Lee Tze-fan, Diana. / "April 2000." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (p. 243-266). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Yeung Fai. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 125-138). / Abstracts in English and Chinese; questionnaires also in Chinese. / Acknowledgement --- p.iii / Declaration --- p.iv / List of Tables --- p.v / List of Figures --- p.viii / Abstract --- p.ix / Abbreviation --- p.xiv / Chapter Chapter One --- Introduction / Background --- p.1 / Chapter 1.1 --- Definition / Chapter 1.2 --- Disease Prevalence / Chapter 1.3 --- Associated Disability / Chapter 1.4 --- Treatment-effectiveness / Chapter 1.5 --- Rehabilitation / Chapter Chapter Two --- Hong Kong Situation --- p.56 / Chapter 2.1 --- What is known --- Hong Kong elderly population database / Chapter 2.2 --- Service provision for the elderly in Hong Kong / Chapter Chapter Three --- Methodology --- p.68 / Chapter 3.1 --- Aims / Chapter 3.2 --- Subject and methodology / Chapter Chapter Four --- Results --- p.93 / Chapter 4.1 --- Results at baseline / Chapter 4.2 --- "Trend with time (0,12,48 weeks) between the exercise group and the control group" / Chapter 4.3 --- Results at first follow up (12 weeks) / Chapter 4.4 --- Results at second follow up (48 weeks) / Chapter 4.5 --- Results from baseline to second follow up within the exercise group or within the control group / Chapter Chapter Five --- Discussion --- p.113 / Chapter 5.1 --- Short-term efficacy of pulmonary program / Chapter 5.2 --- Long-term efficacy of pulmonary program / Chapter 5.3 --- The characteristics of pulmonary program / Chapter Chapter Six --- Conclusion --- p.124 / Reference --- p.125 / Appendix The Questionnaire Used in Interviews --- p.139

Background. Habitual short (HSS) and long sleeper (HLS) were very interesting but under-research area. / Conclusion. Our study suggested that sleep duration of human being has marked inter-individual variability with existence of extreme sleepers at both ends. Throughout different phases of the study, there was a consistent negative relationship between sleep duration and socio-economic status. Our finding of unique personality profile between short and long sleepers supported the hypothesis that different personality trait (neuroticism trait) might mediate between sleep duration and socioeconomic variables. Further studies are indicated for investigating genetic as well as biological correlates between personality traits and sleep duration. / Method. Three phases were involved in this research to explore epidemiological, psychological, and PSG characteristics of HSS and HLS. / Phase three: 72 subjects (23 HSS, 41 HNS, and 8 HLS) were assessed by two nights PSG to be followed by multiple sleep latency test (MSLT). 37 subjects (6 HSS, 21 HNS, and 10 HLS) were assessed by four-day Actiwatch. In the first night of PSG assessment, HLS had lower sleep efficiency and longer sleep and REM latency than HSS and HNS. In the second night, REM density in HLS was higher than HSS and HNS. In MSLT, HSS (50.0%) was more likely to have mildly short sleep latency than HLS (0%). Multiple regression of these healthy sleepers suggested that shorter sleep duration was found in those subjects (a) attaining higher education level; (b) suffering from higher life stress; (c) having more sleepiness; and (d) having less neuroticism. / Phase two: 252 subjects attended the face-to-face clinical interview. Among them, there were 33 HSS-7 and 25 HLS-9. After controlling gender and age, HSS had more chance to earn more money, live in larger house, drank more alcohol, and lower neuroticism than HLS. / Result. Phase one: Brief sleep questionnaires with consent were administered to parents of students in 13 primary schools in 2003, and 10381 parents returned their questionnaires (response rate ≈ 67.9%). 593 subjects were excluded because of their incomplete information. Altogether, 9788 subjects were considered as eligible subjects that represented noninstitutionalized Chinese middle-age residents in Hong Kong (47.0% men vs 53.0% women, mean age: 40.9 years +/- 4.9 years [SD]). There were 322 (3.3%) HSS-7 (≤7 hours), 1415 (14.5%) HLS-9 (≥9 hours), and 481 (4.9%) HLS-10 (≥10 hours). HSS had more chance to attain higher education level, earn more money and drank more tea/coffee than HLS. / Zhang Bin. / "May 2005." / Advisers: Y. K. Wing; S. O. Chan. / Source: Dissertation Abstracts International, Volume: 67-01, Section: B, page: 0177. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 155-193). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

研究背景：便秘被過往的研究確認為世界各地老年人的一個常見健康問題，尤其是居住在安老院的長者。香港一項人口普查亦指出便秘也是香港老年人的一個常見健康問題。便秘對長者的生理、心理和社會功能等各方面都產生不良影響。此外，醫療體制亦因處理便秘及其衍生的健康問題而面對沉重的負擔。目前所採用的常規方案是生活模式改變及使用軟便劑，但兩者均未能有效地紓緩便秘的徵狀。由於香港老齡人口持續增長，便秘將會是一個具有潛在持續性的老年健康問題，故尋找一個能有效地紓緩便秘徵狀的方案甚為迫切。耳穴療法是一項普及的中醫療法，亦屬於互補療法。過往在中國進行的研究顯示，耳穴療法能有效地治療便秘，惟此等療效尚未被確實。耳穴療法應是一個對處理便秘具有潛在療效的治療方案。現時，香港尚未有研究評價耳穴療法對處理便秘的療效。 / 研究目的：本研究旨在評價耳穴療法的互補療效，對安老院內的長者便秘徵狀及便秘相關的健康生活品質的干預效果。 / 研究方法：本研究是一個採取混合研究法的臨床研究。先進行化研究，評價耳穴療法對安老院內長者的便秘徵狀及便秘相關的健康生活品質的互補療效；接著進行質化研究，探討面談者對接受耳穴療法的經驗及感受。量化研究是一個隨機對照及雙盲的研究。安老院內的院友被取錄為參與者後，便隨機地獲分配一個研究組別。本研究共有三個研究組別，每名組員分別接受一個預定的干預措施，包括磁珠耳貼療法 (干預組)，王不留行籽耳貼療法 (對照A組) 及耳貼療法 (對照B組)，干預措施是在七個選定的耳穴上進行耳穴療法，共維持十天。研究指標包括便秘徵狀及便秘相關的健康生活品質。此等研究指標分別在干預前 (基線資料)、十天後 (干預措施結束) 和二十天後 (干預措施結束後十天) 進行資料蒐集。統計推斷方法是採用廣義估計方程模型檢驗組間和組內在便秘徵狀及便秘相關的健康生活品質之差異。質化研究的面談者必須是完成整個研究過程的干預組組員，並在量化檢驗的便秘徵狀指標中取得最高分及最低分的各四位組員。透過個別面談，探討面談者對接受耳穴療法以處理便秘的經驗及感受。 / 研究結果：本研究共有99名參與者。祇有90名參與者接受干預措施 (干預組=31；對照A組=28；對照B組=31)，其中的81名參與者完成整個療程 (干預組=29；對照A組=25；對照B組=27)。本研究結果顯示耳穴療法在十天 (p=0.016)及二十天 (p=0.016) 的研究時期內，便秘相關的健康生活品質中的滿意度在干預組及對照A組間有顯著的差異 (十天及二十天均是p=0.016)。