Conclusions The results showed that depression is prevalent among Chinese PLWH and perceived discrimination is a source of stress. Perceived stress, social support and coping strategies had independent effects on mental health outcomes but there were no interaction effects. The Brief COPE was validated and had a structure different from the original, again supporting the importance of cultural variations. Our results hence provided useful instrumentations (PSSHIV and Brief COPE) as well as a good foundation for the development of theories and interventions specific to the needs of the PLWH in China. / Introduction Mental health issues are prevalent among People Living with HIV (PLWH). Instrumentation, conceptualization and theoretical models of stress-coping-mental health relationships among PLWH are important but theoretical and practical differences exist in the context of different cultures and quality of care services. / Objectives The aims of the study were 1) to develop a new Perceived Stress Scale for People Living with HIV (PSSHIV); 2) to validate the Brief COPE inventory among Chinese PLWH; 3) to investigate determinants of perceived stress and psychological well-being. / Results The newly developed PSSHIV and the rearranged version of the Brief COPE were validated and found to have acceptable psychometric properties. Of all participants, 63.3% showed moderate/severe depressive symptoms. 'Problem-solving and Acceptance' and 'Self-blame and Denial' were commonly used coping strategies. Socioeconomic status (SES), perceived discrimination, and optimism were significantly associated with overall stress and some of the subscales of PSSHIV. Perceived stress appeared to mediate the relationship between perceived discrimination and psychological well-being. In addition to perceived stress, social support and some particular coping strategies were associated with depression. Similar though not identical results were found using quality of life as the outcome. / Subject and Methods To achieve Aim 1, PLWH in two Chinese cities were interviewed for item generation and validation. Aims 2 to 4 were achieved through another survey conducted in the same cities. Participants were recruited from the registry of the Centers for Disease Control and Prevention and from users of hospital services and Methadone Maintenance Treatment clinics. Standard statistical methods were used for validation studies. / Su, Xiaoyou. / Adviser: Tak Fai Joseph Lau. / Source: Dissertation Abstracts International, Volume: 73-02, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 181-206). / 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.

Background. In average hypertensive patients m China, approximately 3-4 major cardiovascular disease (CVD) events can be prevented in 100 treated with anti-hypertensive drugs for 5 years. Previous cross-sectional studies in healthy individuals showed that their willingness to payout of pocket for anti-hypertensive drugs dropped substantively after they were informed of the quantitative benefits, harms and costs of the treatment. These findings suggest, importantly, that patients should be provided with evidence and engaged in decision making for such conditions as hypertension in order to make decisions that will satisfy patients. This large effect of evidence-informed decision making found in the cross-sectional study has, however, not been confirmed in more rigorous studies and in diagnosed hypertensive patients in the country. We therefore conducted this randomized controlled trial to assess the effect of individualized, evidence-based counseling on medicine-using behaviors of hypertensive patients. / Methods. This is a randomized controlled trial with 210 patients with mild hypertension and free of CVD recruited in two primary care centers in Shenzhen, China. Individualized, evidence-based counseling on antihypertensive treatment and general counseling on lifestyle modifications (103 patients) were compared with general counseling alone (107 patients). The counseling was provided face-to-face and reinforced by a telephone call a week later. The key information provided in the intervention group included the lO-year CVD risk estimated based on an individual's risk factors, individualized benefit expressed in the absolute risk reduction, side effects, and costs of antihypertensive drugs. Medication use and good adherence at 6-month follow up were used as the primary outcomes. / Results. At baseline, the mean age of patients was 54.3 (SD=7.8) years, 49% were men, 62.4% were currently taking antihypertensive medicines which was all covered by health insurance. The overall attrition rate was 8.6%. At six months, the rate of medication use was marginally higher in the intervention group