Biomedical subjects

D Arthur

Publications and source records attributed to D Arthur.

At least 19 recordsLinked to original sources

PubMed2005

A study of three measures of expressed emotion in a sample of Chinese families of a person with schizophrenia.

Emotional climate or expressed emotion (EE) has been examined in families of white descent who have a family member with schizophrenia but few studies have been conducted in Asian or Chinese families. This study tested the utility of the five-minute interview (FMI), adjective checklist (ACL) and family attitude scale (FAS) in a sample of Chinese family members in Beijing, in an attempt to introduce useful measures of EE into practice. A sample of 51 family members were interviewed and administered the three instruments. A total of 29.4% of families were found to be high-EE critical and 13.7% high-EE emotional over involvement using the FMI. The FAS and ACL prove internally consistent and were significantly correlated but not with the FMI. Cultural explanations for the discrepancies are offered. The measures have applicability in terms of understanding family relationships but further research and replication is necessary to deepen our understanding of EE in Chinese families.

Adaptation, Psychological↗

PubMed2004

Workshop on partial breast irradiation: state of the art and the science, Bethesda, MD, December 8-10, 2002.

Breast conserving surgery followed by radiation therapy has been accepted as an alternative to mastectomy in the management of patients with early-stage breast cancer. Over the past decade there has been increasing interest in a variety of radiation techniques designed to treat only the portion of the breast deemed to be at high risk for local recurrence (partial-breast irradiation [PBI]) and to shorten the duration of treatment (accelerated partial-breast irradiation [APBI]). To consider issues regarding the equivalency of the various radiation therapy approaches and to address future needs for research, quality assurance, and training, the National Cancer Institute, Division of Cancer Treatment and Diagnosis, Radiation Research Program, hosted a Workshop on PBI in December 2002. Although 5- to 7-year outcome data on patients treated with PBI and APBI are now becoming available, many issues remain unresolved, including clinical and pathologic selection criteria, radiation dose and fractionation and how they relate to the standard fractionation for whole breast irradiation, appropriate target volume, local control within the untreated ipsilateral breast tissue, and overall survival. This Workshop report defines the issues in relation to PBI and APBI, recommends parameters for consideration in clinical trials and for reporting of results, serves to enhance dialogue among the advocates of the various radiation techniques, and emphasizes the importance of education and training in regard to results of PBI and APBI as they become emerging clinical treatments.

Breast Neoplasms↗

PubMed2003

What factors influence Hong Kong school students in their choice of a career in nursing?

Chronic and recurrent shortages of nurses, coupled with the increasing demand for high quality and motivated nurses and competition for secondary school leavers from other professions, are issues which prompted this investigation of senior school students' career choice. Using a descriptive survey design, and a questionnaire developed for the study, 1246 Form 6 students in Hong Kong were surveyed, of these 28% respondents reported that they were interested in studying nursing. The findings indicated that students' decision to choose or not choose nursing was significantly influenced by the demographic factors: gender (chi(2) = 42.72, p < 0.0005), biology subject pursued (chi(2) = 18.94, p < 0.0005), previous academic achievement (chi(2) = 34.33, p < 0.0005) and mother's occupation (chi(2) = 21.08, p = 0.012); and their perception of nursing as a career score (t = 14.21, df = 1237, p < 0.0005). Students' intention to study nursing was also significantly affected by social influence: parents (chi(2) = 11.53, p = 0.001), school career masters (chi(2) = 5.52, p = 0.019) and friends (chi(2) = 4.83, p = 0.028); past experience with career activities (chi(2) = 84.479, p < 0.005); and working in hospital (chi(2) = 31.742, p < 0.005). Backward elimination logistic regression analysis concluded that being female (p < 0.0005), biology study at Form 5 and A-level (p < 0.0005), total perception scores (p < 0.0005), and participation in career activities (p < 0.0005) were found to be predictors of the students' intention to study nursing. Results of this study can be used by nurse leaders and recruiters to develop strategies and help school leavers perceive nursing in a more positive way. Expanding the informational sources about nursing can facilitate the recruitment process.

Adolescent↗

PubMed2001

The effect of technology on the caring attributes of an international sample of nurses.