然而，本研究證實磁珠耳貼療法能顯著地紓緩便秘徵狀 (十天：p=0.013；二十天：p<0.001)，提升與便秘相關的健康生活品質 (十天：p=0.005；二十天：p<0.001)，並於三個研究組別中取得最大的療效。此外，質化研究結果顯示，耳穴療法確是一項安全及具認受性的療法，適用於安老院內的院友，可作為處理便秘的治療方案。 / 研究結論：本研究是香港首個通過隨機對照的臨床研究，以評價耳穴療法對處理便秘的互補療效。研究結果顯示磁珠耳貼療法對安老院內的院友具有正向的臨床價值：磁珠耳貼療法能紓緩便秘徵狀及提升便秘相關的健康生活品質；安老院內的院友認為耳穴療法是一項安全及具認受性的療法；對住在安老院內年長的中國人而言，耳穴療法是一項與其文化相關的照護方式。本研究就處理安老院內院友的便秘問題為護理專業提供了有關耳穴療法的新知，並作為日後於護理實務及護理研究方面的參考和方向。 / Background: Constipation has been identified in previous studies as a worldwide health problem among elderly people, especially those living in residential care homes (RCHs). Similarly, constipation is also reported as a common health problem among elderly people in Hong Kong in a local population survey. Constipation adversely affects the biopsychosocial well-being of elderly people. In addition, heavy burden has been imposed on the health care system in dealing with constipation and its related health problems. Constipation is currently managed by laxatives and lifestyle modification. However, constipation is not effectively relieved by these two management strategies. In Hong Kong, the aging population is seen to have an increasing trend. Constipation will then be a potentially expanding health problem among elderly people. All these data indicate an urgent need for effective alternatives to manage this health problem. Auriculotherapy is one popular treatment modality in Chinese medicine, which is also a form of complementary therapy. Previous studies conducted in Mainland China reported promising results in managing constipation with auriculotherapy, although its effectiveness was not affirmed. Auriculotherapy appears to be a promising management strategy for constipation. Until now, no study has been conducted in Hong Kong to evaluate the effectiveness of auriculotherapy in managing constipation. / Aim: The current study aims to evaluate the complementary effects of auriculotherapy in relieving constipation symptoms and in promoting disease-specific health-related quality of life (HRQOL) among elderly RCH residents. / Methods: The present study is a clinical trial that adopts the mixed-method design. A randomized placebo-controlled trial was first conducted to evaluate the complementary effects of auriculotherapy in relieving symptoms of constipation and in promoting disease-specific HRQOL in elderly RCH residents. After the completion of the randomized placebo-controlled trial, the qualitative approach was conducted to explore the participants’ experience and perceptions on the use and complementary effects of auriculotherapy with magnetic pellets in managing constipation. The randomized placebo-controlled trial was a double-blind study. The participants were recruited from elderly RCH residents and then randomly assigned to one of the three study groups. The participants received the assigned intervention, namely, auriculotherapy using auricular plaster with magnetic pellet (experimental group), auriculotherapy using auricular plaster with Semen Vaccariae (placebo-controlled group A), or auriculotherapy using only auricular plaster (placebo-controlled group B). Auriculotherapy was applied onto seven selected auricular acupoints for 10 days. Two outcome variables, namely, constipation symptoms and disease-specific HRQOL, were measured before the implementation of intervention (baseline), on Day 10 (at the completion of the intervention), and on Day 20 (at the 10th-day follow-up after the intervention). The generalized estimating equation model was adopted to evaluate the between-group and within-group differences in the complementary effects of auriculotherapy on constipation symptoms and disease-specific HRQOL. In the qualitative approach, the informants were recruited from participants of the experimental group who had successfully completed the study with mean scores in constipation symptoms at the top- or bottom-four ranking. The informants were individually interviewed to explore their experience and perceptions on the use and complementary effects of auriculotherapy in managing constipation. / Results: Ninety-nine participants were recruited in the study. Ninety participants received the intervention as assigned, and eventually, 81 participants completed the intervention. When the interaction effects of time and group were simultaneously considered, statistical significant differences were only found in the satisfaction subscale of the disease-specific HRQOL between the experimental group and placebo-controlled group A on both Day 10 (p=0.016) and Day 20 (p=0.016). For the experimental group, significant time effects were found in constipation symptoms (Day 10：p=0.013; Day 20：p<0.001) and disease-specific HRQOL (Day 10：p=0.005; Day 20：p<0.001) after receiving auriculotherapy. Most importantly, the participants who received auriculotherapy with magnetic pellets showed the greatest improvement in constipation symptoms and disease-specific HRQOL after the intervention compared with the two placebo-controlled groups. The qualitative findings further revealed that auriculotherapy is a safe, well-accepted therapy in managing constipation among elderly RCH residents. / Conclusion: The current study is the first known randomized placebo-controlled trial that evaluates the complementary effects of auriculotherapy in managing constipation in Hong Kong. The current findings indicate positive clinical value of auriculotherapy with magnetic pellets in managing constipation in elderly RCH residents. Auriculotherapy with magnetic pellets was found to provide favourable therapeutic effects in relieving constipation symptoms and in promoting disease-specific HRQOL among elderly RCH residents. This therapy is also considered by elderly people as a safe and acceptable therapy with minimal side effects. In addition, auriculotherapy is considered as a culturally relevant care modality for Chinese elderly RCH residents. The current study contributes new knowledge to nursing for future reference and directions in both nursing practice and nursing research with regard to the complementary effects of auriculotherapy in managing constipation among elderly RCH residents. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Li, Mei Kuen. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 273-305). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract and appendixes also in Chinese. / Chapter CHAPTER 1 --- INTRODUCTION / Introduction --- p.1 / Background of the study --- p.2 / Aim and significances of the study --- p.6 / Overview of the thesis --- p.6 / Chapter CHAPTER 2 --- LITERATURE REVIEW / Introduction --- p.8 / Constipation: Potentially expanding health problem in elderly population --- p.9 / Prevalence of constipation --- p.9 / Definition of constipation --- p.11 / Physiology and pathophysiology of defecation --- p.13 / Effects of constipation --- p.15 / Adverse individual health consequences --- p.15 / Economic burden in health care system --- p.18 / Contributory factors for constipation --- p.20 / Roles of nurses in managing constipation in current practice --- p.22 / Cautious use of laxatives --- p.24 / Lifestyle modification --- p.24 / Promoting dietary fiber intake --- p.25 / Encouraging oral fluid intake --- p.26 / Promoting physical activity --- p.26 / Integration of complementary therapy into nursing practice in managing constipation --- p.28 / Auriculotherapy --- p.30 / Historical overview of auriculotherapy --- p.30 / Conceptual framework of auriculotherapy --- p.31 / Approaches of auriculotherapy --- p.36 / Mechanism of auriculotherapy --- p.37 / Clinical applications of auriculotherapy in managing constipation --- p.39 / Complementary effects of auriculotherapy in managing constipation: Review of previous studies --- p.41 / Subject characteristics --- p.41 / Intervention protocol --- p.45 / Therapeutic outcome criteria and effectiveness --- p.50 / Strengths and limitations of the reviewed studies --- p.56 / Recommendations for future studies --- p.59 / Significances of the current study --- p.60 / Summary --- p.61 / Chapter CHAPTER 3 --- METHODS / Introduction --- p.63 / Overview of study design --- p.65 / Mixed-method study design --- p.66 / Quantitative approach --- p.66 / Qualitative approach --- p.68 / Research aim and objectives --- p.68 / Research aim --- p.68 / Research objectives --- p.68 / Null hypotheses --- p.69 / Operational definitions --- p.71 / Rationale of the study design --- p.73 / Rationale for adopting the mixed-method design --- p.73 / Rationale for adopting the randomized controlled trial design --- p.75 / Rationale for adopting double-blindness --- p.75 / Rationale for adopting random assignment --- p.76 / Rationale for adopting a pretest and repeated post-test design --- p.78 / Rationale for recruiting placebo-controlled groups --- p.79 / Quantitative approach --- p.81 / Sample --- p.81 / Accessible population --- p.81 / Sampling method and selection of participants --- p.82 / Sample size determination --- p.85 / Experimental intervention --- p.87 / Content of the experimental intervention --- p.87 / Integrity of experimental intervention --- p.92 / Qualification of the intervener --- p.92 / Consistency of implementation of intervention --- p.93 / Compliance of the participants to study instructions --- p.84 / Data collection --- p.95 / Study Instruments and records --- p.95 / Patient Assessment of Constipation Symptom Questionnaire (Cantonese Chinese for Hong Kong) (PAC-SYM) --- p.96 / Patient Assessment of Constipation Quality of Life Questionnaire (Cantonese Chinese for Hong Kong) (PAC-QOL) --- p.97 / Abbreviated Mental Test (Hong Kong version; AMT) --- p.98 / Physical Activity Questionnaire (Hong Kong version; PAQ) --- p.98 / Screening for eligibility of the participant --- p.99 / Demographic and Clinical Data Sheet --- p.99 / Assessment of Clinical Syndrome of Constipation --- p.99 / Assessment of oral intake of Fruits and Vegetables (AFV) --- p.100 / Bowel Movement Record (BMR) --- p.100 / Drug Administration Record (DAR) --- p.101 / Data collection procedure --- p.101 / Qualitative approach --- p.104 / Rationale for adopting criterion sampling --- p.105 / Pilot Study --- p.106 / Feasibility of the sampling method --- p.107 / Feasibility of the data collection instruments and procedure --- p.107 / Feasibility of implementation of the study intervention --- p.108 / Characteristics of the pilot sample --- p.109 / Sample size recalculation --- p.113 / Appropriateness of the interview guide --- p.114 / Recommendations for the main study --- p.115 / Data Analysis --- p.115 / Quantitative data --- p.115 / Assessment of accuracy of data entry --- p.116 / Description of sample characteristics --- p.117 / Assessment of homogeneity of the study groups --- p.117 / Detection of the intervention effect --- p.118 / Justification for choosing parametric statistical tests over non-parametric statistical tests --- p.118 / Adoption of the Generalized Estimating Equations (GEE) model --- p.119 / Rationale for adopting the GEE model --- p.119 / Choosing the appropriate link function and working correlation matrix --- p.121 / Control of possible covariates in data analysis --- p.123 / Qualitative data --- p.124 / Ethical considerations --- p.125 / Principle of respect for persons --- p.126 / Principle of beneficence --- p.127 / Principle of justice --- p.128 / Summary --- p.129 / Chapter CHAPTER 4 --- RESULTS / Introduction --- p.132 / Recruitment and characteristics of participants --- p.133 / Recruitment of participants --- p.133 / Characteristics of the participants --- p.137 / Characteristics of the study sample and homogeneity among study groups --- p.140 / Characteristics of the study sample --- p.141 / Homogeneity of the characteristics of participants who received and those who did not receive the intervention in the study --- p.145 / Homogeneity of the characteristics of participants in the experimental and the placebo-controlled groups --- p.145 / Complementary effects of auriculotherapy in managing constipation --- p.149 / Adopting the GEE model --- p.152 / Checking the missing data --- p.152 / Identifying the covariates --- p.152 / Choosing the appropriate link function --- p.153 / Choosing the appropriate working correlation matrix --- p.160 / Complementary effects of auriculotherapy on constipation symptoms and disease-specific HRQOL --- p.160 / Complementary effects of auriculotherapy on constipation symptoms --- p.161 / Constipation symptoms (PAC-SYM) --- p.161 / Subscales of constipation symptoms --- p.165 / Abdominal symptoms subscale --- p.165 / Rectal symptoms subscale --- p.168 / Stool symptoms subscale --- p.172 / Summary of the complementary effects of auriculotherapy on constipation symptoms --- p.175 / Complementary effects of auriculotherapy on disease-specific HRQOL --- p.177 / Disease-specific HRQOL (PAC-QOL) --- p.177 / Subscales of disease-specific HRQOL --- p.181 / Physical discomfort subscale --- p.181 / Psychosocial discomfort subscale --- p.185 / Worries and concerns subscale --- p.186 / Satisfaction subscale --- p.190 / Summary of the complementary effects of auriculotherapy on disease-specific HRQOL --- p.193 / Effect size calculation --- p.196 / Findings revealed from study records --- p.197 / Monitoring of the intervention dose --- p.198 / Change of bowel movement pattern --- p.198 / Change in drug administration --- p.200 / Reporting of side effects associated with auriculotherapy --- p.202 / Reporting of unexpected beneficial effects after receiving auriculotherapy --- p.202 / Qualitative findings revealed from interview --- p.203 / Recruitment of informants --- p.203 / Characteristics of the informants --- p.204 / Qualitative findings --- p.207 / Benefits of auriculotherapy in managing constipation --- p.208 / Minor discomforts associated with auriculotherapy --- p.210 / Life as usual with the use of auriculotherapy --- p.210 / Willingness to adopt and recommend auriculotherapy to others --- p.213 / Summary of the qualitative findings --- p.214 / Summary --- p.215 / Chapter CHAPTER 5 --- DISCUSSION / Introduction --- p.217 / Profile of participants --- p.217 / Demographic and clinical characteristics of the participants --- p.218 / Baselines outcome variables of the participants --- p.224 / Clinical value of auriculotherapy with magnetic pellets in managing constipation --- p.226 / Summary of the key findings --- p.226 / Complementary effects in relieving constipation symptoms and in promoting disease-specific HRQOL --- p.228 / Safe and well-accepted intervention --- p.236 / Culturally relevant care modality --- p.239 / Challenges associated with recruiting elderly participants --- p.241 / Strengths and limitations of the current study --- p.246 / Strengths of the study --- p.246 / Limitations of the study --- p.253 / Summary --- p.257 / Chapter CHAPTER 6 --- CONCLUSION / Introduction --- p.258 / Contribution of new knowledge to nursing --- p.258 / Implications for nursing practice --- p.259 / Clinical application of auriculotherapy in nursing practice --- p.261 / Strategies to promote integration of auriculotherapy into nursing practice --- p.263 / Implications for nursing research --- p.266 / Recommendations for further studies --- p.268 / Conclusion of the whole study --- p.269 / REFERENCES (ENGLISH) --- p.273 / REFERENCES (CHINESE) --- p.303

Background & Objective: Acute gastroenteritis (AG) outbreak in elderly homes is common in Hong Kong, especially during the winter. Although mainly a self-limiting condition, the associated short-term as well as long-term medical and social costs can be extensive. This case-control study aims to investigate the hygienic risk factors related to infectious AG in elderly homes at both institutional and individual levels. Predictor variables under investigation include hand wash practice, infection control practice, routine institutional hygienic practice, food handling practice, and environmental factors such as the home setting, ventilation measures and isolation room setting. / Conclusions: This study found that 'sometimes or never wash hands after toilet' was a significant personal hygienic risk factor for AG transmission. This indicated that toilet may be the most susceptible place and hands are the most susceptible vehicle for AG transmission in Hong Kong elderly homes. A higher percentage of the NOHs had a more frequent routine cleaning practice than the OHs, demonstrating that routine cleaning practice may be an economical and an effective way to prevent AG infection. / Methods: All the elderly homes in the New Territories East were invited to take part in the study. A total of 34 homes and 2,995 residents were recruited in the study sample. The data collection period was from Dec 2007 to May 2009. Cases were notified within one week after a reported AG case, either by a report from the elderly home in question, the weekly check up with the New Territories East Community Geriatric Assessment Teams (NTE CGATs), regular contact with the elderly homes by the research assistant and case referrals from the Accident and