Biomedical subjects

Joanne W Y Chung

Publications and source records attributed to Joanne W Y Chung.

At least 19 recordsLinked to original sources

PubMed2006

Auriculotherapy on low back pain in the elderly.

The objective of the study was to examine the effectiveness of auriculotherapy using magnetic pellets for the elderly suffering from low back pain (LBP). Sixty participants who were 60-years old or above and had been suffering from LBP were recruited. Participants were randomly allocated to receive auriculotherapy on a 3-week basis using either Semen Vaccariae (control group=30) or magnetic pellets (experimental group=30). Seven auricular acupoints that are believed to have an effect on LBP were selected. Treatment effects were evaluated using the Chinese Pain Intensity Verbal Rating scale (VRS). The experimental group had indeed experienced a significant improvement in pain relief when compared with the control group; and the therapeutic effects were sustained at 2 and 4-week follow-up periods after the therapy. Findings of this study demonstrated that auriculotherapy using magnetic pellets significantly reduce the pain intensity level of the elderly suffering from non-specific LBP.

Acupressure↗

PubMed2006

Are there gender differences in pain perception?

Chronic pain conditions are increasingly prevalent. However, very little is known about the relationship between pain and gender. The purposes of this study were to determine gender differences in pain threshold and tolerance among Chinese adults in Hong Kong and to examine the role of anxiety in pain perception. One hundred seventy-eight healthy, pain-free adults (89 men and 89 women) were recruited from a local university by convenience sampling to participate in the study. All participants completed the State and Trait Anxiety Inventory and underwent a laboratory pain task to determine their pain threshold and tolerance levels. Pain was assessed by using the Pain Intensity Verbal Rating Scale-Chinese version. Compared to men, women had a lower threshold (p < .001) and tolerance (p < .001) for pressure pain, and women reported more pain (p < .01) at the pain tolerance level. Higher trait anxiety scores were associated with higher pain report in men only (r [89] = .22, p = .04). The study indicated that gender differences in pain perception exist among the Chinese population in Hong Kong. A better understanding of the factors that contribute to gender differences in pain perception could reduce gender bias in pain management.

Adult↗

PubMed2006

An evaluation of nursing practice models in the context of the severe acute respiratory syndrome epidemic in Hong Kong: a preliminary study.

AIM AND OBJECTIVE: Like other health-care workers, Hong Kong nurses had their professional knowledge and skills seriously challenged during the SARS outbreak. Could current nursing practices support the care of SARS or SARS-like patients in the future? If not, alternative practices would be needed. Providing a preliminary understanding, this paper compares the conventional with different nursing delivery models in a simulated SARS ward and focuses on nurses' efficiency, infection control practices and views of the two models. DESIGN AND METHODS: This study was conducted in three phases. First, a baseline understanding of nursing practices was achieved through four workflow observations. In an eight-hour day, four research assistants observed nursing activities in the medical and fever wards. These data were used in the second phase to construct two sets of clinical vignettes, pertaining to SARS patient care in both conventional and alternative practice models. These scripts were discussed with nine nurses of various ranks from the hospital under study for their expert validation and input. In the third phase, nurse participants and patient actors enacted the vignettes in a simulated setting. Video-taped observations and four nurse participant interviews were employed. Observational data were analysed through descriptive statistics and independent t-tests. Textual data were coded and categorized for common meanings. RESULTS: Conventional practice from the findings consisted of cubicle and named nurse nursing. While the former reflected modified team and functional nursing, it did not confine patient care within a cubicle as suggested by its name. The latter depicted a modified primary nursing approach in a team, with delegation of care. Preliminary findings concerning infection control and nurse satisfaction revealed that the alternative model had an advantage over the conventional. RELEVANCE TO CLINICAL PRACTICE: This study findings lay the foundation for clinical trials, which would evaluate the significance of patient-care quality, cost-effectiveness and better human resource management by restructuring current nursing practices.

Clinical Competence↗

PubMed2006

Experience sharing on the implementation of telehealth system in Hong Kong.