than that in the control group (65.0% vs 57.9%; odds ratio (OR) = l.35, 95% confidence interval (Cl): [0.77, 2.36]; P value= 0.290). The rate of good adherence in the intervention group was also slightly higher than that in the control group (43.7% vs 40.2%; OR= 1.15, 95% Cl: [0.67, 2.00]; P value= 0.607). The difference in medication use and good adherence between the intervention and control groups was however not statistically significant. The results remained unchanged in multivariate and sensitivity analyses. / Conclusions. The individualized, evidence-based counseling made little difference to the use of and adherence to anti-hypertensive medications in insured patients with mild hypertension in China. The lack of effect of informed decision making is likely a result of persistence of entrenched practice in particular for insured clinical conditions. The finding of this study raises important questions as to whether insurance policies and clinical guidelines reflect the true needs and opinions of the patients, and about the usefulness of informing and engaging patients in decision-making under such circumstances. / 背景：對100 例一般中國高血壓患者，進行持續5 年的降壓藥物治療，可預防心腦血管事件3-4 例。健康人群中進行的橫斷面調查結果顯示，研究對象在獲得降塵藥物治療量化的收益、副作用和花費的信息後，其支付意願明顯下降。此結果的重要提示是，應向患者提供此類信息，並且患者參與自身的醫療決策，使其能夠做出符合其價值觀等的決定。然而，目前尚未在中國開展相闊的隨機對照試驗。上述知情決策的顯著效果亦尚未在患者中得到證實。在此項隨機對照試驗中，我們蚣評價個體化、循證諮詢對高血壓患者服藥情況的影響。 / 方法：這是一項雙中心的隨機對照試驗。研究共納入輕度高血壓患者210例，這些患者均無心腦血管病。干預組患者(共103 例)接受關於降壓藥物的個體化、循證諮詢和生活習慣調整的一般諮詢，對照組患者(共107 例)僅接受一般諮詢。我們為每組患者均提供當面諮詢，並於一周後通過電話進行加強。為干預組患者提供的主要信息包括:基於每例患者危險因素評估的10 年心血管病風險，降塵藥物治療的收益、副作用及花費。其中收益以絕對風險降低表示。以諮詢結束後六個月時患者服藥和良好依從性作為主要結局指標。 / 結果：基線調查中，患者的平均年齡為54. 3 (標準差為7.8) 歲，有49% 的患者為男性， 62. 峭的患者目前正在服用降塵藥物，所有患者的降塵藥物花費均由醫療保險全部或部分支付。研究中總失訪率為8.6% 。諮詢結束後六個月，干預組患者整體服藥率較對照組患者稍高(干預組65.0% 對照組57.9%比值比:1.35，95%可信區問: [0.77 ，2.36];p=0.290) 。干預組患者中，良好依從性的比例亦稍高於對照組(干預組43.7%，對照組40.2%:比值比:1.15 , 95%可信區問: [0.67，2.00]; p= 0.607)。在多因素分析和敏感性分析中，上述結果均無顯著變化。 / 結論：個體化、循證諮詢並未明顯改變中國醫療保險覆蓋下輕度高血壓患者的服藥情況。知情決策無明顯效果很可能由固定化的醫療實踐導致，這種情況對醫療保險覆蓋的治療尤其突出。此研究的發現還引出了兩個重要問題:現行的醫療保險制度和臨床指南是否反映患者的真實需要和想法，患者知情並參與決策是否必要。 / Di, Mengyang. / Thesis Ph.D. Chinese University of Hong Kong 2015. / Includes bibliographical references (leaves 127-139). / Abstracts also in Chinese; some appendixes in Chinese. / Title from PDF title page (viewed on 06, October, 2016). / Di, Mengyang. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.

Chow Yuet-ming. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 254-262). / Abstracts in English and Chinese, appendix in Chinese. / Abstract --- p.i / Acknowledgement --- p.iv / Chapter Chapter 1: --- Introduction --- p.1 / Chapter 1.1 --- Rationale for Selecting this Research Topic --- p.1 / Chapter 1.2 --- Research Objectives --- p.4 / Chapter 1.3 --- Research Questions --- p.5 / Chapter 1.4 --- Overview of the Present Thesis --- p.5 / Chapter Chapter 2: --- Literature review --- p.7 / Chapter 2.1 --- Anorexia Nervosa in Western Countries --- p.7 / Chapter 2.1.1 --- Historical Perspective --- p.8 / Chapter 2.1.2 --- Biomedical Perspective --- p.10 / Chapter 2.1.2.1 --- Physiological manifestation of anorexia nervosa patients --- p.10 / Chapter 2.1.2.2 --- Behavioral manifestation of anorexia nervosa patients --- p.12 / Chapter 2.1.3 --- Psychological Models --- p.14 / Chapter 2.1.3.1 --- Bruch ´ةs view --- p.14 / Chapter 2.1.3.2 --- Minuchin´ةs view --- p.16 / Chapter 2.1.3.3 --- Palazzoli 's view --- p.17 / Chapter 2.1.4 --- Sociological Perspective --- p.24 / Chapter 2.1.5 --- Summary of Part I (2.1) --- p.30 / Chapter 2.2 --- Psychology of Self-development --- p.33 / Chapter 2.2.1 --- "Erikson ,s identity formation" --- p.33 / Chapter 2.2.2 --- Women self-development --- p.38 / Chapter 2.2.3 --- Bowen's differentiation of self --- p.42 / Chapter 2.2.4 --- Summary of Part II (2.2) --- p.46 / Chapter 2.3 --- Anorexia Nervosa in Hong Kong Context --- p.48 / Chapter 2.3.1 --- The notion of self in traditional Chinese family --- p.49 / Chapter 2.3.2 --- Women position in Hong Kong --- p.55 / Chapter 2.3.3 --- Related research in Hong Kong --- p.62 / Chapter 2.3.4 --- Summary of Part III (2.3) --- p.69 / Chapter Chapter 3: --- Theoretical framework --- p.71 / Chapter 3.1 --- Theoretical Framework as Summarized from the Literature Review --- p.71 / Chapter 3.2 --- Definition of Terms --- p.77 / Chapter 3.2.1 --- Anorexia nervosa --- p.77 / Chapter 3.2.2 --- Family --- p.78 / Chapter 3.2.3 --- Family interaction --- p.79 / Chapter 3.2.4 --- Family rule --- p.79 / Chapter 3.2.5 --- Family myths --- p.80 / Chapter 3.2.6 --- Family myths as quest for meaning --- p.80 / Chapter 3.2.7 --- Meaning --- p.80 / Chapter 3.2.8 --- Power --- p.81 / Chapter 3.2.9 --- Power struggle --- p.81 / Chapter 3.2.10 --- Differentiation of self --- p.81 / Chapter Chapter 