by Yim-kam Kwong. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1993. / Includes bibliographical references (leaves 119-133). / ACKNOWLEDGEMENT --- p.vii / LIST OF TABLES --- p.viii / LIST OF FIGURES --- p.x / ABSTRACT --- p.1 / SECTION / Chapter 1. --- INTRODUCTION --- p.3 / Chapter 2. --- LITERATURE REVIEW --- p.6 / Chapter 3. --- MATERIALS AND METHODS --- p.39 / Chapter 4. --- RESULTS --- p.61 / Chapter 5. --- DISCUSSION --- p.103 / Chapter 6. --- CONCLUSION --- p.116 / REFERENCES --- p.119 / APPENDIX --- p.134 / Chapter SECTION 1 --- INTRODUCTION --- p.3 / Chapter SECTION 2 --- LITERATURE REVIEW --- p.6 / Chapter 2.1 --- IRON --- p.6 / Chapter 2.1.1 --- CHEMISTRY --- p.6 / Chapter 2.1.2 --- METABOLISM --- p.6 / Chapter 2.1.2.1 --- Homeostasis --- p.6 / Chapter 2.1.2.2 --- Absorption --- p.8 / Chapter 2.1.2.3 --- Transportation - Role of transferrin in iron transport --- p.9 / Chapter 2.1.2.4 --- Storage --- p.10 / Ferritin --- p.11 / Haemosiderin --- p.13 / Chapter 2.2 --- IRON OVERLOAD --- p.14 / Chapter 2.2.1 --- AETIOLOGY --- p.14 / Chapter 2.2.2 --- PREVALENCE --- p.15 / Chapter 2.2.3 --- MECHANISM --- p.16 / Chapter 2.2.4 --- PATHOLOGY OF IRON OVERLOAD --- p.17 / Chapter 2.2.4.1 --- Increased absorption of iron from the diet --- p.18 / Chapter 2.2.4.2 --- Parenteral administration of excess iron --- p.21 / Chapter 2.2.4.3 --- Increased iron absorption combined with transfusional overload --- p.22 / Chapter 2.2.4.4 --- Miscellaneous conditions --- p.23 / Chapter 2.2.5 --- CLINICAL PRESENTATION --- p.24 / Chapter 2.2.6 --- EFFECT OF IRON OVERLOAD --- p.25 / Chapter 2.2.6.1 --- Role of iron in lipid peroxidation --- p.25 / Chapter 2.2.6.2 --- Iron and neoplasia --- p.26 / Chapter 2.3 --- ASSESSMENT OF IRON OVERLOAD --- p.26 / Chapter 2.3.1 --- NON-SERUM PARAMETER --- p.26 / Chapter 2.3.1.1 --- Localization of stored iron --- p.27 / Chapter 2.3.1.2 --- Morphometric assessment of hepatic iron in liver biopsy --- p.30 / Chapter 2.3.1.3 --- Hepatic iron concentration --- p.31 / Chapter 2.3.1.4 --- Atomic absorption spectrophotometry --- p.32 / Chapter 2.3.1.5 --- Hepatic imaging studies --- p.33 / Chapter 2.3.2 --- SERUM PARAMETERS --- p.34 / Chapter 2.3.2.1 --- Serum ferritin measurement --- p.34 / Chapter 2.3.2.2 --- Serum iron --- p.36 / Chapter 2.3.2.4 --- Transferrin saturation --- p.37 / Chapter SECTION 3 --- MATERIALS AND METHOD --- p.39 / Chapter 3.1 --- SUBJECTS --- p.39 / Chapter 3.1.1 --- SOURCE OF TISSUE SAMPLES AND CASE SELECTION --- p.39 / Chapter 3.1.1.1 --- The controls --- p.39 / Chapter 3.1.1.2 --- The transfusion group --- p.39 / Chapter 3.1.1.3 --- The non-transfusion group --- p.40 / Chapter 3.1.1.4 --- The total group --- p.40 / Chapter 3.2 --- METHODS --- p.40 / Chapter 3.2.1. --- HISTOLOGICAL METHOD --- p.44 / Chapter 3.2.1.1 --- Haematoxylin and Eosin Stain --- p.47 / Chapter 3.2.1.2 --- Perls' Prussian Blue Method --- p.49 / Chapter 3.2.1.3 --- The Rowe's Method of Iron Deposition --- p.47 / Chapter 3.2.1.4 --- Method 1 --- p.48 / Chapter 3.2.1.5 --- Method2 Estimation and grouping of % area --- p.49 / Chapter 3.2.1.6 --- "Comparison of Rowe's method, and the two histological iron grading methods" --- p.54 / Chapter 3.2.2 --- CHEMICAL MEASUREMENT --- p.55 / Chapter 3.2.2.1 --- Sectioning of paraffin liver blocks for chemical measurement --- p.55 / Chapter 3.2.2.2 --- Paraffin removal --- p.56 / Chapter SECTION 4 --- RESULTS --- p.61 / Chapter 4.1 --- HISTOLOGICAL ASSESSMENT --- p.61 / Chapter 4.1.1 --- HISTOLOGICAL STUDY --- p.61 / Chapter 4.1.2 --- SEX DISTRIBUTION --- p.65 / Chapter 4.1.3 --- AGE DISTRIBUTION --- p.65 / Chapter 4.2 --- CHEMICAL MEASUREMENT --- p.81 / Chapter 4.2.1 --- EVALUATION OF ANALYTICAL PRECISION --- p.84 / Chapter 4.2.2 --- RESULT OF CHEMICAL MEASUREMENTS --- p.81 / Chapter 4.2.3 --- ASSOCIATED CONDITIONS IN PATIENTS WITH LIVER TISSUE IRON > 50 μMOL/G --- p.86 / Chapter 4.3 --- CORRELATION OF HISTOLOGICAL ASSESSMENT WITH CHEMICAL MEASUREMENT --- p.88 / Chapter 4.3.1 --- CORRELATION OF HISTOLOGICAL ASSESSMENT WITH CHEMICAL MEASUREMENT BY METHOD 1 --- p.88 / Chapter 4.3.2 --- CORRELATION OF ASSESSMENT WITH CHEMICAL MEASUREMENT BY METHOD 2 --- p.89 / Chapter 4.3.2.1 --- Percentage area --- p.95 / Chapter 4.3.2.2 --- Score --- p.96 / Chapter 4.4 --- PANCREATIC AND MYOCARDIAC HAEMOSIDEROSIS --- p.100 / Chapter 4.4.1 --- METHOD 2 --- p.100 / Chapter SECTION 5 --- DISCUSSIONS --- p.103 / Chapter SECTION 6 --- CONCLUSIONS --- p.116 / REFERENCES --- p.119 / APPENDIX --- p.134