With the growth of the ageing population in Hong Kong, healthcare professionals believe that there will be a great demand of healthcare service at the community level. In 2000, the first prototype of telehealth system was developed, tested and validated by the School of Nursing, The Hong Kong Polytechnic University. With the advancement of information technology and inexpensive video- conference facility, an inter-clinic patient-centered healthcare information system has been evolved and used by a number of satellite clinics since 2003. In order to foster the importance of personal healthcare education at the community level, different versions of the telehealth system were designed and developed for school children and teenagers. Now the research team is focusing on the development of the pocket PC's version. Experience on the deployment of such technology-intensive system in healthcare was discussed in this paper.

Diffusion of Innovation↗

PubMed2006

Using pulse oximetry level to indicate the occurrence of sleep apnoea events.

The aim of this research study was to identify an alternative to nasal airflow as a prompt and unobtrusive indicator of sleep apnoea events. This study attempted to select pulse oximetry (SpO2) level as an alternative parameter to indicate the occurrence of sleep apnoea. Ten subjects diagnosed with sleep apnoea underwent an overnight polysomnography (PSG) study. Signals of nasal flow and SpO2 level were recorded. Time differences were compared between the "onset of nasal airflow cessation" (ONAC) and the "onset of three percent oxygen desaturation from the baseline" (OOD) during sleep apnoea events. The results of this study showed that measuring SpO2 level was more comfortable for patients, but that there was around a twenty second delay after the onset of the cessation of nasal airflow. It was concluded that the measurement of SpO2 level was useful for screening suspected sleep apnoea patients, but it might not be able to provide "online detection" of the occurrence of sleep apnoea events.

Adult↗

PubMed2005

Comparison of the prevalence and risk factors for depressive symptoms among elderly nursing home residents in Taiwan and Hong Kong.

BACKGROUND: Depression in the elderly has become a serious health care issue worldwide. However, no studies have compared the prevalence and risk factors for depressive symptoms among institutionalized Chinese elders living in different regions. OBJECTIVES: To explore and compare the prevalence and risk factors for depressive symptoms among elderly residents of nursing homes in Taiwan and Hong Kong. METHODS: Random sampling was used to recruit participants from eight nursing homes in each region. A total of 150 elders from Taiwan and 214 elders from Hong Kong participated. RESULTS: The prevalence of depressive symptoms was significantly higher in participants from Hong Kong (65.4%) than in Taiwan (43.3%). Logistic regression analysis indicated that gender, satisfaction with living situation, perceived health condition, and perceived income adequacy significantly predicted depressive symptoms in elderly nursing home residents in Taiwan. Significant predictors of depressive symptoms in the Hong Kong sample were satisfaction with living situation, cognitive status, and functional status. CONCLUSIONS: It is important to consider risk factors specific to a target population when developing depression intervention programs.

Aged↗

PubMed2005

An exploratory study of nurses suffering from severe acute respiratory syndrome (SARS).

In 2003, severe acute respiratory syndrome (SARS) came to be recognized as a newly emergent form of disease that is highly contagious. The aim of this study was to describe the perceptions of nurses with SARS in Hong Kong, as the perceptions of nurses who have suffered from SARS have not been studied. Ten nurses who had suffered from SARS were interviewed, either face-to-face or by telephone, about their subjective experiences. These interviews provided in-depth, descriptive data, which were analysed using content analysis. Nine broad categories were identified: uncertainty, information control, feelings of anger and guilt, lack of preparation and fear of death, feelings of isolation and loneliness, physical effects, support, change of perspective of life, and change of perspective of nursing. Although the dreaded disease affected the nurses tremendously, both physically and psychologically, it has also had its positive side. As a result of experiencing the illness, the participants came to treasure relationships, health and everyday life more. In caring for patients, they came to see the world more from the perspective of the patients. They found that they need to take the time to reassure patients and families and to seriously listen to all of their concerns.

Adaptation, Psychological↗

PubMed2004

Experiences of online learning: students' perspective.

This paper explores students' views of an online learning initiative within a post-registration degree in nursing in Hong Kong. A self-administered questionnaire was used for data collection. One hundred and ninety eight students completed the study. Online learning was seen to be convenient allowing students to study at their own pace and time. Students reported that online learning enabled them to hold a higher level of accountability for their own learning and to learn independently. Not all experiences were positive. A major hindrance to online learning was the inadequate opportunity for human interaction which was deemed necessary for establishing peer support and developing in-depth group discussion on subject matter. These findings provide a guide for further development and improvement in online teaching and learning methodologies.

