Aims: The overall aims of the study were to identify the information needs of Chinese HF population and to examine the effectiveness of a heart failure disease management programme (HFDMP) on patients' clinical outcomes, health-related quality of life (HRQoL), and psychological status. / Background: Heart failure (HF) is a major and increasing public health problem globally. In China, there were approximately 4,000,000 patients with HF in the year 2000 and the number is continuously increasing due to the aging population. HF greatly influences patients' lives in all aspects. Programmes are therefore in imperative need to manage the disease and increase patients' sense of well-being. / Conclusion: Findings of the study provide further evidence that the simple combination of education and telephone follow-up could improve patients' medication adherence, HRQoL, and psychological status among Chinese HF population. Moreover, booklet developed in the study, to a certain extent, can be used as the tool for clinical HF education in China. The study also provides clues and direction for health professionals to develop interventions under the situation of busy clinical work and limited resources in Chinese health care practice. / Methods: First of all, a questionnaire survey (phase I, n=347), of which the questionnaire validation (n=247) was also included, and qualitative interviews with 26 patients and 24 health professionals (phase II) were consecutively conducted to know the information needs of patients with HF. According to the results of phase I and phase II studies, a booklet was developed to address the information needs of patients. Then a prospective controlled trial (phase III, n=160) was undertaken to examine the effectiveness of a HFDMP, including the components of two-session inpatient booklet education and weekly telephone follow-up for 4 weeks after discharge, on patients' performance of 6-minute walking test (6-MWT), clinical outcomes [death, cardiac-related admission (CRA) and length of stay (LoS) in hospital], medication adherence, HRQoL, and psychological status (depression and anxiety). Data collection was carried out at baseline, at 4 weeks (programme end) and 3 months (study end) after hospital discharge. Inferential statistics including independent t-test, paired t-test, Chi-square test, Fisher's exact test, the Mann-Whitney U test, and the Generalized Estimating Equation model, were used to compare the baseline and various outcome variables within and between groups. / Results: According to the results of phase I, the questionnaire entitled "Heart Failure Patient Learning Needs Inventory" is valid and reliable to measure learning needs among Chinese HF population. Based on the information needs identified in phase I and II, infonnation about HF regarding definition, symptoms, risk factors, classification, treatment strategies, and self-management strategies such as weight and symptoms monitoring, low-salt diet, medication compliance, exercise, and emotion management was included in the booklet. The accuracy, readability, and applicability of the booklet were established by an expert panel and potential users. / With regard to the effectiveness of the HFDMP on patients' outcomes, patients in the experimental group showed greater improvement through the study period than those in control group in the following aspects: a significantly better medication adherence (p < 0.001) as measured by the Chinese version of the Morisky Medication Adherence Scale, a significantly better HRQoL (p < 0.001) as assessed by the Chinese version of the Minnesota Living with Heart Failure Questionnaire, and a significantly greater reduction in depression and anxiety (p < 0.001) as assessed by the Chinese version of the Hospital Anxiety and Depression Scale. However, effectiveness of the programme on patients' 6-MWT, death, CRA, and LoS were not confirmed in the present study. / Yu, Mingming. / Adviser: Sek Ying Chair. / Source: Dissertation Abstracts International, Volume: 73-06, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 267-310). / 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 and appendix also in Chinese.

A model was developed in this study to understand women's cervical screening behaviour. It revealed that the interaction among institutional factors, risk appraisal, coping appraisal, and health beliefs and cultural factors contributed to the complex nature of screening behaviour among Chinese women. The institutional component provided the contextual factors within which women perceived the risk of cervical cancer, perceived the practice of cervical screening, and decided to take or not to take cervical screening. Risk appraisal provided the premise factor that induces women to seek coping strategies to reduce or remove the risk. During the process of coping appraisal, women's motivation to have cervical screening could be increased or decreased as the perceived benefits and costs of screening interacted with each other. The importance of the women's health beliefs and cultural factors was reflected in the way that they were affected by their notions of health behaviour and their cultural beliefs about cervical cancer risk and cervical screening participation. Commitment to participate in screening was a reinforcing factor inducing women to take up an offer of cervical screening. / Aim: To explore the knowledge and the perception of the risk of cervical cancer, identify the factors determining cervical screening behaviour, and develop a model to understand cervical screening behaviour among women in mainland China. / Background: Cervical cancer is the most common type of cancer, and is the second most common cause of cancer death in women in mainland China. Cervical screening is the most important intervention for the secondary prevention of cervical cancer. Theories of health behaviour and empirical research highlight risk perception as a significant factor motivating people to opt for cancer screening. However, little is known about the risk perception of cervical cancer and the factors influencing the screening participation of women in mainland China. / Conclusion: This study provides evidence of the complex factors influencing cervical screening behaviour and contributes new knowledge to the understanding of cervical screening behaviour within the Chinese cultural context. It further informs programmes for the promotion of cervical screening among this population. / Methods: A mixed method design consisting of two phases was used, employing both quantitative and qualitative methods of data collection. First, a cross-sectional survey was conducted to collect a baseline assessment of women's knowledge of cervical cancer and screening, their perceptions of the risk of cervical cancer, and the relationship between these factors and their cervical screening behaviour. Findings from this phase also guided the purposive sampling of participants in phase two. / Results: The findings from phase one demonstrated that the availability of an organized screening programme was a major motivator for women to opt for cervical screening. Multivariate analysis shows that having children (OR=2.57, p=0.026), a perception that visiting doctors regularly is important for health (OR-2.66, p=0.025), average (OR-4.84, 1)=0.006) and high levels of knowledge about cervical screening (OR-9.66, p=0.001) were significantly associated with having been screened in the previous three years. / Then in phase two, qualitative research was conducted using semi-structured interviews of 27 women, 16 of whom had been screened and 11 had not. The interview structure was based on an initial analysis of the data from phase one and from a review of the related literature. The data from the interviews were analyzed using latent content analysis, involving an interpretative reading of the symbolism underlying the surface structure in the text. The audio recordings of the interviews were transcribed verbatim in Chinese, and then the key phrases which were important for the objectives of the study were identified. The key phrases and words were grouped according to their commonality of meaning. Then, these groups of data were sorted and classified to create categories and sub-categories, which were mutually exclusive, explicit and accurate without overlapping. / Two themes emerged from the qualitative data from phase two. Theme I was that perceptions of cervical cancer and cervical screening included five categories: the perceived effects of suffering from cervical cancer; the perception of cervical screening; a lack of understanding about cervical cancer and screening; the perceived risk of cervical cancer; and factors related to the cultural beliefs system. Theme II was that the institutional and health care practitioner system included two categories: availability of an organised physical examination programme and the role of the health care practitioner in encouraging cervical screening utilization. / Gu, Can. / Adviser: Chan, Carmen. / Source: Dissertation Abstracts International, Volume: 73-02, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 244-267). / 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.