by Ho Mun-Wan, Audrey. / Thesis (Ph.D.)--Chinese University of Hong Kong, 1991. / Includes bibliographical references. / Title Page --- p.i / Thesis Committee --- p.ii / Table of Contents --- p.iii / Abstract --- p.ix / List of Figures --- p.xii / List of Tables --- p.xiv / List of Appendices --- p.xviii / Acknowledgements --- p.xxi / Statement of Originality --- p.xxiii / Chapter CHAPTER I --- INTRODUCTION: STATEMENT OF RESEARCH PROBLEM --- p.1-11 / Chapter 1.1 --- Introduction --- p.2 / Chapter 1.2 --- Death and Quality of Life --- p.3 / Chapter 1.3 --- Pain and Quality of Life --- p.6 / Chapter 1.4 --- Measuring Quality of Life in Chinese Population --- p.8 / Chapter 1.5 --- The Research Problem and Sample --- p.10 / Chapter CHAPTER II --- LITERATURE REVIEW AND CONCEPTUAL FRAMEWORK --- p.12-62 / Chapter 2.1 --- Introduction --- p.13 / Chapter Part A: --- The Concept of Quality of Life / Chapter 2.2 --- Definitions of Quality of Life --- p.14 / Chapter 2.3 --- Towards a Structural Definition of Quality of Life --- p.19 / Chapter 2.4 --- Quality of Life: Subjective or Objective? --- p.22 / Chapter 2.5 --- Quality of Life and Social Cultural Context --- p.28 / Chapter Part B: --- Ideology and Psychology of Death and Dying / Chapter 2.6 --- Chinese Ideas on Death and Dying --- p.31 / Chapter 2.7 --- Western Religions in Hong Kong --- p.38 / Chapter 2.8 --- Local Folk Beliefs on Death and Dying --- p.41 / Chapter 2.9 --- Psychology of Death and Dying --- p.42 / Chapter Part C: --- Measuring the Quality of Life of Terminally I11 Patients / Chapter 2.10 --- Quality of Life of End Stage Cancer Patients of the West --- p.48 / Chapter 2.11 --- Factors Affecting Quality of Life of Terminally I11 Patients --- p.51 / Chapter 2.12 --- Existing Measures on Quality of Life and Pain --- p.55 / Chapter 2.13 --- Summary --- p.61 / Chapter CHAPTER III --- TOWARDS CONSTRUCTING A CHINESE QUALITY OF LIFE QUESTIONNAIRE FOR THE THE TERMINALLY ILL PATIENTS --- p.64-107 / Chapter 3.1 --- Introduction: The Need for a Chinese Quality of Life Questionnaire (CQLQ) --- p.65 / Chapter 3.2 --- Preparatory Survey I: Identification of the Needs of Patients by Medical and Health Professionals --- p.67 / Chapter 3.3 --- Preparatory Survey II: Identification of the Needs of Patients by Severely I11 Patients --- p.75 / Chapter 3.4 --- Design of the Chinese Quality of Life Questionnaire (CQLQ) --- p.84 / Chapter 3.5 --- Preparatory Survey III: First Validation of the Chinese Quality of Life Questionnaire --- p.87 / Chapter 3.6 --- Preparatory Survey IV: Second Validation of the Chinese Quality of Life Questionnaire --- p.104 / Chapter 3.7 --- Summary --- p.107 / Chapter CHAPTER IV --- THE DEVELOPMENT OF A CHINESE PAIN QUESTIONNAIRE FROM THE McGILL PAIN QUESTIONNAIRE --- p.108-128 / Chapter 4.1 --- Introduction --- p.109 / Chapter 4.2 --- Preparatory Survey I: Collection of Cantonese Pain Descriptors --- p.110 / Chapter 4.3 --- Preparatory Survey II: Pilot Test of the Preliminary Pain Descriptors --- p.112 / Chapter 4.4 --- Modification of the Cantonese Pain Questionnaire --- p.115 / Chapter 4.5 --- Preparatory Survey III: Pilot Test of the Modified Pain Descriptors --- p.122 / Chapter 4.6 --- Preparatory Survey The Development of A Scoring System --- p.122 / Chapter 4.7 --- Preparatory Survey V: Pilot Test of the Final Draft of the Chinese Pain Questionnaire (CPQ) --- p.126 / Chapter 4.8 --- Summary --- p.128 / Chapter CHAPTER V --- EXPLORING THE VALIDITY OF TWO NEWLY DEVELOPED QUESTIONNAIRES: CQLQ AND CPQ - A FEASIBILITY STUDY --- p.129-161 / Chapter 5.1 --- Introduction --- p.130 / Chapter 5.2 --- The Study Design and Methodology --- p.130 / Chapter 5.3 --- "The Demographic, Social, Economic, and Illness Status of Subjects" --- p.145 / Chapter 5.4 --- Summary --- p.161 / Chapter CHAPTER VI --- THE VALIDATION FINDINGS --- p.162-241 / Chapter 6.1 --- Introduction --- p.163 / Part A / Chapter 6.2 --- Reporting on the Concurrent Validity in a Patient Sample --- p.163 / Chapter 6.3 --- Reporting on the CQLQ Validation Findings --- p.177 / Chapter 6.4 --- Reporting on the CQLQ Reliability --- p.211 / Chapter 6.5 --- Age and Quality of Life --- p.214 / Part B / Chapter 6.6 --- Reporting on the Validation of the CPQ Findings --- p.223 / Chapter 6.7 --- Summary of CPQ Findings --- p.241 / Chapter CHAPTER VII --- "STRUCTURAL, PAIN-ILLNESS, AND PSYCHOLOGICAL DETERMINANTS OF OVERALL QUALITY OF LIFE" --- p.242-286 / Chapter 7.1 --- Introduction --- p.243 / Chapter 7.2 --- Structural Model of Quality of Life --- p.243 / Chapter 7.3 --- Pain-Illness Model of Quality of Life --- p.264 / Chapter 7.4 --- Psychological Model of Quality of Life --- p.282 / Chapter 7.5 --- Summary --- p.286 / Chapter CHAPTER VIII --- CONCLUSION AND FUTURE DIRECTIONS / Chapter 8.1 --- Introduction --- p.288 / Chapter 8.2 --- The Chinese Quality of Life Questionnaire --- p.288 / Chapter 8.3 --- The Validity of the Chinese Quality of Life Questionnaire --- p.291 / Chapter 8.4 --- The Chinese Pain Questionnaire --- p.300 / Chapter 8.5 --- Liimitations and Implications --- p.304 / REFERENCES --- p.306-314 / APPENDICES --- p.315-408

Chen Qian. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (leaves 141-156). / Abstract and questionnaires in English and Chinese. / ABSTRACT --- p.I / 中文摘要 --- p.III / ACKNOWLEDGEMENTS --- p.IV / ABBREVIATIONS --- p.V / LIST OF TABLES --- p.VII / TABLE OF CONTENTS --- p.IX / Chapter CHAPTER 1: --- INTRODUCTION --- p.1 / Chapter 1.1 --- "General principles of diagnosis, treatment and efficacy evaluation in TCM" --- p.3 / Chapter 1.1.1 --- Basic principle of TCM in diagnosis and treatment --- p.3 / Chapter 1.1.2 --- Principles of combination use of TCM --- p.3 / Chapter 1.1.3 --- Principles of TCM prescription --- p.5 / Chapter 1.2 --- TCM is beneficial to human health --- p.6 / Chapter 1.2.1 --- "TCM is beneficial, but needs further modernized confirmation" --- p.6 / Chapter 1.2.2 --- TCM is effective when used following the principles of TCM --- p.21 / Chapter 1.2.3 --- The proper use and efficacy of TCM need further investigations --- p.21 / Chapter 1.3 --- Unwanted effects of TCM --- p.24 / Chapter 1.3.1 --- Unwanted effects of TCM are commonly seen --- p.24 / Chapter 1.3.2 --- Adverse effects of TCM classified based on medical systems --- p.25 / Chapter 1.3.3 --- Reasons related to adverse effects of TCM --- p.30 / Chapter 1.4 --- Studies on the use of TCM in Hong Kong --- p.31 / Chapter 1.5 --- Hypothesis and purpose of this study --- p.33 / Chapter CHAPTER 2: --- METHODOLOGY --- p.34 / Chapter 2.1 --- Rationale of questionnaire survey --- p.34 / Chapter 2.1.1 --- Choice of study method --- p.34 / Chapter 2.1.2 --- Types of diseases in the survey --- p.39 / Chapter 2.2 --- Issues related to implementation of questionnaire survey --- p.39 / Chapter 2.2.2 --- Interviewers and respondents --- p.40 / Chapter 2.2.3 --- Materials of the survey --- p.41 / Chapter 2.2.4 --- Collection period of questionnaire form --- p.42 / Chapter 2.2.5 --- Procedure of the questionnaire survey --- p.42 / Chapter 2.3 --- Questionnaire format and the content --- p.44 / Chapter 2.4 --- Statistics methods --- p.46 / Chapter 2.5 --- Pilot study for validation of the survey --- p.46 / Chapter CHAPTER 3: --- RESULTS --- p.48 / Chapter 3.1 --- Results from the main patient survey --- p.48 / Chapter 3.1.1 --- General characteristics of main patient group…… --- p.48 / Chapter 3.1.2 --- The attitude of the main patient group towards TCM --- p.48 / Chapter 3.1.3 --- Use of herbal medicines in the main patient group --- p.49 / Chapter 3.1.3.1 --- Chinese herbal medicines used for tonics or food supplements --- p.51 / Chapter 3.1.3.2 --- Chinese herbal medicines used for treating illnesses --- p.52 / Chapter 3.2 --- Results from medical patients --- p.55 / Chapter 3.2.1 --- General characteristics of medical patients in the survey --- p.55 / Chapter 3.2.2 --- The attitude of medical patients towards TCM --- p.56 / Chapter 3.2.3 --- Use of herbal medicines in medical patients --- p.57 / Chapter 3.2.3.1 --- Chinese herbal medicines used for tonics or food supplements --- p.57 / Chapter 3.2.3.2 --- Chinese herbal medicines used for treating illnesses --- p.58 / Chapter 3.2.4 --- Use of herbal medicine in the patients with the metabolic syndrome --- p.61 / Chapter 3.2.4.1 --- About the patients with hypertension and/or dyslipidaemia --- p.62 / Chapter 3.2.4.2 --- About the patients with diabetes mellitus --- p.63 / Chapter 3.3 --- Results from surgical patients --- p.64 / Chapter 3.3.1 --- General characteristics of surgical patients --- p.64 / Chapter 3.3.2 --- The attitude of surgical patients towards TCM --- p.65 / Chapter 3.3.3 --- Use of herbal medicines in surgical patients --- p.66 / Chapter 3.3.3.1 --- Chinese herbal medicines used for tonics or food supplements --- p.66 / Chapter 3.3.3.2 --- Chinese herbal medicines used for treating illnesses --- p.67 / Chapter 3.3.3.3 --- TCM used in gynaecological and surgical patients --- p.70 / Chapter CHAPTER 4: --- DISCUSSION --- p.73 / Chapter 4.1 --- The use of TCM in Hong Kong patients --- p.73 / Chapter 4.2 --- The attitude of patients towards TCM --- p.82 / Chapter 4.3 --- Limitations in the survey --- p.83 / Chapter 4.4 --- Further investigations --- p.89 / Chapter CHAPTER 5: --- CONCLUSIONS --- p.90 / Chapter 5.1 --- TCM is commonly used in Hong Kong patients for either health promotion or illnesses prevention and treatment --- p.90 / Chapter 5 2 --- The use of TCM in Hong Kong patients lacks formal regulation and management --- p.90 / TABLES --- p.91 / APPENDIX --- p.133 / Chapter 1. --- Informed consent form --- p.133 / Chapter 2. --- Questionnaire form (English version) --- p.136 / Chapter 3. --- Questionnaire form (Chinese version) --- p.138 / BIBLIOGRAPHY --- p.141 / Chapter 1. --- Full Publications --- p.141 / Chapter 2. --- Conference abstracts --- p.141 / REFERENCES --- p.144

Ng Sau Kwan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (leaves 107-127). / Abstracts in English and Chinese. / ABSTRACT --- p.ii / ACKNOWLEDGEMENTS --- p.vi / TABLE OF CONTENTS --- p.vii / LIST OF TABLES --- p.ix / LIST OF APPENDICES --- p.x / Chapter Chapter 1: --- INTRODUCTION / Background of the study --- p.1 / Significance of the study --- p.3 / Chapter Chapter 2: --- LITERATURE REVIEW / Introduction --- p.6 / Search Strategy --- p.6 / Overview of the Concepts of Pain --- p.7 / Types of Pain --- p.8 / Nature of Postoperative Pain --- p.9 / Effects of Pain --- p.9 / Factors Influencing Pain Management Outcomes / Undermanaged Postoperative Pain --- p.11 / Assessing Pain in Postoperative Patients --- p.14 / Pain Relief and Patient Satisfaction --- p.16 / Health Locus of Control --- p.20 / Health Care Professionals' Attitudes --- p.22 / Barriers to Postoperative Pain Relief --- p.24 / Psychosocial Factors Influencing Patient Satisfaction --- p.26 / Nursing and Quality Assurance of Pain Management --- p.29 / Pain Management Strategies / Organization of an Acute Pain Service --- p.32 / Pharmacological Pain Management --- p.35 / Nonpharmacological Pain Management --- p.37 / Summary of Literature Review --- p.38 / Chapter Chapter 3: --- METHOD / Introduction --- p.41 / Aim and objectives of the study --- p.41 / Research Questions --- p.42 / Research Hypotheses --- p.43 / Operational Definitions --- p.43 / Research Design --- p.44 / Settings --- p.45 / Sample --- p.46 / Instruments --- p.47 / The Modified American Pain Society Patient Outcome Questionnaire (APS-POQ-Modified) --- p.48 / The State Scale of State-Trait Anxiety Inventory (STAI) --- p.50 / The Multidimensional Health Locus of Control Form C Scale (MHLC) --- p.53 / The Modified Patient Satisfaction Questionnaire (PSQ-Modified) --- p.54 / Demographic Data Form --- p.55 / Translation and Content Validity of the Instruments --- p.55 / Pilot Study --- p.57 / Data Collection Procedures --- p.60 / Data Analysis / Effect Size and Power of the Study --- p.62 / Ethical Considerations --- p.64 / Conclusion --- p.65 / Chapter Chapter 4: --- RESULTS / Introduction --- p.66 / Reliability of the Instruments --- p.67 / Demographic Characteristics / Medical Characteristics --- p.70 / Physical and Psychosocial Characteristics of Pain / Pain intensity and pain interference --- p.72 / Beliefs about pain --- p.73 / State anxiety --- p.73 / Health locus of control --- p.73 / Patient satisfaction --- p.75 / Responses to Modified Patient Outcome Questionnaire --- p.75 / Comparisons of Patient Satisfaction Ratings with Demographic / Characteristics --- p.77 / Correlates of Patient Satisfaction --- p.78 / Predictors of Patient Satisfaction --- p.80 / Conclusion --- p.82 / Chapter Chapter 5: --- DISCUSSION / Introduction --- p.84 / Demographic Characteristics --- p.84 / Effect Size and Power of the Study --- p.85 / Patient Satisfaction with Pain Management and Pain Intensity --- p.86 / Multidimensional Health Locus of Control --- p.90 / Beliefs or Misconceptions about pain --- p.94 / Education on Pain Management --- p.98 / Conclusion --- p.101 / Chapter Chapter 6: --- "LIMITATIONS, IMPLICATIONS, RECOMMENDATIONS AND CONCLUSION" / Introduction --- p.102 / LIMITATIONS OF THE STUDY --- p.102 / IMPLICATIONS FOR NURSING PRACTICE --- p.106 / RECOMMENDATIONS FOR FUTURE PRACTICE / AND RESEARCH --- p.110 / CONCLUSION --- p.113 / REFERENCES --- p.115

by Au Kit Ling. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1991. / Bibliography: leaves 138-142. / Abstract / Acknowledgements / Chapter / Chapter 1 --- Introduction --- p.1 / Chapter 2 --- Literature Review --- p.16 / Chapter 3 --- Theoretical Perspective and Research Procedure --- p.38 / Chapter 4 --- Definition of Health Situation and Action Employed --- p.54 / Chapter 5 --- Managing the Label of Attending Psychiatric Out-patient Clinic --- p.96 / Chapter 6 --- Conclusion and Discussion --- p.118 / Bibliography --- p.138 / Appendix --- p.143

Cheng Wai Ring Caroline. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (leaves 74-84). / Abstracts in English and Chinese. / Acknowledgement --- p.i / Abstract --- p.ii / 摘要 --- p.iv / Table of contents --- p.vi / Publications --- p.x / List of figures --- p.xi / List of tables --- p.xii / Abbreviations --- p.xiii / Chapter Chapter 1 --- Introduction / Chapter 1.1 --- Coronary Heart Disease --- p.2 / Chapter 1.1.1 --- Epidemiology --- p.2 / Chapter 1.2 --- Hypercholesterolemia and CHD --- p.3 / Chapter 1.2.1 --- Atherosclerotic plaque and lipoprotein --- p.4 / Chapter 1.2.2 --- NCEP ATP III guidelines --- p.5 / Chapter 1.2.2.1 --- CHD risk assessment --- p.5 / Chapter 1.2.2.2 --- Target lipid control --- p.8 / Chapter 1.2.2.3 --- Therapeutic lifestyle changes --- p.9 / Chapter 1.2.2.4 --- Pharmacological interventions --- p.10 / Chapter 1.2.2.5 --- Adherence to lipid-lowering therapy --- p.13 / Chapter 1.3 --- Adherence to drug therapy --- p.14 / Chapter 1.3.1 --- Definition of adherence --- p.14 / Chapter 1.3.2 --- Methods to assess adherence --- p.16 / Chapter 1.3.2.1 --- Expressions of adherence measurements --- p.20 / Chapter 1.3.3 --- Time effect on adherence --- p.21 / Chapter 1.3.4 --- Predictors of adherence --- p.22 / Chapter 1.3.5 --- Impact of poor adherence to statins --- p.23 / Chapter 1.4 --- Objectives and hypotheses --- p.25 / Chapter Chapter 2 --- Materials and Methods / Chapter 2.1 --- Study site --- p.27 / Chapter 2.2 --- Patient selection criteria --- p.28 / Chapter 2.2.1 --- Inclusion criteria --- p.28 / Chapter 2.2.2 --- Exclusion criteria --- p.29 / Chapter 2.3 --- Patient recruitment --- p.30 / Chapter 2.4 --- Assessments --- p.32 / Chapter 2.4.1 --- Adherence assessment --- p.32 / Chapter 2.4.1.1 --- Electronic monitoring --- p.32 / Chapter 2.4.1.2 --- Patient report --- p.33 / Chapter 2.4.1.3 --- Pill count --- p.34 / Chapter 2.4.1.4 --- Predictors of adherence --- p.34 / Chapter 2.4.2 --- Clinical outcome assessment --- p.35 / Chapter 2.4.2.1 --- Lipid control --- p.35 / Chapter 2.4.3 --- Economic outcome assessment --- p.35 / Chapter 2.4.3.1 --- Total direct medical cost --- p.35 / Chapter 2.4.3.2 --- Healthcare cost per member per month --- p.36 / Chapter 2.5 --- Sample size --- p.36 / Chapter 2.6 --- Statistical analysis --- p.37 / Chapter Chapter 3 --- Results / Chapter 3.1 --- Study sample --- p.40 / Chapter 3.1.1 --- Demographic characteristics --- p.41 / Chapter 3.1.2 --- Co-morbidity factors --- p.42 / Chapter 3.2 --- Adherence measurement --- p.44 / Chapter 3.2.1 --- Electronic monitoring --- p.44 / Chapter 3.2.2 --- Patient report --- p.45 / Chapter 3.2.3 --- Pill Count --- p.46 / Chapter 3.2.4 --- Correlation among methods for measuring adherence --- p.47 / Chapter 3.2.5 --- Trend of adherence and persistence over time --- p.48 / Chapter 3.2.6 --- Independent predictors of adherence --- p.49 / Chapter 3.3 --- Outcome assessment --- p.52 / Chapter 3.3.1 --- Clinical outcomes --- p.52 / Chapter 3.3.2 --- Economic outcomes --- p.52 / Chapter 3.4 --- Association between adherence and clinical outcomes --- p.53 / Chapter 3.4.1 --- Adherence and LDL-C reduction --- p.53 / Chapter 3.4.2 --- Adherence and NCEP ATP III target --- p.55 / Chapter 3.5 --- Association between adherence and economic outcomes --- p.55 / Chapter 3.5.1 --- Adherence and healthcare utilization --- p.55 / Chapter Chapter 4 --- Discussion and Conclusion / Chapter 4.1 --- Discussion --- p.59 / Chapter 4.1.1 --- Accuracy of patient report and pill count --- p.59 / Chapter 4.1.2 --- Persistence to statin therapy over time --- p.62 / Chapter 4.1.3 --- Predictors for patient adherence --- p.63 / Chapter 4.1.4 --- Clinical impacts of patient adherence --- p.66 / Chapter 4.1.5 --- Economic impacts of patient adherence --- p.68 / Chapter 4.1.6 --- Limitations --- p.70 / Chapter 4.2 --- Conclusion --- p.71 / References --- p.74 / Appendices / Appendix A-1. Framingham risk scoring system for male --- p.86 / Appendix A-2. Framingham risk scoring system for female --- p.87 / Appendix B-1. Information sheet provided to nurses of the Cardiology clinic --- p.88 / Appendix B-2. Information sheet provided to nurses of the Diabetes clinic --- p.89 / Appendix B-3. Information sheet provided to nurses of the Lipid clinic --- p.90 / Appendix C. Data collection form --- p.91 / Appendix D. Instruction sheet provided to the study patient --- p.94 / Appendix E. Unit cost of items from electronic dispensing record and Hong Kong Gazette 2003 for estimating total direct medical cost --- p.95

Lee, Ching Ching. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 90-103). / Abstracts in English and Chinese. / Acknowledgments --- p.i / Abstract --- p.ii / 論文摘要 --- p.iv / Table of Contents --- p.vi / List of Tables --- p.x / List of Figures --- p.xi / Chapter Chapter 1 --- Introduction / Chapter 1.1. --- Quinolone Antimicrobial Agents --- p.1 / Chapter 1.1.1. --- Development --- p.1 / Chapter 1.1.2. --- Mode of action --- p.3 / Chapter 1.1.3. --- Mechanisms of resistance to quinolones --- p.4 / Chapter 1.1.3.1. --- Target genes mutations --- p.4 / Chapter 1.1.3.2. --- Decreased intracellular quinolone accumulation --- p.5 / Chapter 1.1.3.3. --- Plasmid-mediated quinolone resistance --- p.6 / Chapter 1.2. --- Plasmid-mediated Quinolone Resistance Genes (qnr) --- p.8 / Chapter 1.2.1. --- Discovery of qnrA genes --- p.8 / Chapter 1.2.2. --- Discovery of qnrS genes --- p.9 / Chapter 1.2.3. --- Discovery of qnrB genes --- p.10 / Chapter 1.2.4. --- Discovery of qnrC genes --- p.11 / Chapter 1.2.5. --- Discovery of qnrD genes --- p.12 / Chapter 1.2.6. --- Origins of qnr genes --- p.12 / Chapter 1.2.7. --- Qnr proteins and mode of action --- p.14 / Chapter 1.2.8. --- Epidemiology and quinolones resistance activity of qnr genes --- p.16 / Chapter 1.2.9. --- Epidemiology of fluoroquinolone-resistant Enterobacteriaceae --- p.17 / Chapter 1.2.10 --- Multidrug-resistant in extended-spectrum-B-lactamase- and AmpC-producing Enterobacteriaceae --- p.19 / Chapter 1.3. --- Background of Study --- p.20 / Chapter 1.4. --- Objectives of Study --- p.21 / Chapter Chapter 2 --- Materials & Methods / Chapter 2.1. --- Study Design --- p.22 / Chapter 2.2. --- Antimicrobial Susceptibility Testing --- p.24 / Chapter 2.2.1 --- Bacterial isolates --- p.24 / Chapter 2.2.2. --- Screening for ESBL and AmpC production by disk diffusion test --- p.24 / Chapter 2.2.3. --- Determination of minimal inhibitory concentrations (MICs) --- p.25 / Chapter 2.3. --- "Detection of qnrA, qnrB and qnrS Genes by Multiplex PCR" --- p.27 / Chapter 2.3.1. --- Total DNA preparation --- p.27 / Chapter 2.3.2. --- "Multiplex PCR assay for qnrA, qnrB and qnrS genes detection" --- p.27 / Chapter 2.3.3. --- Agarose gel electrophoresis --- p.29 / Chapter 2.4. --- "Detection of TEM-, SHV-, CTX- and PMAmpC Type B-Lactamase Genes by PCR" --- p.30 / Chapter 2.5. --- PCR Assays for Further Genotypic Characterization Purpose --- p.32 / Chapter 2.5.1. --- PCR assay to amplify qnrB genes --- p.32 / Chapter 2.5.2. --- PCR assay