Emergency Department from the Prince of Wales Hospital (PWH). One hundred and forty cases and 280 matched controls were recruited. For every AG case reported, two sex and age (within 5 years) and elderly home matched controls were selected. Structured questionnaires were conducted in face-to-face interviews in the elderly homes by trained interviewers. Information about the ventilation and the environmental hygiene of the elderly homes was collected by observation from the research team at the beginning of the study. Descriptive analysis was performed for the characteristics of cases and controls. Multivariate and multilevel logistic regression models were applied and odds ratios (ORs) were calculated for the potential hygienic risk factors. / Results: Multiple conditional logistic regression analysis revealed 'sometimes or never wash hands after toilet' OR:3.09 (95%CI: 1.28 -- 7.42) [ref gp: wash hands every time after toilet] was the major significant risk factor for AG in elderly homes, indicating the possible route of person-to-person transmission. Other significant risk factors included: Self-nutrition evaluation as 'not enough' (OR: 2.07; 95%CI: 1.05 -- 4.06), 'Being hospitalized in past month before the interview' (OR: 2.86; 95%CI: 1.16 -- 7.05), 'Simplified Barthel Index scored &lt;15" (OR: 2.63; 1.06 -- 6.53), and 'Alzheimer's' (OR: 2.75; 95% 1.18 -- 6.40). The institutional hygiene factors were investigated based on the descriptive analysis between the outbreak homes (OHs) and the non-outbreak homes (NOHs). The results indicated that the health worker (HW) to resident ratio was much lower in OHs than NOHs (50% OHs: 1:30-55 vs > 80% NOHs:1:10-29), and a higher percentage of the NOHs had a more frequent routine cleaning practice than the OHs. / Fung, Pui Kwan. / Adviser: Ho Suzanne Sutying. / Source: Dissertation Abstracts International, Volume: 73-02, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 182-206). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

A mixed-methods design consisting of two phases was adopted. In Phase I, a purposive sample of 31 older Clnnese people with KOA was invited for a semi-structured interview to explore their perceptions and experiences of exercise. Five major categories emerged: typical living pattern with KOA, self-management of KOA, the practice of exercise, views about exercise, and preferences for learning exercise. The findings were used in the development of an exercise programme for this client group. / Knee osteoarthritis (KOA) is prevalent in the growing older Chinese population in Hong Kong. Therapeutic exercise for KOA has strong empirical evidence of its effectiveness on reducing knee pain and physical disability in people with KOA provided that they persists in practising the recommended exercise regimen. However, few previous studies have incorporated the client's perspectives into the design of an exercise programme for promoting continual practice of exercise. This study aimed to develop a new therapeutic exercise programme and pilot its acceptability to promote continual practice for older Chinese people with KOA. / The Phase II study used both quantitative and qualitative approaches to examine participants' satisfaction with the new exercise programme, adherence to the prescribed exercises, mastering of the exercise movements and health outcomes (knee pain, stiffness and range-of-motion, physical function, muscle strength and endurance of the lower extremities, and quality of life). A convenience sample of 33 older Chinese people with KOA participated in the programme. Seven measurement tools in Chinese versions (if applicable) were used to collect quantitative data from the participants: the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the 12-item Short Form of the Medical Outcome Study Questionnaire (SF-12), a goniometer, the Timed-Stands Test (TST), a satisfaction questionnaire, an exercise diary, and a return-demonstration performance record sheet. Six of the participants were invited for a semi-structured interview to explore their experience of the programme. / The quantitative results showed that the participants were highly satisfied with the exercise programme with a mean score of 90.15 out of 100 (SD = 8.05). Their average exercise adherence was high with a mean percentage of 91.04% (SD = 14.54) and their overall performance in mastering of the exercise movements was good with a mean score of 76.71 out of 100 (SD = 21.75). Most participants' health outcomes significantly improved at three months after the exercise programme, except for the SF-12 physical health summary score. The qualitative findings revealed four major categories: satisfaction with the exercise programme, mastering of the exercise movements, experience of the exercise's effects, and integration of the exercises into the daily routine. These findings were mainly consistent with the quantitative results of the study. / The results of this study showed that the exercise programme was acceptable to the participants in terms of satisfaction with the programme, adherence to the prescribed exercises and mastering of the exercise movements. Therefore, adopting a client-centred approach is likely to be a way forward in the development of exercise programmes for promoting continual practice of therapeutic exercise regimens by older Chinese people with KOA. / Lee, Fung Kam. / Advisers: Tak Ying Ann Shiu; Tze Fan Diana Lee; Kwok Wei Winnie So. / Source: Dissertation Abstracts International, Volume: 73-06, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 332-369). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese; some appendixes in Chinese.