This paper commences by refining the psychometric characteristics of a quantitative instrument, which was developed to examine the caring attributes of an international sample of 1957 nurses working in 11 countries. Using factor analysis to support the construct validity, and removing weak items, the original 60 caring items were reduced to a 31 item global caring scale which revealed the sub-scales: 'caring communication'; 'caring involvement'; 'caring advocacy'; and 'learning to care'. The sub-scales were internally consistent and revealed generally high correlation coefficients. The subjects also responded to a scale, which was designed to measure degree of technological influence and provide a score for each respondent to reflect how highly they were influenced by technology in the work units of their hospital. The sample was then divided into three equal groups to reflect high, medium and low technological influence. The caring attribute scores then became the dependent variable by which the degree of technology was compared. The group with the lowest technological influence recorded the lowest mean score for caring while the group with the highest technological influence recorded the highest mean score for caring. A significant difference between the group with lowest and highest technological influence (F=6.84, p<0.001) was noted. This also applied to the 'caring communication' and 'caring involvement' sub-scales. For 'caring advocacy' the lowest technology group recorded the highest caring mean which was found to be significantly different to both mean scores for medium and highest technology groups (F=7.15, p<0.001). These results are discussed in the light of the international sample and suggestions for future research are raised.

Attitude of Health Personnel↗

PubMed2001

Dipole localization of human induced focal afterdischarge seizure in simultaneous magnetoencephalography and electrocorticography.

Localizations were compared for the same human seizure between simultaneously measured MEG and iEEG, which were both co-registered to MRI. The whole-cortex neuromagnetometer localized a dipole in a sphere phantom, co-registered to the MEG sensor array, with an error of 1.4 mm. A focal afterdischarge seizure was induced in a patient with partial epilepsy, by stimulation at a subdural electrocorticography (ECoG) electrode with a known location, which was co-registered to the MRI and to the MEG sensor array. The simultaneous MEG and ECoG during the 30-second seizure was measured and analyzed using the single, moving dipole model, which is the localization model used clinically. The dipole localizations from simultaneous whole cortex 68-channel MEG and 64-channel ECoG were then compared for the repetitive spiking at six different times during the seizure. There were two main regions of MEG and ECoG activity. The locations of these regions were confirmed by determining the location clusters of 8,000 dipoles on ECoG at consecutive time points during the seizure. The mean distances between the stimulated electrode location versus the dipole location of the MEG and versus the dipole location of the ECoG were each about one (1) centimeter. The mean distance between the dipole locations of the MEG versus the dipole locations of the ECoG was about 2 cm. These errors were compared to errors of MEG and ECoG reported previously for phantoms and for somatosensory evoked responses (SER) in patients. Comparing the findings from the present study to those from prior studies, there appeared to be the expected stepwise increase in mean localization error progressing from the phantom, to the SER, to the seizure.

Adolescent↗

PubMed2001

Nursing competencies: personal characteristics contributing to effective nursing performance.

AIMS OF THE STUDY: Core competencies are important in enabling an individual to adapt to new environments and perform superior professional practice. This study was to identify the underlying competencies which contributed to effective nursing performance. BACKGROUND: Most of the previous competencies are either derived from researchers' conceptual analysis or based on practitioners' direct report. Competencies derived from these methods either are subject to bias or are unable to identify the essential elements for effective nursing care. METHOD: Following the McBer method, 50 experienced nurses in China were asked to report 82 valid critical incidents in their jobs. Two individuals coded the scripts and decided the presence of each competency according to a pre-established coding system. RESULTS: Ten competencies including interpersonal understanding, commitment, information gathering, etc. were identified. Each competency was illustrated by behavioural indicators. CONCLUSIONS: Skills, traits, motives and attitudes all contribute to effective nursing performance. The findings assist in the delineation and development of nursing competencies and thus provide realistic working behaviours for nursing education and management.

Adult↗

PubMed2001

Symptom frequency and severity in patients with metastatic or locally recurrent lung cancer: a prospective study using the Lung Cancer Symptom Scale in a community hospital.

PURPOSE: To define symptoms and therapeutic requirements for patients with metastatic or locally recurrent lung cancer. METHODS AND MATERIALS: Data were collected from 69 consecutive patients with locally advanced lung cancer seen in consultation at a radiation oncology facility serving a community hospital in Virginia. The Lung Cancer Symptom Scale, a validated quality of life instrument, measured the incidence of symptoms in this group. RESULTS: Average survival for the entire group was 7 months. Fifty-seven patients received 81 courses of radiation therapy, 33 directed at thoracic disease and 48 delivered to sites of metastasis. Thirty-three percent of those who received radiation therapy required treatment to more than one anatomic site. Every patient was symptomatic at the time of consultation, with the number (p = 0.001) and severity (p = 0.001) of symptoms they suffered worse in the patient group seen 0 to 3 months prior to death rather than 4 to 6 months prior to death. With the exception of cough, symptoms were marked in their severity. CONCLUSIONS: Patients with advanced lung cancer suffer frequent and severe symptoms that worsen in the final months of life. The appropriate timing and combination of radiotherapy and chemotherapy are yet to be resolved. Future studies will require use of validated quality of life instruments to better catalogue palliation and treatment toxicity.

