, dementia, and negative mood. Chemical restraint use was independently associated with older age, falls, bladder incontinence, use of feeding tube, dementia, poor cognitive function, delirium, behavioral problems, and negative mood. The increasing time-trend of physical but not chemical restraint use remained significant after adjusting for other factors as mentioned above (coefficient = 0.092, P < .001). Use of physical and chemical restraint was highly prevalent among LTCF residents in Hong Kong, with an increasing trend over a period of 11 years, especially targeting the most physically and cognitively frail older people. Appropriate healthcare staff education and policy change are urgently needed to ensure personal care that is characterized by respect, dignity, empathy, and compassion for the older generation.
Publisher: Wiley
Date: 07-07-2022
DOI: 10.1111/AJAG.13101
Abstract: In 2007, the World Health Organization published a guide on age‐friendly cities. However, little is known about interventions that have been implemented to promote age‐friendly communities in rural and remote areas. This paper presents the findings from a scoping review undertaken to locate available evidence of interventions, strategies, and programs that have been implemented in rural and remote areas to create age‐friendly communities. This scoping review used the Joanna Briggs Institute (JBI) methodology. A total of 219 articles were included in this review. No intervention studies were referred to as ‘age‐friendly’. However, there were interventions (mostly healthcare‐related) that have been implemented in rural and remote areas with older people as participants. There were also non‐evaluated community programs that were published in the grey literature. This review identified the common health interventions in older people and the indirect relevance to the WHO age‐friendly framework domains in rural and remote contexts. The eight age‐friendly domains were not explicitly utilised as a guide in the development of interventions for older people in rural and remote settings. Implementation of age‐friendly interventions in rural and remote areas requires a multisectoral approach that is tailored to address the specific needs of in idual communities. Age‐friendly interventions also need to consider socio‐ecological factors to adequately and holistically address community needs and ensure long‐term sustainability.
Publisher: JMIR Publications Inc.
Date: 24-05-2018
DOI: 10.2196/10662
Publisher: Wiley
Date: 13-02-2016
DOI: 10.1111/GER.12116
Abstract: This study aims to describe the prevalence of chewing problems and oral dryness when eating and examine their risk factors among Chinese community-dwelling older adults. Chewing problems and oral dryness are two common oral health complaints in older people. A number of factors associated with these two oral health problems in older people have been reported, but information regarding Chinese older adults is scarce. Secondary analysis was conducted on the data collected from 3422 Hong Kong adults aged ≥60 who had completed a screening instrument for long-term care services for the first time. Among the respondents, 15.3% reported having chewing problems and 3.5% reported having oral dryness when eating. More dependence on instrumental activities of daily living (IADL, OR = 1.06, p < 0.001) was associated with a greater likelihood of chewing problems, while more negative mood (OR = 1.19, p < 0.001) was associated with a greater likelihood of oral dryness when eating, after adjusting for the effects of socio-demographic characteristics and medical conditions. Informal care support, poor nutrition status and difficulty in brushing teeth/dentures were positively and significantly associated with these two perceived oral health problems. The prevalence of both chewing problems and oral dryness was low in Hong Kong older Chinese adults. IADL was related to chewing problems, while negative mood was related to oral dryness independently and significantly, which provide a knowledge base upon which to develop strategic programs of oral health promotion among older Chinese adults.
Publisher: Wiley
Date: 20-07-2020
DOI: 10.1111/JOCN.15394
Publisher: Wiley
Date: 20-02-2007
DOI: 10.1111/J.1525-1446.2007.00621.X
Abstract: OBJECTIVE AND SAMPLE: This paper reports on the learning experience of 88 Chinese older adults who attended a health Web-navigating workshop. Through a 3-hr training workshop, participants were guided to browse through seven health Web sites that provide authoritative health information by the Hong Kong government, academic institutions, or professional bodies. Upon completion of the workshop, an evaluation was made of the participants' confidence in navigating health Web sites by themselves at home and in utilizing the health information sources. The findings indicated that participants' confidence in seeking health information via the Internet was not associated with their age, educational level, or experience of using computers before the workshop but was significantly associated with their satisfaction with the workshop (p<.05). Significant change of source of health information was noted at follow-up, suggesting that the workshop was successful. Implications of the results for running health Web-navigating programs among Chinese older adults are discussed.
Publisher: MDPI AG
Date: 25-09-2019
Abstract: While health literacy influences better outcomes of mental health patients, sociocultural factors shape the nature of the relationship. On this matter, little is known about how sociocultural factors affect health literacy practices of nurses, especially in low-income countries. This paper examines how local precepts, within culture and language, shape mental health nurses’ (MHNs) practice and understanding of patients’ health literacy level in Ghana. The study used a qualitative descriptive design involving 43 MHNs from two psychiatric hospitals. Conventional content analysis was used to analyze the data. Although the MHNs acknowledged the importance of health literacy associated with patients’ health outcomes, their practice was strongly attributed to patients’ substantial reliance on cultural practices and beliefs that led to misinterpretation and non- compliance to treatments. MHNs shared similar sociocultural ideas with patients and admitted that these directed their health literacy practice. Additionally, numerous health system barriers influenced the adoption of health literacy screening tools, as well as the MHNs’ low health literacy skills. These findings suggest MHNs’ direct attention to the broader social determinants of health to enhance the understanding of culture and its impact on health literacy practice.
Publisher: Wiley
Date: 26-09-2014
DOI: 10.1111/GGI.12342
Abstract: The aim of present study was to describe the prevalence of medication adherence, and to examine its risk factors among Chinese community-dwelling older adults with chronic diseases. Secondary analysis was carried out on the data collected from 3167 Hong Kong adults aged ≥60 years who lived in their private home, had at least one type of chronic disease and had completed a screening instrument for long-term care services for the first time in 2006. The outcome variable was the self- or caregiver-reported medication adherence. Among the respondents, 90.8% reported having good medication adherence in the past 7 days. More dependence on activities of daily living (P < 0.001), stroke (P = 0.003) or diabetes (P = 0.036), had medication review by physicians (P < 0.001) and received more informal care support (P = 0.005) were positively associated with medication adherence, whereas more cognitive impaired (P = 0.008), more negative mood (P = 0.071) and perceived poor health (P < 0.001) were negatively associated with medication adherence. The prevalence of self-reported medication adherence was high in Hong Kong Chinese community-dwelling older adults. A number of modifiable factors associated with medication adherence were identified, which provides specific targets for interventions.
Publisher: Elsevier BV
Date: 10-2013
DOI: 10.1016/J.NEDT.2012.05.009
Abstract: Life-long learning involves the development of skills in critical thinking (CT), effective group process (GP), and self-directedness (SDL). Recent studies have shown that small group learning with active interactions is effective in enabling students to develop themselves as independent learners beyond graduation. With a view to integrative learning, the purpose of this study was to evaluate life-long learning outcomes through the work of small group teaching and learning for a class of undergraduate nursing freshmen during one academic year. A mixed-methods approach was used to evaluate the CT, GP and SDL of 99 freshmen with a self-assessment questionnaire before and after their learning activities in three nursing courses, and to identify themes from a total of six focus group interviews with the students and teachers. The CT, GP and SDL results obtained from self-assessment did not indicate significant differences. Four themes emerged from the qualitative analysis. Many factors contributed to the results on life-long learning skill development of students in this study. The qualitative analysis provided good insights for future teaching and learning development. With a developmental perspective, life-long learning may be better developed and evaluated over a longer period of time in the nursing program.
Publisher: MDPI AG
Date: 18-07-2022
Abstract: Caregiving appraisal is the caregivers’ cognitive evaluation of caregiving stressors. It determines the caregiving outcomes and caregiver health. Dementia caregivers have shown relatively negative caregiving appraisals. However, there is a lack of interventions to improve caregiving appraisal. This study describes the multi-phase process of developing and validating an evidence-based bibliotherapy protocol for improving the caregiving appraisal of informal caregivers of people with dementia. Two phases were included in the development: In Phase 1, a series of reviews of theory and evidence were conducted to identify the theoretical underpinnings, the core components, the dosage, and the mode of delivery of evidence-based bibliotherapy. In Phase 2, focus groups consisting of an expert panel of 16 clinicians and academics were used to validate the intervention protocol. Evidence synthesis was used in Phase 1 to formulate a draft intervention protocol. Content analysis was used in Phase 2 to work out the principles to revise the intervention protocol. The validated evidence-based bibliotherapy protocol included eight weekly sessions, and each session targeted improving one aspect of the essential factors that influence caregiving appraisal. This study provided a culturally sensitive and contextually appropriate evidence-based bibliotherapy protocol ready to be tested in a clinical trial.