4: --- Research Methodology --- p.83 / Chapter 4.1 --- General Overview --- p.83 / Chapter 4.2 --- Research Methodology of this Study --- p.88 / Chapter 4.2.1 --- Rationale in Selecting Qualitative Method --- p.88 / Chapter 4.2.2 --- Research Design --- p.89 / Chapter 4.2.3 --- Unit of Analysis --- p.90 / Chapter 4.2.4 --- Sampling --- p.90 / Chapter 4.2.5 --- Methods of Data Collection --- p.92 / Chapter 4.2.5.1 --- Direct Observation of the Family Interviews of AN families --- p.92 / Chapter 4.2.5.2 --- Participant Observation in an AN Mutual Support Group --- p.94 / Chapter 4.2.5.3 --- Summary of the Case Study Protocol of this Study --- p.96 / Chapter 4.2.6 --- Time Frame for Data Collection --- p.96 / Chapter 4.2.7 --- Method of Analysis --- p.97 / Chapter 4.2.8 --- Validity and Reliability of this Study --- p.97 / Chapter 4.2.9 --- Summary of Chapter --- p.98 / Chapter Chapter 5: --- Results of the Study :Data Gathered from Family Interview Sessions --- p.100 / Chapter 5.1 --- Case History --- p.100 / Chapter 5.2 --- Results Gathered from Family Interview Sessions --- p.104 / Chapter 5.2.1 --- Having difficulties in differentiating from the family and self- starvation as a means of asserting the personal boundariesin the families --- p.104 / Chapter 5.2.2 --- Being triangulated in the parents' marital discords and self- starvation as a means of diluting their conflicts --- p.122 / Chapter 5.2.3 --- Self-sacrificing for the family interest --- p.131 / Chapter 5.2.4 --- "Being helpless and powerless in the families, self-starvation as a means of empowering the mothers in the families " --- p.134 / Chapter Chapter 6: --- Results of the Study:Data Gathered from Mutual Support Group Sessions --- p.138 / Chapter 6.1 --- Case History --- p.138 / Chapter 6.2 --- Results Gathered from Mutual Support Group sessions --- p.140 / Chapter 6.2.1 --- Having difficulties in handling peer relationship --- p.140 / Chapter 6.2.2 --- Having difficulties in resisting their mothers intrusiveness to their personal boundaries and self-starvation as a means of exerting their personal boundaries --- p.143 / Chapter 6.2.3 --- Being triangulated in their parents marital discords and self- starvation as a means of diluting the marital conflicts --- p.149 / Chapter 6.2.4 --- Acting for their mothers in the families --- p.149 / Chapter 6.3 --- Cross-checking of findings with group members and worker --- p.161 / Chapter Chapter 7: --- Discussions and Conclusion --- p.163 / Chapter 7.1 --- Research Findings of this Study --- p.163 / Chapter 7.2 --- Contributions of this Study --- p.173 / Chapter 7.3 --- Limitations of this Study --- p.174 / Chapter 7.4 --- Recommendation --- p.175 / Chapter 7.4.1 --- Future Research --- p.175 / Chapter 7.4.1.1 --- Proposed Theoretical Framework for Future Study --- p.175 / Chapter 7.4.1.2 --- Proposed Methodology --- p.179 / Chapter 7.4.2 --- Management of AN patients --- p.179 / Chapter 7.4.3 --- Prevention of AN --- p.181 / Appendix I: The Chinese verbatim of family interview sessions --- p.183 / Appendix II: The Chinese verbatim of mutual support group sessions --- p.234 / List of Figures: / Figure 1: Summary of the framework from western literature --- p.75 / "Figure 2: Interplay among individual, family and society " --- p.76 / Figure 3: Socio-demographic characteristics of the AN patients and their families of the family interview sessions --- p.91 / Figure 4: Socio-demographic characteristics of the AN patients and their families of the mutual support group --- p.92 / Figure 5: Summary of the proposed theoretical framework of Understanding self-starvation in Hong Kong --- p.178 / Bibliography --- p.254

Chan Wai Hung Fredric. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (leaves 67-72). / Abstracts in English and Chinese. / Acknowledgement --- p.i / Abstract --- p.ii / 摘要 --- p.iv / Table of contents --- p.vi / Publications --- p.ix / List of figures --- p.x / List of tables --- p.xi / Abbreviations --- p.xii / Chapter Chapter 1 --- Introduction / Chapter 1.1 --- Anticoagulation effect of warfarin --- p.2 / Chapter 1.2 --- Indications of warfarin therapy --- p.3 / Chapter 1.3 --- Monitoring systems for anticoagulation therapy --- p.4 / Chapter 1.4 --- Optimum target intensities for anticoagulation therapy --- p.5 / Chapter 1.5 --- Factors affecting anticoagulation effect of warfarin --- p.6 / Chapter 1.5.1 --- Drugs --- p.7 / Chapter 1.5.2 --- Diet --- p.8 / Chapter 1.5.3 --- Health supplements --- p.8 / Chapter 1.5.4 --- Comorbidities --- p.9 / Chapter 1.5.5 --- Genetic factors --- p.10 / Chapter 1.6 --- Management of anticoagulation therapy in Chinese patients --- p.11 / Chapter 1.7 --- Barriers to optimal INR control --- p.13 / Chapter 1.8 --- Two models of care for