ORCID Profile
0000-0002-3750-7396
Current Organisations
The Chinese University of Hong Kong Faculty of Medicine
,
The Chinese University of Hong Kong
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Publisher: Elsevier BV
Date: 04-2011
DOI: 10.1016/J.IJNURSTU.2010.12.004
Abstract: To review the diagnostic accuracy of end-tidal carbon dioxide detection in detecting inadvertent airway intubation and verifying correct placement of nasogastric tubes. We undertook a meta-analysis of diagnostic studies. All clinical trials that evaluated the diagnostic accuracy of the colorimetric capnometry or capnography in detecting inadvertent airway intubation and differentiating between respiratory and gastrointestinal tube placement in adults were included. Electronic databases including MEDLINE, CINAHL, EMBASE, All EBM Reviews, WanFang Data, China Journal Net, Chinese Medical Current Contents, and Index to Chinese Periodical Literature were searched from inception to July 2009. DATA EXTRACTION AND QUALITY ASSESSMENT: Data were extracted using a form piloted prior to use. Two reviewers independently extracted data relating to purpose of the trial, s le, measurements used, index test results and reference standard. Methodological quality of eligible trials was assessed independently by two reviewers using a modified version of the Quality Assessment of Diagnostic Accuracy Studies for assessing studies of diagnostic accuracy. The accuracy of diagnostic tests is presented in terms of sensitivity, specificity, predictive values, and likelihood ratios. Nine clinical trials were eligible for inclusion in the meta-analysis. Eight trials were undertaken in intubated and mechanically ventilated patients and two trials also involved participants who were alert or awake. Eight involving a total of 456 nasogastric feeding tube placements investigated the diagnostic accuracy of either colorimetric capnometry or capnography to detect feeding tube placement. One trial involving 195 gastric tube insertions compared the diagnostic accuracy of simultaneous use of a colorimetric carbon dioxide detector and capnography to detect feeding tube placement. The use of colorimetric capnometry or capnography had a sensitivity ranging from 0.88 to 1.00, specificity 0.95 to 1.00, positive likelihood ratio 15.22 to 283.35, negative likelihood ratio 0.01 to 0.25. A summary receiver operator characteristics (SROC) curve was constructed and showed an area under the curve was 0.9959. Three trials reported significant cost savings using end-tidal carbon dioxide detectors. There is evidence to support the use of capnography or colorimetric capnometry for the identification of nasogastric feeding tube placement in mechanically ventilated patients.
Publisher: Wiley
Date: 03-06-2008
DOI: 10.1002/NUR.20289
Abstract: A survey of 1,487 nurses was conducted to examine barriers to and facilitators of research utilization. Characteristics of the organization were the greatest barriers to research utilization the highest ranked of these were inadequate facilities, lack of authority to change practice, lack of time, and lack of cooperation from physicians. The three highest ranked organizational facilitators were managerial support, colleague support, and education to increase nursing knowledge. Age and years of working experience were not significantly correlated with any of the subscales. To integrate the use of research evidence into the culture of various clinical settings, and with the aim of extending evidence-based practice into the private and primary health care sectors in Hong Kong, local organizational barriers and facilitators need to be addressed.
