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Biomedical subjects

D T Lee

Publications and source records attributed to D T Lee.

At least 37 records · Page 2Linked to original sources
PubMed2000

Identifying women at risk of postnatal depression: prospective longitudinal study.

OBJECTIVE: To identify psychosocial risk factors for postnatal depression among Hong Kong Chinese women. DESIGN: Prospective longitudinal study involving self-report questionnaires and face-to-face interviews. SETTING: University teaching hospital, Hong Kong. PARTICIPANTS: Two hundred and twenty consecutive Chinese women who were admitted to the postnatal ward of the Department of Obstetrics and Gynaecology from 6 November 1996 to 18 January 1997. MAIN OUTCOME MEASURES: Psychiatric diagnoses were established using the clinician-administered Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders. Psychosocial risk factors were ascertained by conducting face-to-face interviews and using psychometric rating scales. RESULTS: Of the 330 women who delivered during the study period, 220 (66.7%) agreed to participate in the study. The 220 participants had a mean age of 29 years (range, 16-42 years). Postnatal depression was associated with depression during pregnancy, elevated depression score at delivery, and prolonged postnatal 'blues'. Other correlates of postnatal depression were temporary housing accommodation, financial difficulties, two or more induced abortions, past psychiatric disorders (including depression), and an elevated neuroticism score. Postnatal depression was more likely if the spouse was disappointed with the gender of the newborn. CONCLUSION: Some risk factors are similar to those found in the West, whereas others (spouse disappointment and history of abortion) may be unique to the local population. To help identify women who are at particularly high risk of developing postnatal depression, obstetricians and midwives in Hong Kong should consider codifying the identified risk factors into a check-list.

Adolescent↗
PubMed1999

Spontaneous abortion: a randomized, controlled trial comparing surgical evacuation with conservative management using misoprostol.

OBJECTIVE: To compare the efficacy of surgical evacuation of the uterus with medical evacuation using misoprostol in cases of spontaneous abortion. DESIGN: A prospective, randomized, controlled trial. SETTING: A university teaching hospital. PATIENT(S): Six hundred thirty-five women who aborted spontaneously and who consented to pretreatment randomization. INTERVENTION(S): Routine surgical evacuation or medical evacuation of the uterus using misoprostol. MAIN OUTCOME MEASURE(S): Immediate, short-term (2-3 weeks), and medium-term (6 months) medical complications. RESULT(S): There was a significantly lower incidence of immediate and short-term complications in the group treated with misoprostol compared with the surgically treated group. There were also fewer major complications in the 6 months after treatment in the medically treated group. Approximately 50% of the medically treated group subsequently required surgical evacuation, and these subjects required significantly more analgesia. CONCLUSION(S): Treatment with misoprostol can reduce the demand for surgical evacuation in cases of spontaneous abortion, and its use is associated with fewer medical complications.

Abortifacient Agents, Nonsteroidal↗
PubMed1999

Use of physical restraints on elderly patients: an exploratory study of the perceptions of nurses in Hong Kong.

A qualitative study was designed to explore nurses' perceptions of the use of physical restraints on elderly patients in Hong Kong. Content analysis of semi-structured interviews with 20 registered nurses working in medical and geriatric settings of two regional hospitals revealed that although nurses generally had mixed feelings about the use of physical restraints on elderly patients, they did not question this 'routine' practice and their knowledge about the consequences and alternatives to the use of restraint was limited. It was found that nurses had an overriding concern in ensuring elderly patients' physical safety and using restraints therefore provided them with a sense of security. The deleterious impact of restraint on the care received by elderly patients was largely unrecognized. Implications for practice and future studies are discussed in the light of these findings.

Adult↗
PubMed1999

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.

Aged↗
PubMed1998

Case management: a review of the definitions and practices.

Case management has been suggested as an innovative strategy which facilitates the linking of quality and cost-effective care. However, there is little consensus about what is actually being introduced under the name of case management. It is suggested that this absence of a clear understanding of case management has been an obstacle in moving forward case management practice and research. This paper presents a critical review of the confusion surrounding case management with an attempt to unravel issues relevant to the implementation of case management into community nursing practice in Hong Kong. It is concluded that there is a need for different definitions of case management as a result of the differences in the cultural and health care context in which it is being practised. Also, if case management programmes are to be advanced, there needs to be more co-ordinated effort in researching not only the expected outcomes but also the structures and processes of these programmes so that findings of similar case management programmes can be compared for ways of future improvement.

