published_or_final_version / Nursing Studies / Master / Master of Nursing

Asthma is a common chronic disease for children and is a leading cause for their hospitalization. Despite its negative health impact, a local survey has shown that children with asthma as well as their parents have a lack of understanding for asthma management (Wong, Wong, Chung & Lau, 2001). However, to help asthmatic children to better cope with their condition, it is important for health care professional such as nurses to enhance their knowledge in asthma management. Recent empirical research has shown that education promoting knowledge of asthma management can improve health outcomes in asthmatic children. Therefore, it is important to develop an evidence-based asthma education guideline for them. This dissertation aims to evaluate the empirical evidence of the education program for asthmatic children, with the age ranging from 5 to 18, and their parents. The goal of the proposed program is to reduce their re-hospitalization rate by enhancing their knowledge of asthma care. A translational nursing research was conducted and 10 studies focusing on asthma education program for children and their parents were identified from electronic databases. Critical appraisal was performed using the recognized assessment tool, named the Scottish Intercollegiate Guidelines Network (SIGN) (2008). Recommendations were developed based on the data extracted from the review. Based on the literatures reviewed, it was found that a 45-to-60 minute one-to-one educational intervention conducted by nurses using self-management plan is the most effective method for improving the health outcomes for asthmatic children. A plan of translating the empirical information extracted from the review into practice was developed and the potential of implementation was assessed. Based on the assessment, it was found that there is high transferability of the findings from the review and the proposed innovation is feasible in the selected clinical setting. In addition, the benefits generated from the proposed innovation also outweigh its cost. An evidence-based guideline was then developed based on the high and medium level of evidence. The grades of the recommendation were stated as well. A comprehensive communication plan targeting on various stakeholders was prepared. A pilot study was designed to examine the feasibility of the proposed innovation before the full-scale implementation. The outcomes of the proposed innovation include the re-hospitalization rate of asthmatic children, the patients’ and nurses’ level of knowledge in asthma care, the satisfactory level of patients and nurses towards the innovation, the competency of nurses in conducting the innovation, and the utilization rate and the cost of the innovation. They would be evaluated using appropriate methodologies. The proposed innovation would be considered as effective if the primary outcome, the re-hospitalization rate of asthmatic children is reduced. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Older adults are particularly vulnerable to the development of pressure ulcers (PUs) as a result of skin changes and reduced mobility (Knox, Anderson & Anderson, 1994; Russell et al., 2003). This is associated with diminished quality of life, longer hospitalisations and increased morbidity and mortality (Margolis et al., 2002).In view of the high incidence of PUs (grade 1-4) occurring in elderly patients in acute care, a systematic review of related studies was conducted in August 2011. The optimal frequency and methods of repositioning are described in the literature. With well-designed implementation and evaluation plans, the proposed repositioning guidelines are likely to reduce the incidence of PUs (grade 1-4), while in turn lessening the healthcare burden and preserving patients’ quality of life. Pilot testing, a trial run to test the feasibility of the innovation, will be carried out in the proposed medical ward, and training provided to all staff before the intervention. To proceed with the change, the intervention must be cost-effective and beneficial to all stakeholders. Outcome evaluation determines the number of goals achieved by the innovation and to what degree, and is very important (Melnyk & Fineout-Overholt, 2005).The PU incidence (grade 1-4) is expected to be different after the implementation of the innovation. / published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Nursing Studies / Master / Master of Nursing

Sex among men has been existed in all society with variety of reasons. They are often stigmatized by other people. As a result, men who have sex with men (MSM) are less willing to expose themselves even if they have health problems. To increase the awareness of the public and establish trust relationship within health organizations and MSM, Internet is a good platform to promote health concepts and health education. In recent 10 years, Internet becomes popular. There was an increasing trend that MSM people are using Internet to seek partners. As a result, the sexually transmitted infections (STI) among MSM people had been increasing in recent years. The global population of HIV infection among MSM increased from3.9 million in 2007 to 20.4 million in 2010. It is predicted that the number will further increase to 23.3 million in 2015 (Joint United Nations Programme on HIV and AIDS [UNAIDS], 2011). In Hong Kong the HIV infection rate among MSM is still increasing around 42.4% of HIV infected cases were MSM (Department of Health, 2010).Therefore, a comprehensive health promotion program is needed to promote safer sex and prevent further spread of STI in Hong Kong. Internet-based Sex Education Program is a health promotion program that was held in many countries. Those studies used webpage containing sex education materials such as STI knowledge, STI prevention methods, information about risky sexual behavior, knowledge of condom using skills, negotiation skills with partners and information of STI screening. Results showed that internet-based sex education program is successful in most countries. Three electron bibliographical databases MEDLINE, CINAHL and Cochrane Library were used to search the relevant primary studies. After assessing the quality of the studies, six studies were found fulfilling the criteria of the program. By comparing the transferability and feasibility of the interventions of the six reviewed literatures, a new guideline was set. Stake holders were identified and through communication with the stake holders, a pilot study plan was designed and data collected from the pilot study would be used to modify the online health education program and provide a better nursing care for MSM clients. Online health education program for MSM contributes a better platform to promote sexual health through internet. The program helps to prevent STI and HIV transmission and it is expected that the guideline of the program can be used by different health care settings such as hospitals or clinics when they are providing health education to MSM clients. A decrease of STI and HIV infection among MSM clients is expected since the program is carried out in public settings and hoping that MSM clients could gain benefit from it. / published_or_final_version / Nursing Studies / Master / Master of Nursing

