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Hu H, Chau PH, Choi EPH. Physical activity, exercise habits and health-related quality of life in maintenance hemodialysis patients: a multicenter cross-sectional study. J Nephrol 2024:10.1007/s40620-024-01935-6. [PMID: 38658480 DOI: 10.1007/s40620-024-01935-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/20/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Although exercise has the potential to yield numerous benefits for maintenance hemodialysis patients, the relationship between physical activity, exercise habits, and health-related quality of life (HRQOL) has not been thoroughly investigated. This study aimed to characterize the physical activity, exercise habits, and HRQOL of maintenance hemodialysis patients while examining the associations between these factors. METHODS A convenience sampling was used to recruit 827 patients from 74 dialysis units in China. The structured questionnaire included sociodemographics, the International Physical Activity Questionnaire, exercise habits, and the Kidney Disease Quality of Life Short Form 1.3. An independent samples t-test, multivariable logistic regression analysis, and multivariable linear regression analysis were used. RESULTS The physical activity levels of 69% of participants were found to be below the recommendation of the World Health Organization. Despite 62.4% of participants reporting regular exercise, 73.8% reported light exercise intensity, and 92.6% engaged in walking or jogging. Participants' HRQOL was higher in the low-intensity exercise group compared with the moderate-to-hard-intensity exercise group. Moderate-to-high physical activity was associated with better HRQOL in 13 of the 19 domains and regular exercise was linked to higher HRQOL in four of the 19 domains. CONCLUSIONS This study identified a low level of physical activity, light exercise intensity, and walking as the primary exercise type among the participants. A significant correlation was found between higher physical activity levels, regular exercise, and better HRQOL for maintenance hemodialysis patients. It is advisable to implement strategies to enhance physical activity levels and design exercise programs for maintenance hemodialysis patients based on their real-world physical activity levels and exercise habits.
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Affiliation(s)
- Huagang Hu
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 5/F, Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
- School of Nursing, Medical College, Soochow University, Box 203, 1 Shizi Street, Suzhou, 215006, Jiangsu Province, China
| | - Pui Hing Chau
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 5/F, Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - Edmond Pui Hang Choi
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 5/F, Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong.
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Huang J, Qian X, Choi EPH, Chau PH. The Consequences of Unmet Needs for Assistance With Daily Life Activities Among Older Adults: A Systematic Review. Med Care Res Rev 2024:10775587241233798. [PMID: 38450440 DOI: 10.1177/10775587241233798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Many older adults are experiencing unmet needs for assistance with the activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Such unmet needs might threaten their physical and psychosocial well-being. We conducted a systematic review to provide a comprehensive picture of the health consequences of unmet ADL/IADL needs among older adults. Twenty-eight published articles were included for qualitative synthesis. We found that unmet ADL/IADL needs were consistently associated with higher health care utilization (e.g., hospitalization, medical spending) and adverse psychosocial consequences (e.g., anxiety, depression), while the findings of falls and mortality remain inconsistent. More studies are needed to draw firm conclusions and to allow for quantitative synthesis. This review advocates for more coordinated and comprehensive long-term care services for older adults. Future studies should explore how the adverse health outcomes identified in this review can be prevented or improved by adequately meeting older adults' needs for assistance.
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Affiliation(s)
- Jing Huang
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Xingxing Qian
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong
| | | | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong
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Cheung DST, Ho MH, Chau PH, Yu DSF, Chan WL, Soong SI, Woo J, Lin CC. Screening for Frailty Using the FRAIL Scale in Older Cancer Survivors: A Cross-sectional Comparison With the Fried Phenotype. Semin Oncol Nurs 2024:151617. [PMID: 38423822 DOI: 10.1016/j.soncn.2024.151617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 02/01/2024] [Accepted: 02/07/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES To examine the diagnostic performance of the FRAIL Scale for frailty screening with reference to the Fried phenotype and investigate its association with health outcomes in older cancer survivors. DATA SOURCE In this cross-sectional quantitative study, participants were post-treatment cancer survivors aged 65 or above. Measurements included the FRAIL Scale, Fried phenotype, Geriatric Depression Scale-15 item, Modified Barthel Inventory, and EORTC Core Quality of Life Questionnaire. Receiver operating characteristic curve analysis was performed to evaluate the diagnostic performance of the FRAIL Scale with reference to the Fried phenotype. Health outcomes associated with being frail as estimated by the FRAIL Scale and Fried phenotype were also examined using regressions. RESULTS Based on 293 older cancer survivors, the area under curve (AUC) of the FRAIL Scale was 0.79, and the optimal cut-off of 1 yielded a sensitivity of 92% and specificity of 41%. According to regression results, the FRAIL Scale was modified by adding an item on time since cancer treatment completion (AUC = 0.81), and using a cut-off of 2 for older cancer survivors, which yielded a sensitivity of 74% and specificity of 67%. The modified FRAIL Scale was associated with depressive symptoms, functional independence, fatigue, dyspnea, physical functioning, and role functioning. CONCLUSIONS The modified FRAIL Scale is proposed for use in older cancer survivors, and a cut-off of 2 should be used. IMPLICATIONS FOR NURSING PRACTICE The modified FRAIL Scale can serve as a brief screening tool for identifying frailty among older cancer survivors in practice.
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Affiliation(s)
| | - Mu-Hsing Ho
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Doris Sau Fung Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Wing Lok Chan
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Sung Inda Soong
- Department of Clinical Oncology, Pamela Youde Nethersole Hospital, Hong Kong
| | - Jean Woo
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Chia Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Alice Ho Miu Ling Nethersole Charity Foundation Professorship in Nursing, Hong Kong
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Ho JYE, Lai ET, Chau PH, Chong KC, Woo J. The role of older adult-focused social vulnerability on the relationship between temperature and emergency department attendance in a subtropical Asian city. Arch Gerontol Geriatr 2024; 117:105195. [PMID: 37734171 DOI: 10.1016/j.archger.2023.105195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/08/2023] [Accepted: 09/09/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE Older adults exhibit a wide range of capabilities and vulnerabilities that affect their capacity to respond to heat. This study analysed the associations between hot temperatures and Accident & Emergency (A&E) attendance taking into account older adult-focused social vulnerability. METHODS Daily A&E attendance data of Young-old (65-74) and Old-old (75+) was obtained for Hong Kong 2010-2019 hot seasons and stratified into three Social Vulnerability Index (SVI) groups (Low, Moderate, High). Mean temperature (lag 0-2) was analysed on A&E attendance at each SVI using Generalized Additive Models and Distributed Lag Non-linear Models. RESULTS High temperatures were associated with increased same-day (lag 0) relative risk (RR) of A&E attendance for Young-old and Old-old in High SVI districts, with RR being 1.024 (95 % CI: 1.011, 1.037) and 1.036 (95 % CI: 1.018, 1.053), respectively. The Old-old living in Moderate and Low SVI districts also demonstrated increased RR of 1.037 (95 % CI: 1.028, 1.047) and 1.022 (95 % CI: 1.009, 1.036), respectively. Fewer emergency visits were found on the subsequent day (lag 1) of hot temperatures. CONCLUSIONS Older adults, both young-old and old-old, living in districts with higher social vulnerability tended to have increased risk of A&E attendance associated with same-day high temperature. With climate change and rapidly aging population, cities should prepare to meet needs of more vulnerable older adults in extreme heat.
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Affiliation(s)
- Janice Ying-En Ho
- Department of Architecture, The University of Hong Kong, Hong Kong SAR, China; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Eric Tc Lai
- Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
| | - Ka Chun Chong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jean Woo
- Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China; Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong SAR, China
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Chen Z, Ho M, Chau PH. Gender-specific moderating role of abdominal obesity in the relationship between handgrip strength and cognitive impairment. Clin Nutr 2023; 42:2546-2553. [PMID: 37931374 DOI: 10.1016/j.clnu.2023.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND & AIMS Both low handgrip strength (HGS) and abdominal obesity (AO) are associated with cognitive impairment. However, it remains unclear whether low HGS and AO interact to affect cognition, and whether the synergistic effect varies by gender. This study aimed to examine whether the association between low HGS and incident cognitive impairment was moderated by AO among Chinese older men and women. METHODS We used the data of participants (≥60 years) from four waves (2011-2018) of the China Health and Retirement Longitudinal Study. We defined low HGS as the maximal HGS of <28 kg in men and <18 kg in women, and AO as waist circumference of ≥90 cm for men and ≥80 cm for women. Cognitive impairment was defined as a global cognitive score in the lowest 10th percentile. For each gender, we used subdistribution hazards model to estimate subdistribution hazard ratios (SHRs) for the association of low HGS and AO with incident cognitive impairment, treating mortality as the competing event and controlling for other covariates. Multiplicative interaction was assessed through a cross-product interaction term of low HGS and AO in the model. Additive interaction between low HGS and AO was evaluated by calculating the relative excess risk due to interaction (RERI) and attributable proportion due to interaction (AP). RESULTS We included 3704 participants (Mean age: 66.9 ± 5.81; 54.9% male). During the 7-year follow-up, 1133 events of interest occurred (731 cognitive impairments and 402 deaths). Incidence rates of cognitive impairment and mortality were 4.1 (95% CI: 3.8 to 4.4) and 2.2 (95% CI: 2.0 to 2.5) per 100 person-years. There were positive multiplicative (SHR for the product term = 1.974, 95% CI: 1.114 to 3.500) and additive interactions (RERI = 1.056, 95% CI: 0.027 to 2.086, AP = 0.454, 95% CI: 0.158 to 0.750) of low HGS and AO on the risk of cognitive impairment among older men. Male participants with both low HGS and AO showed an increased risk of cognitive impairment (SHR = 2.325, 95% CI: 1.498 to 3.609) compared with those without either. There was no evidence of interaction among older women (SHR for the product term = 1.151, 95% CI: 0.725 to 1.825; RERI = 0.044, 95% CI: -0.524 to 0.613; AP = 0.039, 95% CI: -0.458 to 0.536). CONCLUSIONS Low HGS and AO may interact to synergistically increase the risk of cognitive impairment among Chinese older men. Screening the highest-risk subpopulation, who may benefit most from neurocognitive prevention strategies, may maximize potential public health gains.
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Affiliation(s)
- Zi Chen
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Mandy Ho
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong, China.
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Wu C, Choi EPH, Chau PH, Štulhofer A. Adaptation and validation of the Chinese version of the New Sexual Satisfaction Scale-Short Form in a sample of Chinese women. Sex Med 2023; 11:qfad065. [PMID: 38162254 PMCID: PMC10756855 DOI: 10.1093/sexmed/qfad065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 01/03/2024] Open
Abstract
Background Existing research on sexual satisfaction has been carried out primarily in Western samples, lacking insights from less sexually permissive cultures such as China, particularly in the case of heterosexual and sexual minority women. Aim This study aimed to culturally adapt and validate the New Sexual Satisfaction Scale-Short Form (NSSS-S) in a sample of Chinese women with diverse sexual identities. Methods The standard forward-backward translation procedure and cognitive debriefing were conducted to translate the NSSS-S into Mandarin Chinese (NSSS-SC). The psychometric properties of the NSSS-SC were assessed in this cross-sectional survey. Outcomes The primary outcome measure was the NSSS-S. The World Health Organization Quality of Life-Abbreviated Form, the Positive Sexuality Scale, the Female Sexual Function Index, and a single-item measure of sexual satisfaction were used to test the measure's validity. Results A total of 336 Chinese women were recruited, with an average age of 26.82 years (SD, 6.03; range, 18-56). The 1-dimensional model had a good fit to the data and was invariant across 2 sexual identity groups (cisgender heterosexual and sexual minority women) and age. The NSSS-SC had good reliability; no significant floor and ceiling effects were observed. We found moderate to strong correlations between the NSSS-SC scores and the sexual satisfaction, sexual function, positive sexuality, and quality-of-life indicators. On average, cisgender heterosexual women were characterized by higher sexual satisfaction scores when compared with sexual minority women. Clinical Translation The NSSS-SC can be used as a reliable and culturally appropriate measure of sexual satisfaction in women of different ages and sexual identities, which could be used in future sex-related surveys. Strengths and Limitations This study is the first to translate the NSSS-S into Chinese and validate the NSSS-SC in a sample of Chinese women with varied sexual identities. However, this study recruited only female participants; future studies should also validate the NSSS-SC in Chinese men. Conclusion The NSSS-SC is linguistically equivalent to the original scale and has solid psychometric properties, which can be used to assess sexual satisfaction levels in diverse samples of Chinese women.
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Affiliation(s)
- Chanchan Wu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Aleksandar Štulhofer
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, 10000, Croatia
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Liu X, Wang T, Cheung DST, Chau PH, Ho MH, Han Y, Lin CC. Dyadic advance care planning: systematic review of patient-caregiver interventions and effects. BMJ Support Palliat Care 2023:spcare-2023-004430. [PMID: 37857471 DOI: 10.1136/spcare-2023-004430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION Family caregiver's involvement in advance care planning (ACP) is essential to provide high-quality end-of-life (EOL) care and to ease the surrogate decision-making burden. However, no systematic review has focused on existing ACP interventions involving patients and their families. AIM To systematically summarise current ACP interventions involving patients and their families. METHODS Five English and two Chinese databases were searched from inception to September 2022. The eligible studies were experimental studies describing original data. The Joanna Briggs Institute critical appraisal tools assessed the methodological quality. Narrative synthesis was conducted for data analysis. RESULTS In total, twenty-eight articles were included. Fifteen studies were randomised controlled trials, and the rest 13 studies were quasi-experimental studies. The data synthesis identified: (1) Key intervention components: strategies to promote ACP, ACP discussion and follow-up, as well as the role of family caregivers; (2) Effects on intended outcomes: interventions have shown benefit on completion of ACP actions, while inconsistent findings were found on the process outcomes and quality of EOL care. In addition, a logic model for patient-caregiver dyadic ACP was created, and the underlying mechanisms of action included well-preparation, open discussion and adequate support for plan/action. CONCLUSIONS This review provides comprehensive evidence about patient-caregiver dyadic ACP, a promising intervention to better prepare for EOL communication and decision-making. A logic model has been mapped to give a preliminary indication for future implementation. More empirical studies are needed to improve this model and culturally adapt it in a real-world setting.