anticoagulation therapy - routine medical care and co-ordinated anticoagulation service --- p.14 / Chapter 1.9 --- Outcomes of two models of anticoagulation management --- p.14 / Chapter 1.9.1 --- Clinical outcomes --- p.14 / Chapter 1.9.2 --- Economic outcomes --- p.16 / Chapter 1.10 --- Clinical pharmacist involvement in the management of anticoagulation therapy --- p.17 / Chapter 1.11 --- Anticoagulation management in Hong Kong --- p.18 / Chapter 1.12 --- Hypothesis and objectives --- p.19 / Chapter Chapter 2 --- Materials and Methods / Chapter 2.1 --- Setting and subjects --- p.22 / Chapter 2.2 --- Interventions --- p.23 / Chapter 2.2.1 --- Newly proposed model --- p.23 / Chapter 2.2.1.1 --- Training of clinical pharmacist --- p.23 / Chapter 2.2.1.2 --- Development of management protocol --- p.24 / Chapter 2.2.1.3 --- Treatment algorithm of pharmacist-managed anticoagulation service --- p.25 / Chapter 2.2.1.4 --- Validation of the Coagucheck Pro DM --- p.28 / Chapter 2.2.2 --- Usual practice model --- p.29 / Chapter 2.3 --- Outcome measures --- p.29 / Chapter 2.3.1 --- Primary clinical outcomes --- p.29 / Chapter 2.3.1.1 --- Therapeutic and expanded therapeutic INR ranges --- p.29 / Chapter 2.3.1.2 --- A method to determine the amount of patient-time spent in each INR category --- p.30 / Chapter 2.3.2 --- Secondary clinical outcomes --- p.31 / Chapter 2.3.3 --- Economic outcomes --- p.32 / Chapter 2.3.4 --- Humanistic outcomes --- p.34 / Chapter 2.4 --- Sample size estimation --- p.34 / Chapter 2.5 --- Statistical analysis --- p.35 / Chapter Chapter 3 --- Results / Chapter 3.1. --- Patient demographics and indications --- p.37 / Chapter 3.2. --- Control of INR --- p.42 / Chapter 3.3. --- Incidence of major bleeding and thromboembolism --- p.44 / Chapter 3.4. --- Direct medical cost analysis --- p.46 / Chapter 3.5. --- Patient satisfaction --- p.48 / Chapter Chapter 4 --- Discussion and Conclusion / Chapter 4.1 --- Discussion --- p.51 / Chapter 4.1.1 --- Clinical outcomes of anticoagulation clinic --- p.52 / Chapter 4.1.2 --- Direct medical cost analysis --- p.56 / Chapter 4.1.3 --- Patient satisfaction --- p.59 / Chapter 4.1.4 --- Limitations --- p.62 / Chapter 4.1.5 --- Future studies --- p.63 / Chapter 4.2 --- Conclusion --- p.66 / References --- p.67 / Appendices / Appendix A. Management protocol --- p.73 / Appendix B. Data collection form --- p.96 / Appendix C. PSQ-18 --- p.104

末期腎衰竭乃是一種慢性並且會持續惡化的疾病，現時唯一的治療方案便是腎功能替代療法。在香港，一般新發現患有末期腎衰竭的病人，將會被安排進行持續性家居腹膜透析。接受持續性家居腹膜透析的病人均需遵照以下四項治療性方案(包括限制膳食和流質食物，服用處方葯物，及跟從腹膜透析的指引)，以減慢病程的惡化。以往有關病人遵照治療性方案的研究，大多側重於使用血液透析的病人及醫護專業人仕的評估。本研究的目的乃是從現正進行持續性家居腹膜透析的病人的觀點，去明白及解釋病人遵照治療性方案的模式。 / 此硏究採用混合方法硏究設計，並分兩期進行。在第一期的調查，173位病人自我評估其遵照治療性方案中四個環節的程度。調查結果顯示:參加對葯物及腹膜透析的遵照程度，比限制膳食和流質食物的遵照程度為高。再者，男性、較年青、或進行了透析治療一至三年的參加者，自覺其遵照程度比其他參加者為低。此調查結果將指導第二期硏究的最大變化採樣，方法是跟據參加者自我報告其遵照治療性方案的程度分為跟從及不跟從兩組，硏究採用立意取樣方法去選取36位不同性別、年齡、及透析年歷的參加者作第二期硏究的面談。整合第一期的調查及第二期的面談結果後，硏究為參加者遵照治療性方案的模式提供了解釋。 / 結果顯示參加者的遵照模式乃是一個浮動過程，此過程可分為三個階段: 起初的遵照模式、隨後的遵照模式、及長期的遵照模式。在起初的遵照模式階段，參加者嘗試嚴謹地遵照各項治療性方案，但體會到這是不能持久的。在進行了透析二至六個月後，參加進入隨後的遵照模式，透過試驗、監察及不斷的調校，參加者學會選擇性地去遵照某些治療性方案。當參加者接受透析三至五年後，他們開始進入長期的遵照模式，在這階段，參加者已能將自行修改了的治療性方案融入日常的生活當中。 / 參加者遵照治療性方案的浮動過程，乃是受其「抱怨失去自主及常規」和「嘗試挽回自主及常規」所驅使。此浮動情況在每個階段都會發生。除了透析年歷，影響參加者遵照治療性方案的決定性因素乃是其家人及醫護專業人仕的支持。參加並認為醫護專業人仕非常強調其需絶對遵照所有治療性方案，反眏現行以治療為本的照料模式。 / 此硏究在理論及臨床上皆有貢獻。在理論方面，此乃首個硏究確立接受持續性家居腹膜透析的病人，在遵照治療性方案的浮動過程中出現的三個階段。在臨床上，此三個階段的確立可作為策劃護理方案的參照，以幫助病人順利過渡各個階段。硏究的結果亦倡導醫療模式的轉變，即由以治療作主導的模式轉變為以病人為本的照料模式，授權病人在末期腎衰竭的治療過程中參與自我料理。 / End-stage renal disease (ESRD) is a chronic, progressive and debilitating illness with renal replacement therapy (RRT) as the only treatment modality. In Hong Kong, patients newly diagnosed with ESRD who require RRT are generally started on continuous ambulatory peritoneal dialysis (CAPD). Patients receiving CAPD are required to adhere to a renal therapeutic regimen comprising four components (dietary and fluid restrictions, and medication and dialysis prescriptions) to decelerate disease progression. Studies on patients' adherence have mainly focused on those undergoing haemodialysis and are generally from healthcare professionals' perspectives. The aim of this study was to understand and explain adherence from the perspectives of patients undergoing CAPD. / The study employed a mixed-methods design and was conducted in two phases. In phase I, a survey was conducted to examine 173 patients' self-reported adherence to the four components of the therapeutic regimen. Results showed that participants were more adherent to dialysis and medication prescriptions than to fluid and dietary restrictions. Moreover, participants who were male, younger or had received dialysis for 1 to 3 years rated themselves as more non-adherent than other participants. These findings guided the maximum