In Hong Kong, the number of colon cancer patients has increased over the years. But at the same time, early detection of colon cancer has also become more readily available due to the recent technological advancement and increased accessibility to medical care. In recent years, more patients have become eligible for having curative sphincter saving operation and one of the objectives of this operation is to preserve continence function without stoma formation. However, colon cancer patients’ journeys do not finish after their operation. For instance, they may have bowel disorder after the operation, namely ‘Anterior Resection Syndrome’. This debilitating condition may not be amenable by surgical technique or medical therapy and it affects the bio-psycho-social wellbeing of the patient. One of the responsibilities of nurses is to promote the general wellbeing of the clients. Therefore, in this study, the possible methods of alleviating the condition of Anterior Resection Syndrome among colon cancer patients were inspected. By using strategic search of current evidences, this study found that several primary studies support the use of biofeedback to alleviate the condition. After conducting a comprehensive review of the selected studies, the biofeedback treatment was considered as an appropriate recommendation for the current clinical setting. After assessing the implementation potential of the current practice, an evidence-based protocol with considerations of local factors was established. In addition, in order to minimize resistance on the change of current practice, plans on communicating with stakeholders, pilot study and evaluation were carefully established. The purpose of this study is to provide professional nursing care by using evidence based practice for those in need. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Although effective anti-tuberculosis agents have been available for over thirty years, tuberculosis (TB) is still a global health concern and the incident rate in Hong Kong remains high. Directly Observed Therapy, Short-course (DOTS) strategy, in combination with patient education are proved to be more effective in reducing TB incidence than the DOTS strategy alone. However, there is a lack of evidence based protocol to guide nurses through the implementation of health education for TB patients. This dissertation is a translational nursing research aims at developing an evidence-based health education guideline for nurses to deliver health education to TB patients to improve treatment adherence. The objectives are to gather evidence on the effectiveness of nursing health education in promoting treatment adherence among TB patients, conduct quality assessment of the reviewed articles, develop evidence-based health education protocol for TB patients, assess the implementation potential of the innovation and discuss its implementation and evaluation plan. In this dissertation, a systematic review of 8 relevant and up-to-date research papers was performed and a guideline was then generated based on the extracted data. The guideline consists of 3 components: effective individual health education, essential elements for health education booklet and training for nurses. The implementation potential of the guideline is considered to be high while the implementation and evaluation plan of the guideline are also discussed. With the implementation of the evidence-based protocol on TB health education, the treatment adherence of the TB patients is expected to be increased. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Psoriasis is a chronic, inflammatory skin disorder and approximately 1% to 3% of the world’s populations are suffering from it. As numerous studies have shown that psoriasis is highly correlated with psychological distresses, one of the critical issues in the psoriasis patient care is the psychological problem. However, in the existing care for psoriasis, no guideline has been developed for patients’ psychological issue. Therefore, the aim of this translational research is to develop an evidence-based psychological care guideline with an implementation and evaluation plan for psoriasis patients in a dermatology setting. In this dissertation, 11 studies were selected after assessing the relevance of the obtained full texts. Data of these studies were extracted, and the quality of data was assessed by the Critical Appraisal Skills Programme and the Scottish Intercollegiate Guidelines Network. Evidences obtained from the literature review were aggregated and also critically reviewed. After these processes, an Evidence Based Protocol was developed. In the guideline, information related to the psychological assessment and interventions for psoriasis are included. Then the implementation potential of the guideline produced was examined in terms of the transferability, feasibility and the cost-benefit ratio. A pilot test was also conducted to identify any problems of the actual implementation of the mentioned guideline. Both process and outcome evaluation would be as used to assess the feasibility and the effectiveness of the guideline. In the end, this guideline isexpected to manage psychological aspects of psoriasis patients so as to improve their quality of life. / published_or_final_version / Nursing Studies / Master / Master of Nursing