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Affiliation(s)
- Xiaohang Liu
- School of Nuring, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
| | - Tongyao Wang
- School of Nuring, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nuring, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
| | - Pui Hing Chau
- School of Nuring, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
| | - Mu-Hsing Ho
- School of Nuring, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
| | - Yuanxia Han
- Department of Pancreatic Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Chia-Chin Lin
- School of Nuring, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
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Qian XX, Chau PH, Fong DYT, Ho M, Woo J. Post-Hospital Falls Among the Older Population: The Temporal Pattern in Risk and Healthcare Burden. J Am Med Dir Assoc 2023; 24:1478-1483.e2. [PMID: 37591487 DOI: 10.1016/j.jamda.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVES Older adults are prone to falls following hospital discharge, resulting in healthcare utilization and costs. The fall risk might change over time after discharge. To fill research gaps in this area, this study examined the temporal pattern in incidence and healthcare burden of post-hospital falls in older adults. DESIGN A territory-wide retrospective cohort study was conducted. SETTING AND PARTICIPANTS Participants were Hong Kong adults aged ≥65 years and discharged from hospitals between January 2007 and December 2017. METHODS The participants were followed for 12 months to identify fall-related inpatient episodes, accident and emergency department (AED) visits, and mortality after discharge. The post-hospital falls were further analyzed in 2 subcategories (1) only requiring AED visits and (2) requiring hospitalization. The incidence rate and faller incidence proportion for total falls and subcategories during the different periods were examined. The corresponding healthcare utilization and costs were calculated. RESULTS Among the 606,392 older adults discharged from hospitals during the study period, 28,593 individuals (4.7%) experienced at least 1 post-hospital fall within 12 months, resulting in a total of 33,158 falls (57 per 1000 person-years). Out of post-hospital falls presenting to hospitals, one-third only required AED visits, and two-thirds required hospitalization. The fall incidence rate peaked in the first 3 weeks after discharge and gradually decreased to a stable level from the fourth to ninth week. The annual healthcare costs related to post-hospital falls exceeded USD 28.9 million in older adults, with the mean cost per faller and fall being USD 11,129 and USD 9596. CONCLUSIONS AND IMPLICATIONS The fall-related healthcare utilizations after discharge impose a substantial economic burden on older adults. During the first 9 weeks, particularly the first 3 weeks, older adults were at high risk of falling. The efforts on resource allocation for fall prevention are suggested to prioritize this period.
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Affiliation(s)
- Xing Xing Qian
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
| | - Daniel Y T Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Mandy Ho
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Yu HJ, Ho M, Chau PH, Fong DYT. Trajectories of fasting glucose and glycated haemoglobin in obese and non-obese incident diabetes: Results from two large cohort studies. Diabetes Obes Metab 2023; 25:2835-2845. [PMID: 37336785 DOI: 10.1111/dom.15173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/22/2023] [Accepted: 05/30/2023] [Indexed: 06/21/2023]
Abstract
AIMS Diabetes development mechanisms vary by weight status. We aimed to compare cardiometabolic risk and characterize fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c) trajectories before diagnosing type 2 diabetes in individuals with/without obesity. METHODS Data from the China Health and Retirement Longitudinal Study (CHARLS) and English Longitudinal Study of Ageing (ELSA) were analysed. Participants without diabetes and with a body mass index of 18.5-40 kg/m2 at baseline were included. Incident diabetes was ascertained by self-reported physician diagnosis and/or antidiabetic drug use, FPG ≥126 mg/dl and/or HbA1c ≥6.5%. The difference in the FPG/HbA1c trajectory before the diabetes diagnosis in participants with/without obesity was examined using mixed-effects models. RESULTS Among 11 925 eligible participants, 1361 incident diabetes cases (mean age: 61.4 years; male: 46.2%) were identified within 15 years of follow-up. Obese diabetes showed higher levels of diastolic blood pressure and C-reactive protein at diagnosis than non-obese diabetes. Mixed-effects models indicated the difference in the FPG trajectory before diagnosis by weight status was non-significant with a slope difference of 0.149 mg/dl (SE = 0.642, p = .816, CHARLS) and 0.013 mg/dl (SE = 0.013, p = .337, ELSA). However, obese diabetes showed a steep increase in HbA1c before diagnosis with a slope difference of 0.036% (SE = 0.016, p = .021) in the CHARLS and 0.032% (SE = 0.014, p = .027) in the ELSA, respectively. Sex-stratified analyses showed that the difference in HbA1c trajectory before the diabetes diagnosis by weight status was only significant in males. CONCLUSIONS Obese and non-obese diabetes developments may share a similar FPG but distinct HbA1c trajectory. Obese diabetes interventions require more attention to cardiometabolic risks. Moreover, studies addressing weight/sex-related differences in diabetes aetiologies and treatments are warranted.
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Affiliation(s)
- Hong-Jie Yu
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
| | - Mandy Ho
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
| | - Pui Hing Chau
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
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Yu HJ, Ho M, Liu X, Yang J, Chau PH, Fong DYT. Incidence and temporal trends in type 2 diabetes by weight status: A systematic review and meta-analysis of prospective cohort studies. J Glob Health 2023; 13:04088. [PMID: 37651631 PMCID: PMC10471153 DOI: 10.7189/jogh.13.04088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Background Diabetes is more prevalent among overweight/obese individuals, but has become a significant public health challenge among normal weight populations. In this meta-analysis, we aimed to estimate diabetes/prediabetes incidence and its temporal trends by weight status. Methods PubMed, Embase, Web of Science, and Cochrane Library were searched until 8 December 2021. Prospective cohort studies reporting diabetes incidence by baseline body mass index (BMI) categories in adults were included. The median year of data collection was used to assess the temporal trends. Subgroup analyses and meta-regression were also performed. Results We included 94 studies involving 3.4 million adults from 22 countries. The pooled diabetes incidence in underweight, normal-weight, and overweight/obese adults was 4.5 (95% confidence interval (CI) = 2.8-7.3), 2.7 (95% CI = 2.2-3.3), and 10.5 (95% CI = 9.3-11.8) per 1000 person-years, respectively. The diabetes incidence in low- and middle-income countries (LMICs) was higher than in high-income countries among normal-weight (5.8 vs 2.0 per 1000 person-years) or overweight/obese (15.9 vs 8.9 per 1000 person-years) adults. European and American regions had a higher diabetes incidence than the non-Western areas, regardless of weight status. Underweight diabetes incidence decreased significantly from 1995-2000 to 2005-2010. Diabetes incidence in normal-weight populations has increased continuously since 1985 by an estimated 36% every five years. In overweight/obese adults, diabetes incidence increased between 1985-1990 and 1995-2000, stabilised between 2000 and 2010, and spiked suddenly after 2010. Conclusions Diabetes incidence and its temporal trends differed by weight status. The continuous upward trend of diabetes incidence among overweight/obese individuals requires urgent attention, particularly in LMICs. Furthermore, diabetes among normal-weight individuals is becoming a significant public health problem. Registration PROSPERO (CRD42020215957).
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Affiliation(s)
- Hong-jie Yu
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Mandy Ho
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Xiangxiang Liu
- National Clinical Research Center for Infectious Diseases, The Third People’s Hospital of Shenzhen, Shenzhen, China
| | - Jundi Yang
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
| | - Pui Hing Chau
- School of Nursing, University of Hong Kong, Hong Kong SAR, China
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Tsui PK, Chau PH, Wong JYH, Wang MP, Gao X, Lam OLT, Leung KCM, Lo ECM, Tiwari A. Oral care knowledge, attitude and practice among nursing staff in acute hospital settings in Hong Kong. PLoS One 2023; 18:e0289953. [PMID: 37582111 PMCID: PMC10427009 DOI: 10.1371/journal.pone.0289953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 07/17/2023] [Indexed: 08/17/2023] Open
Abstract
Investigating the oral care delivered by nursing staff in acute hospital setting is having a remarkable shortage within the current literature. This was provoked due to lack of previous performed investigation in the acute hospital setting besides inconsistent existence of a standardized and comprehensive oral care knowledge, attitude and practice (KAP) instrumentation. Therefore, the purpose of this study is to assess the oral care KAP level for inpatients among nursing staff; to identify possible barriers to the provision of oral care; and to identify training preferences to improve the oral care of inpatients, in acute hospital settings in Hong Kong; and to provide standardized comprehensive KAP based assessment tool that would benefit and guide other future studies. In this study, a cross-sectional survey was conducted after a 55-item self-administered structured questionnaire was developed. A modified KAP tool was developed. The tool includes 4 domains: oral care knowledge, attitude, practice, and experience. Nursing staff was recruited from July 2018 to April 2019 via convenience sampling. Either online or printed questionnaires were completed. Proportions of nursing staff with good KAP, as defined by having 60% of the total score in the respective domain, were estimated with 95% confidence intervals (CI). Analysis of covariance was used to compare the mean scores of KAP among different independent variables and identify the factors associated with good KAP. 404 nursing staff were recruited. Approximately 29.5%, 33.7% and 14.9% of the respondents had good oral care knowledge, attitude and practice, respectively, and 53.2% of the respondents had unpleasant oral care experience. Better oral care practice was associated with higher levels of oral care knowledge (β = 0.1) and oral care attitude (β = 0.3). To conclude: nursing staff in acute hospital settings reported low levels of oral care KAP with variations between the RN, EN and HCA. This study adds to the literature the association between oral care unpleasant experiences and the oral care practice, as well as oral care knowledge and attitude which also in turns associated with practice. The developed standardised tool could be applied for future studies. Recommendations on the future research, training and practices were made.
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Affiliation(s)
- Pui Ki Tsui
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
- Department of Childcare, Elderly and Community Services, Hong Kong Institute of Vocational Education (Sha Tin), Hong Kong Special Administrative Region, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Janet Yuen Ha Wong
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
- School of Nursing & Health Studies, Hong Kong Metropolitan University, Hong Kong Special Administrative Region, Hong Kong, China
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Xiaoli Gao
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Otto Lok Tao Lam
- George & Fay Yee Centre for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Katherine Chiu Man Leung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Edward Chin Man Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Agnes Tiwari
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
- School of Nursing, Hong Kong Sanatorium & Hospital Limited, Hong Kong Special Administrative Region, Hong Kong, China
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Hu H, Wu C, Kwok JYY, Ho MH, Chau PH, Lok KYW, Choi EPH. Effects of Different Exercises on Physical Function, Dialysis Adequacy, and Health-Related Quality of Life in Maintenance Hemodialysis Patients: A Systematic Review and Network Meta-Analysis. Am J Nephrol 2023; 54:379-390. [PMID: 37536298 DOI: 10.1159/000532109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Clinical guidelines recommend exercise training for patients undergoing maintenance hemodialysis (MHD). However, the effectiveness of different types of exercise remains uncertain. OBJECTIVES The aims of the study were to compare and rank the effect of different types of exercise on walking capacity, cardiorespiratory fitness, dialysis adequacy, and health-related quality of life (HRQOL) in patients undergoing MHD. METHODS Eight databases (four English and four Chinese) were searched from inception to January 1, 2022. Randomized controlled trials evaluating the efficacy of different exercises for patients undergoing MHD were included. Two independent reviewers screened the literature, extracted data, assessed the risk of bias, and evaluated the certainty of evidence. A frequentist random-effect network meta-analysis was conducted. RESULTS Ninety trials with 4,084 participants comparing 15 types of exercise were included, reporting on the six-minute walking test (45 trials), peak oxygen uptake (22 trials), dialysis adequacy (30 trials), and HRQOL (23 trials). Network meta-analysis showed that the most effective intervention for walking capacity was intradialytic aerobic exercise combined with blood flow restriction with a mean difference and 95% confidence interval of 97.35 (11.89-182.81), for peak oxygen uptake it was non-intradialytic combined aerobic and resistance exercise with a value of 4.35 (2.25-6.44), for dialysis adequacy it was intradialytic combined aerobic and resistance exercise with a value of 0.17 (0.06-0.28), for the physical component summary of HRQOL it was intradialytic aerobic exercise with a value of 4.93 (2.31-7.54), and for the mental component summary of HRQOL it was non-intradialytic combined aerobic and resistance exercise with a value of 6.36 (0.45-12.27). Ultimately, intradialytic combined aerobic and resistance exercise could improve all the above outcomes compared to usual care. CONCLUSIONS This study concluded that intradialytic combined aerobic and resistance exercise is optimal for MHD patients due to its significant positive effects on multiple outcomes. Walking capacity can be further enhanced by combining blood flow restriction with exercise. For improving dialysis adequacy, intradialytic exercise proves to be more effective than non-intradialytic exercise. Further well-designed clinical trials are needed to investigate the effects of exercise with varying durations, intensities, and frequencies.