Publisher: Elsevier BV
Date: 2010
DOI: 10.1016/J.IJNURSTU.2009.08.004
Abstract: There is a growing use of multisensory therapy in enhancing sense of well-being and reducing challenging or stereotypic self-stimulating behaviour in people with a developmental disability. This review aimed to present the best available evidence on the effect of multisensory therapy in adult clients with developmental disabilities on the frequency of challenging behavior, stereotypic self-stimulating behavior, and positive behaviour and changes of physiological measures. Systematic review. A search of electronic databases of published research studies (January 1985-December 2008) was conducted, using appropriate search terms. The reference lists and bibliographies of retrieved articles were reviewed to identify research not located through other search strategies. Studies that investigated the effects of multisensory environment in relation to outcomes were examined. Data were extracted independently by two reviewers. Methodological quality was also assessed by two reviewers against key quality criteria. One hundred and thirty-two studies were identified from database search of which 17 met the inclusion criteria for review. The evidence supports that participants' had displayed more positive behaviour after multisensory therapy sessions. There is no strong evidence supporting that multisensory therapy could help in reducing challenging behaviour or stereotypic self-stimulating behaviour. This systematic review demonstrates a beneficial effect of multisensory therapy in promoting participants' positive emotions. While the reviewers acknowledge the difficulty in carrying out randomized controlled trial in people with developmental disabilities and challenging behavior, the lack of trial-derived evidence makes it difficult to arrive at a conclusion of the effectiveness of the multisensory therapy. Future study should use well-designed randomised controlled trials to evaluate the short and long term effectiveness of multisensory therapy. There is also a need for qualitative studies which allow the clients to tell the stories of their experiences.
Publisher: Informa UK Limited
Date: 13-11-2014
Publisher: SAGE Publications
Date: 10-2021
Publisher: Elsevier BV
Date: 02-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2016
Publisher: Springer Science and Business Media LLC
Date: 27-10-2020
DOI: 10.1186/S12909-020-02273-4
Abstract: Interprofessional collaborative practice (IPCP) is increasingly recognised as being crucial for the provision of holistic care and optimising health outcomes among older adults, many with multiple complex health problems. However, little is known about the challenges of facilitating this in practice. Therefore, this study explores these issues from the perspective of different healthcare professionals and how this might inform interprofessional education curricula. Sixteen different healthcare professionals working in a variety of aged care (acute, rehabilitative and community) settings were invited to participate in in idual semi-structured in-depth interviews designed to: (i) explore the meaning of IPCP (ii) explore the facilitators of and barriers to IPCP and (iii) examine the opportunities and challenges in interprofessional gerontological education. All interviews were tape-recorded and transcribed verbatim with thematic analysis conducted by two independent researchers. Three major themes emerged from the interviews: the need for IPCP role preparedness, scope and liability and strategies for interprofessional education. Respondents shared a common belief that IPCP improves the quality of life of older adults in both hospital and community settings by improving person-centred coordinated care and decision making in care planning. However, respondents perceived major barriers to IPCP to be lack of knowledge about healthcare professionals’ scope of practice, lack of training in interprofessional collaboration, professional culture and stereotypes, and liability issues. Suggested approaches to overcome these barriers included innovative teaching and learning approaches, engaging students early on in the curriculum of health professional degree programmes, and enhancing collaborative effective communication in health and social care settings. It is anticipated that these findings will be used to inform the development of a new interprofessional gerontological education curriculum that aims to enhance students’ competence in IPCP.
Publisher: Springer Science and Business Media LLC
Date: 07-09-2009
Publisher: SAGE Publications
Date: 30-04-2016
Publisher: Informa UK Limited
Date: 06-2022
DOI: 10.1080/09638288.2021.1933220