Hospital readmission is prevalent among people with chronic obstructive pulmonary disease (COPD), particularly among older people in Hong Kong. Evidence shows that hospital readmissions exert a considerable impact on patients. Studies in this area primarily identify various associative factors based on the perspectives of health professionals. However, these factors are inadequate in illustrating the needs of older people and in illuminating the phenomenon of hospital readmissions. A thorough understanding of the issue can be achieved if the related experiences are interpreted from the perspective of the patients and in terms of their context. Understanding of their experiences has paramount significance in uncovering the unmet needs of patients and in informing the provision of healthcare services. Yet, there is a dearth of studies unfolding the experiences of Chinese older people. / This study aimed to explore and describe the lived experience of hospital readmissions of Chinese older people with COPD and to identify Chinese socio-cultural influences on the experience. Understanding was acquired through descriptive phenomenology. Twenty-two Chinese older people aged 62 to 89 were recruited by purposive sampling. They had been readmitted 4 to 14 times in the previous year. The older people were interviewed once during their hospitalization, and their readmission experiences were elicited from these unstructured interviews. Narrative descriptions were analyzed using the phenomenological method described by Giorgi (1985). / The general structure of the lived experience of hospital readmissions of Chinese older people with COPD reveals that older people refrain from unnecessary readmissions because they regard hospital care as the last resort in relieving breathlessness. When their breathlessness becomes intolerable, they perceive the urgency of surviving the distress. Craving for survival, they seek hospital readmission, which provides them immediate relief from the imminent threat. After being readmitted to a hospital, they feel powerless when their need for hospital care is disregarded by their doctors. Considering themselves as demanding to their families in daily lives, older people remain conscious of relieving their burden during their periods of hospital readmission because they regard this as the only opportunity to relieve their burden. Older people come to realize hospital readmissions are unavoidable after they put every effort to refrain from it but hospital care remains necessary. They further rationalize hospital readmissions as inevitable and resign themselves to it because of their perception of aging, doctors’ accounts of COPD, experience with and knowledge of the disease, and belief in fate. This acceptance of the inevitability of hospital readmissions precipitates an attitudinal shift toward the belief of living for the moment. Their past experiences inspire them to be satisfied with the current state of living and engage the present. This positive outlook enables them to embrace the experiences of hospital readmissions into their lives. Six invariant constituents emerged from the lived experience. The constituent “refraining from unnecessary readmissions” describes how older people manage their diseases in relation to hospital readmissions. “Craving for survival” explains why they seek hospital readmissions. “Feeling being disregarded and powerless” and “being conscious of relieving burden to families” characterize their experience of hospital readmissions. “Resigning to hospital readmissions” illustrates how they understand the recurrence of this phenomenon and “living for the moment” illuminates how they live with their experiences. / A deep understanding of hospital readmissions is embodied in the experiences of older people. The findings emphasize that hospital readmissions among Chinese older people are complex experiences shaped by their sociocultural context. The meanings of hospital readmissions to older people are influenced by their assumption of a submissive patient role, collectivism, external attribution style, and past life experiences. Although older people appear to accept and cope well with hospital readmissions, this study uncovers their needs as they move to and fro the hospital and home. The findings of this study offer implications in promoting the wellness of Chinese older people as they go through this revolving door. / 再次住院在患有慢性阻塞性肺病人士中相當普遍，尤其是在中國老年患者。研究證據顯示再次住院對病人有很大的影響。現有的研究偏重於從醫務人員角度尋找不同的關聯因素，但該些因素並不足以反映老年人的需要以及解釋再次住院的現象。只有透過病人的觀點以及結合他們的背景來闡釋這些相關經驗，才能作出深入了解。了解病人的再次住院經驗有助於找出病人的需要以及指引醫療服務的提供。然而，有關中國老年人再次住院經驗的探討相當缺乏。 / 是次研究目的是探討和描述患有慢性阻塞性肺病的中國老年人再次住院的體驗，以及認識中國社會文化對再次住院經驗的影響。研究採用描述現象學方法。研究以立意抽樣方式選取了22名62至89歲的中國老年人。他們在去年入院次數為4至14次。這些老年人在住院期間均接受一次非結構式訪談以了解他們的再次住院經驗。這些敘述性描寫再按 Giorgi (1985) 的現象學方法作出分析。 / 患有慢性阻塞性肺病中國老年人再次住院的體驗的通用結構顯示他們避免不必要的再次住院，因為他們將住院護理視為紓緩呼吸困難的最後方法。當他們的呼吸困難惡化至無法忍受，他們會感受到從危病中活下來的迫切性。因著渴望生存的意識，他們尋求再次住院以即時消除緊迫的生命威脅。再次入院後，對於醫生漠視其住院護理的需要，他們感到無力。由於考慮到他們在日常生活中對家人的需求頗多，老年人以再次住院其間來減輕家庭負擔，因他們視這其間為唯一能減輕家庭負擔的機會。儘管老年人盡能力以避免再次入院，但他們依然需要住院護理，老年人逐漸意識到再次住院為無可避免。由於老年人對於老化的感知、醫生對慢性阻塞性肺病的解明、患病經驗和對疾病的相關知識以及相信命運的看法，他們更將再次住院合理化為無可避免並順從。接受再次住院為無可避免促成他們的態度轉變為活在當下。過去的經驗令他們對目前的生活感到滿意並希望活在當下。這個正面想法令他們將再次住院接納為生活的一部份。六個不變組成要素呈現於老年人的再次住院體驗當中。組成要素「避免不必要的再次住院」描述老年人如何管理慢性阻塞性肺病以避免再次住院。「渴望生存」解釋了他們尋求再次住院的原因。「感到被忽略和無力」以及「減輕家庭負擔的意識」敘述了他們再次住院的經驗。「順從再次住院」說明了他們對再次住院現象發生的理解，而「活在當下」說明了他們如何接納再次住院經驗。 / 對於再次住院的深入了解具體表現於老年人的經驗當中。是次研究結果強調，老年人再次住院是由他們的社會文化背景塑造而成的複雜經驗。對於老年人而言，再次住院的意義受到他們對順從性病人角色的假設、集體主義觀念、外部歸因以及過往的生活經驗所影響。雖然老年人似乎接受並適應再次住院，是次研究發現了他們在這現象中的需要。研究結果對於促進再次住院的中國老年人的健康帶來新的啟示。 / Tang, Wing Ki. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2015. / Includes bibliographical references (leaves 342-393). / Abstracts also in Chinese. / Title from PDF title page (viewed on 05, October, 2016). / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.