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Affiliation(s)
- Huagang Hu
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China,
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China,
| | - Chanchan Wu
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Jojo Yan Yan Kwok
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Mu-Hsing Ho
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kris Yuet Wan Lok
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Edmond Pui Hang Choi
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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Hu L, Xu B, Chau PH, Choi EPH. Reproductive concerns among young adult women with breast cancer: a systematic review protocol. BMJ Open 2023; 13:e071160. [PMID: 37451712 PMCID: PMC10351261 DOI: 10.1136/bmjopen-2022-071160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 06/29/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Reproductive concerns refer to worries about impaired or lost reproductive ability due to disease or/and treatment. Many young female patients with breast cancer experience reproductive concerns because they still desire to have children at the time of diagnosis. Reproductive concerns can impact patients' treatment decision-making as well as their psychological health and quality of life. Understanding the situation, contributing factors and health-related consequences of reproductive concerns among patients with breast cancer is essential to minimise their impacts. METHODS AND ANALYSIS A systematic review will be conducted. We will search five English databases (PubMed, Embase, CINAHL, Web of Science and APA PsycInfo) and four Chinese databases (Wang Fang database, VIP, CBM and CNKI) for pertinent studies. Other relevant studies will be identified from the reference lists of included studies. Two reviewers will independently perform study selection, data extraction and quality appraisal. Any discrepancies between the two reviewers will be resolved through consultation and discussion with the senior reviewer. A formal narrative synthesis will be performed to summarise the findings of individual studies. This review aims to improve understanding of the level of reproductive concerns, factors associated with reproductive concerns and health-related consequences of reproductive concerns among patients with breast cancer. The findings can contribute to the development of tailored interventions to alleviate reproductive concerns of patients with breast cancer, enhancing their psychological health and quality of life. ETHICS AND DISSEMINATION Ethical approval is not required for this review, as it will be based on published studies. The findings will be disseminated by publishing in a journal. PROSPERO REGISTRATION NUMBER CRD42022375247.
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Affiliation(s)
- Li Hu
- School of Nursing, The University of Hong Kong, Hong Kong, China
- Breast Surgical Department, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Binbin Xu
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong, China
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Xu X, Liu X, Ho MH, Chau PH, Cheung DST, Lin CC. Factors Related to Functional Capacity Deterioration in Surgical Lung Cancer Patients: A Systematic Review. Cancer Nurs 2023:00002820-990000000-00159. [PMID: 37430422 DOI: 10.1097/ncc.0000000000001269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
BACKGROUND A decline in functional capacity is anticipated after lung resection. However, the factors related to functional capacity deterioration in surgical lung cancer patients have not been systematically reviewed. OBJECTIVE To investigate the factors related to functional capacity deterioration and the trajectory of functional capacity after lung cancer surgery. METHODS PubMed, CINAHL, Scopus, and SPORTDiscus were searched between January 2010 and July 2022. Two reviewers conducted a critical appraisal of individual sources. Twenty-one studies met the inclusion criteria. RESULTS This review presents evidence for risk factors related to functional capacity deterioration after lung cancer surgery, including patient characteristics (age), preoperative clinical factors (vital capacity, quadriceps force, B-type natriuretic peptide level), surgery-related factors (surgical procedure, duration of chest tube drainage, postoperative complications), and postoperative clinical factor (C-reactive protein level). Most patients had a significant decline in functional capacity in the short term (≤1 month from surgery). In the medium term (1 to ≤6 months from surgery), although the functional capacity did not return to the preoperative level, the decline became insignificant. CONCLUSIONS This study is the first to review factors related to functional capacity in lung cancer patients. The findings can help clinicians to better identify patients at risk of functional capacity decline and allocate clinical resources more efficiently. IMPLICATIONS FOR PRACTICE The risk factors related to the functional capacity decline in surgical lung cancer patients should be evaluated routinely during perioperative nursing assessments. Preoperative and postoperative nursing interventions can potentially improve modifiable risk factors and prevent functional capacity deterioration.
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Affiliation(s)
- Xinyi Xu
- Authors' Affiliation: School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
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Liu X, Xu X, Cheung DST, Chau PH, Ho MH, Takemura N, Lin CC. The effects of exercise with or without dietary advice on muscle mass, muscle strength, and physical functioning among older cancer survivors: a meta-analysis of randomized controlled trials. J Cancer Surviv 2023:10.1007/s11764-023-01396-z. [PMID: 37266818 DOI: 10.1007/s11764-023-01396-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 04/28/2023] [Indexed: 06/03/2023]
Abstract
PURPOSE To evaluate the effect of exercise with or without dietary advice on muscle mass, muscle strength and physical functioning (including perceived physical functioning and physical performance) in old cancer survivors. METHODS A systematic literature search was undertaken in May 2022 by searching multiple databases. Randomized controlled trials (RCTs) that compared exercise with or without dietary advice to control group among old cancer survivors were screened. Meta-analyses were conducted to evaluate the effects of exercise with or without dietary advice on muscle mass, muscle strength, and physical functioning. RESULTS Data from 21 trials were included in this study, including 16 exercise trials and 5 exercise + dietary advice studies. Regarding exercise, evidence supported its significant benefits on muscle strength among old cancer survivors, while no effect was seen on physical functioning and muscle mass. Concerning exercise combined with dietary advice, meta-analysis showed overall benefits on physical functioning, while limited study examined muscle mass and strength. As for safety and feasibility of interventions, low recruitment rate, moderate compliance, and few adverse events were reported. CONCLUSIONS Exercise combined with dietary advice is a more effective approach for old cancer survivors in improving physical functioning compared with exercise alone. Future study is needed to explore the effects of exercise combined with dietary advice on combating sarcopenia. As recruitment and compliance among old cancer survivors were challenging, strategies to stimulate their motivation and promote habitual healthy behaviour are warranted. IMPLICATIONS FOR CANCER SURVIVORS It is necessary for old cancer survivors to receive exercise and dietary support to improve physical functioning.
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Affiliation(s)
- Xiaohang Liu
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Xinyi Xu
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Mu-Hsing Ho
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
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Wu C, Chau PH, Choi EPH. Validation of the adapted female sexual function index among Chinese cisgender heterosexual women and sexual and gender minority women. J Sex Med 2023; 20:878-887. [PMID: 37076184 DOI: 10.1093/jsxmed/qdad052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND The Female Sexual Function Index (FSFI) remains the most widely used scale for assessing female sexual function. However, while an adapted version of the FSFI has been proven to be suitable for Western sexual minority women, it has yet to be used in China. AIM This study aimed to validate the Mandarin Chinese version of the adapted FSFI among Chinese cisgender heterosexual women and sexual and gender minority women, and evaluate its psychometric properties. METHODS A cross-sectional online survey was conducted. The modified scoring method related to zero responses was examined, and structural validity, internal consistency, internal reliability, convergent validity, and known-group validity were evaluated. OUTCOMES The primary measure was the adapted FSFI, and the Positive Sexuality Scale and the New Sexual Satisfaction Scale-Short Form were used to test convergent validity. RESULTS A total of 431 Chinese adult women were recruited, including 193 cisgender heterosexual women and 238 sexual and gender minority women. Confirmatory factor analysis using the original scores supported the original 6-factor model. Using both Cronbach's α and McDonald's ω, the results showed that the values of the total scale and 6 subscales were in the 0.76 to 0.98 and 0.83 to 0.98 ranges, respectively, indicating satisfactory reliability. Moderate-to-strong correlations among the total FSFI scores and positive sexuality and sexual satisfaction were found (r = 0.32-0.71), supporting good convergent validity. CLINICAL IMPLICATIONS The adapted FSFI facilitates the use of more inclusive language in the clinical setting, allowing for a more comprehensive and unbiased assessment of sexual function in all women. STRENGTHS AND LIMITATIONS This study recruited both cisgender women of varied sexual orientations and gender minorities who were assigned female at birth, demonstrating that the adapted FSFI could be suitably applied to sexual minority populations. However, from a fully inclusive perspective of sex and gender, there is no research on how to accurately evaluate transgender women with female external genitalia or appropriately assess those with a female reproductive system but who do not self-identify as female. Therefore, more in-depth research is needed to further revise the FSFI for better use in the wider female population. CONCLUSION This Chinese version of the adapted FSFI has good psychometric properties and is a reliable and valid instrument to assess female sexual function. Furthermore, the modified scoring method could be an effective alternative among samples of sexually inactive women.
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Affiliation(s)
- Chanchan Wu
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, 5/F, Academic Building, 3 Sassoon Road, Pok Fu Lam, Hong Kong SAR, China
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, 5/F, Academic Building, 3 Sassoon Road, Pok Fu Lam, Hong Kong SAR, China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, 5/F, Academic Building, 3 Sassoon Road, Pok Fu Lam, Hong Kong SAR, China
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Xu X, Chau PH, Cheung DST, Ho MH, Lin CC. Preferences for end-of-life care: A cross-sectional survey of Chinese frail nursing home residents. J Clin Nurs 2023; 32:1455-1465. [PMID: 35933614 DOI: 10.1111/jocn.16483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/27/2022]
Abstract
AIM AND OBJECTIVES To assess (1) the experience, knowledge and preferences of end-of-life care among frail nursing home residents and (2) the preferences of residents' family caregivers. BACKGROUND Globally, nursing homes are becoming an important place where many older people will receive their end-of-life care. Thus, assessing the end-of-life care preferences among nursing home residents is crucial. DESIGN Cross-sectional survey. METHODS Residents aged ≥65 years, with frail or pre-frail status (n = 286) in 34 nursing homes were interviewed using a structured questionnaire. Descriptive statistics were used to describe the outcomes and regression analyses were used to evaluate factors related to the outcomes. Kappa statistics were used to examine the agreement between the preferences among 21 residents and their family caregivers. The manuscript was guided by the STROBE checklist. RESULTS 5.9% and 10.5% of the participants had heard of advance care planning and advance directive respectively. After explanations of the terms by the research team, 42.3% of the participants preferred advance care planning, whereas 22.0% preferred advance directive. The top reason for not preferring advance care planning/advance directive is perceiving them as 'not necessary'. Nursing homes were the most preferred place to receive end-of-life care (41.6%). Whereas hospitals were the most preferred place for death (36.0%). The agreement among resident and family caregiver dyads ranged from none to minimal in most outcomes. CONCLUSIONS This study revealed the lack of awareness around advance care planning and advance directive among frail nursing home residents. Future research should focus on developing effective educational interventions to enhance the residents' awareness of these topics. RELEVANCE TO CLINICAL PRACTICE To increase awareness among nursing home residents, more educational programs should be implemented. Frail older residents might not see the relevance of advance care planning; interventions need to include both current and future care to increase its relevance.
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Affiliation(s)
- Xinyi Xu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Mu-Hsing Ho
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong.,Alice Ho Miu Ling Nethersole Charity Foundation Professorship in Nursing, Hong Kong, Hong Kong
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Li WY, Lu J, Dai Y, Tiwari A, Chau PH. A feasibility study on home-based kyphosis-specific exercises on reducing thoracic hyperkyphosis in older adults. Int J Nurs Sci 2023; 10:133-141. [PMID: 37128480 PMCID: PMC10148263 DOI: 10.1016/j.ijnss.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/16/2023] [Accepted: 03/16/2023] [Indexed: 05/03/2023] Open
Abstract
Objectives This study aimed to assess the feasibility of the home-based kyphosis-specific exercises among Chinese older adults with different exercise habits and explore its potential effects on reducing the kyphosis angle and improving physical performance. Methods A single-group, pre-and post-test design was conducted according to CONSORT 2010 statement: extension for pilot and feasibility trials. A total of 20 participants aged ≥60 with thoracic hyperkyphosis and rehabilitation potential were recruited from four local communities in Wuhan, China. Participants underwent a six-week home-based kyphosis-specific exercises intervention that included warm-up, muscle strengthens, spinal alignment, spinal mobility and flexibility, and cool down five sections (22 exercises). The intervention involved seven 1-h group classes and 35 times daily home practice with identical content. At pre- and post-intervention, the participants' kyphosis angle in two standing postures, static balance, dynamic balance, cardiopulmonary function, dynamic gait assessment, pain, and self-image were assessed and compared. Feasibility was assessed by group class attendance, home practice adherence, and participant evaluations. Results All participants completed group classes and >75% home practice. Post-intervention, the participant's kyphosis angle in relaxed and best-standing postures was changed by -12.0° (-15.5°, -4.0°) (Z = - 3.98, P < 0.001)and -10.0° (-14.0°, -5.3°) (Z = -3.79, P < 0.001), respectively. In addition, participants had significantly less pain (P < 0.001), better self-image (P < 0.001), and improved performance in five physical assessments (P < 0.01). Different pre-intervention hyperkyphosis angle and daily physical activity did not affect intervention effects. Most participants considered the interventional exercise as moderate intensity and satisfactory. Conclusions Home-based kyphosis-specific exercises showed the possibility of being a feasible intervention. And it was advantageous to reducing the kyphosis angle and improving physical performance.
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Affiliation(s)
- Wei Ying Li
- School of Nursing, Nanjing Medical University, Nanjing, China
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Corresponding author. School of Nursing, Nanjing Medical University, Nanjing, China.
| | - Jinling Lu
- Department of Gastric Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yong Dai
- Infection Control Office, The Liyuan Hospital of Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Agnes Tiwari
- School of Nursing, Hong Kong Sanatorium & Hospital Limited, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Corresponding author.