Aged↗

PubMed2001

Long-term local control and survival after concomitant boost accelerated radiotherapy for locally advanced cervix cancer.

Between 1989 and 1994, a prospective clinical trial tested the safety and efficacy of concomitant boost accelerated superfractionated (CBASF) radiotherapy for patients with locally advanced cervix cancer. CBASF radiotherapy included 45 Gy/25 fractions to the pelvis and a 14.4 Gy/9 fraction concomitant boost to the primary tumor, followed by brachytherapy for a total point A dose of 85 Gy to 90 Gy. The 22 patients of International Federation of Gynecology and Obstetrics stages IIIA-IVA who received CBASF radiotherapy now have a median follow-up time of more than 8 years. The 7-year actuarial rates of local control and overall survival are 81% and 36%, respectively. Serious late toxicity included bowel injury requiring colostomy in eight patients within 2.5 years after treatment, but no other severe toxicity was observed after longer follow-up intervals. The local control and survival rates achieved with CBASF radiotherapy were higher than those observed within a matched contemporaneous cohort of patients treated with standard radiotherapy alone at the same institution (p = 0.1 for local control, 0.09 for survival). The encouraging trend toward improved tumor control, tempered by the complication rate, suggests an opportunity to apply more sophisticated radiotherapy techniques that might sustain the favorable effects of dose intensification while mitigating the normal tissue toxicity.

Adult↗

PubMed2001

The effects of the problem-based Alcohol Early-Intervention Education Package on the knowledge and attitudes of students of nursing.

The profession of nursing is seeking to establish its unique professional identity by developing discipline-focused research and clinical practice supported by university education. However, according to refereed literature, educating undergraduate nurses in alcohol-related problems is lacking. The literature reveals that nurses in general lack the necessary knowledge, attitudes, and skills to work with problem drinkers. Alcohol early intervention is advocated as a strategy compatible with contemporary nursing practice. This paper reports a study that commenced with the development of a problem-based, five-week Alcohol Early Intervention Education Package (AEIEP). This package became an intervention around which the knowledge and attitudes of a sample of 212 students of nursing were evaluated. A comprehensive instrument was developed to measure the respondent's knowledge and attitude regarding alcohol-related problems in general and specifically in early intervention. The effects of the education intervention on the different strata of students, were examined in a quasi-experimental, pre-post test design. The findings demonstrated it had a significant effect on the knowledge and attitudes of students enrolled in an integrated bachelor of nursing curriculum.

Adult↗

PubMed2001

Reduced length of stay by implementation of a clinical pathway for bariatric surgery in an academic health care center.

Bariatric surgery is being performed in increasing numbers in an era when reimbursements are being reduced. Academic health centers bear the responsibility for training surgeons to perform these operations yet must keep costs to a minimum and retain high quality. The UCLA Bariatric Surgery Program developed a clinical pathway for the pre- and postoperative management for gastric bypass patients to achieve these goals. Medical records for 182 consecutive gastric bypass patients were retrospectively reviewed before implementation of the pathway (Group I) during the fiscal year of 1998/1999. Data on average length of stay, average intensive care unit length of stay, average standard variable cost, percentage readmission rate, and percentage return to the operating room were collected. This information was compared with the data collected prospectively from 182 patients after implementation of the pathway in July of 1999 (Group II) during the fiscal year of 1999/2000. Hospital cost per admission was reduced by 40 per cent in Group II compared with Group I (P < 0.02). The average length of stay was reduced from 4.05 days in Group I to 3.17 days in Group II (P < 0.033). Overall readmission rate was decreased from 4.2 per cent in Group I to 3.2 per cent in Group II (P < 0.05). There were no differences in morbidities between both groups. The pathway reduced costs by reducing the hospital length of stay, intensive care unit utilization, and readmission rates. Quality was maintained as evidenced by a similar pattern of postoperative morbidities yet readmission rates were reduced. Our results indicate that implementation of a clinical pathway for bariatric surgery reduces cost and improves quality of care in an academic institution.