Abstract: To examine the psychometric properties of a Chinese version of the Participation Strategies Self-Efficacy Scale (PS-SES) among stroke survivors. The PS-SES was translated into Chinese. A cross-sectional descriptive study was conducted with 336 stroke survivors recruited from the neurology departments of five hospitals in China. Reliability, concurrent validity, and construct validity of the scale were determined. The Chinese version of the PS-SES (PS-SES-C) showed good internal consistency and test-retest reliability, with a Cronbach's α of 0.98 and an intraclass correlation coefficient of 0.79. There was a moderate to strong positive correlation between the PS-SES-C and Chinese version of the General Self-Efficacy Scale ( The PS-SES-C is a reliable and valid instrument for assessing self-efficacy in managing the participation of Chinese stroke survivors.Implications for rehabilitationSelf-efficacy significantly predicts activity and participation in stroke survivors and is a major outcome measure in many stroke rehabilitation programmes.The translated Chinese version of the Participation Strategies Self-efficacy Scale is a valid and reliable tool to evaluate stroke survivors' self-efficacy in managing participation.The Chinese version of the Participation Strategies Self-efficacy Scale can be used to assess stroke recovery among the Chinese population in clinical and research settings.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2012
Publisher: SAGE Publications
Date: 06-05-2022
DOI: 10.1177/17571774221092558
Abstract: The emergence of COVID-19 has been an ordeal for nurses worldwide. It is crucial to understand their experiences at the frontline, attempt to allay their concerns, and help inform future pandemic response capabilities. To explore nurses’ lived experiences at the frontline in order to identify and address their concerns and help enhance future responses to infectious disease outbreaks. A qualitative study was carried out. Semi-structured interviews were conducted with 60 registered nurses who came to Hubei from different parts of China to care for patients with COVID-19. Interviews were audio-recorded and transcribed verbatim for thematic analysis. Six major themes emerged: emotional turmoil due to personal and professional concerns, quality issues with personal protective equipment and associated physical discomfort, witnessing and managing patient distress, readiness of emergency response mechanisms in the health system, collective community awareness and preparedness, and heightened professional pride and confidence in future epidemic control. Nurses were placed in challenging and unfamiliar situations to deal with unexpected and unpredictable events which caused considerable psychological and physical distress. Support in the form of government edicts, hospital management policies, community generosity and collegiality was highly welcomed by the nurses. Policy makers and managers should ensure that nurses are provided with the support and resources necessary for dealing with large-scale infectious disease outbreaks. Priority should be given to risk assessment, infection prevention and control, and patient and staff health and safety.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2017
Publisher: Springer Science and Business Media LLC
Date: 10-03-2021
DOI: 10.1186/S12955-021-01730-Y
Abstract: The Trunk Impairment Scale (TIS) has been translated into Chinese, but the psychometric properties of the Chinese version of the TIS (TIS-C) have not yet been established. We aimed to examine the reliability and validity of the TIS-C for assessing sitting balance among Chinese people with a stroke. A descriptive, cross-sectional design was used. We recruited a convenience s le of 170 subacute stroke patients aged 18 years or over from the neurology departments of four traditional Chinese medicine hospitals in China. Patients completed the TIS-C, the Berg Balance Scale and the Modified Barthel Index. The psychometric properties of the TIS-C were examined to establish test–retest reliability, internal consistency, equivalence, and content, criterion, and construct validity. Intraclass correlation coefficients for inter-rater and intra-rater reliability ranged from 0.75 to 0.89 and from 0.90 to 0.97, respectively. The TIS-C Cronbach α was 0.86. The strong correlation between the total score of the TIS-C and the Berg Balance Scale ( r s = 0.81, p 0.001) or Modified Barthel Index ( r s = 0.84, p 0.001) suggested good concurrent and convergent validity, respectively. Known-group validity was supported by the significant difference ( p 0.001) in TIS-C scores between participants with mild and moderate stroke. The TIS-C is a valid and reliable tool for assessing static and dynamic sitting balance as well as coordination of trunk movement among stroke survivors with mild and moderate stroke.