variation sampling of 36 purposively recruited participants of different genders, ages, and duration of dialysis from the adherent and non-adherent groups for the phase II interview. The survey and interview data were merged in the interpretation of findings to provide an understanding of participants' adherence. / Findings indicate that participants' adherence was a dynamic process with three stages: initial adherence, subsequent adherence and long-term adherence. At the stage of initial adherence, participants attempted to follow instructions but found that strict persistent adherence was impossible. After the first 2 to 6 months of dialysis, participants entered the stage of subsequent adherence. Through experimenting, monitoring and making continuous adjustments, they learned to adopt selective adherence. The stage of long-term adherence commenced after participants had received dialysis for more than 3 to 5 years. At this stage, they were able to assimilate the modified therapeutic regimen into everyday life. / The dynamic process of adherence was driven by "grieving for the loss of autonomy and normality" and "attempting to regain autonomy and normality". The process was dynamic as there were fluctuations at each stage of the participants' adherence. In addition to the duration of dialysis, the major determinant influencing the participants' adherence was the support provided by family members and healthcare professionals. Moreover, participants perceived that the focus of care provision was on strict adherence to all components of the therapeutic regimen, reflecting a biomedical model of care. / This study has theoretical and clinical significance. Theoretically, this is the first study that identified three stages in the dynamic process of adherence among patients undergoing CAPD. Clinically, with reference to each stage identified, nursing interventions can be developed to help patients achieve a smooth transition throughout all the stages. The findings also call for a paradigm shift from the biomedical model of care to patient-centred care, so as to empower patients to engage in self-management of their ESRD. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Lam, Lai Wah. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references. / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese; some appendixes also in Chinese. / LIST OF TABLES --- p.xv / LIST OF FIGURES --- p.xvi / LIST OF ABBREVIATIONS --- p.xvii / LIST OF APPENDICES --- p.xviii / Chapter CHAPTER ONE --- INTRODUCTION / Introduction --- p.1 / ESRD and its management in the Hong Kong context --- p.2 / The research problem --- p.3 / Aim of the study --- p.6 / Overview of the thesis --- p.6 / Chapter CHAPTER TWO --- LITERATURE REVIEW / Introduction --- p.7 / Literature search strategies --- p.7 / The concept of adherence --- p.8 / Theoretical models used to understand adherence --- p.14 / Health belief model --- p.14 / Locus of control --- p.16 / Self-efficacy --- p.19 / Transtheoretical model --- p.22 / Measurement of adherence --- p.24 / Prevalence of adherence --- p.27 / Patients undergoing HD --- p.28 / Patients undergoing PD --- p.31 / Factors influencing patients’ adherence --- p.34 / Demographic and clinical characteristics --- p.34 / Social support --- p.37 / Knowledge about adherence --- p.39 / Chinese culture --- p.43 / Exploring adherence from patients’ perspectives --- p.47 / Adherence among patients undergoing dialysis in Hong Kong --- p.51 / An introduction to the concept of self-management --- p.52 / Summary --- p.53 / Chapter CHAPTER THREE --- METHODOLOGY / Introduction --- p.56 / Aim --- p.56 / Objectives --- p.56 / Operational definitions --- p.57 / Research design --- p.57 / The paradigm of mixed methods research --- p.58 / Justification for using a mixed methods design --- p.60 / Application of the mixed methods design --- p.61 / Phase I study --- p.67 / Sampling --- p.67 / Setting --- p.67 / Sampling method and sample size --- p.67 / Data collection method --- p.68 / Instrument --- p.68 / Data collection procedures --- p.70 / Data analysis --- p.70 / Pilot Study --- p.71 / Validity and reliability --- p.72 / Phase II study --- p.74 / Sampling --- p.74 / Sample size --- p.74 / Sampling method --- p.75 / Data collection method --- p.80 / Semi-structured interview --- p.80 / Development of the interview guide --- p.81 / Data collection procedures --- p.82 / Making contact with participants --- p.82 / The interviewing process --- p.83 / Data analysis --- p.87 / Pilot study --- p.89 / Rigour of the study --- p.91 / Credibility --- p.91 / Dependability --- p.95 / Confirmability --- p.95 / Transferability --- p.95 / Ethical considerations --- p.96 / Summary --- p.98 / Chapter CHAPTER FOUR --- FINDINGS OF