Computer-Assisted Instruction↗

PubMed2004

Effective personal protective clothing for health care workers attending patients with severe acute respiratory syndrome.

BACKGROUND: Optimal usability is crucial in providing protection for health care workers who are exposed to severe acute respiratory syndrome day and night while taking care of patients with the virus. No research study has yet tested the usability of personal protective clothing (PPC). METHOD: The study was carried out in 3 stages. PPC available in Hong Kong were sorted by their physical properties in the first stage. The second stage was a single-blinded study examining the different usability aspects of the PPC. The third stage was a simulated viral load test. RESULTS: Four types were identified: good water repellency and water resistance, poor air permeability (Type A PPC); good water repellency and air permeability, poor water resistance (Type B PPC); poor water repellency, poor water resistance, and fair air permeability (Type C PPC); and good water repellency, poor air permeability, and fair water resistance (Type D PPC). Type D PPC had a significantly higher number of contamination sites on the subjects' dorsum and palm. Type C PPC had the highest contamination over the trunk. Findings in the viral load test showed that there was a significant difference in the contamination of the face (t=4.69, df=38, P<.00) between 1 and 2 strokes. CONCLUSION: Type A PPC is effective in providing a desirable protective function against droplet splash, if a disposable PPC is required. Type C PPC, the surgical gown, is also appropriate, as the cost is low, air permeability is fair, and the level of possible hand contamination is lowest among the 4 groups in the current study.

Adult↗

PubMed2004

Rapid assessment of a helpdesk service supporting severe acute respiratory syndrome patients and their relatives.

BACKGROUND: To contain severe acute respiratory syndrome, the Hong Kong Hospital Authority set a policy that stipulated there should be no visitors to hospital wards. A helpdesk service was established with the goal of providing immediate emotional and communication support to relatives while severe acute respiratory syndrome patients were isolated during the acute phase of the illness. AIM: This study describes the results of a rapid assessment of the effectiveness of a helpdesk service designed to meet the immediate needs of relatives of severe acute respiratory syndrome patients in Hong Kong. DESIGN: Survey. METHOD: Eighty-three respondents, representing about 46.3% of relatives (179), attending the helpdesk on the day of the study were recruited. Service evaluation data was collected using a self-administered questionnaire completed by respondents. RESULTS: Nearly 100% of respondents who used the service found the delivery service with on-site counselling useful for alleviating their anxiety. However, about half of these relatives complained of insufficient information regarding the patient's condition and progress. The majority of respondents were satisfied with the service. In describing the most important traits of the service providers, caring and enthusiasm were mentioned most frequently by respondents who stated that they were very satisfied with the service. CONCLUSION: The results support the value of the service, and demonstrate that the service is effective in meeting relatives' immediate needs. These needs include information, aid in fulfilling their role as caretaker for the patient (delivering prepared soup) and psychological support. The results suggest that facilitation of visitation of patients by relatives via video conferencing and education of the public on the nature and course of severe acute respiratory syndrome to reduce the social stigma of having a potentially life-threatening disease should be introduced in Hong Kong. RELEVANCE TO CLINICAL PRACTICE: The results highlight important attributes that helpers (nurses) should have in order to alleviate the suffering of severe acute respiratory syndrome patients and their relatives.

Adult↗

PubMed2004

Non-attendance at an orthopaedic and trauma specialist outpatient department of a regional hospital.

PURPOSE: To assess the extent of and reasons for non-attendance in the Orthopaedic and Trauma Specialist Outpatient Department. METHOD: The first stage was a retrospective survey and the second stage was a structured face-to-face interview. RESULTS: In stage 1, monthly statistics (12 months) were reviewed. There were no significant statistical differences between the attendance and default counts/rates and the seasons, except the default rate (F = 5.537 (3,8), P = 0.024). The mean default rate ranged from 17.6 to 20.62% over the four seasons. April-June had the lowest mean default rate. In stage 2, 50 subjects were recruited randomly; 25 had attended the clinic and 25 had not. There were no significant differences in the demographic characteristics between the two groups or in the ratings of the attitudes towards the various professional groups. However, those who did not attend the clinic expressed most dissatisfaction with the waiting time, the quality of consultation, and the facilities in the waiting area. DISCUSSION: Although the exact waiting time was not recorded, this did not stop us from evaluating the work process with the aim of shortening waiting time and improving the quality of that time. To develop measures that shorten waiting time, it was necessary to review the functional process of a consultation session. The quality of waiting time can be enhanced by rearranging the waiting areas, providing more chairs, improving the lighting, and ensuring the cleanliness of the toilet facilities. An education programme that adopts a behavioural approach is suggested to help clients appreciate the value of follow-ups.

