published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Coronary artery disease (CAD) is known as the second killer in Hong Kong. The Hong Kong Hospital Authority reported nearly 7000 patients suffered from acute myocardial infarction (AMI) in year 2010 to 2011. Percutaneous transluminal coronary angioplasty (PTCA) is a minimal access surgical treatment for coronary artery disease but studies have shown that patients experienced different levels of anxiety before and during PTCA which led negative impact to the patients. Music can be regarded as a safe, cost-effective therapy to reduce one’s anxiety level. It can be carried out by nurses without any specific technique. However, there was no systemic review for using music therapy to patients undergoing PTCA. Therefore, this dissertation aims to evaluate the best available evidence on using music therapy for patients undergoing PTCA. Four electronic databases, Medline, CINAHL, Embase & PsycINFO, were searched for studies to investigate the efficacy of music therapy in patients undergoing PTCA. There were seven studies were eligible with data extracted and quality assessment performed by the critical appraisal skill programme (CASP) checklist. Four studies were graded as high quality, which consistently demonstrated a statistically significant more reduction in the anxiety level of patients who received music therapy either before and/or during PTCA than those who had no music therapy. Consequently, an evidence-based guideline of using music therapy for patients undergoing PTCA was developed according to the guideline development process of SIGN (2010). The use of music therapy is transferable and feasibly in the local setting with little manpower concern. The total cost estimated for running the innovation for a year was HKD 83,775 which was considered as cost-effective to reduce patients’ anxiety level and avoid associated adverse events. A 14-months programme including communication with the stakeholders, pilot testing, staff training and clinical application of the proposed music therapy was designed. Qualitative and quantitative data on patient, healthcare provider and system outcomes would be accounted throughout the programme. The effectiveness of the guideline would be determined by the reduction of patient’s anxiety level by using the Chinese version of State-Trait Anxiety Inventory (STAI) (Shek, 1993). Moreover, healthcare provider outcome would be evaluated by questionnaire and the expenditure of the proposed music therapy would be monitored closely. / published_or_final_version / Nursing Studies / Master / Master of Nursing

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

The purpose of this study was to investigate the influence of gender, time since diagnosis, and the family environment on the psychosocial adaptation of cancer patients. This study was important because there is a deficit in the literature investigating the effects of the family environment on psychosocial adaptation in male and female cancer patients with diverse diagnoses. This study measured psychosocial adaptation by the patient's ability to adjust to cancer-related stressors in the areas of social relationships, involvement in health care, psychological well-being, household and work related duties, and family relationships. The family environment was measured by the patient's perceived level of cohesion, expressiveness, and conflict in the family.The study's sample consisted of 149 stage I or II cancer patients over the age of 50 with no prior cancer diagnosis, recurrence, or metastases. Participants completed a set of questionnaires, including the Psychosocial Adjustment to Illness Scale and the Family Relationship Index. The combination of gender, time since diagnosis, and the family environment, with demographic variables held constant, was significant and accounted for nearly one-third (27 %) of the variance in cancer patients' psychosocial adaptation. Results showed that the family environment is a significant predictor of psychosocial adaptation in cancer patients. Gender and time since diagnosis were not significantly related to psychosocial adaptation. Implications from this study are offered. / Department of Counseling Psychology and Guidance Services

This study investigated the interaction between test feedback style (interactive and delivered) and a client’s information processing style (experiential and rational) based on Cognitive Experiential Self-Theory (CEST) with a sample comprised of 39 clients from a university outpatient clinic and a community outpatient clinic in a midsized, midwestern city. Participants were randomly assigned to one of three groups: interactive test feedback, delivered test feedback, and examiner attention control group. Participants attended three sessions (initial session, feedback session, follow-up session) with a doctoral-level examiner. Participants in the two experimental groups (interactive and delivered feedback) received test feedback on their MMPI-2 profiles based on their assigned feedback condition while participants in the control group were not provided with feedback until after the conclusion of the study. The instruments assessing client response to treatment over time consisted of process-oriented (client’s perception of counselor and session) and outcome-oriented (symptomatology and self-esteem) measures. The results of two MANCOVAs (one for process and one for outcome variables) found no difference between participants who received test feedback and the control group. Partial support was found for the attribute by treatment interactions. There was some support for the matching effect of experiential information processing and interactive test feedback. This interaction was significant for self-esteem; individuals with higher levels of experiential information processing who received interactive feedback reported higher levels of self-esteem over time than those participants receiving delivered feedback or examiner attention only. The interaction of experiential information processing and treatment group was also significant for symptomatic distress; however, this interaction was opposite to the hypothesized direction. A matching effect for rational information processing and delivered test feedback was not supported. Finally, the three-way interaction of test feedback style, information processing style, and time was not significant for the process- or outcome-oriented benefits. The current study is one of the first studies to examine personality feedback with a community outpatient population. The lack of support for the benefits of personality feedback is noteworthy. In part, the results may be explained by low statistical power. Further examination of beta weights and directions of effects, however, suggest that even with a larger sample support for the benefits of personality feedback may not be found. These findings suggest caution should be exercised in generalizing previous results to a more severely impaired community population. Other limitations are discussed and implication for theory, research, and practice are provided. / Department of Counseling Psychology and Guidance Services

No description available.