Publisher: Wiley
Date: 11-10-2010
DOI: 10.1111/J.1365-2702.2010.03317.X
Abstract: Aim and objective. The primary aim was to examine the prevalence of poststroke depression in Chinese stroke survivors six months after discharge from a rehabilitation hospital. A second aim was to determine whether six‐month poststroke depression was associated with psychological, social and physical outcomes and demographic variables. Background. There has been increasing recognition of the influence of depression on poststroke recovery. While some previous studies report associations between depression and social, psychological, physical and clinical outcomes, few studies had sufficient s le sizes for regression analysis thereby limiting the clinical applicability of their findings. Design. A cross‐sectional design was used. Method. Data were collected from 124 male and 86 female stroke survivors (mean age 71·7, SD 10·2 years). The Geriatric Depression Scale was used to measure depression, the State Self‐esteem Scale to measure state self‐esteem, the London Handicap Scale to measure participation restriction, the Social Support Questionnaire to measure satisfaction with social support and the Modified Barthel Index to measure functional ability. Results. Forty‐two survivors (20·5%) reported mild and 33 (16·1%) reported severe depression. The presence of depression was associated with low levels of state self‐esteem, social support satisfaction and functional ability. Logistic regression analysis revealed that these variables were statistically significant in predicting the probability of having depression ( p 0·05). Conclusions. Analyses in the present study revealed distinct patterns of correlates of depression, and the results were in agreement with prior studies that depression has a consistent positive association with physical disability, living arrangements and social support and no significant association with the different types of brain lesion. Relevance to clinical practice. There is a need, routinely, to assess stroke survivors for depression and, where necessary, to intervene with the aim of enhancing psychological and social well‐being.
Publisher: Wiley
Date: 17-11-2009
Publisher: Elsevier BV
Date: 08-2021
Publisher: SAGE Publications
Date: 11-2020
Publisher: Wiley
Date: 15-04-2011
DOI: 10.1111/J.1365-2702.2010.03586.X
Abstract: Aim. To identify omissions in hand hygiene practice and glove use among hospital workers in Hong Kong. Background. Hospital‐acquired infection is the commonest complication affecting hospitalised patients. Even though research evidence suggests that hand hygiene and proper glove use are the most important ways to prevent the spread of disease and infection, compliance with both are reported to be unacceptably low. Design. An observational study of hospital workers in one acute and two convalescence and rehabilitation hospitals in Hong Kong was conducted. The participating clinical areas included the medical and surgical wards, accident and emergency department and intensive care unit. Methods. Hand hygiene practice and glove use amongst 206 hospital health and support workers, stratified according to years of working experience, were observed. Results. The number of observed episodes for hand hygiene was 1037 and for glove use 304. Compliance with hand hygiene was 74·7% and with glove use 72·4%. In approximately two‐third of episodes, participants washed their hands after each patient contact though, 78·5% failed to rub their hands together vigorously for at least 15 seconds. The major break in compliance with glove use was failure to change gloves between procedures on the same patient. In 28·6% of observed glove use episodes, participants did not wear gloves during procedures that exposed them to blood, body fluids, excretion, non‐intact skin or mucous membranes. Significant differences in performance scores on antiseptic hand rub were found between the two types of hospital and on glove use between the three groups of work experience: ≤5, 6–10, years. Relevance to clinical practice. Education and reinforcement of proper hand hygiene practice and glove use among hospital health and support workers is needed.
Publisher: Frontiers Media SA
Date: 31-01-2018
Publisher: Elsevier BV
Date: 11-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2006
DOI: 10.1111/J.1479-6988.2006.00036.X
Abstract: Aim Despite increasing efforts to promote the utilisation of research in daily nursing practice it is apparent that there are a number of obstacles to address. This paper reports a study to examine the barriers to, and facilitators of, research utilisation among registered nurses in Hong Kong. Methods A survey design and a random s ling method was used. The final s le consisted of 1487 registered nurses working in private and public health-care sectors in Hong Kong. A bilingual version of the Research Utilisation Questionnaire, comprising a 31-item barriers scale, and an 8-item facilitators scale was used. The instrument was mailed to participants who were asked to return the completed questionnaire by mail. Results The highest ranking barriers to research utilisation reported by respondents were related mainly to organisational factors with regards to inadequate facilities, no authority to change procedures, and time constraints. Hong Kong nurses, however, did not appear to see any problem with regards to items related to characteristics of research, such as conclusions drawn from research being justified, research articles not being published fast enough, and literature reporting conflicting results. This indicates that nurses are aware of research developments in nursing and can critically analyse research reports. With regards to facilitators of research utilisation, respondents agreed that managerial and peer support are the greatest facilitators. Conclusions The results indicate that factors influencing research utilisation are multidimensional and should be taken into account by all involved in the research enterprise: researchers, practitioners, educators, managers and policy-makers. The results of this study provide directions on how to assist nurses in Hong Kong in their efforts to utilise research.