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Wu C, Chau PH, Choi EPH. Quality of Life and Mental Health of Chinese Sexual and Gender Minority Women and Cisgender Heterosexual Women: Cross-sectional Survey and Mediation Analysis. JMIR Public Health Surveill 2023; 9:e42203. [PMID: 36811941 PMCID: PMC9996424 DOI: 10.2196/42203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 01/06/2023] [Accepted: 01/18/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Health-related research on sexual minority populations in China is lacking, and research on sexual and gender minority women (SGMW, including transgender women and persons of other gender identities assigned female at birth of all sexual orientations, and cisgender women with nonheterosexual orientations) is even less. Currently, there are limited surveys related to mental health in Chinese SGMW, but there are no studies on their quality of life (QOL), no studies comparing the QOL of SGMW with that of cisgender heterosexual women (CHW), and no studies on the relationship between sexual identity and the QOL as well as associated mental health variables. OBJECTIVE This study aims to evaluate the QOL and mental health in a diverse sample of Chinese women and make comparisons between SGMW and CHW and then investigate the relationship between sexual identity and the QOL through the role of mental health. METHODS A cross-sectional online survey was conducted from July to September 2021. All participants completed a structured questionnaire containing the World Health Organization Quality of Life-abbreviated short version (WHOQOL-BREF), the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder scale (GAD-7), and the Rosenberg Self-Esteem Scale (RSES). RESULTS In total, 509 women aged 18-56 years were recruited, including 250 (49.1%) CHW and 259 (50.9%) SGMW. Independent t tests showed that the SGMW reported significantly lower levels of QOL, higher levels of depression and anxiety symptoms, and lower self-esteem than the CHW. Pearson correlations showed that every domain and the overall QOL were positively associated with mental health variables, with moderate-to-strong correlations (r range 0.42-0.75, P<.001). Multiple linear regressions found that participants belonging to the SGMW group, current smokers, and women with no steady partner were associated with a worse overall QOL. The mediation analysis found that depression, anxiety, and self-esteem significantly completely mediated the relationship between sexual identity and physical, social, and environment domains of the QOL, while the relationship between sexual identity and the overall QOL and psychological QOL was partially mediated by depression and self-esteem. CONCLUSIONS The SGMW had poorer levels of QOL and a worse mental health status than the CHW. The study findings affirm the importance of assessing mental health and highlight the need to design targeted health improvement programs for the SGMW population, who may be at higher risk of a poor QOL and mental health.
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Affiliation(s)
- Chanchan Wu
- School of Nursing, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong, China (Hong Kong)
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Yu HJ, Ho M, Chau PH, Geng L, Fong DYT. Salivary telomere length and the risks of prediabetes and diabetes among middle-aged and older adults: findings from the Health and Retirement Study. Acta Diabetol 2023; 60:273-283. [PMID: 36371747 DOI: 10.1007/s00592-022-02004-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 11/03/2022] [Indexed: 11/14/2022]
Abstract
AIM To assess the association of telomere length (TL) with prediabetes/diabetes and to explore the potential factors affecting TL among individuals with prediabetes/diabetes by weight status. METHODS This study included 3,379 eligible adults (aged 45-85 years, males: 42%) from the US Health and Retirement Study in 2008. TL was assayed using quantitative PCR of saliva (T/S ratio). Linear and nonlinear associations between TL and prediabetes/diabetes were assessed using the logistic regression and restricted cubic spline model, respectively, adjusting for TL-plate numbers, age, sex, race, body mass index, lifestyles, diabetes medications, and cardiometabolic parameters (blood pressure, C-reactive protein, and total cholesterol). Multiple linear regression was used for testing any factors associated with TL. RESULTS Among 3,379 participants, 868 (25.7%) had prediabetes with a mean TL of 1.34 ± 0.37 (T/S ratio) and 858 (25.4%) had diabetes with a mean TL of 1.36 ± 0.43 (T/S ratio). Neither linear nor nonlinear association of TL with prediabetes/diabetes was significant by weight status. Age was negatively associated with TL in both normal-weight (β = - 0.002, p = 0.025) and overweight/obese (β = - 0.002, p = 0.006) prediabetes, but non-significant in normal-weight and overweight/obese diabetes. BMI and cardiometabolic parameters were not associated with TL in prediabetes/diabetes by weight status. CONCLUSIONS Salivary TL was not associated with prediabetes/diabetes among the US middle-aged and older adults. Further longitudinal studies are required to establish the link between TL and diabetes development and to identify potential factors affecting TL shortening, particularly in normal-weight diabetic patients.
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Affiliation(s)
- Hong-Jie Yu
- School of Nursing, The University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong SAR, China
| | - Mandy Ho
- School of Nursing, The University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong SAR, China.
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong SAR, China
| | - Leiluo Geng
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong SAR, China
- Department of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Daniel Yee Tak Fong
- School of Nursing, The University of Hong Kong, 3 Sassoon Road, Pokfulam, Hong Kong SAR, China
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21
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Ho M, Smith R, Chau PH, Chung CY, Fong DYT. Chinese version Weight-Related Eating Questionnaire to assess psychological aspects of eating behaviours in Chinese adults: abridged secondary publication. Hong Kong Med J 2023; 29 Suppl 2:29-32. [PMID: 36951003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Affiliation(s)
- M Ho
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
| | - R Smith
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
| | - P H Chau
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
| | - C Y Chung
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
| | - D Y T Fong
- School of Nursing, The University of Hong Kong, Hong Kong SAR, China
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22
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Mavragani A, Choi KWY, Wu C, Chau PH, Kwok JYY, Wong WCW, Chow EPF. Web-Based Harm Reduction Intervention for Chemsex in Men Who Have Sex With Men: Randomized Controlled Trial. JMIR Public Health Surveill 2023; 9:e42902. [PMID: 36602853 PMCID: PMC9893729 DOI: 10.2196/42902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/10/2022] [Accepted: 11/29/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Men who have sex with men (MSM) who practice chemsex have a higher likelihood of engaging in risky sexual behaviors and higher rates of HIV infection and other sexually transmitted infections (STIs) than those who do not. OBJECTIVE This trial aimed to evaluate the effectiveness of a web-based intervention in reducing the sexual harms of chemsex among MSM. METHODS The study was a 2-arm, assessor-blinded, randomized, parallel-group trial with a 3-month follow-up period. The study was conducted in the year 2021 in Hong Kong. Underpinned by the theory of planned behaviors and a harm reduction approach, the intervention consisted of interactive components and knowledge-based information about chemsex. Participants in the control group received brief information and content about sexual violence. The primary outcome was self-efficacy in refusing risky sexual behaviors and chemsex, as measured by the Condom Self-Efficacy Scale (CSES), Self-Efficacy for Sexual Safety (SESS) instrument, and Drug Avoidance Self-Efficacy Scale (DASES). The secondary outcomes included intentions to have chemsex, actual engagement in chemsex, HIV and other STI testing, and condom use in the last 3 months. All outcomes were self-reported. An online structured questionnaire was used to collect data. RESULTS In total, 316 MSM enrolled in the study. The intervention group demonstrated a significantly larger improvement in condom-use self-efficacy (as measured by CSES scores; time-by-group interaction: β=4.52, 95% CI 2.03-7.02; P<.001), self-efficacy for sexual safety (as measured by SESS scores; time-by-group interaction: β=2.11, 95% CI 0.66-3.56; P=.004), and drug avoidance self-efficacy (as measured by DASES scores; time-by-group interaction: β=6.98, 95% CI 1.75-12.22; P=.009). Regarding the secondary outcomes, participants in the intervention group demonstrated a significantly larger reduction in the likelihood of having engaged in chemsex in the last 3 months (time-by-group interaction: odds ratio [OR]=0.23, 95% CI 0.10-0.53; P=.001) and likelihood of having had the intention to engage in chemsex in the last 3 months (time-by-group interaction: OR=0.37, 95% CI 0.18-0.78; P=.009). Participants in the intervention group also showed a significantly larger increase in the likelihood of having undergone HIV testing in the last 3 months (time-by-group interaction: OR=3.08, 95% CI 1.72-5.54; P<.001). CONCLUSIONS This study suggests that a web-based intervention with a harm reduction approach can enhance the self-efficacy of MSM in refusing risky sexual behaviors and chemsex and improve the uptake of HIV testing. We also provide initial evidence that such interventions can reduce both the intention of MSM to engage in chemsex and their actual engagement in chemsex. TRIAL REGISTRATION ISRCTN Registry ISRCTN20134522; https://www.isrctn.com/ISRCTN20134522. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12889-021-10742-8.
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Affiliation(s)
| | - Kitty Wai Ying Choi
- School of Nursing, The University of Hong Kong, Hong Kong, China (Hong Kong).,Sticky Rice Love, Hong Kong, China (Hong Kong)
| | - Chanchan Wu
- School of Nursing, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Jojo Yan Yan Kwok
- School of Nursing, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - William Chi Wai Wong
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Eric Pui Fung Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
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23
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Lai ETC, Chau PH, Cheung K, Kwan M, Lau K, Woo J. Perception of extreme hot weather and the corresponding adaptations among older adults and service providers-A qualitative study in Hong Kong. Front Public Health 2023; 11:1056800. [PMID: 36875383 PMCID: PMC9980346 DOI: 10.3389/fpubh.2023.1056800] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/09/2023] [Indexed: 02/12/2023] Open
Abstract
Background Extreme hot weather events are happening with increasing frequency, intensity and duration in Hong Kong. Heat stress is related to higher risk of mortality and morbidity, with older adults being particularly vulnerable. It is not clear whether and how the older adults perceive the increasingly hot weather as a health threat, and whether community service providers are aware and prepared for such future climate scenario. Methods We conducted semi-structure interviews with 46 older adults, 18 staff members of community service providers and two district councilors of Tai Po, a north-eastern residential district of Hong Kong. Transcribed data were analyzed using thematic analysis until data saturation was reached. Results It was agreed upon among the older adult participants that the weather in recent years has become increasingly hot and this led to some health and social problems for them, although some participants perceived that hot weather did not have any impact in their daily lives and they were not vulnerable. The community service providers and district councilors reported that there is a lack of relevant services in the community to support the older adults in hot weather; and there is generally a lack of public education regarding the heat-health issue. Conclusions Heatwaves are affecting older adults' health in Hong Kong. Yet, discussions and education effort regarding the heat-health issue in the public domain remain scarce. Multilateral efforts are urgently needed to co-create a heat action plan to improve community awareness and resilience.
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Affiliation(s)
- Eric T C Lai
- Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Pui Hing Chau
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ken Cheung
- Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Michelle Kwan
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kevin Lau
- Department of Civil, Environmental and Natural Resources Engineering, Luleå Tekniska Universitet, Luleå, Sweden
| | - Jean Woo
- Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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24
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Chau PH, Lau KKL, Qian XX, Luo H, Woo J. Visits to the accident and emergency department in hot season of a city with subtropical climate: association with heat stress and related meteorological variables. Int J Biometeorol 2022; 66:1955-1971. [PMID: 35900375 PMCID: PMC9330976 DOI: 10.1007/s00484-022-02332-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 07/08/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND Literature reporting the association between heat stress defined by universal thermal climate index (UTCI) and emergency department visits is mainly conducted in Europe. This study aimed to investigate the association between heat stress, as defined by the UTCI, and visits to the accident and emergency department (AED) in Hong Kong, which represents a subtropical climate region. METHODS A retrospective study involving 13,438,846 AED visits in the public sector from May 2000 to September 2016, excluding 2003 and 2009, was conducted in Hong Kong. Age-sex-specific ANCOVA models of daily AED rates on heat stress and prolonged heat stress, adjusting for air quality, prolonged poor air quality, typhoon, rainstorm, year, day of the week, public holiday, summer vacation, and fee charging, were used. RESULTS On a day with strong heat stress (32.1 °C ≤ UTCI ≤ 38.0 °C), the AED visit rate (per 100,000) increased by 0.9 (95% CI: 0.5, 1.3) and 1.7 (95% CI: 1.3, 2.1) for females and males aged 19-64 and 4.1 (95% CI: 2.7, 5.4) and 4.1 (95% CI: 2.6, 5.6) for females and males aged ≥ 65, while keeping other variables constant. On a day with very strong heat stress (38.1 °C ≤ UTCI ≤ 46.0 °C), the corresponding rates increased by 0.6 (95% CI: 0.1, 1.2), 2.2 (95% CI: 1.7, 2.7), 4.9 (95% CI: 3.1, 6.7), and 4.7 (95% CI: 2.7, 6.6), respectively. The effect size of heat stress associated with AED visit rates was negligible among those aged ≤ 18. Heat stress showed the greatest effect size for males aged 19-64 among all subgroups. CONCLUSION Biothermal condition from heat stress was associated with the health of the citizens in a city with a subtropical climate and reflected in the increase of daily AED visit. Public health recommendations have been made accordingly for the prevention of heat-related AED visits.