In hierdie studie is daar gefokus op Tourettesindroomlyers se leefwereldstigting, met spesifieke verwysing na hulle kognitiewe funksionering. Tourettesindroom is 'n neuropsigiatriese versteuring wat gewoonlik tydens die kinderjare 'n aanvang neem en wat deur motoriese en/of vokale tics gekenmerk word. Tourettesindroomlyers kan 'n verskeidenheid aanverwante versteurings manifesteer, byvoorbeeld Obsessief-kompulsiewe Versteuring, Aandaggebrekversteuring, met of sander hiperaktiwiteit, fobies en ander affektiewe afwykings. Aangesien die werklike oorsake van T ourettesindroom steeds 'n onbekende faktor is, is die behandeling van hierdie chroniese toestand nie 'n gewaarborgde sukses nie. Dit wil voorkom asof die insidensie van Tourettesindroom, wat heelwat hoer onder manlikes as vroulikes is, hoer is as wat aanvanklik vermoed is. Al ses die fasette van menswees kan deur Tourettesindroomlyers negatief beleef word. Op fisiese gebied toon navorsing verskillende abnormaliteite in die brein, byvoorbeeld by die afskeiding van die neurosenders soos dopamien en serotonien, 'n reduksie in die volume van die basale ganglia, 'n kleiner linker globus pallidus en versteurings in die frontale lobbe, die corpus callosum en die basale ganglia se senuweebane. Hulle konatiewe faset kan oorheers word deur hulle ongemotiveerdheid op kognitiewe gebied. Die normatiewe faset word dikwels weens verslawende gedrag belemmer. Die Tourettesindroomlyers se sosialisering kan swak wees weens hulle gedragsprobleme. Hierdie navorsing bevestig vorige ondersoeke wereldwyd wat toon dat depressie, slaapprobleme, angsversteurings en die onvermoe om stres te hanteer by sommige Tourettesindroomlyers kan bydra tot uitputting wat hulle kognitiewe funksionering belemmer. Tourettesindroomlyers presteer op kognitiewe gebied 6f uitstekend 6f uiters swak. Groot uiteenlopendhede word in die neuropsigologiese gedrag van Tourettesindroomlyers gemanifesteer, met 'n vermindering in hulle uitvoerende kognitiewe funksionering weens tekorte in hulle kognitiewe prosesseringsvermoens. Dit het verarmende gevolge vir hulle kognitiewe inhoud, struktuur en uiteindelik kognitiewe produkte. Algemene en spesifieke leerprobleme is die gevolg. Dit is dus te begrype dat Tourettesindroomlyers se betrokkenheid, belewing en betekenisgewing by die skoolsituasie en leerstof negatief beleef kan word. Saam met hulle vernederende simptome, fluktuasie van hulle punte en belemmerde leefwereldstigting, is die logiese gevolg ontwrigte selfbeelde. Tourettesindroomlyers benodig daadwerklike ondersteuning in hulle selfaktualisering ten einde waardevolle mensepotensiaal vir SuidAfrika te behou. / The focus of this study is the life-world formation of Tourette syndrome sufferers, with specific reference to their cognitive functioning. Tourette syndrome is a neuropsychological disorder which usually has its inception during childhood and is characterised by motor and/or vocal tics. Tourette syndrome sufferers may also exhibit a variety of related disorders, for example Obsessive Compulsive Disorder, Attention Deficit Disorder, with or without hyperactivity, phobias and various affective disorders. The cause of Tourette syndrome is still unknown, therefore treatment cannot be guaranteed to be successful. The incidence of Tcurette syndrome is higher than was initially suspected and is more prevalent among men. Tourette syndrome sufferers can negatively experience all six facets of humanity. In the physical area research indicates various abnormalities in the brain, for example the secretion of neurotransmitters, a reduction in the volume of the basal ganglia, a smaller left globus pallidus and disorders in the frontal lobes, the corpus callosum and the nerve circuitry of the basal ganglia. The conative facet may be dominated by their lack of motivation in the cognitive area. The normative facet is often hampered due to addictive behaviour. Socialisation can be poor due to behaviour problems. This research confirms previous investigations world-wide which indicated that depression, sleep and anxiety disorders and the inability to handle stress contributes to exhaustion, which impedes cognitive functioning. In the cognitive area Tourette syndrome sufferers perform either extremely well or extremely poorly. There are great discrepancies in the neuropsychological behaviour of Tourette syndrome sufferers and a reduction in their executive cognitive functioning due to shortages in their cognitive processing abilities. This has impoverishing consequences for their cognitive content, structure and eventually cognitive products resulting in general and specific learning disabilities. It is therefore understandable that Tourette syndrorne sufferers' involvement with, experiences of and attribution of meaning to the school situation and study material are negatively influenced. Add their humiliating symptoms, fluctuation of marks and hampered life-world formation and the logical result is disrupted self-images. Tourette syndrome sufferers need crucial support in their self-actualisation in order to be able to offer South Africa worthy human potential. / Psychology of Education / D. Ed.(Sielkundige Opvoedkunde)

M.Sc. (Psychology) / Please refer to full text to view abstract

M.A. (Psychology) / Please refer to full text to view abstract

The purpose of this study was to investigate whether elderly clients in an acute care setting perceived themselves as being treated with dignity and respect, and whether clients with a higher socioeconomic status are more likely than clients with a lower socioeconomic status to be treated with dignity and respect. Sixty-two elderly clients who had been in hospital at least five days, were alert and oriented during their hospitalization, and could speak English were selected for the study. Using a convenience sampling technique, the clients were selected from medical and surgical units of two major teaching hospitals. They were interviewed within three days after discharge to respond to items on a questionnaire selected from the Medicus Quality Assurance Tool. The results of the study show that elderly clients may not perceive that they are consistently treated with dignity and respect. Older clients (75+ years) are less likely than younger older clients (65-74) to be treated with dignity and respect, and elderly clients with a lower socioeconomic status and women, are less likely to be treated with dignity and respect. / Applied Science, Faculty of / Nursing, School of / Graduate