Publisher: JMIR Publications Inc.
Date: 30-05-2022
Abstract: mmersive virtual reality (IVR) applications are gaining popularity in health care education. They provide an uninterrupted, scaled environment capable of simulating the full magnitude of sensory stimuli present in busy health care settings and increase students’ competence and confidence by providing them with accessible and repeatable learning opportunities in a fail-safe environment. his systematic review aimed to evaluate the effects of IVR teaching on the learning outcomes and experiences of undergraduate health care students compared with other teaching methods. EDLINE, Embase, PubMed, and Scopus were searched (last search on May 2022) for randomized controlled trials (RCTs) or quasi-experimental studies published in English between January 2000 and March 2022. The inclusion criteria were studies involving undergraduate students majoring in health care, IVR teaching, and evaluations of students’ learning outcomes and experiences. The methodological validity of the studies was examined using the Joanna Briggs Institute standard critical appraisal instruments for RCTs or quasi-experimental studies. The findings were synthesized without a meta-analysis using vote counting as the synthesis metric. A binomial test with i P /i & .05 was used to test for statistical significance using SPSS (version 28 IBM Corp). The overall quality of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation tool. total of 17 articles from 16 studies totaling 1787 participants conducted between 2007 and 2021 were included. The undergraduate students in the studies majored in medicine, nursing, rehabilitation, pharmacy, biomedicine, radiography, audiology, or stomatology. The IVR teaching domains included procedural training (13/16, 81%), anatomical knowledge (2/16, 12%), and orientation to the operating room setting (1/16, 6%). The quality of the 75% (12/16) of RCT studies was poor, with unclear descriptions of randomization, allocation concealment, and outcome assessor blinding procedures. The overall risk of bias was relatively low in the 25% (4/16) of quasi-experimental studies. A vote count showed that 60% (9/15 95% CI 16.3%-67.7% i P /i =.61) of the studies identified similar learning outcomes between IVR teaching and other teaching approaches regardless of teaching domains. The vote count showed that 62% (8/13) of the studies favored using IVR as a teaching medium. The results of the binomial test (95% CI 34.9%-90% i P /i =.59) did not show a statistically significant difference. Low-level evidence was identified based on the Grading of Recommendations Assessment, Development, and Evaluation tool. his review found that undergraduate students had positive learning outcomes and experiences after engaging with IVR teaching, although the effects may be similar to those of other forms of virtual reality or conventional teaching methods. Given the identification of risk of bias and low level of the overall evidence, more studies with a larger s le size and robust study design are required to evaluate the effects of IVR teaching. nternational prospective register of systematic reviews (PROSPERO) CRD42022313706 www.crd.york.ac.uk rospero/display_record.php?RecordID=313706
Publisher: MDPI AG
Date: 02-07-2020
Abstract: Background and Objectives: To investigate the health literacy (HL) among older adults in Taiwan, we referenced an existing integrated model of HL to confirm the influencing factors of HL in older adults. We propose this study to examine the personal, situational, and socioenvironmental factors influencing HL among older adults. Materials and Methods: A cross-sectional survey was conducted at a district hospital and affiliated community center in northern Taiwan from August 2016 to May 2017. This study used the Mandarin Chinese version of the European Health Literacy Survey Questionnaire (EU-Q47). We designed three models based on the three domains of HL. Model 1 assesses personal factors. Model 2 incorporates situational factors. Model 3 adds the socioenvironmental factor. Results: We recruited 161 participants aged over 65 years. Most adults in this study had limited overall HL. The final regression model revealed that age years, unknown insurance status, and dominant spoken dialect of Hakka or Taiwanese were significantly associated with higher scores of HL. Conclusions: Our study results may help clinicians with early identification of older adults at high risk for poor HL and help health administrators establish geriatric policies and health education plans.
Publisher: Oxford University Press (OUP)
Date: 11-2010
DOI: 10.1086/656587
Abstract: Despite World Health Organization recommendations, the rate of 23-valent pneumococcal (PPV) and influenza (TIV) vaccination among elderly persons in Hong Kong, China, is exceptionally low because of doubts about effectiveness of vaccination. The efficacy of dual vaccination remains unknown. From 3 December 2007 to 30 June 2008, we conducted a prospective cohort study by recruiting outpatients aged ≥65 years with chronic illness to participate in a PPV and TIV vaccination program. All were observed until 31 March 2009. The outcome of subjects, including the rates of death, hospitalization, pneumonia, ischemic stroke, acute myocardial infarction, and coronary and intensive care admissions, were determined. Of the 36,636 subjects recruited, 7292 received both PPV and TIV, 2076 received TIV vaccine alone, 1875 received PPV alone, and 25,393 were unvaccinated, with a duration of follow-up of 45,834 person-years. Baseline characteristics were well matched between the groups, except that there were fewer male patients in the PPV and TIV group and fewer cases of comorbid chronic obstructive pulmonary disease among unvaccinated persons. At week 64 from commencement of the study, dual-vaccinees experienced fewer deaths (hazard ratio [HR], 0.65 95% confidence interval [CI], 0.55-0.77] P<.001) and fewer cases of pneumonia (HR, 0.57 95% CI, 0.51-0.64 P<.001), ischemic stroke (HR, 0.67 95% CI, 0.54-0.83 P<.001), and acute myocardial infarction (HR, 0.52 95% CI, 0.38-0.71 P<.001), compared with unvaccinated subjects. Dual vaccination resulted in fewer coronary (HR, 0.59 95% CI, 0.44-0.79 P<.001) and intensive care admissions (HR, 0.45 95% CI, 0.22-0.94 P=.03), compared with among unvaccinated subjects. Dual vaccination with PPV and TIV is effective in protecting elderly persons with chronic illness from developing complications from respiratory, cardiovascular, and cerebrovascular diseases, thereby reducing hospitalization, coronary or intensive care admissions, and death.
Publisher: JMIR Publications Inc.
Date: 28-03-2018
DOI: 10.2196/JMIR.8382
Publisher: Informa UK Limited
Date: 04-12-2013
Publisher: Wiley
Date: 12-07-2014
DOI: 10.1002/GPS.4160
Abstract: This study examined the effectiveness of a translated version of Resources for Enhancing Alzheimer's Caregiver Health (REACH) II in Hong Kong's service delivery context. The localized intervention was adapted from REACH II with 12 in idual-based sessions, which addressed multiple domains including disease education, safety, caregiver (CG) well-being, and care recipients' problem behavior. Two-hundred and one dementia family dyads completed the intervention. The efficacy of the intervention was demonstrated by the significant improvement in the perception of positive aspects of caregiving, reduction in depressive symptoms, subjective burden, bother and caregiving risks among CGs, and abatement in behavioral problems among care recipients. Treatment implementation was reflected from the high rate of adoption of each intervention component by interventionists and satisfactory reception from CGs. Promises in reach and adoption were demonstrated by the participation of 85 interventionists from 11 NGOs across 18 districts and CGs of a variety of demographic characteristics. This study is the first attempt to translate a highly successful evidence-based dementia CG intervention developed in the USA into the Hong Kong service delivery context. The current results echoed the success of REACH II. The values and challenges of translational research are discussed.
Publisher: BMJ
Date: 26-03-2018
Abstract: Prehospital delay of acute myocardial infarction (AMI) is common globally, and Hong Kong—home of a rapidly ageing Chinese population—is not an exception. Seeking emergency medical care promptly is important for patients. Treatment-seeking behaviours have been shown to be associated with knowledge of AMI symptoms and specific cultural beliefs. This study aimed to assess the level of knowledge of AMI symptoms and expected treatment-seeking behaviour among older Chinese in Hong Kong. A cross-sectional population-based survey was conducted at the Elderly Health Centres in Hong Kong from March to September 2016. Face-to-face interviews were conducted with a structured questionnaire based on previous studies and local adaptations. Among 1804 people aged 65 years and above who completed the questionnaire, chest pain (80.2%), palpitations (75.8%) and fainting (71.9%) were the major symptoms recognised as AMI related. Meanwhile, stomach ache (46.9%), coughing (45.4%) and neck pain (40.8%) were recognised as not AMI related. The mean expected discomfort intensity during AMI onset was 7.7 out of 10 (SD=2.1). Regarding the expected treatment-seeking behaviour, seeking non-emergent medical care was the most popular action when AMI symptoms emerged during the day, without chest pain or with lower discomfort intensity, whereas calling an ambulance was the most common option when AMI symptoms emerged at night or with high discomfort intensity. To minimise delays in seeking treatment, future health education should focus on increasing the public knowledge of AMI symptoms and the need to call an ambulance during an emergency.