Academic Medical Centers↗

PubMed2000

The alcohol use disorders identification test (AUDIT): validation of an instrument for enhancing nursing practice in Hong Kong.

This paper describes the psychometric analysis of the alcohol use disorders identification test (AUDIT) after it was modified for use in Hong Kong and administered to examine the patterns of hazardous and harmful drinking. The modified version of AUDIT was an 18-item instrument in which 10 items were completely adopted from the original version and 8 items were added to improve its cultural sensitivity. It was translated into Chinese and back translation was undertaken to confirm the equivalence of the Chinese and English versions. Following a pilot study the instrument was administered to 450 subjects who were recruited from two acute general hospitals, a University Health Clinic and three community health centres. The content validity was judged as adequate by a panel of five international and local experts and the instrument achieved a high reliability coefficient of 0.99 during a test-retest procedure conducted with 20 subjects. Factor analysis was performed on the responses obtained from 450 subjects which supported the construct validity of the 18-item instrument. The modified instrument had a consistently high internal consistency reliability (Cronbach's alpha=0.96-0.97) when tested in the different settings. It was found that a higher percentage of respondents from the hospitals (14.5%) drank at a hazardous or harmful levels compared to those from the community (6.2%) or the University (5.3%). The AUDIT proved a reliable and valid measure with potential applications in Chinese cultures. Early intervention and identification of 'at risk' drinking by the AUDIT is supported as a strategy to be implemented by nurses in primary and secondary health care settings in Hong Kong, where there are indications of increasing alcohol overuse.

Adolescent↗

PubMed2000

The effects of the 'learning by proposing to do' approach on Hong Kong nursing students' research orientation, attitude toward research, knowledge, and research skill.

The knowledge, attitudes, research orientation and skills of a group of Hong Kong Registered Nurses studying a BSc(Hons) Nursing course were evaluated using a quantitative instrument developed specifically for this purpose. The objectives of the study were to develop and examine the reliability and validity of the instrument and to evaluate the effects of a Research Methodology subject which focused on learning by 'proposing to do'. The instrument was administered to 72 participants at the beginning of the research subject, and 14 weeks later at the end of the subject. There was a statistically significant increase in the means for the knowledge, research orientation and skills sections of the instrument between pre- and post-testing. The instrument proved reliable as a measure of the research constructs and offers opportunities for future comparative research studies.

Adult↗

PubMed1999

Caring attributes, professional self concept and technological influences in a sample of Registered Nurses in eleven countries.

Caring, the theoretical foundation of nursing, is identified as one of the core values by Hospital Authorities world-wide to be actualised in clinical practice. Exactly how caring attributes relate to nurses' professional self image and quality nursing service in the context of a contemporary technological environment have yet to be operationalised. In total, 1957 Registered Nurses from 11 different countries were involved in the study which aimed to: develop an understanding of and compare the responses to items relating to caring, professional self concept and technological influences. To collect data an instrument containing 104 Likert items was administered to RNs working in general hospitals. The instrument contained sections which examined professional self concept, technological influences and caring attributes. Descriptive and inferential statistics revealed that many of the Asian nurses in the sample were younger, had less experience yet were more qualified than their 'western' colleagues. The mean scores for the caring attributes for nurses from the Philippines, Sweden and South Africa were significantly higher than those from China (Beijing), Korea, China (Hong Kong) and Scotland. The Korean sample demonstrated the lowest mean score for professional self concept while the New Zealand sample the highest. The Australian, Canadian, NZ, Scotland and Swedish samples were strongly of the opinion that the increase in technology has not brought about the any more spare time in nursing and generally had a more negative opinion about the influence of technology when compared to those from China (Beijing), Philippines, China (Hong Kong) and Singapore. The results are discussed in the light of the cultural differences in the sample and recommendations for future research are considered.

Adult↗

PubMed1999

Assessing nursing students' basic communication and interviewing skills: the development and testing of a rating scale.

This study explores the communication skills of a group of nursing students who were required to interview a simulated client as part of their studies. In order to assess the students and to improve the process of learning discrete skills, an instrument was developed and tested as part of this process. The subjects were 212 nurses enrolled in a bachelor of nursing programme, in New South Wales, Australia, who were studying a problem-based learning package the focus of which was 'alcohol early intervention'. The sub-groups within the sample included registered nurses, a significant percentage of whom had completed their basic nursing education in overseas countries. The Simulated Client Interview Rating Scale (SCIRS) was developed to assess basic humanistic communication skills as well as beginning motivational interviewing skills. The students were required to interview a simulated client and demonstrate competence in interviewing. This was assessed by the SCIRS which was completed by the students and the simulated clients. The instrument proved to be a reliable and valid means of assessing student interview technique as well as a flexible educational tool, while valuable insights into students' interviewing techniques were gained.

