Validation of the Chinese general self-efficacy scale among individuals with schizophrenia in Hong Kong

The concept of self-efficacy has recently produced considerable interest among mental illness researchers. Self-efficacy was found to be associated with the number of hospitalizations, social adjustment, rehabilitation outcome, and levels of positive symptoms among individuals with schizophrenia. Given its escalating importance in psychiatric rehabilitation, a scale to assess self-efficacy with established psychometric properties is urgently needed. Validated scales that measure self-efficacy of Chinese with severe mental illness are however extremely limited. The Chinese General Self-efficacy Scale (CGSS) was generic in design and had not been validated for use with people with mental illness. The purpose of this study is to examine psychometric properties of CGSS for use among persons with schizophrenia in Chinese societies. The content validity of items was endorsed by a panel of 8 rehabilitation professionals with 75% to 100% of agreement. The scale was tested in sample of 78 individuals with schizophrenia and found to have excellent internal consistency (0.92-0.93) and very good to excellent test re-test reliability (0.75-0.94). Exploratory factor analysis yielded a two-factor solution explaining 69.0% of variance which was different from overseas studies which showed the scale to be unidimensional. The scale was concluded to be reliable and valid to assess self-efficacy of Chinese with schizophrenia. Potential uses of this scale were suggested.     

Residential care placement: perceptions among elderly Chinese people in Hong Kong

A qualitative study was designed to explore the perceptions of residential care placement among elderly Chinese people in Hong Kong. Content analysis of the semi-structured interviews with 20 community residents aged 60 years or over revealed that elderly people in Hong Kong generally had mixed feelings towards such placement. While they believed that residential care was an unavoidable alternative to family care in their later lives it was an important source of fear in their later years, especially for those who perceived their health as deteriorating. Residential care homes were generally seen as the ultimate 'dumping place' where one would 'idle till death' and the quality of care provided in these homes was anticipated to be problematic. It was found that most of these beliefs were formed as a result of indirect experience through 'listening to stories of neglect or abuse from friends and relatives whose relatives were residential care home residents'. Implications for professionals working with elderly people are discussed in the light of these findings.     

Health-related quality of life of Chinese people with schizophrenia in Hong Kong and Taipei: a cross-sectional analysis

Health-related quality of life is an important outcome indicator of mental health. We assessed the perception of health-related quality of life of persons with schizophrenia in Hong Kong and Taipei. In-person survey interviews were conducted using the Chinese World Health Organization Quality of Life Scale--Brief Version. A convenience sample was recruited from psychiatric outpatient departments: 176 from Hong Kong and 80 from Taipei. We found that both groups were significantly less satisfied with their psychological and social relationship domains compared to other domains. Poor mental health predicted poor perception of health-related quality of life. Schizophrenia has an impact on many aspects of a person's functioning. A rehabilitation model that takes into account symptoms, financial situation, family support, and social functioning is required.     

A qualitative study of cough medicine abuse among Chinese young people in Hong Kong

Drug abuse has been a social problem for many years and is often complicated by the emergence of new types of abused drugs or new forms of abuse. Abuse of cough medicine has been a focus of concern in Hong Kong since the late 1980s. This paper describes the findings of a qualitative study of the phenomenon of cough medicine abuse in Hong Kong. Focus group interviews were conducted to explore the perceived causes and effects of cough medicine abuse among Chinese young people in Hong Kong. The results from focus group interviews with cough medicine abusers, their family members, and service providers reveal that the primary factors accounting for adolescent cough medicine abuse are social pressure (peer and environmental influences), personal problems (evasion and avoidance), family (difficult relationships or harmful incidents), availability (ease of access), and ignorance. The research participants reported that their cough medicine dependence had serious side effects that threatened their physical and psychological wellbeing, as well as their interpersonal and family relationships. Based on the findings, several recommendations for the prevention of cough medicine abuse are proposed.     

Individual empowerment among Chinese cancer patients in Hong Kong

Among the various chronic diseases, cancer is the leading cause of death in Hong Kong. This article presents the process of how cancer patients are being enabled and strengthened to overcome powerlessness based on the interview findings of 12 participants. Interviews were analyzed using constant comparison. The basic social process of empowerment included finding meaning in life, seeking mastery over illness, and acceptance of illness. This study's unique findings suggest that the process of empowering cancer patients consists of more than giving patients control, choice, or resources, such as knowledge and skills. Nurses have an important role in facilitating patients to find meaning in life, as well as in the transformation of thoughts and attitudes. Nurses' personal qualities and skills embedded in the nurse-patient relationship constitute an important source of empowerment for patients.     