Publisher: BMJ
Date: 11-2014
Publisher: Public Library of Science (PLoS)
Date: 06-07-2015
Publisher: JMIR Publications Inc.
Date: 05-02-2020
Abstract: o study has comprehensively investigated the association between the usage of typical screen-based electronic media devices and sleep quality in a Chinese population with in iduals in a wide range of ages. his study aimed to understand the characteristics of television (TV) viewing, computer usage, and mobile phone usage in a representative Chinese population in Macau and to examine their roles in predicting the variations in sleep quality. his cross-sectional study was an analysis of 1500 Macau residents aged 15 to 90 years based on a community-based health needs assessment study entitled, “Healthy Living, Longer Lives.” Data collection was conducted in 7 districts of Macau from 2017 to 2018 through face-to-face interviews. The durations of daily TV viewing, computer usage, and mobile phone usage were recorded in a self-administered questionnaire. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality. he prevalence of TV, computer, and mobile phone usage was 78.4% (1176/1500), 51.6% (769/1490), and 85.5% (1276/1492), respectively. The average daily hours of usage were 1.75 (1.62), 1.53 (2.26), and 2.85 (2.47) hours, respectively. Females spent more time watching TV ( i P /i =.03) and using mobile phones ( i P /i =.02) and less time on the computer ( i P /i =.04) as compared to males. Older adults were more likely to watch TV while young people spent more time using the computer and mobile phones ( i P /i for all trends& .001). The mean PSQI global score was 4.79 (2.80) among the participants. Females exhibited significantly higher PSQI scores than males (5.04 vs 4.49, respectively i P /i & .001). No linear association was observed between the PSQI score and the amount of time spent on the 3 electronic devices ( i P /i =.58 for PSQI-TV, i P /i =.05 for PSQI-computer, and i P /i =.52 for PSQI-mobile phone). Curve estimation showed significant quadratic curvilinear associations in PSQI-TV ( i P /i =.003) and PSQI-computer ( i P /i & .001) among all the participants and in PSQI-mobile phone among youths (age, 15-24 years i P /i =.04). After adjustment of the gender, age, body mass index, demographics, and lifestyle factors, more than 3 hours of TV viewing and 4 hours of computer usage or mobile phone usage was associated with 85% (95% CI 1.04-1.87 i P /i =.008), 72% (95% CI 1.01-2.92 i P /i =.045), and 53% (95% CI 1.06-2.22 i P /i =.03) greater odds of having poor sleep quality (PSQI score& ), respectively. he mobile phone was the most popular screen-based electronic device used in the Macau population, especially among young people. “J” shape associations were observed between sleep quality and the duration of TV viewing, computer usage, and mobile phone usage, indicating that the extreme use of screen-based electronic devices predicted poorer sleep status, whereas moderate use would be acceptable.
Publisher: Wiley
Date: 16-10-2023
DOI: 10.1111/AJAG.13250
Publisher: MDPI AG
Date: 04-01-2021
DOI: 10.3390/HEALTHCARE9010038
Abstract: This study examined student and practising nurses’ health literacy knowledge, and its correlates in Ghana. It was underpinned by an adapted version of the Institute of Medicine’s (IOM) conceptual framework of health literacy. We used convenience and snowball s ling techniques to collect data from 876 nurses (477 student nurses and 399 practising nurses) in a cross-sectional survey from February 2019 to June 2019. The respondents were drawn from all the former ten administrative regions of Ghana. Approximately 75.4% of the respondents had heard of health literacy. However, health literacy knowledge was generally low (average score of 6.6 out of 20) among both groups, with student nurses (average score of 5.8 out of 20) having significantly lower scores than practising nurses (average score of 7.4 out of 20). Factors associated with health literacy knowledge among student nurses included gender (male, B = −0.499, p 0.01), trust in others (B = −0.874, p 0.001), cultural values (B = 0.276, p 0.001), year of study (B = 0.244, p 0.05), and frequency of curative care use (B = −0.236, p 0.05). For practising nurses, trust (B = −1.252, p 0.01), cultural values (B = 0.357, p 0.01), and working experience (B = 0.612, p 0.01) were associated with their health literacy knowledge. Thus, responses targeted at gaps in health literacy knowledge of student and practising nurses must be sensitive to personal characteristics (e.g., gender), social values (e.g., issues of trust, and cultural beliefs and practices), as well as factors relating to nursing education and experience.
Publisher: JMIR Publications Inc.
Date: 02-06-2020
DOI: 10.2196/16772
Abstract: Social network sites (SNSs) are widely exploited in health education and communication by the general public, including patients with various conditions. Nevertheless, there is an absence of evidence evaluating SNSs in connecting health professionals for professional purposes. This pilot randomized controlled trial was designed to evaluate the feasibility of an intervention aiming to investigate the effects of a continuous professional education program utilizing Facebook to obtain knowledge on dementia and care for patients with dementia. Eighty health professionals from Hong Kong were recruited for participation in the study and randomized at a 1:1 ratio by a block randomization method to the intervention group (n=40) and control group (n=40). The intervention was an 8-week educational program developed to deliver updated knowledge on dementia care from a multidisciplinary perspective, either by Facebook (intervention group) or by email (control group) from October 2018 to January 2019. The primary outcomes were the effects of the intervention, measured by differences in the means of changes in pre- and postintervention scores of knowledge assessments from the 25-item Dementia Knowledge Assessment Scale (DKAS) and formative evaluation of 20 multiple choice questions. Other outcome measurements included participant compliance, participant engagement in Facebook, satisfaction, and self-perceived uses of Facebook for continuing professional education programs. Significantly more intervention group participants (n=35) completed the study than the control group (n=25) (P .001). The overall retention rate was 75% (60/80). The mean of changes in scores in the intervention group were significant in all assessments (P .001). A significant difference in the mean of changes in scores between the two groups was identified in the DKAS subscale Communication and Behavior (95% CI 0.4-3.3, P=.02). There was no significant difference in the total DKAS scores, scores of other DKAS subscales, and multiple choice questions. Participant compliance was significantly higher in the intervention group than in the control group (P .001). The mean numbers of participants accessing the learning materials were 31.5 (SD 3.9) and 17.6 (SD 5.2) in the intervention and control group, respectively. Polls attracted the highest level of participant engagement, followed by videos. Intervention group participants scored significantly higher in favoring the use of Facebook for the continuing education program (P=.03). Overall, participants were satisfied with the interventions (mean score 4 of a total of 5, SD 0.6). The significantly higher retention rate, together with the high levels of participant compliance and engagement, demonstrate that Facebook is a promising tool for professional education. Education delivered through Facebook was significantly more effective at improving participants’ knowledge of how people with dementia communicate and behave. Participants demonstrated positive attitudes toward utilizing Facebook for professional learning. These findings provide evidence for the feasibility of using Facebook as an intervention delivery tool in a manner that can be rolled out into practical settings.
Publisher: Springer Science and Business Media LLC
Date: 25-06-2018
DOI: 10.1007/S00127-018-1555-5
Abstract: In the original publication of this article, Acknowledgements Section was not included. The Acknowledgements are given below. The original article has been corrected.
Publisher: JMIR Publications Inc.
Date: 03-09-2020
Abstract: /A
Publisher: SAGE Publications
Date: 28-10-2018
Abstract: This study investigates the feasibility and the preliminary efficacy of a Cognitive Stimulating Play Intervention on cognitive functions. Thirty older people with early to moderate dementia were recruited from 2 day-care centers, which were randomized into intervention and control groups. The recruitment, attendance, completion rates, and the interview with staff showed that the intervention was feasible. Analysis of covariance results showed that there was a significant difference between groups on memory storage and retrieval functions. The mean memory storage and retrieval functions were 5.92 (95% confidence interval [CI]: 1.83-9.91 P = .006) and 4.12 (95% CI: 0.75-7.50 P = .018) points higher than that for the control group, respectively, which contributed moderate to large effects (partial η 2 = 0.189-0.248). There was no significant difference between groups in global cognition measured using the Montreal Cognitive Assessment and verbal fluency. Practical issues that emerged during implementation were discussed.