Case Management↗
PubMed1998

The processes of case management: a review of the evaluation of a pilot study for elderly people in Hong Kong.

AIM: This paper is based on research into case management that aimed to evaluate the processes of the introduction of case management for elderly people into the community nursing services in Hong Kong. BACKGROUND: The Hospital Authority in Hong Kong introduced a pilot Case Management scheme into the Community Nursing Services. A research project was therefore developed to evaluate this case management model. METHOD: The processes were measured through information gained from group interviews, daily diaries and weekly activity sheets. FINDINGS: The roles and work practices of the Care Coordinators and Case Managers are described and the benefits of case management to patients, carers and nurses are highlighted. Difficulties are also discussed and good practices are identified. CONCLUSION: Staff in the hospital and community need time to get used to the model of case management and to the accompanying documentation. The role of the case manager needs to be clearly dilineated.

Aged↗
PubMed1998

Detecting postnatal depression in Chinese women. Validation of the Chinese version of the Edinburgh Postnatal Depression Scale.

BACKGROUND: We evaluated the utility of the Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) and measured the prevalence of major depression six weeks after confinement among Chinese women in Hong Kong. METHOD: A prospective cohort of 145 women completed the EPDS, the 12-item General Health Questionnaire (GHQ) and the Beck Depression Inventory (BDI) six weeks after giving birth. They were then assessed with the Structured Clinical Interview for DSM-III-R, non-patient version (SCID-NP) to establish psychiatric diagnosis. The criterion validity of EPDS was tested against this clinical diagnosis, and the concurrent validity against the GHQ and BDI scores was also evaluated. The internal consistency of the scales was measured by Cronbach's alpha coefficient. RESULTS: The Chinese EPDS had satisfactory psychometric properties and a cut-off score of 9/10 is recommended for screening depressive illness in a general postnatal population. At six weeks postpartum, 5.5% of the study population suffered from major depression. CONCLUSIONS: The Chinese EPDS will be useful for screening for postnatal depression.

Adolescent↗
PubMed1998

Comparison between high-pass resolution perimetry and differential light sensitivity perimetry in patients with glaucoma.

PURPOSE: High-pass resolution perimeters such as the Ophthimus (High Tech Vision, Malmö, Sweden) may provide an easier, faster assessment of the visual field than conventional perimeters such as the Humphrey (Humphrey Instruments Inc., San Leandro, CA, U.S.A.), which is based on differential light sensitivity. The Ophthimus provides global indices and statistical analyses conceptually similar to those produced by the Humphrey. In addition, the Ophthimus provides, as a unique parameter, the estimated neural capacity. PATIENTS AND METHODS: Twenty-one patients with chronic open-angle glaucoma and reliable fields on both Humphrey and Ophthimus testing were evaluated. The results from the two different techniques were compared. RESULTS: The estimated neural capacity was correlated to global deviation and mean deviation at a statistically significant level. There were also correlations between mean deviation and global deviation and between pattern standard deviation and local deviation, but not between retest standard deviation and short-term fluctuation. CONCLUSION: It is not clear at this point if the neural capacity of the Ophthimus provides any clinically useful information over and above global deviation. Mean test time was shorter with the Ophthimus system than the Humphrey. Performance on the reliability indices was better for the Ophthimus. The Ophthimus may prove useful in following patients with glaucoma.

Aged↗
PubMed1997

Psychiatric morbidity following miscarriage: a prevalence study of Chinese women in Hong Kong.

OBJECTIVE: Previous studies reported that 48-51% of women in Western countries developed depressive disorder following a miscarriage. There is, however, little data among non-Western populations. The aim of this study was to measure the prevalence of psychiatric morbidity following miscarriage among Chinese women in Hong Kong. METHODS: Subjects were interviewed immediately after a miscarriage to collect medical, psychiatric, and sociodemographic data. Six weeks following the miscarriage, 150 subjects were assessed with the Structured Clinical Interview for DSM-III-R (SCID) to establish psychiatric diagnoses. RESULTS: 18 subjects (12%) met the DSM-III-R criteria for major depression and 2 subjects (1.3%) were diagnosed anxiety disorder NOS six weeks after the miscarriage. CONCLUSIONS: Chinese women in Hong Kong have a lower rate of psychiatric morbidity after a miscarriage.