Adult↗

PubMed2003

Postoperative pain management: study of patients' level of pain and satisfaction with health care providers' responsiveness to their reports of pain.

The present prospective survey was conducted in a 1200-bed hospital to examine postoperative patients' current pain intensity, most intense pain experienced, satisfaction with postoperative pain management, and differences regarding pain and satisfaction levels. All adult patients admitted to a hospital in Hong Kong for surgery, except those receiving local anesthesia, were eligible to enter this study. The patient outcome questionnaire developed by the American Pain Society was used to solicit data about patients' pain and satisfaction with pain relief. The subjects were 294 postoperative patients. Approximately 85% complained about varying degrees of pain during the 24 h prior to the assessment of their pain. When interviewed, most patients complained of mild to moderate pain (median = 2 on a 10-point scale), while the median for 'worst pain intensity' was 5. Approximately 80% of the subjects indicated that both the nurses and physicians reminded them to report pain when it occurred. Only 143 (48.6%) agreed that the nurses and physicians sufficiently emphasized the importance of pain relief. Those who received acute pain services, provided by anesthetists, reported lower levels of current pain intensity. Over 65% of the subjects were satisfied with all levels of health care providers, regarding their postoperative pain management.

Adult↗

PubMed2003

Visual stimulation as pain relief for Hong Kong Chinese patients with leg ulcers.

Analgesic potential of visual stimulation was examined in 33 patients with leg ulcers in a randomized, controlled, crossover clinical trial. Patients were alternating between wearing an eyeglass display with soundless VCD broadcast (V-sessions) and a static blank screen (B-sessions) while receiving superficial debridement and wound dressing for their leg ulcers. A significant reduction in pain scores was found during V-sessions (VAS 67.7 +/- 28.4 vs. 25.6 +/- 29.8 when V-sessions vs. B-sessions, with p < 0.01). Age was positively correlated with the improvement in VAS, whereas gender, residency, and the underlying medical conditions were not correlated with the improvement in pain score. The use of visual stimulation might be beneficial to both genders, in an older age group regardless of the underlying medical conditions. This is the pioneer use of visual stimulation as a non-pharmacological adjuvant to pain relief among a local Chinese population. The study will certainly add knowledge to the existing pain relief methods.

Adult↗

PubMed2002

Diagnostic reasoning processes using patient simulation in different learning environments.

The purpose of the study was to explore the diagnostic reasoning process among nursing students with different learning environments. A case-study design was adopted. Twenty subjects were randomly drawn from the last year of a pre-registration nursing programme in two institutions, 10 from a university and 10 from a nursing school. They were asked to complete the Bigg's Study Process Questionnaire and identify the differential diagnosis for the three simulated scenarios. The results showed no significant difference in study approaches between the two groups. Two subjects from the university made an incorrect differential diagnosis, as did one from the nursing school. Subjects from the university showed a mix of horizontal (66.6%) and vertical reasoning patterns (33.4%), while those from the nursing school used horizontal (100%) reasoning patterns. The results indicated that all subjects from the nursing school adopted backward chaining strategies (horizontal) for decision-making, i.e. hypothesis-driven. About a third of the subjects from the university adopted forward chaining strategies (vertical), i.e. data-driven. The study did not show any particular advantages from either of the two learning environments in terms of study approach. However, it highlighted the variations in decision strategies among students in the university setting.

Curriculum↗

PubMed2002

The effect of visual stimuli on pain threshold and tolerance.