Publisher: Hindawi Limited
Date: 03-08-2020
DOI: 10.1111/HSC.13114
Publisher: Wiley
Date: 06-06-2017
DOI: 10.1111/PAPR.12587
Abstract: The Pain Sensitivity Questionnaire (PSQ), a self-reported scale, has been used to assess the pain sensitivity level in a Caucasian population. However, a validated Mandarin Chinese version of the PSQ is not available. This study was aimed to translate the PSQ into Mandarin Chinese (PSQ-C) and validate it to measure pain sensitivity among Chinese people. The English version of the PSQ has been translated into Mandarin Chinese (PSQ-C), according to the standard steps of cross-cultural adaptation of self-reported scales. Three of the 17 items were revised owing to cultural adaptation. The final version was validated on a population of 182 Chinese people in Changsha City, China, during October to December 2015. The participants underwent electrical experimental pain testing. The psychometric properties of the PSQ-C and its subscales were examined. The Cronbach's alpha coefficients for the PSQ-C-total, PSQ-C-moderate, and PSQ-C-minor were 0.90, 0.86, and 0.81, respectively. Acceptable test-retest reliability, content validity, and construct validity were demonstrated. Concurrent validity was shown via significant positive correlations between PSQ-C scores and perceived pain intensity at pain threshold and during pain stimulation with a fixed intensity. Convergent validity was shown via significant positive correlations between Pain Catastrophizing Scale scores and PSQ-C scores. Known group validity was demonstrated via higher PSQ-C-total and PSQ-C-moderate scores among those with high neuroticism scores. These results indicate that the PSQ-C has reasonably good psychometric properties, similar to the original English and German versions. The PSQ-C is a reliable and useful tool to assess pain sensitivity levels in a Chinese population.
Publisher: Oxford University Press (OUP)
Date: 04-2009
DOI: 10.1093/NTR/NTP025
Abstract: New smoke-free legislation implemented in Hong Kong on 1 January 2007, prohibited smoking in the vast majority of indoor workplaces and public places. Experiences of western countries indicated that the need for smoking cessation services would increase after enactment of the smoke-free legislation, but no systematic study of this issue has been undertaken in Southeast Asia. The present study aimed to examine the impact of smoke-free legislation in promoting smoking cessation through a local quitline. The present study reports the results of a telephone survey using interrupted time-series analysis. We operated a toll-free smoking cessation hotline (quitline) for the general public from August 2005 to September 2007. The present study measured the percent change in the number of telephone calls received and handled before and after the smoke-free legislation. We evaluated the quitline for 9-month periods before (January-September 2006) and after (January-September 2007) the smoke-free legislation was implemented. The call rate in the initial period was 27.6 per month compared with 34.9 per month after enactment of the legislation, a 26% increase. Based on interrupted time-series models, the initial impact of the smoke-free legislation was to increase the number of telephone calls received and handled per week (p < .001), but the impact was temporal and deteriorated within 6 months. Implementation of the new smoke-free legislation had a short-term effect in promoting the utilization of a smoking cessation quitline in Hong Kong. A systematic and long-term tobacco control c aign should be combined with smoke-free legislation to promote and sustain smokers' interests in smoking cessation.
Publisher: Oxford University Press (OUP)
Date: 11-2012
Abstract: although social engagement and depressive symptoms are important concerns for long-term care facility residents, the dynamic relationship between them has not been adequately studied. this study examines the relationship between social engagement and depressive symptoms and changes in social engagement and depressive symptoms among Chinese residents of long-term care facilities over 6 years. a latent growth model was used to analyse six waves of data collected using the Resident Assessment Instrument Minimum Data Set 2.0 in the Hong Kong Longitudinal Study on Long-Term Care Facility Residents. Ten residential facilities with a total of 1,184 eligible older adults at baseline were included in the study. after controlling for demographic variables at baseline, a higher level of social engagement was associated with fewer depressive symptoms. Trajectories of social engagement were significantly related to trajectories of depressive symptoms. Participants who recorded positive social engagement growth reported reduction in depressive symptoms. the findings of our study extend previous research by showing that increased social engagement is associated with decreased depressive symptoms over time. In long-term residential care settings, it is important for services to engage residents in meaningful social activities in order to reduce depressive symptoms.
Publisher: Informa UK Limited
Date: 13-01-2021
Publisher: Informa UK Limited
Date: 07-2011
DOI: 10.1080/01621424.2011.592421
Abstract: The objective of this study was to evaluate the factor structure of the Instrumental Activities of Daily Living (IADL) Involvement and Capacity scales of the Chinese version of the Minimum Data Set-Home Care (MDS-HC) in a s le of Chinese older adults living in Hong Kong (n=3,523). The results of confirmatory factor analyses supported the one-factor model for both IADL Involvement and IADL Capacity scales. Evidence indicated that both scales had good internal consistency (.88) and were reliable and valid in assessing IADL among elderly Chinese community dwellers.
Publisher: Hong Kong Academy of Medicine Press
Date: 20-09-2018
DOI: 10.12809/HKMJ187244
Abstract: With the ageing of the global population, China is projected to be impacted significantly by the rising number of patients with Alzheimer's disease (AD). A cure for AD is not yet available, so society should be prepared for an increasing AD-related burden. In this review, we examine this impending problem and provide overviews on (a) the magnitude of the problem of AD in Hong Kong/China in the near future (b) the genetic and lifestyle risk factors that contribute to AD (c) current diagnostic approaches and the potential of newly discovered genetic biomarkers for early detection (d) medications, non-pharmacological interventions, and possible preventive measures and (e) the need for social and psychological care from the community. In Hong Kong, primary care and AD-related support for at-risk in iduals, patients, and caregivers are inadequate. A joint effort from the medical community, government, universities, non-governmental organisations/charities, and industry should initiate the development of a long-term programme for AD. Finally, we outline recommendations for the relevant parties to consider.
Publisher: Wiley
Date: 14-07-2015
DOI: 10.1111/JOCN.12902
Publisher: MDPI AG
Date: 02-04-2019
DOI: 10.20944/PREPRINTS201809.0028.V2
Abstract: Aims: A community-based multi-component intervention (increasing awareness of the importance of physical activity in chronic illness management through reading comic books, training regarding warm-up stretching exercises, identifying facilitators and barriers to exercise through photosharing, supporting self-reflection and development of action plans) was developed to promote physical activity (PA) among patients with diabetes and hypertension. This study aimed to evaluate the efficacy of this intervention on health behaviour (walking) and health outcomes. Design: A non-randomized controlled trial with waitlisted control and pre- and post-measures. Setting: Community centres for the elderly. Participants: A total of 204 older adults with diabetes and/or hypertension were recruited. They were assigned to either the intervention group (IG) or waitlisted to the control group (CG). Intervention: Under the supervision of a nurse, six weekly group meetings were arranged in community centres for the elderly in which the participants freely exchanged their views regarding the barriers and facilitators of regular physical activity. Participants were encouraged to take photos in their neighbourhood or at home and brought these photos to share at the group meetings. The photos showed both the barriers and the facilitators to PA. In the last meeting, each participant worked out a plan to perform PA in the coming four weeks. Measures: PA referred to the number of steps taken per day and it was measured by a Garmin Accelerometer at baseline, Week 6 and Week 10. Other measures included the nine-item Self-Efficacy Scale for Exercise - Chinese version (SEE-C), the 23-item Chinese Barriers to Exercise Scale and Senior Fitness Tests. Generalised Estimating Equations (GEE) models compared the outcomes over time between IG and CG. Results: A statistically significant difference in the changes in the average number of steps taken daily between the two groups at Week 10 (mean difference = 965.4 95% confidence interval: 92.2, 1838.6, p = 0.030) was observed, although the difference at Week 6 was non-significant (mean difference = 777.6 95% confidence interval: & minus .3, 1590.5, p = 0.061). IG participants also showed significant improvements in lower body strength (mean difference = 0.967 95% confidence interval: 0.029, 1.904, p = 0.043) and lower limb flexibility (mean difference = 2.068 95% confidence interval: 0.404, 3.731, p = 0.015) at Week 10 compared to CG participants. Conclusion: This multi-component intervention improved the participants& rsquo physical activity level and physical fitness, particularly in lower limb flexibility and body strength.
