Introduction: Colposcopy is a gynaecological invasive day procedure involving visualization of cervix for diagnostic and therapeutic purpose. Women who are waiting for this procedure often experience high anxiety. Several studies have demonstrated that adopting pre-colposcopy patient education strategy can relieve such psychological distress. In this translational research, a relevant evidence-based education guideline is formulated for a colposcopy clinic in a local public hospital. Objectives: The objectives of this translational research proposal include (1) extracting the current empirical evidence on the education intervention for minimizing the psychological distress among women waiting for their first colposcopy examination; (2) developing an educational protocol; (3) and developing a plan of intervention and evaluation for the proposed protocol. Methods: A literature search for studies dealing with patient education of women at risk of cervical cancer was performed in PubMed and PsycINFO. After data extraction from the identified studies, the methodology quality of the studies was appraised by the methodology checklist of Scottish Intercollegiate Guidelines Network (SIGN) (2011). Then, an evidence-based protocol was formulated according to the recommendations drawn from the evidence. Before putting the protocol into practice, a systematic implementation potential assessment was done by evaluating the transferability of the findings, and the feasibility and cost-benefit ratio of the protocol. Both communication and evaluation plan were developed for a smooth implementation of the protocol. Results: 10 studies fulfilled the inclusion criteria of the literature search and were used for developing an evidence-based protocol of pre-colposcopy patient education. After the assessment, distributing written and audio-visual education materials at patients’ first colposcopy appointment is concluded to be a feasible innovation in the target setting. Conclusion: Based on the extracted evidence from the systematical review, patient education strategy can potentially benefit the first-time colposcopy patient in the target setting to alleviate their anxiety during their wait for the examination. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Chemotherapy is one of the major treatments for cancer patients to cure or palliate their disease. Cancer patients experience physiological and psychological distress during chemotherapy treatment. Anxiety is the most common symptom observed in cancer patients undergoing chemotherapy. Anxiety has also proven to be highly associated with anticipatory nausea and vomiting (ANV). In the local chemotherapy day ward, almost half of the cancer patients verbalize that they feel anxious and are afraid of turning up for chemotherapy due to the fear of its side effects. However, clinical measure for treating patients’ anxiety during chemotherapy is limited. One of the complementary and alternative medicines (CAM), massage therapy, becomes a useful means for cancer patients to relieve their physical and psychological distress. Yet, massage is not a routine CAM being integrated into the cancer treatment in Hong Kong, including the target center. Thus, a translational study is proposed in order to develop a massage program for cancer patients receiving chemotherapy to relieve their anxiety. A systematic search of five electronic journal databases identified 9 randomized controlled trials (RCTs) on the use of massage therapy for cancer patients in relieving their anxiety. The appraisal tool developed by the Critical Appraisal Skills Programme was used to evaluate the quality of the selected studies. The findings of the selected studies concluded that massage therapy is effective in relieving anxiety for cancer patients. A massage program is proposed to be implemented in a chemotherapy day ward. This translational research proposal will illustrate how such a massage program is planned. The implementation potential has been assessed and the potential benefits of massage do outweigh its risks and the costs of running this program. An evidence-based guideline has been developed to ensure patient safety and increase effectiveness of the massage program. The communication process with stakeholders has been planned in order to gain their support for this massage program. Staff training will be organized and a pilot study has been designed to test the feasibility of this program. An evaluation plan has also been developed to assess the effectiveness of this program. Anxiety level, measured by using State Trait Anxiety Inventory-State (STAI-S), is set as the primary patient outcome of this study. In addition, Numerical Rating Scale (NRS), rating from 0 to 10, will be used as the secondary patient outcome to measure the severity of nausea and vomiting. Lastly, the satisfaction level of patients, volunteers and nurses will be measured using a 4-point Likert scale. Therefore, the proposed massage program can be improved and refined according to the evaluation findings. It is believed that the proposed massage program can reduce anxiety for cancer patients receiving chemotherapy and thus improving their quality of life. / published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / Sports Science / Master / Master of Science in Sports Science

In Hong Kong, there has about 70% patients who attend Accident and Emergency Department (AED) is categorized as semi- or non-urgent cases. The medical conditions with the relative longer waiting time provoke the anxiety level. Furthermore the anxiety is worsen by the noisy waiting environment. These phenomena not only affect the psychological but also the physiological changes of patients. Therefore, there is a need to develop an evidence-based intervention that can effectively reduce the anxiety level during the waiting time. The music intervention is proposed to be implemented to reduce the anxiety in the AED setting as this intervention has been proven with a significant anxiolytic effect in variety of healthcare setting. This dissertation is a translational research that aims to identify the advantages or music intervention, develop an evidence-based practice (EBP) guideline for health care providers, and design an evaluation plan for evaluating the protocol effectiveness. The transferability and feasibility of the literature were high. The target setting is one of the AEDs in Hong Kong and the music intervention can be given in cubicle or waiting room by using Mp3 or speakers respectively. The music album is preferably chosen by patients and the intervention last for about 30-60 minutes. An implementation plan for pilot testing was developed to trying out the guideline and to reduce the potential problems during implementation. Comprehensive evaluation plans on stakeholders were developed. This dissertation contributes to develop an evidence-based protocol for healthcare-providers to follow and demonstrate in real situation. / published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