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Affiliation(s)
- Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
| | - Kevin Ka-Lun Lau
- Department of Civil, Environmental and Natural Resources Engineering, Luleå University of Technology, Luleå, Sweden
| | - Xing Xing Qian
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Hao Luo
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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25
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Chen Z, Ho M, Chau PH. Handgrip strength asymmetry is associated with the risk of neurodegenerative disorders among Chinese older adults. J Cachexia Sarcopenia Muscle 2022; 13:1013-1023. [PMID: 35178892 PMCID: PMC8977973 DOI: 10.1002/jcsm.12933] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/19/2021] [Accepted: 01/10/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Neurodegenerative disorders, as the irreversible condition, have a long, silent preclinical period. Recognition of early physical signs of neurodegenerative disorders had important practical implications for identifying at-risk population. The aim of this study was to investigate whether handgrip strength (HGS) asymmetry was associated with the incidence of neurodegenerative disorders among Chinese older adults. METHODS This study used the data of participants aged 60 years and over from three waves (2011-2015) of China Health and Retirement Longitudinal Study. HGS asymmetry was measured with HGS ratio (maximal non-dominant HGS/maximal dominant HGS), with the value less than 0.9 or more than 1.1 considered as HGS asymmetry. Physician-diagnosed neurodegenerative disorders were identified by self-reported or proxy-reported information. Competing risk analysis was conducted to examine the association between HGS asymmetry and incident neurodegenerative disorders, with mortality treated as the competing event. RESULTS A total of 4925 participants were included in the analysis [mean (SD) age: 68.1(6.68); female: 49.7%]. Eight hundred and eighty-eight (18.0%) participants had low HGS and 2227 (45.2%) had HGS asymmetry. During the 4 years of follow-up, there were 156 cases of neurodegenerative disorders and 422 cases of mortality. The incidence of neurodegenerative disorders was 8.7 per 1000 person-years [95% confidence interval (CI): 7.4-10.2], and the incidence of mortality was 23.5 per 1000 person-years (95% CI: 21.4-25.9). Both the cause-specific model and the Fine-Gray subdistribution hazard model showed that participants with HGS asymmetry had increased hazard of neurodegenerative disorders [hazard ratio (HR) = 1.66, P = 0.002, 95% CI: 1.202-2.297; subdistribution hazard ratio (SHR) = 1.65, P = 0.002, 95% CI: 1.202-2.285]. Low HGS, but not HGS asymmetry, was related to the higher hazard of mortality (HR = 1.61, P < 0.001, 95% CI: 1.297-1.995; SHR = 1.58, P < 0.001, 95% CI: 1.286-1.951). CONCLUSIONS Handgrip strength asymmetry was associated with the future risk of neurodegenerative disorders among Chinese older adults. Public healthcare providers could consider examining HGS asymmetry along with the maximal HGS as a way to identify those at elevated risk of neurodegenerative disorders.
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Affiliation(s)
- Zi Chen
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Mandy Ho
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong, China
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26
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Lok KY, Ko RW, Fan HS, Chau PH, Wong JY, Wang MP, Tsang V. Feasibility and Acceptability of an Online WhatsApp Support Group on Breastfeeding: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e32338. [PMID: 35262504 PMCID: PMC8943542 DOI: 10.2196/32338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 01/17/2022] [Accepted: 01/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background Mobile health, the use of mobile technology in delivering health care, has been found to be effective in changing health behaviors, including improving breastfeeding practices in postpartum women. With the widespread use of smartphones and instant messaging apps in Hong Kong, instant messaging groups could be a useful channel for delivering breastfeeding peer support. Objective The aim of this paper is to study the feasibility and acceptability of an online instant messaging peer support group by trained peer counselors on improving breastfeeding outcome in primiparous women in Hong Kong. Methods A two-arm, assessor-blind, randomized controlled feasibility study will be conducted on 40 primiparous women with the intention to breastfeed. Participants are recruited from the antenatal obstetrics and gynecology clinic of a public hospital in Hong Kong and randomly assigned at a 1:1 ratio to either intervention or control group. The intervention group receives peer support in an online instant messaging group with trained peer counselors on top of standard care, whereas the control group receives standard care. Breastfeeding outcome will be assessed for 6 months post partum or until weaned. The breastfeeding status, the proportion and duration of exclusive and any breastfeeding in each group, and the self-efficacy and attitude of participants will be assessed. The feasibility and acceptability of the study would also be assessed in preparation for a full randomized controlled trial. Results This study (protocol version 1 dated January 5, 2021) has been reviewed and approved by the institutional review board of the University of Hong Kong, Hospital Authority Hong Kong West Cluster (reference UW 21-039), on January 26, 2021. Data collection is ongoing and expected to be completed in December 2021. The findings will be updated on clinical trial registry and disseminated in peer-reviewed journals. Conclusions This study aims to assess the feasibility and effectiveness of an online instant messaging peer support group in improving the breastfeeding outcome of primiparous women in Hong Kong. Its findings could inform the feasibility of a full-scale trial with this intervention design. Trial Registration ClinicalTrials.gov NCT04826796; https://clinicaltrials.gov/ct2/show/NCT04826796 International Registered Report Identifier (IRRID) DERR1-10.2196/32338
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Affiliation(s)
- Kris Yw Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Rachel Wt Ko
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Heidi Sl Fan
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - P H Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Janet Yh Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - M P Wang
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong
| | - Vicky Tsang
- Natural Parenting Network, Hong Kong, Hong Kong
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27
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Huang J, Choi EPH, Chau PH. The impact of unmet needs for assistance with activities of daily living on the self-rated health and life satisfaction of Chinese community-dwelling older adults. Aging Ment Health 2022; 27:803-810. [PMID: 35238264 DOI: 10.1080/13607863.2022.2045563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES This study examined the associations of change in unmet needs for assistance with Activities of Daily Living (ADLs) with the self-rated health and life satisfaction of community-dwelling Chinese older adults. METHODS Using national longitudinal data from the Chinese Longitudinal Healthy Longevity Study, we examined the associations of change in unmet ADL needs with self-rated health and life satisfaction from baseline (T1) to a 3-year follow-up (T2) among 1,914 ADL-limited older adults. Change in unmet ADL needs was categorized into 'Persistently Unmet,' 'Unmet at T1 Only,' 'Unmet at T2 Only,' and 'Never Unmet.' Self-rated health and life satisfaction were rated by 5-point Likert scales. Linear mixed models were performed to examine the associations, controlling for sociodemographics, health conditions, and social support. RESULTS Older adults whose ADL needs were 'Persistently Unmet,' 'Unmet at T2 Only,' or 'Never Unmet,' showed a significant decline in self-rated health, but those whose ADL needs were 'Unmet at T1 Only' exhibited a significant rise at follow-up. While life satisfaction was stable among older adults with 'Persistently Unmet' or 'Never Unmet' ADL needs, it significantly decreased among those with 'Unmet at T2 Only' ADL needs and increased among those with 'Unmet at T1 Only' ADL needs. CONCLUSION Unmet needs may play an even more significant role in negatively impacting life satisfaction than the ADL limitation itself. Unmet ADL needs' effects on self-rated health and life satisfaction appeared to be short-term rather than long-term. Thus, it is never too late to adequately meet older adults' ADL needs. UNLABELLED Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2022.2045563.
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Affiliation(s)
- Jing Huang
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong.,School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | | | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong
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28
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Yu HJ, Ho M, Liu X, Yang J, Chau PH, Fong DYT. Association of weight status and the risks of diabetes in adults: a systematic review and meta-analysis of prospective cohort studies. Int J Obes (Lond) 2022; 46:1101-1113. [PMID: 35197569 DOI: 10.1038/s41366-022-01096-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/30/2022]
Abstract
Obesity is a known risk factor for type 2 diabetes mellitus (T2DM); however, the associations between underweight and T2DM and between weight status and prediabetes have not been systematically reviewed. We aimed to estimate the relative risks (RRs) of prediabetes/T2DM in underweight/overweight/obesity relative to normal weight. PubMed, Embase, Web of Science, and Cochrane Library were searched from inception to December 8, 2021. Prospective cohort studies with a minimum 12-month follow-up period reporting the association between baseline body mass index (BMI) categories and risk of prediabetes/T2DM in adults were included. Study quality was assessed using the Newcastle-Ottawa Scale. The main analyses of T2DM risk were performed using the ethnic-specific (Asian/non-Asian) BMI classification and additional analyses of prediabetes/T2DM risk by including all eligible studies. Random-effects models with inverse variance weighting were used. Subgroup analyses and meta-regression were conducted to explore the potential effects of pre-specified modifiers. The study protocol was registered with PROSPERO (CRD42020215957). Eighty-four articles involving over 2.69 million participants from 20 countries were included. The pooled RR of prediabetes risk was 1.24 (95% CI: 1.19-1.28, I2 = 9.7%, n = 5 studies) for overweight/obesity vs. normal weight. The pooled RRs of T2DM based on the ethnic-specific BMI categories were 0.93 (95% CI: 0.75-1.15, I2 = 55.5%, n = 12) for underweight, 2.24 (95% CI: 1.95-2.56, I2 = 92.0%, n = 47) for overweight, 4.56 (95% CI: 3.69-5.64, I2 = 96%, n = 43) for obesity, and 22.97 (95% CI: 13.58-38.86, I2 = 92.1%, n = 6) for severe obesity vs. normal weight. Subgroup analyses indicated that underweight is a protective factor against T2DM in non-Asians (RR = 0.68, 95% CI: 0.40-0.99, I2 = 56.1%, n = 6). The magnitude of the RR of T2DM in overweight/obesity decreased with age and varied by region and the assessment methods for weight and T2DM. Overweight/obesity was associated with an increased prediabetes/T2DM risk. Further studies are required to confirm the association between underweight and prediabetes/T2DM, particularly in Asian populations.
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Affiliation(s)
- Hong-Jie Yu
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
| | - Mandy Ho
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China.
| | | | - Jundi Yang
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
| | - Pui Hing Chau
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
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29
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Kwok JYY, Lee JJ, Choi EPH, Chau PH, Auyeung M. Stay mindfully active during the coronavirus pandemic: a feasibility study of mHealth-delivered mindfulness yoga program for people with Parkinson's disease. BMC Complement Med Ther 2022; 22:37. [PMID: 35130894 PMCID: PMC8818838 DOI: 10.1186/s12906-022-03519-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 01/20/2022] [Indexed: 11/10/2022] Open
Abstract
Importance Patients with long-term neurological conditions, such as Parkinson’s disease (PD), are particularly vulnerable to the public health measures taken to combat the COVID-19 pandemic. The inaccessibility of center-based rehabilitation further aggravated their motor dysfunctions as well as mental distress, leading to exacerbation of motor and non-motor symptoms, high healthcare utilization and worsened health-related quality of life (HRQOL). Objective This study aimed to evaluate the feasibility, safety, and preliminary effects of the mHealth-delivered home-based mindfulness yoga program on functional balance, motor symptoms, mental health and HRQOL in patients with PD. Design, setting and participants This prospective, single-arm, non-randomized feasibility study adopted a sequential explanatory mixed-method design. Adults (aged ≥ 18) with a clinical diagnosis of idiopathic Parkinson’s disease (Hoehn and Yahr stage I to III) who were able to stand unaided and walk with or without an assistive device were enrolled via convenience sampling. Intervention Home-based mindfulness yoga training were delivered via video-conferencing software (Zoom) in eight bi-weekly 90-min sessions. Main outcomes and measures This current study measured functional balance, motor symptoms, perceived balance confidence, perceived freezing of gait symptoms, anxiety and depression, mindfulness and HRQOL using a tele-assessment approach at baseline and 1-week post-intervention. All participants were invited to attend qualitative individual interviews to explore their experience of using online mindfulness yoga program as a lifestyle intervention for PD rehabilitation. Results Among the ten patients, 80% completed the program with an adherence rate of 98.4%. All participants were able to learn and practice mindfulness yoga following the eight bi-weekly online mindfulness yoga training sessions, without any significant adverse events. Tele-assessment of outcomes were feasible and uneventful. Qualitative feedback revealed participants had a high preference of using the tele-rehabilitation approach to stay mindful and being active, both physically and socially, while confronting the changes brought by COVID-19 pandemic. Conclusions and relevance The mHealth-delivered home-based mindfulness yoga intervention was feasible, safe, and well-accepted among people with PD to relieve the burden brought by COVID-19 pandemic. Future studies should adopt a design with enhanced rigor, a comparison group, and enlarged sample size to evaluate the efficacy of the program in patients with long-term neurological conditions and/or physical impairments. We recommend a longer intervention duration of at least 8 weeks to enhance the psychophysiological effects.
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Affiliation(s)
- Jojo Yan Yan Kwok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 4/F, William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
| | - Jung Jae Lee
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 4/F, William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China
| | - Edmond Pui Hang Choi
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 4/F, William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 4/F, William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China
| | - Man Auyeung
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR, China
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30
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Chen Z, Ho M, Chau PH. Prevalence, Incidence, and Associated Factors of Possible Sarcopenia in Community-Dwelling Chinese Older Adults: A Population-Based Longitudinal Study. Front Med (Lausanne) 2022; 8:769708. [PMID: 35083235 PMCID: PMC8784542 DOI: 10.3389/fmed.2021.769708] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/27/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose: This study aimed to assess the prevalence, incidence, and associated factors of possible sarcopenia in a nationwide representative sample of the community-dwelling older Chinese population. Methods:This study used the data of participants aged 60 years and over from the China Health and Retirement Longitudinal Study (CHARLS). Data on participants from three waves (2011-2015) of CHARLS were extracted. Possible sarcopenia was defined as low muscle strength or low physical performance, based on the Asian Working Group for Sarcopenia 2019 consensus. We first described baseline prevalence and four-year incidence of possible sarcopenia. Then multiple logistic regression and multivariable parametric proportional hazard model with Weibull distribution were used to examine the association of risk factors with baseline prevalence and four-year incidence of possible sarcopenia, respectively. Results:The prevalence of possible sarcopenia was 46.0%. The four-year incidence of possible sarcopenia was 11.9 per 100 person-years. Multivariable analysis revealed that advanced age and depressive symptoms were associated with increased prevalence of possible sarcopenia, while receiving education and moderate or high physical activity were associated with a lower risk of possible sarcopenia prevalence. For incidence, only advanced age was associated with an increased risk of possible sarcopenia incidence. Conclusion:Our study revealed the substantial burden of possible sarcopenia and related risk factors in community-dwelling settings in China. It highlighted the importance of early detection and intervention in this subclinical group for the prevention of sarcopenia.