Publisher: Elsevier BV
Date: 09-2005
DOI: 10.1016/J.JCRC.2005.06.004
Abstract: To assess the psychometric properties of the Simplified Therapeutic Intervention Scoring System (TISS 28) scale. A prospective observational design was used. Patients were recruited from a medical-surgical intensive care unit (ICU) and 4 rehabilitation wards of 2 university-affiliated hospitals in Hong Kong. Data necessary for the calculation of the TISS 28, the Therapeutic Intervention Scoring System (TISS 76), and severity of illness scoring system (Simplified Acute Physiology Score [SAPS II]) were recorded for each patient during the first 24 hours after his/her admission to an ICU. A significant positive correlation was found between the TISS 76 and the TISS 28 scores as well as the TISS 28 and the SAPS II scores. There was a significant difference between the TISS 28 scores among ICU patients and patients in rehabilitation wards. A significant correlation was found between the TISS 28 scores of the first and second set of TISS 28 scores. Although the findings supported the validity and reliability of the TISS 28, there were limitations of the TISS 28 in measuring nursing workload in ICUs. Hence, continued amendment and validation of the TISS 28 on larger s les in different ICUs would be required so as to provide clinical nurses with a valid and reliable assessment of nursing workload.
Publisher: Informa UK Limited
Date: 02-2006
DOI: 10.1080/13548500500093688
Abstract: Depression is common in patients following stroke and has been found to be related to the degree of functional disability, recovery and engagement in rehabilitation. Consequently, screening for depression is crucial in this group in order to facilitate the delivery of appropriate psychological support. The current study sought to determine key psychometric properties of the Chinese version of the Geriatric Depression Scale (GDS) in this group. Three versions of the GDS were evaluated, these being the 30-item original measure (GDS-30), the short-form version comprising 15 items (GDS-SF) and a recently developed innovative four-item version (GDS-4). Confirmatory factor analysis revealed the GDS-30 and GDS-SF to offer an acceptable fit to data suggesting utility of these measures for screening. However, the GDS-4 offered a poor fit to the data, suggesting this measure was an inadequate measure of depression in this clinical group. Further, though GDS-30 and GDS-SF measures revealed good internal consistency, the performance of the GDS-4 was marginal. However, all GDS-derived measures demonstrated excellent convergent and ergent validity. It is concluded that the GDS-30 is a useful and appropriate screening instrument in this group. Further, the GDS-SF shows promise in terms of development as a multidimensional measure of depression that may have predictive and outcome monitoring potential. The psychometric shortcomings of the GDS-4 strongly suggest that this measure is unsuitable for screening in this clinical group.
Publisher: Springer Science and Business Media LLC
Date: 20-05-2022
DOI: 10.1186/S12912-022-00907-0
Abstract: While there is a growth in the number of advanced practice nurses, there is a dearth of research examining their role transition from registered nurses. This study aimed to identify critical elements in the career path of nursing graduates who have taken up advanced practice roles and examine their perceived impact on patient care. An exploratory descriptive study was performed. In idual semi-structured interviews were conducted face-to-face with 10 nursing graduates now in advanced practice roles, and their ten respective managers. All interviews were audio-recorded and transcribed verbatim for latent and manifest content analyses. The nursing graduates, six of whom were male, had a mean age of 35 years. All possessed a master’s degree and formal post-registration education and/or training. Six had at least three years’ experience as an advanced practice nurse. The managers, all female, had a mean age of 49 years. Eight had at least one year’s experience in their current position. Six key themes emerged: prior enhancement of personal and professional knowledge and skills active participation in clinical roles and knowledge translation in preparation for advanced practice adapting to new and erse advanced practice nursing responsibilities role of advanced practice nurses in leadership personal qualities crucial for success in advanced practice and provision of evidence-based patient-centered care. Postgraduate education, management knowledge and leadership skills, and active participation in clinical roles and knowledge translation appear crucial ingredients for promotion of nursing graduates to advanced practice roles. Other ingredients include a positive outlook, flexibility and adaptability, and good interpersonal, communication and problem-solving skills.