THE PHASE I STUDY / Introduction --- p.99 / Results --- p.99 / Participants --- p.99 / Demographic and clinical characteristics of the participants --- p.100 / Overall adherence to the therapeutic regimen --- p.103 / Number of days non-adherent to the therapeutic regimen --- p.103 / Degree of deviation from the therapeutic regimen --- p.104 / Adherence in relation to demographic and clinical variables --- p.106 / Summary --- p.109 / Chapter CHAPTER FIVE --- FINDINGS OF THE PHASE II STUDY / Introduction --- p.110 / Demographic and clinical characteristics of the participants --- p.110 / Major categories and subcategories identified --- p.115 / Perceptions of adherence --- p.117 / Meaning of adherence --- p.117 / Perceived needs to adhere --- p.118 / Perceived levels of adherence --- p.120 / The process of adherence --- p.123 / Initial adherence --- p.124 / Practising two major types of adherence --- p.124 / Striving to live with strict adherence --- p.124 / Doing what I am told --- p.124 / Trying my best --- p.125 / Exercising self-control --- p.127 / Adopting partial adherence --- p.128 / Recognizing limitations of current types of adherence --- p.129 / Sacrificing freedom for strict adherence --- p.129 / Social restriction --- p.129 / Having nothing to eat --- p.132 / Paying the price of inadequate adherence --- p.133 / Physiological complications --- p.134 / Need for additional treatment --- p.136 / Harsh comments from healthcare professionals --- p.137 / Realizing the need for changes in adherence --- p.139 / Rationalising an easy-going approach to adherence --- p.139 / Seeing the need for stricter adherence --- p.144 / Subsequent adherence --- p.146 / Experimenting with an easy-going approach to adherence --- p.147 / Allowing some slippage --- p.147 / Monitoring indicators of adherence --- p.148 / Making continuous adjustments --- p.149 / Adopting selective adherence --- p.153 / Long-term adherence --- p.158 / Factors influencing the process of living with adherence --- p.159 / Support --- p.159 / Family members --- p.159 / Healthcare professionals --- p.163 / Hope for the future --- p.165 / Situational factors --- p.168 / Dinning out --- p.169 / Employment --- p.171 / Summary --- p.173 / Chapter CHAPTER SIX --- DISCUSSION / Introduction --- p.177 / The dynamic process of adherence --- p.179 / Initial adherence --- p.182 / Following instructions --- p.182 / Grieving for the loss of autonomy and normality --- p.184 / Social restriction --- p.185 / Unmet nutritional and psychosocial needs --- p.187 / Subsequent adherence --- p.193 / Experimenting with an easy-going approach to adherence --- p.193 / Attempting to regain autonomy and normality --- p.198 / Dialysis --- p.199 / Medication --- p.201 / Fluid --- p.204 / Diet --- p.205 / Long-term adherence --- p.209 / Support as a major determinant of adherence --- p.212 / Family --- p.213 / Healthcare professionals --- p.216 / Biomedical model of care --- p.221 / Disease-oriented perspective --- p.222 / One-way paternalistic communication --- p.228 / Summary --- p.232 / Chapter CHAPTER SEVEN --- CONCLUSIONS / Introduction --- p.235 / Limitations of the study --- p.235 / Implications --- p.237 / Implications for clinical practice --- p.237 / Initial stage --- p.237 / Provision of timely appropriate support --- p.238 / Psychological support --- p.238 / On-site support --- p.239 / Adjustment of the CAPD training content --- p.240 / Empowering patients for self-management of their ESRD --- p.241 / Subsequent stage --- p.244 / Long-term stage --- p.245 / Implications for administration --- p.246 / Implications for nursing education --- p.247 / Recommendations for further research --- p.249 / Conclusions --- p.252 / REFERENCES --- p.254

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.

近年来，针对就业和就学中遭遇歧视的困境，中国乙肝携带者发起一场要求消除歧视、维护合法权益的抗争运动。为什么乙肝携带者就业歧视问题在中国如此显著？面对国家和市场这两大最具权势的系统，公民社会将何以对抗？本文旨在从社会学的视角对这场“将‘乙肝’去除"的运动进行解读。 / 本文采用个案研究方法，以北京益仁平中心为主要研究对象，围绕 “乙肝"在中国的建构和重构过程，将研究聚焦于三个方面：第一，乙肝污名化过程以及国家、市场中的话语权；第二，反乙肝歧视维权运动的条件和动员机制；第三，“将‘乙肝’去除"中的政治和权力话语三角。 / 本文从社会运动理论中的资源动员、政治机会结构和框架理论出发解读中国乙肝携带者的维权运动；将运动中的微观景象与宏观社会结构结合起来，考察影响乙肝携带者维权运动的主要因素以及运动的动员机制。研究伊始分别从国家和市场两个领域审视乙肝歧视问题在中国的建构过程，阐明乙肝污名化是政府权威以及市场中医药商和医学权威共谋下的合力作用，从而为乙肝携带者反歧视抗争运动的后续研究选择一个合适的立足点。笔者在案例中发现，组织在维权运动中将乙肝携带者群体动员起来，采取有效的策略，充分利用其在资源获得方面的优势、建立乙肝维权组织网络、善于把握时机营造政治机会空间、并能够吸纳律师和媒体的专业力量是维权行动能取得成功的重要因素。 / 组织在维权行动中的话语框架对运动的发展至关重要。乙肝携带者群体对组织运动框架的认同是动员成功的基础；掌握定义“乙肝"的主动权、运动领袖的可信性、框架话语表达的日常化、与媒体的良好关系等策略有助于框架在动员中与参与者、旁观者产生共鸣；抗争精英通过话语框架为抗争活动提供合法性。 / 反乙肝歧视维权运动可以看作是一个“将‘乙肝’去除"的“去污名化"运动。一方面，中央政府与地方政府有着各自自主性利益；另一方面，乙肝携带者群体内部就抗争形式也难以统一，这两种分裂情况交叉形成了一个围绕“将‘乙肝’去除"的，以规则、效益和权利为话语的权力三角，支撑反歧视行动的抗争空间。权力三角的多变性决定去除“乙肝"的行动是有策略的、冒险的，但却相对稳定。 / Hepatitis B Virus carriers (HBVers) have launched series social movements targeting at eliminating discriminations against HBVers in job market and promoting fair employment in recent decade of years. Why does nowhere match the HBV discrimination in such country like China? How is contentious politics possible when the powerless engage in struggles with power holders, like state and market in China? The thesis attempts to learn the intricacies of body politics with sociological approaches. / Yirenping, a NGO located in Beijing, is selected as research object in this case study. Concentrating on the political nature of the HBV confrontations, this thesis is comprised of three parts: first, the stigmatization of HBV in China; second, tactics and strategies that employed against the system of discrimination; third, the politics of “Removing HBV" and the power triangle among state, market and civil society. / The analysis of the HBV movement is informed by three sociological theories of social movements: resource mobilization, political opportunity structure and framing, meanwhile macro structure and micro interaction are combined. It is postulated that this disease discrimination in China occurs when confronting an entrenched stigmatization conjoined from both state and market dedicated to keeping the HBVers excluded and marginalized, which serves as a departure point for further analysis of the struggles for power against this discrimination. Resources mobilized, leaderships and organizations, networks among HBVers and outside supporters, strategies in mobilization positively facilitate the anti-discrimination movements. Utilizing the institutional advocacies as well as informal networks with officials, NPC & CPCCC delegates open more political opportunities within the preexisting political environment. / Framing is essential to the movement mobilization. Identifying closely with the visions and missions in movements, the self conceptualization of HBV-discrimination, charismatic leaders, the everyday narrative of the frame, as well as strategic media coverage help promoting resonance among movement participants and standers-by. Framing strategies provide legitimacy for HBV selves in collective movements. / Finally, the thesis came to the conclusion that anti-discrimination-against-HBVers social movements in China can be interpreted as a process of struggle to “Removing HBV" power. Central government and local ones have their autonomies and interests respectively, while weak but observed divisions in protesting strategies also exist within the HBVers, which shape a triangle of power struggles among the dominant and dominated groups. The power triangle is flexible, and the “Removing HBV" movements are strategic, risk-taking, while being routinized. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / 郭娜. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 137-156) / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in Chinese and English. / Guo Nuo. / 中文摘要 --- p.i / 英文摘要 --- p.ii / 引言 --- p.1 / Chapter 第一章 --- 导论 乙肝：作为医学问题和作为社会问题 --- p.3 / Chapter 1.1 --- 作为医学问题的乙型肝炎及其全球地理分布 --- p.3 / Chapter 1.2 --- 乙型肝炎在中国 --- p.6 / Chapter 1.3 --- 作为社会问题的乙肝歧视 --- p.8 / Chapter 1.4 --- 研究方法 --- p.10 / Chapter 1.5 --- 小结 --- p.14 / Chapter 第二章 --- 研究问题与文献回顾 --- p.15 / Chapter 2.1 --- 社会运动理论的发展脉络 --- p.16 / Chapter 2.2 --- 认同与社会运动的动员 --- p.21 / Chapter 2.3 --- 中国底层社会与维权抗争研究回顾 --- p.24 / Chapter 2.4 --- 中国反乙肝歧视运动的分析框架 --- p.26 / Chapter 2.5 --- 小结 --- p.34 / Chapter 第三章 --- 政府与入职体检 --- p.35 / Chapter 3.1 --- 新中国成立之初的公共卫生政策 --- p.35 / Chapter 3.2 --- 中国人事制度改革和公务员职业声望 --- p.39 / Chapter 3.3 --- 体检标准与强制乙肝检测 --- p.43 / Chapter 3.4 --- 小结 --- p.47 / Chapter 第四章 --- 市场话语权与定义“乙肝" --- p.49 / Chapter 4.1 --- 市场中的虚假广告 --- p.50 / Chapter 4.2 --- 体检经济 --- p.54 / Chapter 4.3 --- 医药商与医学权威 --- p.56 / Chapter 4.4 --- 小结 --- p.58 / Chapter 第五章 --- 乙肝携带者的个人经验 --- p.61 / Chapter 5.1 --- 疾病的社会建构 --- p.62 / Chapter 5.2 --- 乙肝携带者的认知过程 --- p.66 / Chapter 5.3 --- 乙肝携带者的抗争选择 --- p.68 / Chapter 5.4 --- 小结 --- p.74 / Chapter 第六章 --- 从个体经验到集体行动：公民社会的回应 --- p.76 / Chapter 6.1 --- 从个人困境到集体行动 --- p.76 / Chapter 6.2 --- 反乙肝歧视运动中的资源动员 --- p.80 / Chapter 6.3 --- 反乙肝歧视组织网络 --- p.82 / Chapter 6.4 --- 反乙肝歧视运动中的机会空间 --- p.86 / Chapter 6.5 --- 小结 --- p.90 / Chapter 第七章 --- 框架策略：反乙肝歧视运动中的动员 --- p.91 / Chapter 7.1 --- 认同与社会运动 --- p.91 / Chapter 7.2 --- 反乙肝歧视运动的行动框架 --- p.95 / Chapter 7.3 --- 反乙肝歧视运动的动员策略 --- p.100 / Chapter 7.4 --- 小结 --- p.107 / Chapter 第八章 --- 身体的政治：将“乙肝"去除 --- p.108 / Chapter 8.1 --- 权力的维度 --- p.108 / Chapter 8.2 --- 反乙肝歧视行动的抗争轨迹 --- p.111 / Chapter 8.3 --- 国家、市场与公民社会：将“乙肝"去除 --- p.116 / Chapter 8.4 --- 小结 --- p.130 / Chapter 第九章 --- 总结与讨论 --- p.131 / 参考文献 --- p.137 / Chapter 附录A --- 访谈提纲 --- p.157 / Chapter 附录B --- 64名被访者基本信息概况 --- p.160 / 致谢 --- p.162

