Investigating factors associate to nurses' attitudes towards perinatal bereavement care

Aim. The purpose of this study was to explore nurses’ attitudes towards perinatal bereavement care and to identify factors associate with such attitudes. Background. Caring for and supporting parents whose infant has died is extremely demanding, difficult and stressful. It is likely that the attitude of nursing staff can influence recovery from a pregnancy loss and nurses with positive attitude to bereavement care can help bereaved parents to cope during their grieving period. Method. Data were collected through a structured questionnaire; 334 nurses were recruited (63% response rate) from the Obstetrics and Gynaecology unit in five hospitals in Hong Kong during May–August 2006. Outcome measures including attitudes towards perinatal bereavement care, importance on hospital policy and training support for bereavement care. Results. Majority of nurses in this study held a positive attitude towards bereavement care. Results showed that only 39·3% (n = 130) of nurses had bereavement related training. By contrast, about 89·8% of nurses (n = 300) showed they need to be equipped with relevant knowledge, skills and understanding in the care and support of bereaved parents and more than 88·0% (n = 296) would share experiences with colleagues and seek support when feeling under stress. Regression model showed that age, past experience in handling grieving parents and nurses’ perceived attitudes to hospital policy and training provided for bereavement cares were factors associate with nurses’ attitudes towards perinatal bereavement care. Conclusions. Hong Kong nurses emphasized their need for increased knowledge and experience, improved communication skills and greater support from team members and the hospital for perinatal bereavement care. Relevance to clinical practice. These findings may be used for health policy makers and nursing educators to ensure delivery of sensitive bereavement care in perinatal settings and to enhance nursing school curricula respectively.     

我国香港、台湾地区护理管理立法可鉴之处一览

中华人民共和国卫生部颁布的《护士管理办法》,自1994年开始实施至今已经十年有余了。随着我国医疗卫生体制改革的推进,随着医疗服务市场的不断发展《,护士管理办法》的内容有待完善和修改。笔者仅以此文,介绍一下我国港台地区在护理管理方面具有特色的一些立法规定,相信会对日后完善内地护理管理工作有益。     

The knowledge level and precautionary measures taken by older adults during the SARS outbreak in Hong Kong

The study aims to examine the knowledge and the practice of the precautionary measures taken by older adults in Hong Kong against the outbreak of severe acute respiratory syndrome (SARS). Overall, more than half the participants responded correctly that droplet transmission is one of the main transmission routes of SARS. Those who received formal education demonstrated that they acquired greater knowledge of the sources and precautionary measures for SARS. The types of precautionary measures used and the factors affecting their behaviours were discussed. The results of the study could help the health-care professionals develop appropriate health promotion and disease prevention programmes for older adults.     

Adolescents from low‐income families in Hong Kong and unhealthy eating behaviours: Implications for health and social care practitioners

The development of dietary preferences of adolescents involves a complex interplay of individual behaviours and environmental factors. Interpersonal factors—such as peer influences and unpleasant school experiences—and institutional factors—such as school rules and policies—are closely associated with unhealthy eating of adolescents. Family support and guidance are also crucial in influencing adolescents’ eating habits. However, the low social status, low educational levels, and low household incomes of disadvantaged parents can markedly prevent their children from establishing healthy eating habits. Therefore, adolescents from low‐income families are more likely to engage in unhealthy dietary behaviours and hence to be more susceptible to diet‐related health problems. However, few studies have addressed the difficulties associated with inculcating healthy eating habits among adolescents from low‐income families. Therefore, to investigate the barriers to adopting healthy eating habits, this study adopted a qualitative research approach and conducted five focus‐group semistructured interviews with 30 junior‐ and senior‐form students of a secondary school in Hong Kong, all of whom were from low‐income families. The results revealed skipping meals because of poverty, following irregular meal patterns on school holidays, receiving poor guidance from family and peers, perceiving healthy eating as expensive and unappealing, and geographical inaccessibility to healthy food all prevented these students from healthy eating. These mutually reinforcing factors were interlocking with the economic strain that was experienced by the participants and their families. In particular, the stereotype of “healthful food is expensive” was strong. Therefore, we suggest students from low‐income families should be enabled to understand that healthy eating is not necessarily expensive. The participants’ stereotypes about healthy food was handed down by their parents. Such stereotypes, together with the low health literacy, influence the food preparation habits of the parents. Therefore, parents should be made to aware that healthful food can also be affordable.     