Childhood anxiety disorders are highly prevalent, cause significant distress and functional impairment, are risk factors for depression, suicidal ideation and attempts, substance abuse and smoking, yet often go unrecognized and untreated. As a result, effective prevention and early intervention have become policy and research priorities. This study evaluated the effectiveness of a universal school-based cognitive behavioural intervention in decreasing anxiety symptoms experienced by early adolescents during the transition from elementary to middle or secondary school. The role of gender, coping style, geographic location, and timing of the intervention were also assessed. Participants were 722 grade 7 and 8 students (11 – 14 years) from 41 classrooms in 20 randomly selected public schools in British Columbia. Schools were randomly assigned to either the FRIENDS for Youth program provided within regular classrooms, one hour weekly for 10 weeks or to a waitlist control group. Self-reported anxiety, depression and coping, and parent and teacher assessed difficulties were assessed at pre-, post, and six month follow-up. Results were examined universally and for children who scored above the clinical cut-off for anxiety at pre-test. Results indicate students, including those “at risk”, who participated in the FRIENDS for Youth program had lower anxiety than those in the control group at 6-month follow-up. Gender differences in self-reported anxiety as well as in response to the intervention were found, with girls, including those “at risk” reporting higher anxiety scores than boys, and intervention group girls reporting significantly lower anxiety scores at post-intervention and at 6-month follow-up compared to the control group. Teachers assessed girls as having lower difficulties scores than boys, and intervention group girls reporting significantly lower difficulties scores at post-intervention than the control group. Grade 7 elementary students had significantly lower anxiety scores than middle school students and grade 7 students in the intervention group had significantly lower anxiety scores at post-intervention than the control group. Overall, intervention effects on anxiety were small. For “at risk” participants and for girls, however, the intervention was effective. Results demonstrated a prevention effect with significantly fewer “at risk” students at 6-month follow-up in the intervention group than the control group.

Childhood anxiety disorders are highly prevalent, cause significant distress and functional impairment, are risk factors for depression, suicidal ideation and attempts, substance abuse and smoking, yet often go unrecognized and untreated. As a result, effective prevention and early intervention have become policy and research priorities. This study evaluated the effectiveness of a universal school-based cognitive behavioural intervention in decreasing anxiety symptoms experienced by early adolescents during the transition from elementary to middle or secondary school. The role of gender, coping style, geographic location, and timing of the intervention were also assessed. Participants were 722 grade 7 and 8 students (11 – 14 years) from 41 classrooms in 20 randomly selected public schools in British Columbia. Schools were randomly assigned to either the FRIENDS for Youth program provided within regular classrooms, one hour weekly for 10 weeks or to a waitlist control group. Self-reported anxiety, depression and coping, and parent and teacher assessed difficulties were assessed at pre-, post, and six month follow-up. Results were examined universally and for children who scored above the clinical cut-off for anxiety at pre-test. Results indicate students, including those “at risk”, who participated in the FRIENDS for Youth program had lower anxiety than those in the control group at 6-month follow-up. Gender differences in self-reported anxiety as well as in response to the intervention were found, with girls, including those “at risk” reporting higher anxiety scores than boys, and intervention group girls reporting significantly lower anxiety scores at post-intervention and at 6-month follow-up compared to the control group. Teachers assessed girls as having lower difficulties scores than boys, and intervention group girls reporting significantly lower difficulties scores at post-intervention than the control group. Grade 7 elementary students had significantly lower anxiety scores than middle school students and grade 7 students in the intervention group had significantly lower anxiety scores at post-intervention than the control group. Overall, intervention effects on anxiety were small. For “at risk” participants and for girls, however, the intervention was effective. Results demonstrated a prevention effect with significantly fewer “at risk” students at 6-month follow-up in the intervention group than the control group.

Childhood anxiety disorders are highly prevalent, cause significant distress and functional impairment, are risk factors for depression, suicidal ideation and attempts, substance abuse and smoking, yet often go unrecognized and untreated. As a result, effective prevention and early intervention have become policy and research priorities. This study evaluated the effectiveness of a universal school-based cognitive behavioural intervention in decreasing anxiety symptoms experienced by early adolescents during the transition from elementary to middle or secondary school. The role of gender, coping style, geographic location, and timing of the intervention were also assessed. Participants were 722 grade 7 and 8 students (11 – 14 years) from 41 classrooms in 20 randomly selected public schools in British Columbia. Schools were randomly assigned to either the FRIENDS for Youth program provided within regular classrooms, one hour weekly for 10 weeks or to a waitlist control group. Self-reported anxiety, depression and coping, and parent and teacher assessed difficulties were assessed at pre-, post, and six month follow-up. Results were examined universally and for children who scored above the clinical cut-off for anxiety at pre-test. Results indicate students, including those “at risk”, who participated in the FRIENDS for Youth program had lower anxiety than those in the control group at 6-month follow-up. Gender differences in self-reported anxiety as well as in response to the intervention were found, with girls, including those “at risk” reporting higher anxiety scores than boys, and intervention group girls reporting significantly lower anxiety scores at post-intervention and at 6-month follow-up compared to the control group. Teachers assessed girls as having lower difficulties scores than boys, and intervention group girls reporting significantly lower difficulties scores at post-intervention than the control group. Grade 7 elementary students had significantly lower anxiety scores than middle school students and grade 7 students in the intervention group had significantly lower anxiety scores at post-intervention than the control group. Overall, intervention effects on anxiety were small. For “at risk” participants and for girls, however, the intervention was effective. Results demonstrated a prevention effect with significantly fewer “at risk” students at 6-month follow-up in the intervention group than the control group. / Graduate and Postdoctoral Studies / Graduate

Zhang, Dexing = 階梯式治預防焦慮癥和抑鬱癥的效果和可性的研究 / 張德杏. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 181-205). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts also in Chinese; appendixes includes Chinese. / Zhang, Dexing = Jie ti shi zhi yu fang jiao lü zheng he yi yu zheng de xiao guo he ke xing de yan jiu / Zhang Dexing.