Alcoholism↗

PubMed1999

Therapeutic communication strategies used by Hong Kong mental health nurses with their Chinese clients.

Therapeutic communication is central to mental health nursing and through this process nurse-client relationships can be enhanced. In Hong Kong, mental health nurses are educated in 'western' theories and strategies in using therapeutic communication and the field of communication is predominantly Eurocentric. However, the majority of people in Hong Kong are Chinese and little research has been conducted into how Hong Kong nurses communicate with their Chinese clients. This qualitative study focused on identifying the therapeutic communication strategies used by mental health nurses with Chinese clients in Hong Kong. Three case study vignettes with some of the characteristics of Chinese culture were developed to elicit information about the strategies that respondents used in therapeutic communication. The purposive sample of 20 comprised 10 admission ward nurses and 10 community nurses from two psychiatric hospitals. All participants had at least five years post-registration experience. Content analysis revealed categories of communication and theme clusters for the nurses' response to the vignettes. The result showed a unique cultural influence emerged in communication patterns. In view of the scant nature of existing literature and studies in this area, this research provided some valuable data for further studies. Implications for mental health nursing education and practice in Hong Kong are raised, as are implications for nurses working in multicultural countries such as Australia, the UK and the USA, where there are significant numbers of Chinese clients who would benefit from nurses practising with a deeper understanding of communication strategies which are culturally bound.

Adult↗

PubMed1999

A report of the development of a Chinese and British education initiative.

A significant event in the development of psychiatric and mental health nursing in China was conducted at An Ding Hospital, Beijing from May 5th to 9th 1999. The Peking Union Medical College, School of Nursing and An Ding Psychiatric Hospital hosted a series of workshops, conducted by Professor Philip Burnard (University of Wales), Dr David Arthur (Hong Kong Polytechnic University) and Madam Wang Zhiying (Director of the Nursing Department An Ding Hospital) for approximately 100 nurses from various regions of China.

China↗

PubMed1999

Secondary leukemia or myelodysplastic syndrome after treatment with epipodophyllotoxins.

PURPOSE: The incidence of secondary leukemia after epipodophyllotoxin treatment and the relationship between epipodophyllotoxin cumulative dose and risk are not well characterized. The Cancer Therapy Evaluation Program (CTEP) of the National Cancer Institute (NCI) has developed a monitoring plan to obtain reliable estimates of the risk of secondary leukemia after epipodophyllotoxin treatment. METHODS: Twelve NCI-supported cooperative group clinical trials were identified that use epipodophyllotoxins at low (<1.5 g/m2 etoposide), moderate (1.5 to 2.99 g/m2 etoposide), or higher (> or =3.0 g/m2 etoposide) cumulative doses. Cases of secondary leukemia (including treatment-related myelodysplastic syndrome) occurring on these trials have been reported to CTEP, as has duration of follow-up for all patients, thereby allowing calculation of cumulative 6-year incidence rates of secondary leukemia for each etoposide dose group. RESULTS: The calculated cumulative 6-year risks for development of secondary leukemia for the low, moderate, and higher cumulative dose groups were 3.3%, (95% upper confidence bound of 5.9%), 0.7% (95% upper confidence bound of 1.6%), and 2.2%, (95% upper confidence bound of 4.6%), respectively. CONCLUSION: Within the context of the epipodophyllotoxin cumulative dose range and schedules of administration encompassed by the monitoring plan regimens, and within the context of multiagent chemotherapy regimens that include alkylating agents, doxorubicin, and other agents, factors other than epipodophyllotoxin cumulative dose seem to be of primary importance in determining the risk of secondary leukemia. Data obtained by the CTEP secondary leukemia monitoring plan support the relative safety of using epipodophyllotoxins according to the therapeutic plans outlined in the monitored protocols.

Adolescent↗

PubMed1999

Development of the South-East Forum on Nursing Science (SEAFONS).

The development of regional cooperation in doctoral programs in Asia is described along with the names of the program in each of the following countries: South Korea, Thailand, Japan, Hong Kong, Philippines, and Taiwan. The need for doctoral education in nursing is also described.

Asia, Southeastern↗