Evidence for Elizabethkingia anophelis Transmission from Mother to Infant,Hong Kong

Elizabethkingia anophelis, recently discovered from mosquito gut, is an emerging bacterium associated with neonatal meningitis and nosocomial outbreaks. However, its transmission route remains unknown. We use rapid genome sequencing to investigate 3 cases of E. anophelis sepsis involving 2 neonates who had meningitis and 1 neonate’s mother who had chorioamnionitis. Comparative genomics revealed evidence for perinatal vertical transmission from a mother to her neonate; the 2 isolates from these patients, HKU37 and HKU38, shared essentially identical genome sequences. In contrast, the strain from another neonate (HKU36) was genetically divergent, showing only 78.6% genome sequence identity to HKU37 and HKU38, thus excluding a clonal outbreak. Comparison to genomes from mosquito strains revealed potential metabolic adaptations in E. anophelis under different environments. Maternal infection, not mosquitoes, is most likely the source of neonatal E. anophelis infections. Our findings highlight the power of genome sequencing in gaining rapid insights on transmission and pathogenesis of emerging pathogens.     

丹红注射液合并硝酸甘油对急性心肌梗死患者PCI治疗中无复流现象及C-反应蛋白的影响

目的:研究急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)前静脉注射丹红注射液对术中无复流血流的改善及C-反应蛋白(CRP)的影响。方法:对120例AMI患者术前均给予阿司匹林300 mg、氯吡格雷300 mg等治疗。随机分成A组与B组两组,各60例。A组PCI术前予以丹红注射液,术中出现无复流2例,再予以硝酸甘油冠脉内给药;B组直接行PCI术,术中出现无复流8例,再予以硝酸甘油冠脉内给药,对比两组患者冠脉血流恢复情况。同时两组患者均在术前及术后监测CRP。结果:A组全部冠脉血流恢复TIMI3级,B组有4例冠脉血流恢复TIMI3级,且用丹红注射液组术后CRP降低更明显。结论:PCI术前静脉注射丹红注射液可以降低AMI患者的CRP值,且联合硝酸甘油后较单一给予硝酸甘油可更有效恢复无复流血管的TIMI血流值。     

Successful aging among Chinese near-centenarians and centenarians in Hong Kong: a multidimensional and interdisciplinary approach

Objectives: This study applied a multidimensional model on a continuum to examine successful aging (SA) and investigated whether SA is associated with biomedical and psychosocial–demographic factors among Hong Kong Chinese near-centenarians and centenarians.

Method: A cross-sectional data analysis was performed on a geographically representative sample of 120 near-centenarians and centenarians with an age range of 95–108 years. We developed an integrated and cumulative Successful Aging Index (SAI) based on participants’ performance in four dimensions: (1) physical and functional health (PF), (2) psychological well-being and cognition (PC), (3) social engagement and family support (SF), (4) economic resources and financial security (EF). To examine the criterion validity of SAI, we conducted a multiple binary logistic regression with interviewer-rated health. A multiple regression model was ran to investigate the independent biomedical and psychosocial–demographic correlates of SAI.

Results: Results show that only 5.8% of participants attained SA in all four dimensions. PF had the least achievers, whereas the proportion was the highest in PC. SAI was significantly associated with interviewer-rated health and a high level of high-density lipoprotein cholesterol. Living with family or friends, high level of optimism, fewer diseases, and barriers to social activities were independent predictors of SAI score.

Conclusion: In the light of the lack of consensus on the constituents and assessment of SA especially among very old adults, our findings add to the extant literature by underscoring the importance of the multidimensional nature and the utility of an integrated and cumulative-based assessment of SA at the extreme of longevity.     

A propensity-matched analysis of clinical outcomes between open thyroid lobectomy and high-intensity focused ultrasound (HIFU) ablation of benign thyroid nodules

Background

High-intensity focused ultrasound is a promising, nonoperative treatment for benign thyroid nodules. Our study aimed to compare treatment outcomes of single-session high-intensity focused ultrasound ablation with open lobectomy after propensity score matching.