Concerns and misconceptions about pain among Hong Kong Chinese patients with cancer

It is estimated that approximately 50% of patients with cancer experience pain, and this percentage increases to 80% in patients with terminal cancer. Misconceptions and concerns of patients with cancer regarding the use of opioid analgesics have been identified as one of the major barriers to achieving optimal pain control. Misconceptions and concerns regarding addiction and tolerance to opioid analgesics and patients' desire to be "good" have been reported in the United States. The aim of this survey was to determine if similar misconceptions and concerns exist in Hong Kong Chinese patients with cancer. The results indicate that Hong Kong Chinese patients have the same concerns regarding the use of opioid analgesics. The respondents' fatalistic beliefs are a major hindrance to optimizing pain control, with 79% indicating that pain is an inevitable aspect of hospitalization because they believe that cancer pain cannot be relieved by medications. Fear of addiction was a major concern for 52% of the respondents, and about the same number of respondents believed that opioid analgesics should be administered only as a last resort. Regarding a desire to be "good," more patients reported that they would prefer to disturb nurses rather than physicians. It is desirable that culturally specific education programs be provided to dispel patient misconceptions and concerns regarding the use of opioid analgesics.     

Informal caring networks among Chinese elderly with disabilities in Hong Kong.

Community care has been a major guiding policy in developing services for the elderly in Hong Kong. It has been assumed that Chinese families tend to have a large caring network to render care in the community. However, in a survey conducted in early 1991, it was found that such caring networks for disabled elderly people were very small and inconsequential. Quite a high proportion of Chinese disabled elderly are living alone in the community, and have a small network for emotional support. Effective measures to promote family care of disabled elderly people are discussed. Two pathways for integrating the formal and informal care sectors are examined in relation to promoting effective practice for the frail elderly living in the community.     

Chinese older people in Hong Kong: health beliefs about influenza vaccination

A health belief survey of 70 community-dwelling Chinese older people was carried out in five general outpatient clinics in the Kowloon East hospital cluster of Hong Kong. Subjects were asked about their susceptibility to influenza, their perceptions of its severity, and benefits of and barriers to vaccination. Beliefs in their own good health, the effectiveness of cultural measures adopted to prevent influenza and its curability may be among the reasons why those who decline the vaccination thought they were unlikely to catch the virus. Community nurses should help modify people's health beliefs to motivate them to take up vaccination.     

Transition to residential care: experiences of elderly Chinese people in Hong Kong

A qualitative study was designed to explore the experiences of transition into residential care among elderly Chinese people in Hong Kong. With the elderly people's consent, in-depth interviews were conducted with 10 residents 1 week after their admission into a residential care home. The purpose of the interviews was to explore what the transition experience was like for the Chinese elders and how they settled into residential life. Content analysis of the interview data revealed the significance of cultural influences in the transition experiences. A number of issues suggested in the literature as barriers to adjustment to residential care, such as living with rules and regulations, lack of privacy and autonomy were not regarded as important by the Chinese elders. The Chinese values of balance, harmony and collectivism have made it easier for them to remain open and accept the communal way of living. Yet, these same values have restricted the elders in developing new relationships with staff and other residents. This appears to be the particular challenge facing Chinese elderly residents. Implications for professionals working with elderly residents are discussed in the light of these findings.     

Disaster preparedness among Hong Kong nurses

Title.  Disaster preparedness among Hong Kong nurses
Aim.  This paper is a report of a survey to explore Hong Kong nurses' disaster preparedness.
Background.  Increasingly frequent global disasters are posing threats to human health and life. The World Health Organization has called for countries to have detailed plans at all levels in order to be prepared for disasters that may arise.
Method.  A questionnaire was distributed to convenience samples of practising Registered Nurses studying in Master's degree programmes at a Hong Kong university in 2007.
Results.  Of a possible 174, 164 questionnaires were returned (Response rate 94%). Almost all nurses (97·6%) considered the government health department to be the organization most involved in disastrous situations. The majority (84·8%) were aware of the existence of a protocol on disaster management at their workplace. About one-third would respond in accordance with protocol (38·4%) or rely on directions from their immediate supervisors (34·8%) if a disaster occurred. Almost all the nurses (97%) considered themselves not adequately prepared for disasters. They recognized that a protocol for disaster management (85·4%) and training and drills for disasters (both 84·1%) are useful tools.
Conclusion.  Nurses in Hong Kong are not adequately prepared for disasters, but are aware of the need for such preparation. Disaster management training should be included in the basic education of nurses.     

