published_or_final_version / Nursing Studies / Master / Master of Nursing

Background: With the aging of the global population, the prevalence and incidence of Alzheimer’s disease or related dementia are increasing. Most mild or moderate dementia clients are taken care of at home by informal caregivers, which leave a heavy burden to the caregivers. Researchers have found out that with good intervention services and programmes for the caregivers, their burden, emotional distress and even the care recipients’ symptoms and institutionalization rates would be improved. Objectives: This project is to review these researches to evaluate whether the interventions are effective and/ or cost-effective and how the decision-makers could use the results for evidence-based policy. Methods: A literature search was performed on randomized controlled trials in education, information/ support intervention programmes published from October 2005 to July 2012. Electronic databases (EBSCO, PubMed and CNKI) were searched until July 2012. The Consolidated Standards of Reporting Trials (CONSORT) checklist for reporting randomized controlled trials was used as the guideline to evaluate the quality of identified papers. Results: 16 papers (15 studies) were included in this review and classified into three groups, as home-based, individual-based and group-based interventions. This review found that the intervention programmes had various outcomes and showed some evidence of effectiveness. Most of the papers had good quality. The home-based programmes showed cost-effectiveness in the identified studies. Conclusion: There was some evidence that the home- and group-based interventions were effective and the home-based interventions could be cost-effective. Further studies are recommended and a meta-analysis on the studies and more researches on economic analysis are needed. A community-based long-term dementia management should be built up for better outcomes. / published_or_final_version / Public Health / Master / Master of Public Health

End stage renal failure refers to an irreversible kidney dysfunction in which the kidneys fail to remove toxins from the blood stream. Haemodialysis is an effective treatment modality to sustain the lives of patients with end stage renal failure by removing waste products like urea, creatinine, and excess fluid. It involves a challenging regimen including dietary restrictions to ensure long-term survival. Failure to adhere with the regimen can result in fatal consequences. Renal patient discomfort related to non-adherence is commonly seen in clinical settings; however, there is currently no evidence-based fluid or dietary education program available to haemodialysis patients. This dissertation aims to identify and evaluate current evidence for the effectiveness of dietary and fluid control programs in the treatment of haemodialysis patients, to assess the transferability and feasibility of implementing a nurse-led education program regarding dietary and fluid control in haemodialysis patients, and to develop an evidence-based, nurse-led fluid and dietary control program for haemodialysis patients. Four electronic bibliographical databases including PubMed, Cochrane library, PsycInfo and CINAHL and two searching engines including Google scholar and ProQuest were used to identify studies that examined the effectiveness of educational programs or interventions on fluid or dietary control for patients on haemodialysis. Forty-five unique studies were identified as potentially relevant. Eleven of those studies met the selection criteria and were evaluated in this dissertation. Appraisal instrument was used to evaluate the quality of the selected studies. Six studies and three studies showed statistically significant in reduction of serum phosphate level and interdialytic weight gain respectively after educational intervention. Critical evaluation of the available studies led to an evidence-based, nurse-led, fluid and dietary control program for haemodialysis patients that followed the guideline development process of the Scottish Intercollegiate Guideline Network. Comparison on the similarity of patient characteristics, staff competence, and organizational settings of the evaluated studies were similar to those of the target unit. Therefore, the proposed program may be transferable and feasible. Furthermore, a cost-benefit analysis showed that the benefit of the fluid and dietary control program to patients outweighs the cost needed to implement the program. This dissertation outlines a proposed twenty-week program including marketing of the program, training of staff in the targeted renal unit, pilot testing, and application of the proposed program. Evaluation of the program will focus on three categories: patient outcome, health care provider outcome, and organization outcome. Clinical effectiveness of the program is defined by an overall reduction in patients’ mean interdialytic weight gain and mean serum phosphate level, improvement in knowledge test scores by patients, satisfactory nurses’ attendance rate in the renal training sessions, high nurse satisfaction with the educational program, and reduction of admission rate related to non-adherence. / published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / Community Medicine / Master / Master of Public Health

No description available.

published_or_final_version / Nursing Studies / Master / Master of Nursing

Haematological stem cell transplantation (HSCT) is a revolutionary treatment for haematological malignancies. Although HSCT is potentially curative, patients usually develop stomatitis which is a common and debilitating complication after the transplantation. Furthermore, stomatitis may predispose patients to various complications which are associated with significantly increased morbidity and mortality. In some studies, ice water mouthwash has been shown to be an effective method for the prevention of stomatitis. However, a high-level evidence-based protocol on the prevention of stomatitis has not been fully developed and it is not commonly practiced in most HSCT centers at present. A well established protocol can help to minimize the patients’ suffering and avoid prolonged hospitalization. The nurses who are involved in patient education, assessment, care for, and coping with stomatitis, play an important role to bring these innovations into practice. In this regard, this translational research aims at developing an evidence-based protocol on using ice water mouthwash in the prevention of stomatitis for patients undergoing autologous HSCT. A systematic search for relevant literatures was performed with the use of five electronic databases. Six relevant studies were found. Critical appraisal on the relevant studies was conducted. The level of evidence extracted from the studies was graded according to the Scottish Intercollegiate Guidelines Network (SIGN) and were synthesized to establish the protocol for patients in the proposed setting. The implementation potential of the protocol was assessed in terms of the transferability, feasibility, and cost benefit ratio. An implementation and evaluation plan was established for comprehensive evidence-based protocol development. The successful implementation of the protocol will be beneficial for the patients undergoing HSCT as it may hasten their recovery, shorten their hospital stay, and minimize their distressing experience and suffering. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Agitated behaviours in dementia elderly predispose to negative outcomes. Music intervention is an evidence-based intervention that could help to ease the situation. The integrative and systematic review studies provide evidence that music intervention is effective in reducing agitated behaviours in dementia elderly. The assessment of the implementation potential, the feasibility and transferability demonstrate the music intervention can be implemented in local setting. An evidence-based guideline based on the reviewed papers is developed to use in local HK hospitals or nursing homes. With the help of an effective communication plan to the stakeholders, it is believed that the intervention can be smoothly implemented. Further evaluation helps to review the potentials for sustaining the intervention in the long run. / published_or_final_version / Nursing Studies / Master / Master of Nursing