Publisher: MDPI AG
Date: 27-12-2019
DOI: 10.20944/PREPRINTS201912.0363.V1
Abstract: Background: This study aimed to assess the dementia literacy (DL) level of community-dwelling adults in the four cities (Hong Kong, Guangzhou, Macau and Zhuhai) of the Greater Bay Area of China and to determine the preferred mass media for receiving dementia information. Methods: A multi-city cross-sectional study with 788 community-dwelling adults completed the survey. Dementia literacy was indirectly measured by two validated scales, 30-item Alzhiemer& rsquo s Disease Knowledge Scale (ADKS) and 20-item Dementia Attitudes Scale (DAS). When the ADKS total score was & and DAS total score was & , it was considered as & lsquo inadequate dementia literacy& rsquo . Participants were also asked to indicate whether they would like to receive dementia information via digital media or traditional media. Chi-square tests and logistic regressions were undertaken. Results: About one-third of the participants had inadequate dementia literacy. Those with young age or secondary education preferred to get dementia information from social media. But people living in public housing would like to get information from government or hospital websites. Middle-aged participants inclined to learn dementia from television or radio. Conclusion: It is worthy to conduct territory-wide public education in dementia and develop strategies according to their preferences in the types of mass media.
Publisher: Springer Science and Business Media LLC
Date: 08-04-2022
DOI: 10.1186/S12877-022-02980-1
Abstract: The World Health Organization (WHO) published the Integrated Care for Older People (ICOPE) framework to guide assessing and promoting intrinsic capacity of older adults. This study, adopting the WHO ICOPE framework, assessed the intrinsic capacity impairment and investigated the relationship among intrinsic capacity, social engagement, and self-care capacity on performing activities of daily living. It also assessed the sensitivity of the initial brief screening and the detailed full assessment. This is a cross-sectional study conducted in 11 community centers in Hong Kong. Intrinsic capacity was assessed in two steps identical to WHO ICOPE handbook: using WHO ICOPE brief screening tool (step 1) and detailed full assessment (step 2) to assess the intrinsic capacity domains of locomotion, cognition, vitality, psychological well-being, and sensory capacity (hearing and vision). Structural equational modeling analysis was used to examine the relationship among intrinsic capacity, social engagement, and self-care capacity, and the mediating role of intrinsic capacity in the relationships. A total of 304 older adults with a mean age 76.73 (SD = 7.25) years participated in WHO ICOPE Step 1 brief screening, and 221 participants (72.7%) showed intrinsic capacity impairment. After completing Step 2 full assessment, 202 participants (66.4%) had one or more impaired intrinsic capacity domains. The overall sensitivity and specificity of the screening tool were 95% and 57.6% respectively, whereas the sensitivity of each domain ranged from 74.7% to 100%. The percentage of impairment in locomotion (117, 39.8%), cognition (75, 25.5%), psychological well-being (34, 11.6%), vision (75, 24.7%), hearing capacity (82, 27.9%), and vitality (8, 2.7%). People in younger old age (β = -0.29, p 0.001), with more education (β = 0.26, p 0.001), and absence of hypertension (β = -0.11, p 0.05) were more likely to have better intrinsic capacity. Intrinsic capacity was positively associated with self-care capacity in performing activities of daily living (β = 0.21, p 0.001) and social engagement (β = 0.31, p 0.001). The ICOPE screening tool is a sensitive instrument to detect intrinsic capacity impairment among community-dwelling older adults and it does not demand substantial workforce its use is worthy to be supported. The intrinsic capacity impairment in community-dwelling older adults are prevalent, in particular, in locomotor and cognitive capacity. Actions should be taken to slow or prevent the impairment, support self-care and social engagement in old age.
Publisher: Informa UK Limited
Date: 07-2011
DOI: 10.1080/01621424.2011.592424
Abstract: This study examined the effects of behavioral and cognitive components of care on caregivers' psychological distress among adult children who were the primary caregivers of frail older adults living in the community in Hong Kong. The s le was drawn from a 2008 data set that was used to determine the eligibility for long-term care in Hong Kong. Logistic regressions evaluated the association between caregiver psychological distress and the behavioral and cognitive components of care with a range of covariates. About 35% of the caregivers showed signs of psychological distress. Caregivers who provided more care for instrumental activities of daily living (IADLs), demonstrated a greater intensity of care, lived with the care recipient, or became dissatisfied with the amount of support received from other family members and friends were more likely to express psychological distress. Providing emotional support to the care recipient and being unable to continue providing care were negatively associated with psychological distress, after controlling for the sociodemographic status and health status of the care recipient.
Publisher: MDPI AG
Date: 05-04-2019
Abstract: Aims: A community-based multi-component intervention (increasing awareness of the importance of physical activity in chronic illness management through reading comic books, training regarding warm-up stretching exercises, identifying facilitators and barriers to exercise through photosharing, supporting self-reflection and development of action plans) was developed to promote physical activity (PA) among patients with diabetes and hypertension. This study aimed to evaluate the efficacy of this intervention on health behaviour (walking) and health outcomes. Design: A non-randomized controlled trial with waitlisted control and pre- and post-measures. Setting: Community centres for the elderly. Participants: A total of 204 older adults with diabetes and/or hypertension were recruited. They were assigned to either the intervention group (IG) or waitlisted to the control group (CG). Intervention: Under the supervision of a nurse, six weekly group meetings were arranged in community centres for the elderly in which the participants freely exchanged their views regarding the barriers and facilitators of regular physical activity. Participants were encouraged to take photos in their neighbourhood or at home and brought these photos to share at the group meetings. The photos showed both the barriers and the facilitators to PA. In the last meeting, each participant worked out a plan to perform PA in the coming four weeks. Measures: PA referred to the number of steps taken per day and it was measured by a Garmin Accelerometer at baseline, Week 6 and Week 10. Other measures included the nine-item Self-Efficacy Scale for Exercise–Chinese version (SEE-C), and the 23-item Chinese Barriers to Exercise Scale and Senior Fitness Tests. Generalised estimating equations (GEE) models compared the outcomes over time between IG and CG. Results: A statistically significant difference in the changes in the average number of steps taken daily between the two groups at Week 10 (mean difference = 965.4 95% confidence interval: 92.2, 1838.6, p = 0.030) was observed, although the difference at Week 6 was non-significant (mean difference = 777.6 95% confidence interval: −35.3, 1590.5, p = 0.061). IG participants also showed significant improvements in lower body strength (mean difference = 0.967 95% confidence interval: 0.029, 1.904, p = 0.043) and lower limb flexibility (mean difference = 2.068 95% confidence interval: 0.404, 3.731, p = 0.015) at Week 10 compared to CG participants. Conclusion: This multi-component intervention improved the participants’ physical activity level and physical fitness, particularly in lower limb flexibility and body strength.
Publisher: Wiley
Date: 17-05-2022
DOI: 10.1111/OPN.12471
Publisher: Elsevier BV
Date: 09-2020
Publisher: MDPI AG
Date: 06-10-2022
Abstract: To date, we know little about COVID-19-related health literacy among school leaders, particularly in East Asia. The present study aimed to assess the level of COVID-19-related health literacy and associated factors (vaccine hesitancy, self-endangering behaviour, and work satisfaction) among school leaders in Hong Kong. A cross-sectional study of 259 school leaders was carried out during the COVID-19 pandemic between April 2021 and February 2022. COVID-19-related health literacy using HLS-COVID-Q22, three subscales of self-endangering work behaviour scales (i.e., “extensification of work”, “intensification of work” and “quality reduction”), and two dimensions of Burnout Assessment Tool (BAT) (i.e., psychosomatic complaints and exhaustion) were used. The study employed independent s le t-test, ANOVA, and multilinear regression models. The findings show that more than half (53.7%) of school leaders had insufficient health literacy. Participants with insufficient health literacy scored significantly higher in the following factors: exhaustion related to work situation (p = 0.029), psychosomatic complaints (p 0.001), attitude about vaccination (i.e., less agree with vaccination) (p 0.001), level of informing on COVID-19 related information (i.e., felt less informed) (p 0.001), and level of confusion about COVID-19-related information (i.e., felt more confused) (p 0.001). In a linear regression model predicting attitude about coronavirus vaccination, age (β, −0.188, 95% CI, −0.024, −0.005, p = 0.002) and health literacy (β, −0.395, 95% CI, −0.716, −0.361, p 0.001) were the negative predictors, F(5, 214) = 11.859, p 0.001. For the linear regression model adjusted for sex and age for predicting health literacy, the model was insignificant. Despite being a highly educated group, this study reveals that one in two Hong Kong school leaders have insufficient health literacy. Inadequate health literacy was strongly associated with a negative attitude about vaccination, low information, and confusion about COVID-19-related information. Additionally, insufficient health literacy was associated with the two secondary symptoms of burnouts. The study highlights an urgent need to develop intervention programmes to promote the COVID-19-specific as well as overall health literacy of the school leaders.