Luk, Pik Shan Yvonne. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (leaves 134-146). / Abstracts in English and Chinese ; some text in appendix also in Chinese. / Abstract (English version) --- p.ii-iii / Abstract (Chinese version) --- p.iv / Acknowledgement --- p.v / List of Table --- p.vi / Appendices --- p.vii / Chapter 1 --- Introduction --- p.1-5 / Chapter 2 --- Literature Review / Introduction --- p.6-7 / Psychological Distress --- p.7-13 / Health-related Quality of Life --- p.13-25 / Marital Relationship --- p.26-31 / Summary --- p.31-34 / Chapter 3 --- Aims & Methodology / Aims & Objectives --- p.35-37 / Operational Definition --- p.37-38 / Research Design --- p.38-39 / Setting & Sample --- p.39-40 / Instrument / Psychological Distress --- p.41-43 / Health-related Quality of Life --- p.43.44 / Marital Relationship --- p.44-46 / Demographic Data --- p.47 / Data Collection Procedure --- p.4748 / Ethical Consideration --- p.48-50 / Data Analysis --- p.50-51 / Pilot Study --- p.51-52 / Chapter 4 --- Findings / Introduction --- p.53-54 / Sociodemographic Characteristics --- p.54-56 / Psychological Distress --- p.57-58 / Health-related Quality of Life --- p.59-61 / Marital Relationship --- p.62-65 / Normality of the Outcome Variables --- p.65-66 / Relationships between the Study Outcomes and Sociodemographic Data --- p.66-68 / "Relationships between Anxiety, Depression, Health-Related Quality of Life and Marital Relationship" --- p.68-76 / Summary --- p.16-78 / Chapter 5 --- Discussion / Introduction --- p.79 / Socio-demographic and Clinical Characteristics of CAPD patients --- p.79-84 / Psychological Distress of CAPD Patients --- p.84-85 / Components of Psychological Distress: Anxiety --- p.85-86 / Components of Psychological Distress: Depression --- p.86-88 / Gender differences of the Levels of Anxiety and Depression among CAPD Patients --- p.88-89 / Cultural Difference of Anxiety and Depression among CAPD Patients --- p.89-90 / Health-related Quality of Life among CAPD Patients / Health-related Quality of Life of CAPD Patients Affected by Renal Symptoms --- p.90-91 / Health-related Quality of Life of CAPD Patients Affected by the effects of Kidney Disease --- p.91-93 / Health-related Quality of Life of CAPD Patients Affected by the burden of / Having Kidney Disease --- p.93-94 / Health-related Quality of Life of CAPD Patients Affected by the General Physical Health --- p.94-96 / Health-related Quality of Life of CAPD Patients Affected by the General Mental Health --- p.96-97 / Gender differences of the Levels of Health-related Quality of Life among CAPD Patients --- p.97-98 / Cultural Difference of Health-related Quality of Life among CAPD Patients --- p.98-99 / Sexual Issues and Marital Relationship of CAPD Patients / Sexual Issues of CA PD Patients --- p.100-102 / CAPD Patients' Perception of the Marital Relationship --- p.102-104 / Gender Differences in Perception of the Marital Relationship among CAPD Patients --- p.104 / Cultural Difference in Perception of the Marital Relationship among CAPD Patients --- p.105-106 / "Relationships between Participants' Characteristics and Psychological Distress," / HRQoL and Marital Relationship / "Relationships of Income with Anxiety, Depression and General Mental Health" --- p.107-108 / Relationship between Duration of Receiving Dialysis and Health-related Quality of Life --- p.108-109 / Relationship between Occupational Status and General Mental Health --- p.199.110 / "Relationships among Anxiety, Depression, HRQoL and Marital Relationship" / The Relationship between Anxiety and Depression --- p.110-111 / "The Relationship between Anxiety, Depression and HRQoL" --- p.112 / "The Relationship between Anxiety, Depression and Marital Relationship" --- p.112-113 / The Relationships among Domains of Health-related Quality of Life --- p.113-114 / The Relationship between Health-related Quality of Life and Marital Relationship --- p.114-115 / Predictors of Health-related Quality of Life among CAPD Patients / Anxiety and Depression as Predictors of Health-related Quality of Life --- p.116-118 / Marital Relationship as Predictors of Health-related Quality of Life --- p.118-119 / Summary --- p.119-121 / Chapter 6 --- Conclusion / Limitations / Validity of Participants' Responses --- p.122-123 / Generalization of the Study's Findings --- p.123-124 / Psychometric Property of the Chinese Version of KDQOL-36 --- p.124-125 / The Sexual Items ofKDQOL-SF --- p.125 / Appropriateness of Using HADS and Multiple Correlations --- p.126 / Implications of the Study Findings / Implications for nursing knowledge --- p.126-128 / Implications on the Nursing Practice --- p.128-130 / Recommendations for Further Research --- p.130-132 / Conclusion --- p.132-133 / Chapter 7 --- Reference --- p.134-146 / Chapter 8 --- Appendix --- p.147-179