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Affiliation(s)
| | | | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Qian XX, Chen Z, Fong DYT, Ho M, Chau PH. Post-hospital falls incidence and risk factors among older adults: a systematic review and meta-analysis. Age Ageing 2022; 51:6408804. [PMID: 34718373 DOI: 10.1093/ageing/afab209] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/25/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Post-hospital falls constitute a significant health concern for older adults who have been recently discharged from the hospital. OBJECTIVES To systematically summarise existing evidence on the incidence and risk factors for post-hospital falls among older adults. METHODS A systematic review and meta-analysis was conducted. Six electronic databases were searched to identify cohort studies investigating the incidence and risk factors for post-hospital falls in older adults. The incidence and risk factors for post-hospital falls were extracted. The meta-analysis was used to calculate pooled incidences and 95% confidence intervals (CI). The meta-regression and subgroup meta-analysis were conducted to explore sources of heterogeneity in incidence proportions across the eligible studies. A qualitative synthesis was performed for the post-hospital falls risk factors. RESULTS Eighteen studies from eight countries (n = 9,080,568) were included. The pooled incidence proportion of any and recurrent post-hospital falls was 14% (95% CI: 13%-15%) and 10% (95% CI: 5%-14%), respectively. Follow-up period, study quality, study country, setting, percentage of female subjects, percentage of subjects with previous falls and the primary data collection method for falls significantly contributed to the 64.8% of the heterogeneity in incidence proportions. Twenty-six risk factors for post-hospital falls were identified in the eligible studies, where biological factors were the most commonly identified factors. The highest risks were reported for previous falls, previous fractures, delirium and neurological diseases. CONCLUSION The findings of this study suggested future post-hospital falls prevention should prioritise the needs of older adults with the dominant risk factors. Further investigations into the period-specific incidence and socioeconomic and environmental risk factors for post-hospital falls are also required.
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Affiliation(s)
- Xing Xing Qian
- School of Nursing, The University of Hong Kong, Pok Lu Fam, Hong Kong
| | - Zi Chen
- School of Nursing, The University of Hong Kong, Pok Lu Fam, Hong Kong
| | - Daniel Y T Fong
- School of Nursing, The University of Hong Kong, Pok Lu Fam, Hong Kong
| | - Mandy Ho
- School of Nursing, The University of Hong Kong, Pok Lu Fam, Hong Kong
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Pok Lu Fam, Hong Kong
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Huang J, Choi EPH, Chau PH. The Impact of Unmet ADL Need on the Self-Rated Health and Life Satisfaction of Chinese Older Adults. Innov Aging 2021. [PMCID: PMC8681401 DOI: 10.1093/geroni/igab046.3203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study aims to examine the associations of change in unmet need for assistance with Activities of Daily Living (ADL) with the self-rated health and life satisfaction of community-dwelling Chinese older adults. Using national longitudinal data from the Chinese Longitudinal Healthy Longevity Study, we examined the associations of unmet ADL need with self-rated health and with life satisfaction from baseline (T1) to a 3-year follow-up (T2) among 1,914 older adults with ADL limitation. Change in unmet ADL need was categorized into “Persistently Unmet”, “Unmet at T1 Only”, “Unmet at T2 Only”, and “Never Unmet”. Self-rated health and life satisfaction were rated by 5-point Likert scales. Linear mixed models were performed to examine the associations, controlling for sociodemographic factors, health conditions, and social support. The results showed that older adults whose ADL needs were persistently unmet, those unmet at T2 only, and those never unmet, experienced a significant decline in self-rated health from baseline to follow-up, but those unmet at T1 only experienced a significant rise in self-rated health. While the life satisfaction was stable from baseline to follow-up among older adults whose ADL needs were persistently unmet or never unmet, it significantly decreased among those unmet at T2 only and significantly increased among those unmet at T1 only. The effects of unmet ADL need on self-rated health and life satisfaction appeared to be short-term rather than long-term. These findings facilitate a better understanding of unmet ADL need and emphasize the importance to fully meet the ADL needs of older adults.
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Affiliation(s)
- Jing Huang
- School of Nursing, The University of Hong Kong
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Hu H, Liu X, Chau PH, Choi EPH. Effects of intradialytic exercise on health-related quality of life in patients undergoing maintenance haemodialysis: a systematic review and meta-analysis. Qual Life Res 2021; 31:1915-1932. [PMID: 34731388 DOI: 10.1007/s11136-021-03025-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE To summarize the current evidence regarding the effectiveness of intradialytic exercise (IDE) on the health-related quality of life (HRQOL) of patients undergoing maintenance haemodialysis. METHODS Five English databases (PubMed, EMBASE, Cochrane Library, Web of Science, and ScienceDirect) and four Chinese databases (VIP, WAN FANG, CNKI, CBM) were comprehensively searched from their inception to 18 March 2021. This study was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Two independent reviewers selected the papers and extracted the details of each study therein. Only randomized controlled trials were included. The risk of bias tool version 2.0 was used to evaluate the risk of bias of the included studies. A random-effects meta-analysis was conducted to pool the effect size. RESULTS Thirty-three eligible studies with 1481 participants were included. For the generic HRQOL, assessed by the Medical Outcomes Study Short-Form survey, IDE significantly improved most domains and the physical component summary compared with the control group. Furthermore, aerobic exercise alone significantly improved more domains compared to resistance exercise, combined aerobic and resistance exercise, and other types of exercise. Regarding the kidney-specific HRQOL, IDE improved three of eleven domains, including the symptom/problem list, the effect of kidney disease, and the quality of social interaction. No significant effect was found on other domains of kidney-specific HRQOL. CONCLUSION Intradialytic exercise could benefit patients undergoing haemodialysis in improving most domains of generic HRQOL, but the effect on most domains of kidney-specific HRQOL is insufficient.
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Affiliation(s)
- Huagang Hu
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, SAR, China.,School of Nursing, Medical College, Soochow University, Box 203, 1 Shizi Street, Suzhou, 215006, Jiangsu Province, China
| | - Xu Liu
- Department of Infectious Disease; Guangdong Provincial Engineering Research Center of Molecular Imaging; Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital of Sun Yat-sen University, No. 52, Meihua East Rd, Xiangzhou District, Zhuhai, 519000, Guangdong Province, China
| | - Pui Hing Chau
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, SAR, China
| | - Edmond Pui Hang Choi
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, SAR, China.
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Lin RSY, Yu DSF, Li PWC, Chau PH, Lee JJ. Lived experience of neuropsychiatric symptoms among females with mild cognitive impairment: A phenomenological study. J Adv Nurs 2021; 78:1100-1111. [PMID: 34716611 DOI: 10.1111/jan.15088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/20/2021] [Accepted: 10/16/2021] [Indexed: 11/30/2022]
Abstract
AIMS To explore the lived experience of neuropsychiatric symptoms (NPS) among females with mild cognitive impairment (MCI). DESIGN A phenomenological study using individual, semi-structured, telephone-based interviews was conducted to explore how the NPS are aroused, evolve, and affect the overall well-being, illness perception and the corresponding coping responses adopted by females with MCI. METHODS Twenty-nine participants with MCI were recruited from the community setting in Hong Kong between March and October 2020. Interviews were audio-recorded, transcribed verbatim, and analysed using an interpretative phenomenological analysis approach and constant comparison strategy. RESULTS Three themes were identified: (1) living vigilant lives with threats and uncertainty, (2) snowballing into further negative emotions and (3) seeking outlets for negative emotions. Our findings suggested that the participants' cognitive, functional and social challenges aroused intense emotional responses such as depression, agitation and anxiety. These noting negative emotions were further perpetuated by maladaptive coping responses, unrealistic expectations from coping strategies and overwhelming disease burden. Various internal and external strategies were adopted to enhance emotional adaptation, of which adopting a positive attitude appeared to be the most promising strategy. CONCLUSION This study shed light on the challenging experience of MCI. The cognitive afflictions and the resultant impacts on various life domains evoked a cluster of NPS. Support services need to enhance emotional adjustment through alleviating the various life stressors and strengthening the coping resources. IMPACT Elucidating the lived experience of NPS provides important insights into the development of a more effective, comprehensive and person-centred care planning for the population with MCI. Holistic care planning should extend beyond cognitive health optimization into enhancing disease knowledge, improve emotional coping, rebuild self-identity and bolstering social supports among this preclinical cohort.
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Affiliation(s)
- Rose S Y Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Doris S F Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Polly W C Li
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Jung Jae Lee
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
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Chan SL, Lin CC, Chau PH, Takemura N, Fung JTC. Evaluating online learning engagement of nursing students. Nurse Educ Today 2021; 104:104985. [PMID: 34058645 DOI: 10.1016/j.nedt.2021.104985] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 04/20/2021] [Accepted: 05/17/2021] [Indexed: 05/24/2023]
Abstract
BACKGROUND Previous studies suggest that increased learning satisfaction may encourage learning engagement in an online learning environment. OBJECTIVES To evaluate the level of learning engagement and its relationship with students' perceived learning satisfaction in an online clinical nursing elective course. DESIGN A prospective interventional study. SETTINGS A nursing course was converted to an online format because of the coronavirus disease COVID pandemic. PARTICIPANTS Part-time post-registration nursing undergraduates enrolled in an elective online clinical course. METHODS Related teaching and learning strategies were deployed in the course using the Community of Inquiry framework. All students who completed the course were invited to complete an online survey that included a validated Online Student Engagement questionnaire (OSE). Pearson's correlations were used to determine the association between perceived learning satisfaction and learning engagement. A logistic regression model was used to explore the associations of gender, age, working experience and perceived learning satisfaction with higher learning engagement. RESULTS The questionnaires were completed by 56 of 68 students (82%). The Pearson's correlation coefficient between the mean perceived learning satisfaction and OSE scores was 0.75 (p < .001). Twenty-five students (45%) were identified as highly engaged, using a cut-off of ≥3.5 for the mean OSE score. The mean perceived learning satisfaction (SD) score differed significantly between highly engaged and not highly engaged students [4.02 (0.49) vs. 3.27 (0.62), p < .001]. The logistic regression model showed that a greater perceived learning satisfaction [adjusted odds ratio (OR): 17.2, 95% C.I.: 3.46-86.0, p = .001] was associated with an increased likelihood of higher learning engagement, and >1 year of working experience (adjusted OR: 0.11, 95% C.I.: 0.01-0.89, p = .0039) was associated with a decreased likelihood of higher learning engagement. CONCLUSIONS The study findings suggest that perceived learning satisfaction predicts learning engagement among nursing students in this online learning course.
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Affiliation(s)
- S L Chan
- University of Hong Kong School of Nursing, Hong Kong.
| | - C C Lin
- University of Hong Kong School of Nursing, Hong Kong.
| | - P H Chau
- University of Hong Kong School of Nursing, Hong Kong.
| | - N Takemura
- University of Hong Kong School of Nursing, Hong Kong.
| | - J T C Fung
- University of Hong Kong School of Nursing, Hong Kong.
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Wu C, Choi EPH, Chau PH. The Holistic Health Status of Chinese Homosexual and Bisexual Adults: A Scoping Review. Front Public Health 2021; 9:710575. [PMID: 34504828 PMCID: PMC8421524 DOI: 10.3389/fpubh.2021.710575] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 07/26/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Same-sex marriage is currently not legalized in China, despite the considerably large number of homosexual and bisexual Chinese populations. At the same time, their holistic health status remains unclear. This is the first scoping review conducted to comprehensively examine all the available literature and map existing evidence on the holistic health of homosexual and bisexual Chinese. Methods: This scoping review used the framework of Arksey and O'Malley and followed the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews (PRISMA-ScR). A comprehensive search strategy was carried out across 20 English (EN) and Chinese (both traditional and simplified) electronic databases from January 1, 2001, to May 31, 2020. Two reviewers conducted the reference screening and study selection independently and consulted a third senior reviewer whenever a consensus must be achieved. Data extraction was conducted using a structured data form based on the Cochrane template, after which a narrative synthesis of the findings was performed. Results: A total of 2,879 references were included in the final analysis, with 2,478 research articles, 167 reviews, and 234 theses. Regarding the study populations, the vast majority of studies centered on men only (96.46%), especially men who have sex with men (MSM). Only 1.32% of the studies targeted female sexual minorities. The geographical distribution of all research sites was uneven, with most of them being conducted in mainland China (95.96%), followed by Hong Kong (2.05%), Taiwan (2.02%), and Macau (0.06%). Regarding the specific study focus in terms of the health domain, around half of the studies (45.93%) focused on sexual health only, and an additional quarter of the studies (24.15%) investigated both sexual health and social well-being. Meanwhile, the studies focusing on mental health only accounted for approximately 15% of the total. Conclusions: This scoping review revealed that previous research focused more on male than female sexual minorities, on disease-centered surveys than person-centered interventions, and investigations on negative health conditions than positive health promotion. Therefore, investigations centered on the female sexual minorities and corresponding person-centered interventions are highly needed. Review Registration: The protocol of this review has been registered within Open Science Framework (https://osf.io/82r7z) on April 27, 2020.