Factors related to stress and coping among Chinese nurses in Hong Kong

Few empirical studies have investigated the issues linked to Hong Kong nurses work-related health. The present study investigated factors related to stress and coping among Chinese nurses in Hong Kong. The researchers employed a cross-sectional survey and made within-group comparisons of nurses' stress and coping. Using stratified random sampling the researchers selected nurses from the mailing list of a local professional organization. One hundred and sixty-eight (33.6%) nurses responded. Nurses reported lower stress levels than other workers assessed with the same measure. Paediatric nurses reported the highest stress levels. Nurses at the lower grades reported higher stress levels than nurses at the higher grades. Single nurses had marginally higher stress scores than married nurses and females had slightly higher stress scores than males. However, none of these results were statistically significant. The respondents' major sources of stress were related to nursing issues like too much work, interpersonal relationships, and dealing with hospital administration. The respondents coped with their stresses by seeking support from friends and colleagues, using different cognitive strategies and through leisure activities. There was a statistically significant link between the respondents' stress and sickness levels. The results raise issues about the nature of nurses' working experiences.     

Promoting self-reflection in clinical practice among Chinese nursing undergraduates in Hong Kong

This study evaluated the effect of a structured education programme on improving the self-reflection skills of Chinese nursing undergraduates in managing clinical situations. Johns' Structured Reflection Model was used as a framework for the development of the education programme. Thirty-eight nursing undergraduates attended a 3-hour interactive workshop on reflective skills and were encouraged to practise the skills learned under the guidance of a nurse instructor during their 4-week clinical practicum. The findings indicated that the programme was helpful in improving the undergraduates' reflective skills though only a few of them reached the highest level as critical reflectors. Some undergraduates identified time constraints and the lack of a trusting relationship with their nurse instructor as barriers to their reflective learning. The findings may help nurse educators develop education programmes with structured learning strategies to promote nursing undergraduates' self-refection in clinical practice.     

The assessment of grief among Hong Kong Chinese: a preliminary report

This is a preliminary report of a study that examined the clinical usefulness of the Chinese Grief Reaction Assessment Form (GRAF).The validity, reliability, and factor structure of the form were also explored.We administered the GRAF to 180 bereaved individuals during intake interview for bereavement counseling.The GRAF has obtained good internal Cronbach's alpha reliability of .89 and showed its validity in being able to discriminate between the grief reactions of bereaved individuals experiencing anticipated and unanticipated death in the predicted direction. Bereaved women had stronger grief reaction than men.The item "I do not want to abandon him/her" obtained the highest mean ranked scores among both bereaved men and bereaved women.Our findings support the use of the GRAF as a clinical tool to assess psychological symptoms associated with bereavement among Hong Kong Chinese, which also holds promise for research and program evaluation.     

Suicidality and migration among adolescents in Hong Kong

Suicide as a cause of death among adolescents and migration as a component of population have been growing in importance. Very little research has been conducted on the connections between migration and suicidality among adolescents in Hong Kong, and so is the aim of this article. It uses census and registration data to study suicide mortality, and sample survey data collected for this purpose to investigate suicide attempt, suicide ideation, and self-injurious behavior. Relations between suicidality and socio-demographic/psychological factors replicated those found in the literature. Duration of residence was found important for the study of suicide among migrants. In both the bivariate and multivariate analyses, although the suicidality levels for short-duration (less than 10 years) adolescent migrants were very much lower than the local-born counterparts, those for the long-duration (10 years or more) migrants were very much higher. The findings support the Healthy Migrant Hypothesis and other related hypotheses in migrant mortality studies. They also reveal, in the light of the Integration Theory of Suicide, the problem of migrant integration into the host culture and society, an important social problem for the government to solve.     

Factors that affect back pain among Hong Kong Chinese patients after cardiac catheterization.

BACKGROUND: Cardiac catheterization (CC) is a widely used cardiac investigation procedure in Hong Kong. However, back pain is frequently reported following CC due the prolonged bed rest after the procedure. AIM: The overall aim of this study was to examine factors associated with back pain among Hong Kong Chinese patients after femoral access for CC. METHODS: A prospective study, nested within a randomized clinical trial (RCT), employing secondary analysis of an existing data set from 419 Chinese adults receiving nonemergency CC, were used. Following a review of literature, gender, age, history of back pain, type of dressing on the puncture site, length of bed rest duration, turning privilege during bed rest, catheter size used for CC, duration of the procedure, duration of hemostasis, and body weight were identified as potential factors affecting back pain level. Back pain was assessed at 6 h and the next morning after CC, using the Numeric Pain Intensity Scale (NPIS). Analysis was done using multivariate analysis of variance (MANOVA), after testing for normality of the distribution. RESULTS: Turning privilege (p = 0.001), age (p = 0.04), and body weight (p = 0.006) were significantly related to level of back pain at 6 h and the next morning after CC. CONCLUSION: Results of this study may help nurses have a better understanding about patients' physical needs and appropriate nursing interventions that can be planned to enhance patient comfort following CC.