Chang, Jianfang. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 183-217). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Pau, Mei Lin Margaret. / Thesis (D.Nurs.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 130-152). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese; appendixes includes Chinese.

Sze Pan Ching. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (leaves 162-178). / Abstracts in English and Chinese. / ABSTRACT --- p.i / ABSTRACT (IN CHINESE) --- p.iv / ACKNOWLEGEMENT --- p.vi / TABLE OF CONTENTS --- p.viii / LIST OF FIGURES --- p.xv / LIST OF TABLES --- p.xviii / LIST OF APPENDIX --- p.xx / LIST OF ABBREVIATIONS --- p.xxi / LIST OF DEFINITIONS OF TERMS --- p.xxii / Chapter I. --- INTRODUCTION --- p.1 / Chapter 1.1 --- Epidemiology of hip fracture among elderly worldwide --- p.1 / Chapter 1.2 --- Impact of hip fractures --- p.3 / Chapter 1.2.1 --- Mortality --- p.3 / Chapter 1.2.2 --- Hospitalization and institutionalization --- p.4 / Chapter 1.2.3 --- Morbidity --- p.4 / Chapter 1.2.4 --- Psychological impact and quality of life --- p.5 / Chapter 1.2.5 --- Financial burden --- p.6 / Chapter 1.3 --- Causes of hip fracture --- p.6 / Chapter 1.3.1 --- Mechanisms of hip fracture --- p.7 / Chapter 1.3.2 --- Degenerated protective mechanism --- p.8 / Chapter 1.3.3 --- Poor hip strength indices --- p.9 / Chapter 1.4 --- Prevention of hip fractures --- p.10 / Chapter 1.4.1 --- Reduction of the chance of lateral fall --- p.10 / Chapter 1.4.2 --- Increase hip strength indices --- p.11 / Chapter 1.4.3 --- Limitations of current strategies --- p.12 / Chapter 1.5 --- Hip protectors for prevention of hip fractures --- p.12 / Chapter 1.6 --- Effectiveness of hip protector --- p.14 / Chapter 1.6.1 --- Laboratory studies on effectiveness in force attenuation --- p.14 / Chapter 1.6.2 --- Clinical studies on prevention of hip fractures --- p.16 / Chapter 1.6.3 --- Cost-effectiveness study --- p.17 / Chapter 1.7 --- Problems on the use of hip protectors --- p.19 / Chapter 1.7.1 --- Discomfort --- p.19 / Chapter 1.7.2 --- Extra effort in wearing --- p.20 / Chapter 1.7.3 --- Appearance after wearing --- p.21 / Chapter 1.7.4 --- Urinary incontinence --- p.22 / Chapter 1.7.5 --- Oth er problems --- p.23 / Chapter 1.8 --- Acceptance and Compliance of hip protectors --- p.23 / Chapter 1.8.1 --- Acceptance --- p.23 / Chapter 1.8.2 --- Compliance --- p.24 / Chapter 1.9 --- Strategies to improve compliance of hip protector --- p.25 / Chapter 1.9.1 --- Better design of hip protector --- p.25 / Chapter 1.9.2 --- Encouragement/support to the user --- p.26 / Chapter 1.9.3 --- Support from nursing staff/carer --- p.27 / Chapter 1.10 --- Rationale and objectives of present study --- p.28 / Chapter II. --- METHODOLOGY --- p.36 / Chapter 2.1 --- Development of hip protector --- p.36 / Chapter 2.1.1 --- Design of the pads --- p.36 / Chapter 2.1.2 --- Design of the pants --- p.38 / Chapter 2.1.2.1 --- Fabric materials --- p.38 / Chapter 2.1.2.2 --- Anthropometric measurement --- p.42 / Chapter 2.1.2.3 --- Pattern design --- p.43 / Chapter 2.1.3 --- Trial use of hip protector --- p.43 / Chapter 2.1.4 --- Calculation and statistical method --- p.43 / Chapter 2.2 --- Mechanical test on force attenuation properties --- p.44 / Chapter 2.2.1 --- Testing system --- p.44 / Chapter 2.2.2 --- Simulation of impact force and identification of dropping height --- p.45 / Chapter 2.2.3 --- Testing method --- p.46 / Chapter 2.2.4 --- Calculation and statistical method --- p.47 / Chapter 2.3 --- Compliance study --- p.47 / Chapter 2.3.1 --- Setting --- p.47 / Chapter 2.3.2 --- Subjects --- p.48 / Chapter 2.3.3 --- Study design --- p.49 / Chapter 2.3.4 --- Implementation procedure and intervening Program --- p.49 / Chapter 2.3.4.1 --- Liaison with the heads and responsible staff in the elderly hostels --- p.49 / Chapter 2.3.4.2 --- Education program for hostel staff --- p.50 / Chapter 2.3.4.3 --- Education program for elderly subjects --- p.50 / Chapter 2.3.4.4 --- Fall and fracture risk counseling --- p.51 / Chapter 2.3.4.5 --- Consent and Ethical approval --- p.51 / Chapter 2.3.4.5 --- Provision of hip protector and training program on wearing hip protector --- p.51 / Chapter 2.3.4.6 --- Follow up and encouragement on the use of hip protector --- p.52 / Chapter 2.3.5 --- Outcome measures --- p.52 / Chapter 2.3.5.1 --- Primary outcome --- p.52 / Chapter 