Abortion, Spontaneous↗
PubMed1997

The practice of health education in acute care settings in Hong Kong: an exploratory study of the contribution of registered nurses.

A multiple case study design was used to explore the practice of health education in acute care settings in Hong Kong. Two case studies, a medical ward and a surgical ward, were selected to reflect the real setting in which nurses carry out health education in acute care. Data collection methods involved the use of non-participant observation and semi-structured interviews. Seven nurses and eight patients were interviewed to explore their understanding of health education concepts, the use made in the wards of health education and the factors influencing such practice in the acute settings. Individual and cross-case analysis showed that respondents' understanding of the concept of health education was limited to patient information-giving. Although the importance of health education in acute patient care was acknowledged, the degree to which health education featured in nurses' practice was minimal. Many available opportunities for health education were missed and factors such as nurses' busy-ness and the associated lack of time and staff were identified as influencing health education practice in these acute care settings. Implications for practice and future studies were discussed in the light of these findings.

Adult↗
PubMed1997

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.

Aged↗
PubMed1997

Thermal and metabolic responses to cold-water immersion at knee, hip, and shoulder levels.

To examine the effect of cold-water immersion at different depths on thermal and metabolic responses, eight men (25 yr old, 16% body fat) attempted 12 tests: immersed to the knee (K), hip (H), and shoulder (Sh) in 15 and 25 degrees C water during both rest (R) or leg cycling [35% peak oxygen uptake; (E)] for up to 135 min. At 15 degrees C, rectal (Tre) and esophageal temperatures (Tes) between R and E were not different in Sh and H groups (P > 0.05), whereas both in K group were higher during E than R (P < 0.05). At 25 degrees C, Tre was higher (P < 0.05) during E than R at all depths, whereas Tes during E was higher than during R in H and K groups. Tre remained at control levels in K-E at 15 degrees C, K-E at 25 degrees C, and in H-E groups at 25 degrees C, whereas Tes remained unchanged in K-E at 15 degrees C, in K-R at 15 degrees C, and in all 25 degrees C conditions (P > 0.05). During R and E, the magnitude of Tre change was greater (P < 0.05) than the magnitude of Tes change in Sh and H groups, whereas it was not different in the K group (P > 0.05). Total heat flow was progressive with water depth. During R at 15 and 25 degrees C, heat production was not increased in K and H groups from control level (P > 0.05) but it did increase in Sh group (P < 0.05). The increase in heat production during E compared with R was smaller (P < 0.05) in Sh (121 +/- 7 W/m2 at 15 degrees C and 97 +/- 6 W/m2 at 25 degrees C) than in H (156 +/- 6 and 126 +/- 5 W/m2, respectively) and K groups (155 +/- 4 and 165 +/- 6 W/m2, respectively). These data suggest that Tre and Tes respond differently during partial cold-water immersion. In addition, water levels above knee in 15 degrees C and above hip in 25 degrees C cause depression of internal temperatures mainly due to insufficient heat production offsetting heat loss even during light exercise.

Adult↗
PubMed1996

Cough mixture misuse in Hong Kong--an emerging psychiatric problem?

Cough mixture misuse has become a focus of concern in Hong Kong since the late 1980s. Psychiatric admissions related to cough mixture misuse have been reported with increasing frequency during the past 5 years. A retrospective chart review of psychiatric admissions related to cough mixture misuse for a 54-month period was conducted in two psychiatric units in Hong Kong. Twenty-seven subjects were identified. The main psychiatric presentations included acute organic brain syndrome, schizophreniform psychosis and affective episode. They appeared to be associated with the pharmacological activities of opiates, antihistamines and sympathomimetics, the main ingredients of most cough mixtures.

Adolescent↗
PubMed1996

The clinical role of the nurse teacher: a review of the dispute.

Although clinical education has been acknowledged as being the 'heart' of all nursing education programmes, the role of the nurse teacher in relation to the clinical learning experience of the student nurse is an area of long-standing confusion and dispute. This unresolved problem has led to the lack of a concerted effort in the provision of educational input in the clinical area and the quality of patient care is indirectly being affected. This paper presents a comprehensive review of this dispute, with an attempt to unravel how the debate could be moved forward. It is found that the clinical role of the nurse teacher appears to be implicit and 'hidden', resulting in a wide difference in the interpretation of the extent, purpose and nature of that role. The controversies surrounding these issues were then traced and possible directions for future research are outlined.

Clinical Competence↗