Publisher: Oxford University Press (OUP)
Date: 02-05-2017
Abstract: 'Frailty' is being increasing recognised as a geriatric syndrome of growing importance in the medical field. Acupressure is a non-pharmacological, non-invasive Traditional Chinese Medicine (TCM) treatment, which may serve to improve the quality of life (QOL) or prevent the progressive advancement of frailty in the aged population. to investigate the effects of a 12-week, TCM-principle guided acupressure intervention on the QOL of the frail older people living in the community. this is a randomised controlled trial with waitlist control design. Treatment group received 15 min of acupressure treatment, four times a week from both TCM practitioners and trained caregivers for 12 consecutive weeks. The waitlist control group served as a care-as-usual comparison to the treatment group for the 1st 12 weeks and then received the same treatment. Intention-to-treat principle was followed and mixed-effects models were used for data analysis. the mean age of the participants was 76.12 ± 7.08, with a mean Tilburg frailty index score of 7.13 ± 1.76. Significant between-group differences were found in the change of physical domain score of WHOQOL-BREF (P = 0.001) change of Pittsburgh Sleep Quality Index (P < 0.001) and pain intensity (P = 0.006) with the treatment group demonstrating greater improvement. Within-group effect size analysis also indicated that the acupressure protocol has significant impact on these areas. the study's outcomes indicated that the acupressure protocol, when applied continuously for 12 weeks, 3-4 times a week, could improve the general QOL of frail older people living in community dwellings.
Publisher: Oxford University Press (OUP)
Date: 08-11-2010
DOI: 10.1093/NTR/NTQ192
Abstract: To examine the time patterns and predictors of initiating a quit attempt and subsequent sustained abstinence among youth smokers after receiving a telephone smoking cessation intervention. This was a longitudinal study of 408 current youth smokers aged 12-25 years who called a smoking cessation hotline in Hong Kong. Telephone surveys were conducted at baseline 1 week and 1, 3, and 6 months to assess smoking status and other risk factors. Nonparametric Kaplan-Meier methods and hierarchical Cox's proportional odds models were applied to explore the time patterns and predictors of the quitting process. Half of the youth smokers initiated a quit attempt within 1 month after receiving the baseline telephone intervention, while the likelihood of further quit attempts decreased over time. Two thirds relapsed within the first 7 days after starting a quit attempt. Intention to quit, previous quit attempts, perceived physical unfitness, and other factors could predict the initiation of a quit attempt. Sustained abstinence was facilitated by making an immediate attempt to quit, adopting self-help strategies, and a perceived improvement in physical health. Our findings support the "catastrophic" pathway of youth smokers initiating a quit attempt. Counselors should capture the quitting momentum and motivate youth smokers to quit immediately. Interventions should include a health assessment and discussion of smokers' physical fitness. During the first week of abstinence, intensive monitoring of withdrawal symptoms, together with booster counseling, is helpful in preventing smoking relapse and could remotivate those who fail to sustain their quit attempt.
Publisher: JMIR Publications Inc.
Date: 04-2018
Abstract: o decrease the burden of diabetes in society, early screening of undiagnosed diabetes and prediabetes is needed. Integrating a diabetes risk score into a mobile app would provide a useful platform to enable people to self-assess their risk of diabetes with ease. he objectives of this study were to (1) assess the profile of Diabetes Risk Score mobile app users, (2) determine the optimal cutoff value of the Finnish Diabetes Risk Score to identify undiagnosed diabetes and prediabetes in the Chinese population, (3) estimate users’ chance of developing diabetes within 2 years of using the app, and (4) investigate high-risk app users’ lifestyle behavior changes after ascertaining their risk level from the app. e conducted this 2-phase study among adults via mobile app and online survey from August 2014 to December 2016. Phase 1 adopted a cross-sectional design, with a descriptive analysis of the app users’ profile. We used a Cohen kappa score to show the agreement between the risk level (as shown in the app) and glycated hemoglobin test results. We used sensitivity, specificity, and area under the curve to determine the optimal cutoff value of the diabetes risk score in this population. Phase 2 was a prospective cohort study. We used a logistic regression model to estimate the chance of developing diabetes after using the app. Paired t tests compared high-risk app users’ lifestyle changes. total of 13,289 people used the app in phase 1a. After data cleaning, we considered 4549 of these as valid data. Most users were male, and 1811 (39.81%) had tertiary education or above. Among them, 188 (10.4%) users agreed to attend the health assessment in phase 1b. We recommend the optimal value of the diabetes risk score for identifying persons with undiagnosed diabetes and prediabetes to be 9, with an area under the receiver operating characteristic curve of 0.67 (95% CI 0.60-0.74), sensitivity of 0.70 (95% CI 0.58-0.80), and specificity of 0.57 (95% CI 0.47-0.66). At the 2-year follow-up, people in the high-risk group had a higher chance of developing diabetes (odds ratio 4.59, P=.048) than the low-risk group. The high-risk app users improved their daily intake of vegetables (baseline: mean 0.76, SD 0.43 follow-up: mean 0.93, SD 0.26 t81=–3.77, P .001) and daily exercise (baseline: mean 0.40, SD 0.49 follow-up: mean 0.54, SD 0.50 t81=–2.08, P=.04). he Diabetes Risk Score app has been shown to be a feasible and reliable tool to identify persons with undiagnosed diabetes and prediabetes and to predict diabetes incidence in 2 years. The app can also encourage high-risk people to modify dietary habits and reduce sedentary lifestyle.
Publisher: Springer Science and Business Media LLC
Date: 30-09-2019
DOI: 10.1007/S12603-019-1258-Y
Abstract: Cognitive frailty is a condition where physical frailty and mild cognitive impairment (MCI) co-exist. It is associated with increased risk of dementia and dependency. Previous studies reported that malnutrition and depression are associated with physical frailty and MCI however, their relationships with cognitive frailty remained to be explored. The aims of this study were to examine the association of nutrition and depression with cognitive frailty, in comparison to having physical frailty or MCI alone. This study employed a cross-sectional design. Data collection was conducted in the community settings on the older people without dementia. Dependent variables were cognitive frailty, physical frailty, and MCI. The independent variables were depression and nutrition. Multi-nominal regression was employed to examine the relationships between the dependent and independent variables. The associations were adjusted by four known co-variates, including age, gender, education and APOE ε4 carrier status. A total of 185 participants were recruited from four community centres and one elderly hostel and completed the data collection. Approximately 44.9% of the older people with physical frailty and 82.5% of elderly with MCI belonged to cognitive frailty. Multi-nominal regression models showed that depression is positively associated with cognitive frailty and with physical frailty, but not associated with solely MCI. Nutrition is negatively associated with cognitive frailty, but not associated with physical frailty or MCI alone. Cognitive frailty is associated with malnutrition and depression. Therapeutic interventions managing depression and malnutrition may focus the older people with cognitive frailty to improve efficacy and cost-effectiveness.
Publisher: MDPI AG
Date: 07-04-2020
Abstract: Background: The aim of this cross-sectional study was to assess the dementia literacy of community-dwelling adults in four cities (Hong Kong, Guangzhou, Macau, and Zhuhai) of the Greater Bay Area of China, and to determine their mass media preferences for receiving dementia information. Methods: The survey was completed by 787 community-dwelling adults. Dementia literacy was indirectly measured using two validated scales—the 30-item Alzheimer’s Disease Knowledge Scale and the 20-item Dementia Attitude Scale (DAS). Participants were also asked to indicate whether they wanted to receive dementia information via digital or traditional media. Chi-square tests, logistic regressions, and MANOVA analyses were conducted. Results: Unemployed or retired people had poor attitudes towards dementia and lower levels of knowledge about dementia. Single, cohabiting, or orced people in Hong Kong and Macau had lower DAS scores than married people. Young people and those with a secondary education preferred to get their dementia information from social media. People with a tertiary education and employed people enjoyed searching government or hospital websites for information. Middle-aged, unemployed, or retired people tended to learn about dementia from television or radio. Conclusion: It is worth educating the public about dementia and developing strategies consistent with their preferences for types of mass media.