Publisher: Informa UK Limited
Date: 30-06-2019
Publisher: SAGE Publications
Date: 03-2006
Publisher: Springer Science and Business Media LLC
Date: 15-10-2016
Publisher: SAGE Publications
Date: 25-07-2017
Publisher: Wiley
Date: 19-10-2010
DOI: 10.1111/J.1365-2702.2010.03349.X
Abstract: Aim. To examine the perceptions of the code of professional conduct among practising registered nurses in Hong Kong. Background. A code of professional conduct is intended to guide nurses in their practice and to ensure congruence with nursing goals and objectives. Such a code for nurses in Hong Kong has been in effect for two decades but, to date, no study has examined the perceptions of it among practising nurses. Design. A survey of 320 practising registered nurses working in a hospital cluster in Hong Kong (mean postregistration experience = 11·8 years). Methods. A questionnaire developed to assess nurses’ perceptions of the Code of Professional Conduct devised by the Nursing Council of Hong Kong. Results. Providing safe and competent care, practising in accordance with the law and maintaining agreed standards were ranked in order as the three most important aspects. Safeguarding informed decision‐making for patients who were mentally incapacitated or unable to speak for themselves, participating in continuing nursing education and raising objections to practices that compromise safe and appropriate care were considered the most challenging aspects to achieve in professional nursing practice. Conclusions. To educate nurses to become more assertive in safeguarding patients’ rights and to encourage and support lifelong learning remains a major challenge in professional nursing practice. The profession and statutory bodies need to consider how best to enable practising nurses to address these issues. Relevance to clinical practice. Examining the perceptions of practising nurses about the professional code is necessary to ensure that the profession is prepared to meet the ever‐changing demands and expectations of the public whom it claims to serve.
Publisher: Elsevier BV
Date: 2022
Publisher: Elsevier BV
Date: 08-2010
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 22-01-2018
DOI: 10.1161/STR.49.SUPPL_1.TP152
Abstract: Hemiplegic shoulder pain (HSP) limits stroke survivors’ physical function, which in turn impairs their capabilities in participating in activities and compromises their quality of life (QoL). Systematic reviews report acupuncture is potentially beneficial in reducing HSP and improving physical function. A study was conducted to investigate the feasibility and acceptance of a 6-week acupuncture treatment among community-dwelling survivors. It was hypothesized that there would be no significant problems in recruiting participants, conducting the true and sham treatment, and measuring clinical outcomes. Fifteen survivors with HSP were recruited and assigned randomly to a true acupuncture, sham acupuncture, or control group in a 1:1:1 ratio. Participants in the true acupuncture group received an acupuncture treatment regimen developed by a panel of experts in Chinese and Western medicine. Acupuncture devices with needles that retract into the handle were used in the sham group. Participants in the control group received usual rehabilitative care. Outcomes including HSP, upper extremity function, depressive symptoms, social participation, and QoL were collected at baseline and 1 week after completion of the treatment for the true and sham groups: participants were asked to comment on the acceptability and satisfaction of the treatment within 1 week after the 6-week treatment. Data were collected at baseline and at 7 weeks for the control group. The participants’ mean age was 62.67 years. The mean duration post-stroke was 6.33 years. Eighty percent had an ischemic stroke and 66.7% a left-sided weakness. A total of 7-15 acupoints were used for the true and sham groups. Overall, participants found the traditional Chinese Medicine practitioners helpful and attentive to their health concerns. No adverse events were reported throughout the study. More participants in the true acupuncture group reported reduced HSP after the treatment. They expressed that they were willing to participate in the treatment again. In conclusion, the high level of user satisfaction indicated the feasibility of conducting a large-scale randomized controlled trial to evaluate the effects of the proposed acupuncture treatment on survivors’ post-stroke HSP and health outcomes.