For many hospital patients, the experience brings pain and anxiety. Unfamiliar surroundings, various diagnostic and therapeutic procedures, and the sight and sounds of medical procedures exacerbate pain and anxiety. To block off the anxiety-inducing sights and sounds of hospital surroundings and create a pleasing environment, the therapeutic potential of visual stimulation as a nursing intervention was investigated. In a randomized, controlled, cross-over study, pain was produced by a modified tourniquet technique in 46 healthy volunteers. Subjects were randomly allocated to two groups (Group V and Group B) with subsequent cross-over. Those in Group V watched a soundless video display of natural scenery during tourniquet inflation, whereas in Group B subjects watched a static blank screen. Pain threshold was defined as the time when subjects reported the first detectable pain, whereas pain tolerance was the time the pain was reported to be intolerable and deflation of the tourniquet was requested. With the use of visual stimuli, there was a significant increase in pain threshold (P < 0.05) and pain tolerance (P < 0.01). Gender and the sequence of visual stimuli did not have any significant effect on pain threshold and pain tolerance. Further studies specifically addressing level of anxiety and physiological data correlated with pain scores and visual stimuli are needed. The findings have implications for nurses and other healthcare professionals to use various visual stimuli as positive adjuncts to other methods of pain relief and for different pain conditions in clinical areas.

Adult↗

PubMed2002

An experimental study on the use of manual pressure to reduce pain in intramuscular injections.

To investigate whether the application of manual pressure to the injection site before intramuscular injection reduces pain. An experimental study with intrasubject comparison was conducted using manual pressure to reduce pain associated with intramuscular injection. Seventy-four subjects, participating in an immunization vaccination campaign, were recruited by convenience sampling from a university. They were required to receive two doses of vaccines via intramuscular injections. One was given in a conventional way, i.e. without manual pressure being applied prior to the injection (control condition). The other was given with manual pressure being applied prior to the injection (experimental condition) for 10 seconds. The two conditions were randomly allocated for each subject. The instrument for measuring the perceived pain intensity was the Pain Intensity Verbal Rating Scale (Cantonese). To ensure the consistency of manual pressure being applied to the injection site, a mechanical pressure sensor device was used to record the manual pressure being applied. The mean manual pressure applied was 190.82 mmHg (SD=5.25). Results demonstrated a significant difference in the perceived pain intensity for experimental and control conditions. Subjects with manual pressure applied before injections reported lower pain intensity scores, whilst those without the application of manual pressure before injections reported higher pain intensity scores. Applying manual pressure to an injection site before performing an injection could be an effective means of decreasing pain intensity.

Adult↗

PubMed2002

The effect of visual stimulation via the eyeglass display and the perception of pain.

Hospitalization involves anxiety and pain for many people. Unfamiliar hospital settings, various diagnostic and therapeutic procedures, and the sight and sounds of medical procedures exacerbate pain and anxiety. By blocking off the anxiety-inducing sights and sounds of the hospital surroundings and creating a pleasant environment, an eyeglass display might be able to change the sensation and perception of pain. In this randomized, controlled, crossover study, 72 healthy university student volunteers were asked to wear a light-weight eyeglass that projected a feeling of watching a 52-inch television screen at 6 1/2 feet in distance while pain was produced by a modified tourniquet technique. Subjects were randomly assigned to participate in a V-session or B-session first, with subsequent cross-over. In a V-session, subjects were instructed to wear the eyeglass and watch the soundless display of natural scenery during the inflation. In a B-session, the eyeglass that subjects wore would project a static blank screen. During V-sessions, there was a significant increase in pain threshold (p < 0.001) and pain tolerance (p < 0.001). The degree of immersion was positively correlated with improvement in pain threshold, whereas the anxiety level was negatively correlated with improvement in pain threshold. These findings have implications for using visual stimulation as a positive adjunct to other methods of pain relief and for different pain conditions. This study was considered to be the pioneer use of visual stimulation in the local Chinese community as an adjunct to pain relief.

Adult↗

PubMed2002

The application of eyeglass displays in changing the perception of pain.

We have been examining the potential value of visual stimulation via the eyeglass displays in changing the perception of pain. In this randomized, controlled, cross-over study, 72 healthy university student volunteers were asked to wear a light-weighted eyeglass projecting a feeling of watching a fifty-two-inch television screen in a close distance while pain was produced by a modified tourniquet technique. There is a significant increase of pain threshold and pain tolerance with the effect of visual stimulation. These findings having implications of using visual stimulation as positive adjunct to other methods of pain relief and to different pain conditions in clinical areas.

Adult↗