Publisher: Springer International Publishing
Date: 2021
Publisher: Springer International Publishing
Date: 2021
Publisher: Hindawi Limited
Date: 2010
DOI: 10.1111/J.1365-2524.2009.00900.X
Abstract: This study examined the relationship between psychosocial factors and falls among community-dwelling older adults in the Hong Kong Special Administrative Region of China. The study included 1573 adults aged 60 or above who lived at home and who were applying for long-term care services. These participants were part of a large cross-sectional survey carried out between 2003 and 2004 in which they completed the Hong Kong Chinese version of the Resident Assessment Instrument-Home Care (RAI-HC) assessment. Of those persons who were surveyed, 516 (32.8%, 95% CI 30.5% to 35.2%) had fallen in the previous 90 days. Bivariate analyses showed that five psychosocial factors (depressive symptoms, fear of falling, a decline in social activities, the number of hours of informal care support during weekdays and living alone) were significantly associated with falls (P < 0.05). Logistic regression analysis showed living alone (odds ratio (OR) = 0.62 95% CI 0.44 to 0.86) was the only psychosocial factor significantly associated with falls, after adjusting for the known significant factors related to falls. It was also found that more elders who lived with others had environmental hazards than those who lived alone (71.0% vs 29.0%, chi2 = 4.80, P = 0.028). These findings suggested that living with others may not be as safe as we assume. Interventions to increase awareness of home safety and to seek co-operation with family members in falls prevention are recommended. Fall preventive strategies should be educated to family members who are living with frail older adults. On the other hand, Chinese older adults who live alone often receive support from relatives or friends. Social support seems to be crucial to prevent them from falls and this measure is recommended to be continued in the community.
Publisher: MDPI AG
Date: 21-01-2022
DOI: 10.3390/NU14030471
Abstract: On 30 January 2020, the World Health Organization (WHO) declared the current novel coronavirus disease 2019 (COVID-19) as a public health emergency of international concern and later characterized it as a pandemic. New data show that excess body mass and vitamin D deficiency might be related to the disease severity and mortality. The aim of this study was to evaluate whether latitude, as a proxy of sunlight exposure and Vitamin D synthesis, and prevalent obesity among European populations, is related to COVID-19 spread and severity. European COVID-19 data (incidence and fatality), including information on the prevalence of obesity, social distancing, and others were obtained by the “Our World in Data” website on 17 April 2021. Adjusted analysis showed that higher COVID-19 incidence and fatality were pictured in countries being in higher latitude, both during the whole period, as well as, during the time period 1 November 2020–31 March 2021. Higher incidence and fatality of COVID-19 were observed where the prevalence of overweight/obesity was higher during the whole time period, whereas during the time period 1 November 2020–31 March 2021, only COVID-19 incidence was higher but not a fatality. The present results provide insights for targeted interventions and preventive strategies against COVID-19.
Publisher: Informa UK Limited
Date: 14-10-2014
DOI: 10.1080/10810730.2014.940475
Abstract: The mechanisms underlying the relations among health literacy, perceived capacity for communication, diabetes knowledge, and diabetes self-care are unclear. This study tested this relation using structural equation modeling with a s le of 137 Chinese patients 65 years of age or older with type 2 diabetes. The model showed that health literacy, knowledge, communication capacity, and diabetes self-care formed complex relations. After adjusting for age, education, and Chinese cultural influence, health literacy affected diabetes self-care indirectly through perceived capacity for communication (standardized estimate coefficient=.641, p<.001) but not diabetes knowledge. To enhance self-care, interventions should be tailored to increase patient health literacy and perceived capacity for communication with health care providers. Training should be provided to patients to enhance their communication abilities.
Publisher: Wiley
Date: 27-11-2012
DOI: 10.1111/JOCN.12018
Abstract: To develop and to test the psychometric properties of the Chinese Health Literacy Scale for Diabetes. Patients with diabetes encounter many challenges when making health decisions in their daily lives, as they have access to many different kinds of health information. Health literacy issues are new topics in Chinese society. Without a valid and reliable instrument in Chinese, it is difficult to measure the level of health literacy and promote the concept of health literacy in Chinese societies. A methodological study with a s le of 137 patients with type 2 diabetes aged 65 years or older. Chinese Health Literacy Scale for Diabetes was developed with reference to the revised Bloom's taxonomy model. Psychometric tests (content validity, item analysis, construct validity, discriminative ability and test-retest reliability) were conducted. Correlations between Chinese Health Literacy Scale for Diabetes and four relevant measures were tested. Cronbach's alpha and alpha if item deleted were calculated to assess internal consistency. Cronbach's alpha for Chinese Health Literacy Scale for Diabetes and its four subscales (remembering, understanding, applying and analysing) were 0·884, 0·885, 0·667, 0·654 and 0·717, respectively. The Chinese Health Literacy Scale for Diabetes was significantly correlated with the Diabetic Knowledge Scale (r = 0·398, p < 0·001), the Diabetic Management Self-Efficacy Scale (r = 0·257, p < 0·001), the Preschool and Primary Chinese Literacy Scale (r = 0·822, p < 0·001) and the Chinese Value of Learning Scale (r = 0·303, p < 0·001). It took an average of seven minutes to complete this 34-item instrument. The findings of this study support the Chinese Health Literacy Scale for Diabetes as a reliable and valid instrument for measuring the health literacy of Chinese patients with diabetes. We recommend that clinicians use this tool to assess patients' health literacy before conducting any kind of health promotion.
Publisher: Wiley
Date: 27-04-2021
DOI: 10.1111/JGS.17196
Publisher: SAGE Publications
Date: 10-05-2021
Publisher: Oxford University Press (OUP)
Date: 25-01-2023
Abstract: Despite the well-documented short-to-medium-term effectiveness of e-Health (electronic health) secondary prevention interventions on patients with cardiovascular disease (CVD), there is limited empirical evidence regarding long-term effectiveness. This review aims to evaluate the long-term effects of e-Health secondary prevention interventions on the health outcomes of patients with CVD. This systematic review and meta-analysis followed Cochrane Handbook for Systematic Reviews of Interventions. EMBASE, Medline, Web of Science, and Scopus were searched from 1990 to May 2022. Randomized controlled trials investigating the effects of e-Health secondary prevention on health outcomes of CVD patients that collected endpoint data at ≥ 12 months were included. RevMan 5.3 was used for risk of bias assessment and meta-analysis. Ten trials with 1559 participants were included. Data pooling suggested that e-Health programmes have significantly reduced LDL cholesterol [n = 6 SMD = −0.26, 95% confidence interval (CI): (−0.38, −0.14), I2 = 17%, P & 0.001] systolic blood pressure [n = 5 SMD = −0.46, 95% CI: (−0.84, −0.08), I2 = 90%, P = 0.02] and re-hospitalization, reoccurrence, and mortality [risk ratio = 0.36, 95% CI: (0.17, 0.77), I2 = 0%, P = 0.009]. Effects on behavioural modification, physiological outcomes of body weight and blood glucose, and quality of life were inconclusive. e-Health secondary prevention is effective in improving long-term management of risk factors and reducing the reoccurrence of cardiac events in patients with CVD. Results are inconclusive for behaviour modification and quality of life. Exploring, implementing, and strengthening strategies in e-Health secondary prevention programmes that focus on maintaining behaviour changes and enhancing psychosocial elements should be undertaken. PROSPERO CRD42022300551.
Publisher: Springer Science and Business Media LLC
Date: 10-2011
Publisher: Informa UK Limited
Date: 12-2006
Publisher: Informa UK Limited
Date: 04-01-2006
Abstract: In a world with increasing numbers of older adults and a world wide emphasis placed on lifelong learning, it is crucial to examine and formulate appropriate policy for learning in later life (LLL). Hong Kong has a rapidly aging population, which is projected to double within the next 25 years. However, lifelong learning for the elderly has yet to be fully developed. This article reports the findings of 2 surveys: one on the LLL experience among 190 Chinese elderly in Hong Kong and another on the experiences of 9 center directors in running courses for the elderly. We found that Chinese older persons generally learn for expressive motivation rather than instrumental motivation, although those with higher educational attainment take LLL for both instrumental and expressive motivation. This finding is consistent with those obtained with American populations. Practical courses such as languages and health-related topics were found to be the most popular and Nearly a quarter (27%) of the respondents (in particular those who are well educated) expressed interest in peer teaching. The findings are important to understand LLL in the Chinese population and assist in the formulation of an appropriate LLL policy in Hong Kong. These findings also serve as a comparison for other countries trying to provide continuing education opportunities for its older citizens.
Publisher: SAGE Publications
Date: 10-02-2010
Abstract: Objective: This study evaluates the effect of a care management service (CMS) on falls in older adults. Method: This is a retrospective case-control study with 78 CMS recipients as the case group who received CMS and another 312 community-dwelling frail elders as the control group.The groups were matched by age, gender, activity of daily living, cognitive impairment, and unsteady gait. Thus they were comparable in characteristics and frailty. Results: Among the 390 participants, 89 older adults (23.0%) had falls in the 90 days prior to the survey. After controlling for the identified risk factors for falls, the odds ratio of CMS was 0.27 (95% confidence interval = 0.110-0.663, p .01). Discussion: These findings indicate that CMS recipients have a lower chance for falls compared to their counterparts. The two features of CMS (comprehensive assessment and multidisciplinary actions to reduce fall risks) are discussed.