to amplify qnrS genes --- p.33 / Chapter 2.5.3. --- "PCR assays for genotypic characterizations of the co-existed blaTEM, blaSHV, blaCTX-M and PMAmpC genes of all qnr-positive isolates" --- p.33 / Chapter 2.5.3.1. --- Genotypic characterizations of the co-existed bla-TEM and genes --- p.33 / Chapter 2.5.3.2. --- PCR assays to amplify the co-existed blaCTX_M genes --- p.33 / Chapter 2.5.3.3. --- PCR assay to amplify the co-existed PMAmpC genes --- p.34 / Chapter 2.5.4. --- Sequencing reaction --- p.36 / Chapter 2.5.4.1. --- Purification of PCR product and sequence determination --- p.36 / Chapter 2.5.4.2. --- Sequence analysis --- p.37 / Chapter 2.6. --- Collection of Clinical Data --- p.38 / Chapter 2.6.1. --- Demographics and clinical data --- p.38 / Chapter 2.6.2. --- Definitions --- p.38 / Chapter 2.6.3. --- Data analysis --- p.40 / Chapter Chapter 3 --- Results / Chapter 3.1. --- Bacterial Isolates --- p.41 / Chapter 3.2. --- "Demographics, Medical History, Clinical Features and Clinical Outcomes of Patients" --- p.42 / Chapter 3.3. --- Antimicrobial Susceptibility Testing --- p.44 / Chapter 3.4. --- Detection of qnr Genes --- p.48 / Chapter 3.4.1. --- "Detection of qnrA, qnrB and qnrS genes by multiplex PCR" --- p.48 / Chapter 3.5. --- Detection of ESBLs --- p.49 / Chapter 3.5.1. --- Detection of TEM- and SHV-type ESBLs --- p.49 / Chapter 3.5.2. --- Detection of CTX-M- type ESBLs --- p.51 / Chapter 3.6. --- Detection of PMAmpC Genes --- p.52 / Chapter 3.6.1. --- Detection of PMAmpC genes --- p.52 / Chapter 3.7. --- "The Distribution of qnr and bla Genes for TEM, SHV, CTX-M and PMAmpC" --- p.53 / Chapter 3.8. --- The Characteristics of qnr Isolates --- p.54 / Chapter 3.8.1. --- Genotypes of qnrB and qnrS --- p.54 / Chapter 3.8.2. --- Antimicrobial susceptibility of qnr isolates --- p.58 / Chapter 3.9. --- "The Associations of qnr Genes with Other Bacterial Resistance Genotypes, and the Clinical Characteristics and Outcomes of Patients" --- p.62 / Chapter 3.9.1. --- "Univariate analysis of the associations of qnr genes with other bacterial resistance genotypes, and the clinical characteristics and outcomes of patients" --- p.62 / Chapter 3.9.2. --- "Multivariate analysis of the associations of qnr genes with other bacterial resistance genotypes, and the clinical characteristics and outcomes of patients" --- p.65 / Chapter 3.9.2.1. --- "Multivariate analysis of the associations of qnr genes with other bacterial resistance genotypes, and the clinical characteristics of patients" --- p.65 / Chapter 3.9.2.2. --- "Multivariate analysis of the associations of mortality with qnr genes, bacterial resistance genotypes and other clinical characteristics of patients" --- p.66 / Chapter Chapter 4 --- Discussion / Chapter 4.1. --- Prevalences and Susceptibility of ESBL and PMAmpC in Bacteraemic Enterobacteriaceae Isolates --- p.67 / Chapter 4.2. --- Epidemiology of Plasmid-mediated Quinolone Resistance (qnr) Genes --- p.69 / Chapter 4.3. --- Genotypes of qnr-positive Isolates --- p.72 / Chapter 4.4. --- Antimicrobial Susceptibility of qnr-positive Isolates --- p.75 / Chapter 4.5. --- "The Associations of qnr Genes with Other Bacterial Resistance Genotypes, and the Clinical Characteristics of Patients" --- p.79 / Chapter 4.6. --- "The Associations of Mortality with qnr Genes, Bacterial Resistance Genotypes and Other Clinical Characteristics of Patients" --- p.80 / Chapter 4.7. --- Clinical Importance and Clinical Implications of qnr Genes --- p.82 / Chapter 4.8. --- Limitations of the Current Study --- p.85 / Chapter 4.9. --- Future Studies --- p.87 / Chapter 4.10. --- Conclusions --- p.89 / References --- p.90