Publisher: Wiley
Date: 08-06-2011
DOI: 10.1111/J.1365-2702.2011.03724.X
Abstract: To establish the psychometric properties of the Chinese version of the State Self-Esteem Scale in stroke patients. Self-esteem is seen to enhance peoples' ability to cope with disease: low self-esteem may inhibit participation in rehabilitation and thus result in poor health and social outcomes. Although the Chinese version of the State Self-Esteem Scale has been used as an outcome measure for stroke rehabilitation, no study has examined its factor structure in this patient group. A cross-sectional design. A convenience s le of 265 Chinese stroke patients (mean age 71·4, SD 10·3 years), with a minimum score of 18 out of a possible 30 for the Mini Mental State Exam recruited from two regional rehabilitation hospitals in Hong Kong. An exploratory factor analysis and an internal consistency analysis of the State Self-Esteem Scale were conducted. Pearson's correlation coefficients were calculated between the State Self-Esteem Scale and the Geriatric Depression Scale to determine convergent validity. The final factor solution comprised a three-factor model with correlated constructs and accounted for 49·5% of the total variance. Significant negative correlations were found between the Geriatric Depression Scale and the State Self-Esteem Scale subscale scores (r-0·31 to -0·55, p < 0·01), indicating that the State Self-Esteem Scale had acceptable convergent validity. The new three-factor structure had higher Cronbach's alphas when compared with the original three-factor structure. The State Self-Esteem Scale appears to be a useful measure for assessing state self-esteem in stroke patients. To establish the concurrent, discriminative and construct validities, the factor structure of the SSES could be further developed and tested.
Publisher: Elsevier BV
Date: 08-2010
DOI: 10.1016/J.IJNURSTU.2010.03.015
Abstract: The objective of this study was to investigate the diagnostic performance of biochemical tests used to determine placement of nasogastric (NG) tubes after insertion in adults. A systematic review of diagnostic studies was undertaken. A literature search of the bibliographic databases and the World Wide Web was performed to locate original diagnostic studies in English or Chinese on biochemical markers for detecting NG tube location. Studies in which one or more different tests were evaluated with a reference standard, and diagnostic values were reported or could be calculated were included. Two reviewers independently checked all abstracts and full text studies for inclusion criteria. Included studies were assessed for their quality using the QUADAS tool. Study features and diagnostic values were extracted from the included studies. Of the 10 studies included in this review, seven investigated the diagnostic accuracy of pH, one investigated the diagnostic accuracy of pH and bilirubin respectively, two a combination of pH and bilirubin and one a combination of pH, pepsin and trypsin levels in identifying NG tube location. All studies used X-rays as the reference standard for comparison. Pooled results demonstrated that a pH of <or=4.0 had the ability to predict only 63% of the tubes located in the stomach. However, a pH value of <or=5.5 to determine gastric placement demonstrated a sensitivity of 0.89 (95% CI 0.82-0.94) and a specificity of 0.87 (95% CI 0.81-0.93). Bilirubin coupled with pH had a high specificity (0.99) which demonstrated the ability of the test to identify misplaced tubes in intestine. However, the ability of the test to correctly identify gastric placement of feeding tubes was relatively low (sensitivity<0.90). Due to the heterogeneity of the studies and small s le sizes, conclusions about the diagnostic performance of the different tests cannot be drawn. Better designed studies exploring the accuracy of diagnostic tests are needed to improve the diagnostic policy. Until stronger evidence becomes available practice related to the diagnostic tests used within the clinical setting will continue to be dictated by local preferences and cost factors.
Location: Hong Kong
No related grants have been discovered for Pak Chun Janita Chau.