Publisher: Wiley
Date: 03-06-2015
DOI: 10.1111/JOCN.12885
Publisher: Springer Science and Business Media LLC
Date: 21-04-2017
DOI: 10.1007/S12603-016-0732-Z
Abstract: To compare the preference of food saltiness and the willingness to consume low-sodium food among hypertensive older people, non-hypertensive older people and non-hypertensive young people in a Chinese population. A cross-sectional study based on a quota s le. Three saltiness options (low-sodium, medium-sodium and high-sodium) of soup and bread were offered to each participant who rated the taste of each food on a 5-point Likert scale. Then, the participants rated their willingness to consume the low-sodium content foods on a 5-point Likert scale, given they were informed of the benefit of the low-sodium option. Generalised linear mixed model and multiple linear regression were used to analyse the data. Elderly centres and community centres in Hong Kong. Sixty hypertensive older people, 49 non-hypertensive older people and 60 non-hypertensive young people were recruited from June to August 2014. The tastiness score and the willingness score were the primary outcome measures. The Chinese Health Literacy Scale for Low Salt Consumption - Hong Kong population (CHLSalt-HK) was also assessed. The tastiness rating of the high-sodium option of soup was significantly lower than the medium-sodium option (p<0.001), but there was no significant difference between the low-sodium and the medium-sodium options (p=0.204). For bread, tastiness rating of the low-sodium option and the high-sodium option were significantly lower than the medium-sodium option (p<0.001 for both options). The tastiness score of soup did not have significant difference across the groups (p=0.181), but that of bread from the hypertensive older adults (p=0.012) and the non-hypertensive older adults (p=0.006) was significantly higher than the non-hypertensive young adults. Higher willingness rating to consume the low-sodium option was significantly (p<0.001) associated with higher tastiness rating of the low-sodium option of soup and bread, and weakly associated with higher health literacy of low salt intake (soup: p=0.041 bread: p=0.024). Hypertensive older adults tended to be more willing to consume the low-sodium option than non-hypertensive older adults for soup (p=0.009), there was insignificant difference between non-hypertensive older adults and non-hypertensive young adults (p=0.156). For bread, there was insignificant difference in willingness rating to consume low-sodium option (p=0.375). Older people are at a higher risk of hypertension, reduction of salt intake is important for them to reduce their risk of cardiovascular diseases. There is room for reducing the sodium content of soup, while the sodium in bread should be reduced progressively. Improving the taste of low-sodium food may help to promote reduction in dietary sodium intake.
Publisher: Informa UK Limited
Date: 25-11-2008
Publisher: Informa UK Limited
Date: 08-2014
DOI: 10.2147/CIA.S66351
Publisher: Oxford University Press (OUP)
Date: 08-12-2018
Abstract: Pain and functional limitations can severely impede older adults' quality of life. In Chinese residential care facilities, limited research suggests that residents potentially have significant unmet care needs with pain and related functional limitations. Therefore, we aimed to explore residents' challenges and self-management strategies in these two areas. This knowledge is essential to developing care interventions to improve quality of care and quality of life in Chinese residential care facilities. We conducted semi-structured open-ended interviews with residents (n = 21) in two facilities in eastern and central China and assessed their pain and functional status using self-report measures from Minimum Data Set 3.0. We applied descriptive statistics to the self-reported data and analyzed the interview data using thematic analysis by drawing on the Adaptive Leadership Framework. This framework proposes that in iduals living with chronic conditions need to engage in work to address their complex health concerns and that they need support from the environment to facilitate problem-solving. Residents described significant unmet care needs with pain and functional limitations. To address these care needs, they adopted a substantial number of self-management strategies. While doing so, they faced significant barriers, including service gaps and inadequate direct care. The findings suggest further research to explore long-term care policy change that is needed to provide comprehensive health and medical services and adequate direct care in these facilities. The importance of establishing various types of long-term care facilities is also highlighted.
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.PEC.2017.05.028
Abstract: This study identified the profiles of subgroups of type 2 diabetic (T2DM) patients of the Patient Empowerment Programme (PEP) by different levels of benefits gained in diabetic self-management behaviors, self-efficacy, and health literacy. This study adopted a non-experimental repeated-measures design on T2DM patients who joined PEP, using structured questionnaires. Latent profile analysis (LPA) was used to identify patterns of participants' change on the outcome measures. Findings of LPA revealed that participants who were older, unemployed, weaker in diabetic self-management, and having a higher self-perception in personal disease risk were more likely to join the empowerment sessions and gained more benefits from the program. Participants with lower impairment in energy function and lower autonomy in personal health care showed more improvement in the outcomes. The study identified significant factors associated with patients' participation on and benefits gained from a service delivery model integrating health education and patient empowerment in a primary care setting. Findings from this study shed light on strategies to improve the PEP design in order to meet the needs of in iduals with different health-related profiles.
Publisher: JMIR Publications Inc.
Date: 20-07-2017
Publisher: Elsevier BV
Date: 11-2021
DOI: 10.1016/J.GERINURSE.2021.09.013
Abstract: Dual-tasking (e.g., enrichment of physical activities with mental exercises) is an innovative strategy to enhance older adults' cognition. Meanwhile, Zumba is a popular dance program, but research is limited about its utility on older people or those with mild cognitive impairment (MCI). This study assessed the feasibility of a new intervention called dual-task Zumba Gold (DTZ) for people with MCI. A mixed-methods feasibility study involving ten people aged ≥55 years with MCI was conducted from December 2020 to March 2021. Nine participants completed the study (90%) with high intervention acceptability. Program adherence (90.3%) and implementation fidelity (92.2%) were high. Participants also expressed the program's benefits, challenges, and facilitators. Moreover, pilot test results suggested improvements in global cognition (Z=-2.680 p=0.007), quality of life (Z=-2.688 p=0.008), and mobility (Z=-2.333 p=0.020). Hence, DTZ is feasible and acceptable for people with MCI, offering potential multidomain effects. Future randomized controlled studies should confirm these outcomes.
Publisher: Informa UK Limited
Date: 04-2021
DOI: 10.2147/CIA.S303920
Publisher: JMIR Publications Inc.
Date: 05-09-2020
Abstract: igital communication technologies are playing an important role in the health communication strategies of governments and public health authorities during the COVID-19 pandemic. The internet and social media have become important sources of health-related information on COVID-19 and on protective behaviors. In addition, the COVID-19 infodemic is spreading faster than the coronavirus itself, which interferes with governmental health-related communication efforts. This jeopardizes national public health containment strategies. Therefore, digital health literacy is a key competence to navigate web-based COVID-19–related information and service environments. his study aimed to investigate university students’ digital health literacy and web-based information-seeking behaviors during the early stages of the COVID-19 pandemic in Germany. cross-sectional study among 14,916 university students aged ≥18 years from 130 universities across all 16 federal states of Germany was conducted using a web-based survey. Along with sociodemographic characteristics (sex, age, subjective social status), the measures included five subscales from the Digital Health Literacy Instrument (DHLI), which was adapted to the specific context of the COVID-19 pandemic. Web-based information-seeking behavior was investigated by examining the web-based sources used by university students and the topics that the students searched for in connection with COVID-19. Data were analyzed using univariate and bivariate analyses. cross digital health literacy dimensions, the greatest difficulties could be found for assessing the reliability of health-related information (5964/14,103, 42.3%) and the ability to determine whether the information was written with a commercial interest (5489/14,097, 38.9%). Moreover, the respondents indicated that they most frequently have problems finding the information they are looking for (4282/14,098, 30.4%). When stratified according to sociodemographic characteristics, significant differences were found, with female university students reporting a lower DHLI for the dimensions of “information searching” and “evaluating reliability.” Search engines, news portals, and websites of public bodies were most often used by the respondents as sources to search for information on COVID-19 and related issues. Female students were found to use social media and health portals more frequently, while male students used Wikipedia and other web-based encyclopedias as well as YouTube more often. The use of social media was associated with a low ability to critically evaluate information, while the opposite was observed for the use of public websites. lthough digital health literacy is well developed in university students, a significant proportion of students still face difficulties with certain abilities to evaluate information. There is a need to strengthen the digital health literacy capacities of university students using tailored interventions. Improving the quality of health-related information on the internet is also key.
No related grants have been discovered for Angela YM Leung.