2.3.5.2 --- Secondary outcomes --- p.53 / Chapter 2.3.6 --- Measurement method --- p.55 / Chapter 2.3.6.1 --- Compliance --- p.55 / Chapter 2.3.6.2 --- Falls and fractures incidence --- p.56 / Chapter 2.3.6.3 --- Adverse effect and feedback after wearing hip protector --- p.56 / Chapter 2.3.6.4 --- Fear of fall --- p.57 / Chapter 2.3.6.5 --- Fall and fracture history --- p.57 / Chapter 2.3.6.6 --- Medical co-morbidities --- p.58 / Chapter 2.3.6.7 --- Presence of urinary incontinence --- p.58 / Chapter 2.3.6.8 --- Functional level --- p.58 / Chapter 2.3.6.9 --- Hand function --- p.58 / Chapter 2.3.6.10 --- Mobility --- p.59 / Chapter 2.3.6.11 --- Cognitive function --- p.59 / Chapter 2.3.7 --- Sample size calculation --- p.59 / Chapter 2.3.8 --- Calculation and Statistical method --- p.60 / Chapter III. --- RESULTS --- p.73 / Chapter 3.1 --- Design of hip protector --- p.73 / Chapter 3.1.1 --- The design of pants --- p.73 / Chapter 3.1.1.1 --- The fabric materials --- p.73 / Chapter 3.1.1.2 --- The size of the pants --- p.74 / Chapter 3.1.2 --- The design of pads --- p.75 / Chapter 3.1.2.1 --- Thickness of silicon padding --- p.75 / Chapter 3.1.1.2 --- Dimension of the hard shield --- p.75 / Chapter 3.2 --- Mechanical test on force attenuation properties of the pads --- p.76 / Chapter 3.2.1 --- Impact force --- p.76 / Chapter 3.2.2 --- Impact duration --- p.78 / Chapter 3.2.3 --- Selection of th e prototype --- p.78 / Chapter 3.3 --- Compliance study --- p.79 / Chapter 3.3.1 --- Demograph ics --- p.79 / Chapter 3.3.2 --- Primary outcome --- p.79 / Chapter 3.3.2.1 --- Initial acceptance rate --- p.79 / Chapter 3.3.2.2 --- Compliance rate --- p.79 / Chapter 3.3.2.3 --- Percentage of people wearing hip protector across the study period --- p.81 / Chapter 3.3.2.4 --- Percentage of protected fall --- p.81 / Chapter 3.3.3 --- Secondary outcomes --- p.81 / Chapter 3.3.3.1 --- Fall and related injury among the subjects in the study period --- p.81 / Chapter 3.3.3.2 --- Reasons for non-acceptance --- p.82 / Chapter 3.3.3.3 --- Feedback in using hip protector --- p.84 / Chapter 3.3.3.4 --- Factors associated with compliance and non-compliance (feedback in wearing hip protector) --- p.84 / Chapter 3.3.3.5 --- Factors associated with compliance and non-compliance (subject characteristics) --- p.85 / Chapter 3.3.3.6 --- Effect on mobility after wearing hip protector --- p.85 / Chapter 3.3.3.7 --- Fear of fall after wearing hip protector --- p.85 / Chapter IV. --- DISCUSSION --- p.123 / Chapter 4.1 --- Development of a hip protector for Chinese elderly --- p.124 / Chapter 4.1.1 --- Successful modifications made to the pads --- p.124 / Chapter 4.1.1.1 --- More comfort to wear with silicon cushioning materials added --- p.124 / Chapter 4.1.1.2 --- Better mechanical properties with semi-flexible plastic and silicon pad --- p.125 / Chapter 4.1.1.3 --- Smaller in dimension of the present model might improve appearance after wearing --- p.127 / Chapter 4.1.2 --- No significant improvement on compliance with modification of the pants --- p.128 / Chapter 4.2 --- Sufficient mechanical properties of hip protector demonstrated --- p.129 / Chapter 4.2.1 --- Mechanical test set up --- p.130 / Chapter 4.2.2 --- Mechanism of force attenuation --- p.132 / Chapter 4.3 --- No significant improvement on compliance shown --- p.134 / Chapter 4.4 --- Compliance at night time better than other studies --- p.136 / Chapter 4.5 --- Determinants of compliance mostly related to subjects' feedback of using hip protector rather than on their characteristics --- p.137 / Chapter 4.6 --- Better compliance observed in hostel with higher staff-to-subject ration and with occupational therapist as contact person --- p.138 / Chapter 4.7 --- Better acceptance rate of hip protector shown in the present study --- p.139 / Chapter 4.8 --- Identification of factors influencing acceptance --- p.139 / Chapter 4.9 --- Percentage of protected fall was higher than mean compliance --- p.141 / Chapter 4.10 --- No hip fracture occurred while subjects wearing hip protector --- p.141 / Chapter 4.11 --- Decreased fear of falling after wearing hip protector --- p.142 / Chapter 4.12 --- Limitation --- p.142 / Chapter 4.13 --- Recommendation --- p.143 / Chapter V. --- CONCLUSION --- p.146 / Chapter VI. --- APPENDIX --- p.148 / Chapter VII. --- BIBLIOGRAPHY --- p.162 / Chapter VIII. --- PUBLICATIONS --- p.179