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Affiliation(s)
| | - Edmond Pui Hang Choi
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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Cheung DST, Chau PH, Yeung WF, Deng W, Hong AWL, Tiwari AFY. Assessing the effect of a mind-body exercise, qigong Baduanjin, on sleep disturbance among women experiencing intimate partner violence and possible mediating factors: a randomized-controlled trial. J Clin Sleep Med 2021; 17:993-1003. [PMID: 33551021 DOI: 10.5664/jcsm.9102] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To evaluate the effects of a mind-body exercise, qigong Baduanjin, on sleep disturbances in women experiencing intimate partner violence and explore the mediating role of depressive symptoms, perceived stress, and inflammation in producing the effects. METHODS A subgroup of a parent randomized controlled trial was randomized for a 22-week Baduanjin intervention (n = 94) or wait-list control (n = 92). Questionnaires, including the General Sleep Disturbance Scale, Perceived Stress Scale, and Beck Depression Inventory version II, were administered at baseline, posttraining (6 weeks), and postintervention (22 weeks), and blood samples were collected to assess tumor necrosis factor and interleukin 6 levels at baseline and postintervention only. RESULTS Of the 186 participants, 170 completed the study. Results indicate that the total sleep disturbance scores for the intervention group were significantly lower than those for the wait-list control group at week 6 (difference = -7.96; 95% confidence interval [CI], -13.63 to -2.30; P = .006) and week 22 (difference = -7.17; 95% CI, -12.58 to -1.76; P = .01). Mediation analysis showed a statistically significant indirect effect of the intervention on sleep improvement through reducing depressive symptoms (β = 2.58, 95% CI, 0.69 to 5.09), while the mediating effects of perceived stress and inflammation were not significant. CONCLUSIONS Qigong Baduanjin can be recommended for women who experience intimate partner violence and report sleep disturbances. More research is needed to understand the clinical significance of the observed sleep improvements. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: Qigong Intervention Program for Abused Chinese Women; URL: https://clinicaltrials.gov/ct2/show/NCT02060123; Identifier: NCT02060123.
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Affiliation(s)
- Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Wen Deng
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Athena Wai Lin Hong
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong, China
| | - Agnes F Y Tiwari
- School of Nursing, Hong Kong Sanatorium & Hospital, Hong Kong, China
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Cheung DST, Takemura N, Chau PH, Ng AYM, Xu X, Lin CC. Exercise levels and preferences on exercise counselling and programming among older cancer survivors: A mixed-methods study. J Geriatr Oncol 2021; 12:1173-1180. [PMID: 33985930 DOI: 10.1016/j.jgo.2021.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/14/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess exercise levels and exercise counselling /programming preferences among older cancer survivors. MATERIALS AND METHODS A mixed-methods study design was employed. Quantitative instruments on exercise levels, exercise counselling and programming preferences, frailty status, and cancer-related symptoms were administered to 290 post-treatment older cancer survivors aged ≥65. Twelve participants with different exercise levels and different views on exercise counselling and programming were purposively selected to participate in semi-structured interviews. RESULTS Overall, 58.3% of participants did not meet the recommended exercise guidelines, and 44.1% were not engaging in any vigorous or moderate exercise. Frail survivors were less likely to meet the guidelines (aOR = 0.194, 95%CI = 0.053, 0.712) compared to their robust counterparts. However, 66.9% and 62.8% of participants expressed a definite or possible interest in receiving exercise counselling and participating in an exercise program, respectively. Particularly, survivors who are male, did not receive chemotherapy, are less educated, and have higher symptom burden were less likely to show interest. Most preferred low-intensity exercise (59.8%) and wanted to start the exercise program after treatment (68.2%), which differs from the literature on general adult survivors. The major trigger to initiate and maintain exercise behaviors was the benefits of exercise and a common barrier to exercising was lack of time. CONCLUSION Most older cancer survivors did not meet the recommended exercise guidelines, but they were open to exercise counselling and programming. Reviewing education on the benefits of exercise is especially important after treatment completion to promote healthy lifestyles.
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Affiliation(s)
| | - Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Alina Yee Man Ng
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Xinyi Xu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Chia Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; School of Nursing, College of Nursing, Taipei Medical University, Taiwan; Alice Ho Miu Ling Nethersole Charity Foundation, Hong Kong
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Chau PH, Kwok YYJ, Chan MKM, Kwan KYD, Wong KL, Tang YH, Chau KLP, Lau SWM, Yiu YYY, Kwong MYF, Lai WTT, Leung MK. Feasibility, Acceptability, and Efficacy of Virtual Reality Training for Older Adults and People With Disabilities: Single-Arm Pre-Post Study. J Med Internet Res 2021; 23:e27640. [PMID: 33944795 PMCID: PMC8132975 DOI: 10.2196/27640] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/15/2021] [Accepted: 04/03/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Unlike most virtual reality (VR) training programs that are targeted at homogenous populations, a set of VR games for rehabilitation purposes targeted at a heterogeneous group of users was developed. The VR games covered physical training, cognitive training (classification and reality orientation), community-living skills training, and relaxing scenery experiences. Special considerations for local older adults and people with disabilities were made in terms of hardware choice and software design. OBJECTIVE This study aimed to evaluate the feasibility, acceptance, and efficacy of VR training among users with varying abilities. METHODS A single-arm pretest-posttest evaluation study was conducted. The participants of the evaluation study were encouraged to undergo 30-minute VR training three times a week for 6 weeks. The 30-minute session consisted of 10 minutes of upper-limb motion games, 10 minutes of lower-limb motion games, and 10 minutes of cognitive games/community-living skills training/relaxing scenery experiences, as appropriate. On completion of each session, usage statistics were documented via the built-in VR software, whereas feedback on the experience of the VR games and adverse events was collected via self-reports and staff observations. Feasibility was reflected by usage statistics, and acceptance was reflected by positive feedback. In addition, health outcomes, including upper-limb dexterity, functional mobility, cognitive function, and happiness, were assessed at baseline, as well as 6 weeks and 3 months after baseline. The primary outcomes were upper-limb dexterity and acceptance of playing VR games. RESULTS A total of 135 participants with a mean age of 62.7 years (SD 21.5) were recruited from May 2019 to January 2020, and 124 (91.9%) completed at least one follow-up. Additionally, 76.3% (103/135) of the participants could attend at least 70% of the proposed 18 sessions, and 72.5% (1382/1906) of the sessions had a training time of at least 20 minutes. Linear mixed effect models showed statistically significant effects in terms of upper-limb dexterity (small effect) and cognitive function (moderate effect). Among the 135 participants, 88 provided positive comments. Additionally, 10.4% (14/135) reported mild discomfort, such as dizziness, and none reported severe discomfort. CONCLUSIONS A set of VR training games for rehabilitation could be applied to users with heterogeneous abilities. Our VR games were acceptable to local older adults and those with different disabilities. Benefits in upper-limb dexterity and cognitive function were observed despite partial compliance to the training protocol. Service providers could refer to our experiences when developing VR training systems for their clients.
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Affiliation(s)
- Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | | | | | | | | | | | | | | | | | | | - Wai Ting Thomas Lai
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China
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Choi EPH, Chau PH, Wong WCW, Kowk JYY, Choi KWY, Chow EPF. Developing and testing of an interactive internet-based intervention to reduce sexual harm of sexualised drug use ('chemsex') among men who have sex with men in Hong Kong: a study protocol for a randomised controlled trial. BMC Public Health 2021; 21:713. [PMID: 33849517 PMCID: PMC8045193 DOI: 10.1186/s12889-021-10742-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 11/10/2022] Open
Abstract
Background Sexualised drug use, known as ‘chemsex’ or ‘chemfun,’ is the practice of intentionally using illicit drugs before or during sexual activates to enhance sexual arousal and pleasure. International and local data have both suggested that chemsex is common among men who have sex with men (MSM). Chemsex is generally seen with the engagement of risky sexual activities and therefore poses a threat regarding the potentially increased spread of human immunodeficiency virus and other sexually transmitted infections. However, little work has been done on the primary prevention of chemsex among MSM. Therefore, the aim of this study is to develop and evaluate an interactive internet-based intervention in reducing the sexual harms of chemsex among MSM in Hong Kong, Methods A two-armed, randomised, parallel-group trial with a three-month follow-up period will be conducted. 250 MSM aged 18 years or the above will be recruited through local non-governmental organisations, social media and by snowballing in Hong Kong. Participants will be randomly allocated into either the intervention (n = 125) or control group (n = 125). The interactive internet-based intervention will be developed based on the theory of planned behaviours. Participants in the control group will receive a web-based intervention without any sexual health information and without any interactive components. The primary outcomes will be self-efficacy in refusing risky sexual behaviours and chemsex, as measured by the Drug Avoidance Self-Efficacy Scale, the Self-Efficacy for Sexual Safety and the Condom Self-Efficacy Scale. Subjects in both groups will be evaluated at baseline and 3 months after baseline. Discussion To the best of our knowledge, this will be the first interactive internet-based intervention to specifically target chemsex among MSM. This project can help in the development and testing of culturally relevant health promotion programmes that reduce chemsex among MSM. Using an online delivery mode, the intervention is capable of reaching a large population of targets at a relatively low cost and thus has the potential to reduce the public health burden of chemsex and other risky sexual behaviours among MSM in a cost-effective manner. Trial registration International standard randomized controlled trial number (ISRCTN) registry: ISRCTN20134522 registered on 17 March 2021.
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Affiliation(s)
- Edmond P H Choi
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Pui Hing Chau
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block 21 Sassoon Road, Pokfulam, Hong Kong
| | - William C W Wong
- Department of Family Medicine and Primary Care, University of Hong Kong, Ap Lei Chau, Hong Kong
| | - Jojo Y Y Kowk
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block 21 Sassoon Road, Pokfulam, Hong Kong
| | | | - Eric P F Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.,Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Choi EPH, Huang J, Chau PH, Wan EYF. Health-related quality of life among Chinese primary care patients with different lower urinary tract symptoms: a latent class analysis. Qual Life Res 2021; 30:1305-1315. [PMID: 33447962 DOI: 10.1007/s11136-020-02731-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE No previous study has used a data-driven approach to explore symptom subclasses among patients with lower urinary tract symptoms (LUTS). The objectives of this study were to use latent class analysis (LCA) to identify distinct classes of LUTS among primary care patients and to assess the class differences in health-related quality of life (HRQOL). METHODS In this cross-sectional study, 500 patients were randomly recruited, and 18 symptoms according to the International Continence Society 2002 criteria were assessed. Classes were identified by LCA. Patient HRQOL was measured using the 12-item Short Form Health Survey (version 2), the modified Incontinence Impact Questionnaire-Short Form and the HRQOL item from the International Prostate Symptom Score. RESULTS Six distinct LUTS classes were identified: "asymptomatic" (26.0%), "mild symptoms" (22.6%), "moderate multiple symptoms" (17.0%), "urgency symptoms" (13.8%), "urinary incontinence" (12.0%) and "severe multiple symptoms" (8.6%). Multinomial regression analysis found differences in the gender distribution and prevalence of heart diseases across classes, and multiple linear regression found that patients with "severe multiple symptoms" and "urinary incontinence" had the poorest HRQOL. CONCLUSION Almost three quarters of the primary care patients in this study were suffering from varying degrees of LUTS. The poor HRQOL in "severe multiple symptoms" and "urinary incontinence" implies that patients in these classes require additional attention and treatments.
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Affiliation(s)
- Edmond Pui Hang Choi
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Jing Huang
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Pui Hing Chau
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, University of Hong Kong, Pokfulam, Hong Kong.,Department of Pharmacology and Pharmacy, University of Hong Kong, Pokfulam, Hong Kong
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Qian XX, Chau PH, Kwan CW, Lou VWQ, Leung AYM, Ho M, Fong DYT, Chi I. Investigating Risk Factors for Falls among Community-Dwelling Older Adults According to WHO's Risk Factor Model for Falls. J Nutr Health Aging 2021; 25:425-432. [PMID: 33786558 DOI: 10.1007/s12603-020-1539-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The World Health Organization developed the Risk Factor Model for Falls to describe fall risks in a comprehensive manner. However, there was a lack of study adopting such framework in quantifying falls risk from different factors in a single model. Therefore, this study examined the risk factors from four domains in the Risk Factor Model for Falls among older adults. DESIGN Secondary data analysis of 10-year assessment records of the Minimum Data Set-Home Care instrument. SETTING Hong Kong. PARTICIPANTS 89,100 community-dwelling adults aged 65 and over who first applied for publicly funded long-term care services from 2005 to 2014. MEASUREMENTS The Minimum Data Set-Home Care instrument was used to ascertain older adults' care needs and match them with appropriate services. Additionally, meteorological records from the same period were extracted from the Hong Kong Observatory. The logistic regression model was used to examine risk factors and their associations with falls. RESULTS In total 70 factors were included in the analysis, of which 37 were significantly associated with falls. Behavioral risk factors generally had greater odds ratios of falling, as compared with biological, socioeconomic, and environmental factors. Out of all significant factors, functional status, alcohol drinking, and locomotion outdoors had the largest odds ratios of falling. CONCLUSION Behavioral risk factors for falls are of remarkable influence yet are modifiable among older adults. Hence, falls prevention programs may need to prioritize addressing these factors.
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Affiliation(s)
- X X Qian
- Pui Hing Chau, School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong, Tel: (+852) 3917 6626,
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Li WY, Chau PH, Dai Y, Tiwari AF. The Prevalence and Negative Effects of Thoracic Hyperkyphosis on Chinese Community-Dwelling Older Adults in Wuhan, Hubei Province, China. J Nutr Health Aging 2021; 25:57-63. [PMID: 33367463 DOI: 10.1007/s12603-020-1441-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Globally, 20% to 50% older adults have been found to have thoracic hyperkyphosis. Negative effects on physical performance have been reported. However, there has been a lack of research on the prevalence and negative effects of thoracic hyperkyphosis among Chinese community-dwelling elderly. DESIGN A cross-sectional study. SETTING The communities in Wuhan, China. PARTICIPANTS Three hundred and ninety-five Chinese community-dwelling older adults with thoracic hyperkyphosis. MEASURES Chinese community-dwelling older adults aged 60 or above lived in Wuhan, China from August to December 2018 were recruited for spine and physical performance assessments. The primary outcome was the prevalence of thoracic hyperkyphosis estimated according to the angle of kyphosis which was measured by manual inclinometers. The secondary outcomes were the effects of thoracic hyperkyphosis on physical performance measured by One-leg Standing Test (OLS), Timed Up AND Go Test (TUG), Chest Expansion Test (CE), Six Minutes Walking Test (6MWT), and Farsi Version of Functional Gait Assessment (FGA). The socio-demographic and health-related information were collected by a questionnaire. RESULTS Among 395 participants, the mean angle of kyphosis was 49.0° ± 10.5°, 75.2% of participants had the angle of kyphosis >40° (i.e., having thoracic kyperkyphosis). Compared with older adults having no thoracic hyperkyphosis, older adults with thoracic hyperkyphosis had increased risks performing impaired in OLS (OR=4.55, 95% CI 2.18-9.53, p<0.001), TUG (OR=6.08, 95% CI 2.57-14.40, p<0.001), CE (OR=3.23, 95% CI 1.63-6.38, p=0.001), 6MWT (OR=4.64, 95% CI 1.98-10.86, p<0.001), and FGA (OR=5.18, 95% CI 2.25-11.89, p<0.001) after controlling socio-demographic and health-related factors. CONCLUSION The thoracic hyperkyphosis had high prevalence and associated with impaired performance in balance, gait, and cardiopulmonary function tests among Chinese community-dwelling older adults, which calls for the future intervention.
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Affiliation(s)
- W-Y Li
- Pui Hing Chau, School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Hong Kong,
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Xu XY, Leung AYM, Smith R, Wong JYH, Chau PH, Fong DYT. The relative risk of developing type 2 diabetes among individuals with prediabetes compared with individuals with normoglycaemia: Meta‐analysis and meta‐regression. J Adv Nurs 2020; 76:3329-3345. [DOI: 10.1111/jan.14557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/16/2020] [Accepted: 07/24/2020] [Indexed: 01/21/2023]
Affiliation(s)
- Xin Yi Xu
- School of Nursing Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong Hong Kong
- School of Nursing Faculty of Health and Social Science The Hong Kong Polytechnic University Hong Kong Hong Kong
| | - Angela Yee Man Leung
- School of Nursing Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong Hong Kong
- School of Nursing Faculty of Health and Social Science The Hong Kong Polytechnic University Hong Kong Hong Kong
| | - Robert Smith
- School of Nursing Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong Hong Kong
| | - Janet Yuen Ha Wong
- School of Nursing Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong Hong Kong
| | - Pui Hing Chau
- School of Nursing Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong Hong Kong
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Huang J, Chau PH, Choi EPH, Wu B, Lou VWQ. The Patterns of Caregiving Activities for Family Caregivers of Older Adults in Hong Kong: An Exploratory Latent Class Analysis. J Gerontol B Psychol Sci Soc Sci 2020; 76:1605-1616. [PMID: 33211887 DOI: 10.1093/geronb/gbaa203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study identified the classes (i.e., patterns) of caregivers' activities, based on their engagements in caregiving activities, and explored the characteristics and the caregiver burden of these classes. METHODS This study was a secondary analysis of a cross-sectional survey on the profiles of family caregivers of older adults in Hong Kong. A latent class analysis approach was adopted to classify family caregivers (N = 932) according to their routine involvements in 17 daily caregiving activities: 6 activities of daily living (ADLs) and 8 instrumental activities of daily living activities (IADLs) in addition to emotional support, decision making, and financial support. Multinomial logistic regression and multiple linear regression illuminated the characteristics of the classes and compared their levels of caregiver burden. RESULTS The family caregivers fell into 5 classes: All-Round Care (High Demand, 19.5%), All-Round Care (Moderate Demand, 8.2%), Predominant IADLs Care (High Demand, 23.8%), Predominant IADLs Care (Moderate Demand, 32.5%), and Minimal ADLs and IADLs Care (Low Demand, 16.0%). These classes exhibited different characteristics in terms of care recipients' cognitive statuses and caregiver backgrounds. The levels of caregiver burden differed across classes; the All-Round Care (High Demand) class experienced the highest levels of caregiver burden. DISCUSSION This study contributes to existing scholarship by turning away from a predefined category of care tasks to explore the patterns of caregiving activities. By identifying caregiving activity patterns and understanding their associated characteristics and caregiver burden, prioritizing and targeting caregiver support interventions better is possible.
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Affiliation(s)
- Jing Huang
- School of Nursing, The University of Hong Kong, Hong Kong
| | - Pui Hing Chau
- School of Nursing and Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong
| | | | - Bei Wu
- Rory Meyers College of Nursing and NYU Aging Incubator, New York University, New York City
| | - Vivian W Q Lou
- Department of Social Work and Social Administration and Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong
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Cheung DST, Tiwari A, Chan KL, Fong DYT, Chau PH, Yuen FKH, Tolman RM. Validation of the Psychological Maltreatment of Women Inventory for Chinese Women. J Interpers Violence 2020; 35:4614-4639. [PMID: 29294813 DOI: 10.1177/0886260517715602] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study aimed to revise and validate a Chinese version of Psychological Maltreatment of Women Inventory (C-PMWI). In the preparation phase, the PMWI was first revised for the possible cultural differences between Chinese and non-Chinese women. Supplementary items on use of electronic devices as a contemporary form of monitoring were added. Forward and back translated items were reviewed by a panel of intimate partner violence (IPV) experts, resulting in the scale-level content validity index of 0.94. Cognitive debriefing was conducted to confirm comprehensibility. The newly revised measure was administered to the sample of 1,198 Chinese women, recruited from community centers and shelters in Hong Kong. Exploratory factor analysis conducted on data from half the sample revealed a two-factor structure similar to the original English version: emotional-verbal and dominance-isolation. This structure was verified by confirmatory factor analysis with the other half of the sample. Known-groups validity was demonstrated by significant differences in scores between women with different relationship histories. Moderate-to-strong correlations of the C-PMWI with other forms of IPV, controlling behaviors, relationship satisfaction, and depression established convergent validity. The C-PMWI showed good internal consistency, with Cronbach's alpha >.9 for the entire scale and each subscale. The intraclass correlation across administrations 2 weeks was >.9, demonstrating test-retest reliability. The use of the comprehensive validation procedures in the present study provided evidence for both cultural appropriateness and satisfactory psychometric properties of the C-PMWI. The C-PMWI shows promise as a useful instrument for research and clinical practice with Chinese women.
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Affiliation(s)
| | - Agnes Tiwari
- The University of Hong Kong, Hong Kong
- Hong Kong Sanatorium & Hospital, Hong Kong
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Leung AYM, Yu EYT, Luk JKH, Chau PH, Levin-Zamir D, Leung ISH, Cheung KT, Chi I. Rapid Estimate of Inadequate Health Literacy (REIHL): development and validation of a practitioner-friendly health literacy screening tool for older adults. Hong Kong Med J 2020; 26:404-412. [PMID: 33093243 DOI: 10.12809/hkmj208395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION This study aimed to develop and validate a brief practitioner-friendly health literacy screening tool, called Rapid Estimate of Inadequate Health Literacy (REIHL), that estimates patients' health literacy inadequacy in demanding clinical settings. METHODS This is a methodological study of 304 community-dwelling older adults recruited from one community health centre and five district elderly community centres. Logistic regression models were used to identify the coefficients of the REIHL score's significant factors. Receiver operating characteristic (ROC) curve analysis was then used to assess the REIHL's sensitivity and specificity. Path analysis was employed to examine the REIHL's criterion validity with the Chinese Health Literacy Scale for Chronic Care and concurrent validity with self-rated health scale and the Geriatric Depression Scale-15. RESULTS The REIHL has scores ranging from 0 to 23. It had 76.9% agreement with the Chinese Health Literacy Scale for Chronic Care. The area under the ROC curve for predicting health literacy inadequacy was 0.82 (95% confidence interval=0.78-0.87, P<0.001). The ROC curve of the REIHL showed that scores ≥11 had a sensitivity of 77.8% and specificity of 75.6% for predicting health literacy inadequacy. The path analysis model showed excellent fit (Chi squared [2, 304] 0.16, P=0.92, comparative fit index 1.00, root mean square error of approximation <0.001, 90% confidence interval=0.00-0.04), indicating that the REIHL has good criterion and concurrent validity. CONCLUSION The newly developed REIHL is a practical tool for estimating older adults' inadequate health literacy in clinical care settings.
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Affiliation(s)
- A Y M Leung
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong
| | - E Y T Yu
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - J K H Luk
- Department of Medicine, Fung Yiu King Hospital, Hong Kong
| | - P H Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - D Levin-Zamir
- Department of Health Education and Promotion, Clalit Health Services, Israel.,School of Public Health, University of Haifa, Israel
| | - I S H Leung
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong
| | - K T Cheung
- Centre on Research and Advocacy, Hong Kong Society for Rehabilitation, Hong Kong
| | - I Chi
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, United States
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Chau PH, Li WY, Yip PSF. Construction of the Infection Curve of Local Cases of COVID-19 in Hong Kong using Back-Projection. Int J Environ Res Public Health 2020; 17:ijerph17186909. [PMID: 32967321 PMCID: PMC7557805 DOI: 10.3390/ijerph17186909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/17/2020] [Accepted: 09/18/2020] [Indexed: 11/16/2022]
Abstract
This study aimed to estimate the infection curve of local cases of the coronavirus disease (COVID-19) in Hong Kong and identify major events and preventive measures associated with the trajectory of the infection curve in the first two waves. The daily number of onset local cases was used to estimate the daily number of infections based on back-projection. The estimated infection curve was examined to identify the preventive measures or major events associated with its trajectory. Until 30 April 2020, there were 422 confirmed local cases. The infection curve of the local cases in Hong Kong was constructed and used for evaluating the impacts of various policies and events in a narrative manner. Social gatherings and some pre-implementation announcements on inbound traveler policies coincided with peaks on the infection curve.
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Affiliation(s)
- Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong;
- Correspondence: ; Tel.: +852-39176626
| | - Wei Ying Li
- School of Nursing, The University of Hong Kong, Hong Kong;
| | - Paul S. F. Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong;
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
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Cheung DST, Yeung WF, Chau PH, Lam TC, Yang M, Lai K, Ip CY, Lao L, Lin CC. Patient-centred, self-administered acupressure for Chinese advanced cancer patients experiencing fatigue and co-occurring symptoms: A pilot randomised controlled trial. Eur J Cancer Care (Engl) 2020; 31:e13314. [PMID: 32896014 DOI: 10.1111/ecc.13314] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 06/18/2020] [Accepted: 08/07/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To evaluate the feasibility and potential effects of patient-centred self-administered acupressure for alleviating fatigue and co-occurring symptoms among Chinese advanced cancer patients receiving treatment. METHODS Thirty advanced cancer patients who screened positive for moderate/severe fatigue with symptoms of insomnia and/or pain were recruited from a hospital in Hong Kong. They were randomly assigned (1:1) to receive a 4-week patient-centred self-administered acupressure intervention or health education. Fatigue (primary outcome) and secondary outcomes (sleep quality, pain, fatigue-sleep disturbance-pain symptom cluster severity, anxiety, depression and quality of life) were measured by questionnaires and actigraphy. RESULTS Twenty-four participants (80%) completed the study. Adherence to self-administered acupressure practice was satisfactory, with all retained participants attending all sessions and 90.9% practising acupressure daily. All completers rated the class as very enjoyable or quite enjoyable. Fatigue, pain, symptom cluster severity, anxiety, depression and quality of life appeared to improve from baseline to post-intervention in the intervention group. Among these outcomes, only the between-group difference in anxiety post-intervention was significant. The group × time interaction effect was nonsignificant for all outcomes. CONCLUSIONS Patient-centred self-administered acupressure appears to be feasible and acceptable among advanced cancer patients. A fully powered trial is warranted to confirm the intervention effect.
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Affiliation(s)
- Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Wing Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Tai Chung Lam
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Mingxiao Yang
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kithelia Lai
- Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, China
| | - Chun Yat Ip
- Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, China
| | - Lixing Lao
- School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Virginia University of Integrative Medicine, Virginia, United States
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Hong Kong, China.,School of Nursing, College of Nursing, Taipei Medical University, Taiwan
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50
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Affiliation(s)
- Paul S. F. Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR
| | - Pui Hing Chau
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR
- School of Nursing, The University of Hong Kong, Hong Kong SAR
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