Hospital readmission is prevalent among people with chronic obstructive pulmonary disease (COPD), particularly among older people in Hong Kong. Evidence shows that hospital readmissions exert a considerable impact on patients. Studies in this area primarily identify various associative factors based on the perspectives of health professionals. However, these factors are inadequate in illustrating the needs of older people and in illuminating the phenomenon of hospital readmissions. A thorough understanding of the issue can be achieved if the related experiences are interpreted from the perspective of the patients and in terms of their context. Understanding of their experiences has paramount significance in uncovering the unmet needs of patients and in informing the provision of healthcare services. Yet, there is a dearth of studies unfolding the experiences of Chinese older people. / This study aimed to explore and describe the lived experience of hospital readmissions of Chinese older people with COPD and to identify Chinese socio-cultural influences on the experience. Understanding was acquired through descriptive phenomenology. Twenty-two Chinese older people aged 62 to 89 were recruited by purposive sampling. They had been readmitted 4 to 14 times in the previous year. The older people were interviewed once during their hospitalization, and their readmission experiences were elicited from these unstructured interviews. Narrative descriptions were analyzed using the phenomenological method described by Giorgi (1985). / The general structure of the lived experience of hospital readmissions of Chinese older people with COPD reveals that older people refrain from unnecessary readmissions because they regard hospital care as the last resort in relieving breathlessness. When their breathlessness becomes intolerable, they perceive the urgency of surviving the distress. Craving for survival, they seek hospital readmission, which provides them immediate relief from the imminent threat. After being readmitted to a hospital, they feel powerless when their need for hospital care is disregarded by their doctors. Considering themselves as demanding to their families in daily lives, older people remain conscious of relieving their burden during their periods of hospital readmission because they regard this as the only opportunity to relieve their burden. Older people come to realize hospital readmissions are unavoidable after they put every effort to refrain from it but hospital care remains necessary. They further rationalize hospital readmissions as inevitable and resign themselves to it because of their perception of aging, doctors’ accounts of COPD, experience with and knowledge of the disease, and belief in fate. This acceptance of the inevitability of hospital readmissions precipitates an attitudinal shift toward the belief of living for the moment. Their past experiences inspire them to be satisfied with the current state of living and engage the present. This positive outlook enables them to embrace the experiences of hospital readmissions into their lives. Six invariant constituents emerged from the lived experience. The constituent “refraining from unnecessary readmissions” describes how older people manage their diseases in relation to hospital readmissions. “Craving for survival” explains why they seek hospital readmissions. “Feeling being disregarded and powerless” and “being conscious of relieving burden to families” characterize their experience of hospital readmissions. “Resigning to hospital readmissions” illustrates how they understand the recurrence of this phenomenon and “living for the moment” illuminates how they live with their experiences. / A deep understanding of hospital readmissions is embodied in the experiences of older people. The findings emphasize that hospital readmissions among Chinese older people are complex experiences shaped by their sociocultural context. The meanings of hospital readmissions to older people are influenced by their assumption of a submissive patient role, collectivism, external attribution style, and past life experiences. Although older people appear to accept and cope well with hospital readmissions, this study uncovers their needs as they move to and fro the hospital and home. The findings of this study offer implications in promoting the wellness of Chinese older people as they go through this revolving door. / 再次住院在患有慢性阻塞性肺病人士中相當普遍，尤其是在中國老年患者。研究證據顯示再次住院對病人有很大的影響。現有的研究偏重於從醫務人員角度尋找不同的關聯因素，但該些因素並不足以反映老年人的需要以及解釋再次住院的現象。只有透過病人的觀點以及結合他們的背景來闡釋這些相關經驗，才能作出深入了解。了解病人的再次住院經驗有助於找出病人的需要以及指引醫療服務的提供。然而，有關中國老年人再次住院經驗的探討相當缺乏。 / 是次研究目的是探討和描述患有慢性阻塞性肺病的中國老年人再次住院的體驗，以及認識中國社會文化對再次住院經驗的影響。研究採用描述現象學方法。研究以立意抽樣方式選取了22名62至89歲的中國老年人。他們在去年入院次數為4至14次。這些老年人在住院期間均接受一次非結構式訪談以了解他們的再次住院經驗。這些敘述性描寫再按 Giorgi (1985) 的現象學方法作出分析。 / 患有慢性阻塞性肺病中國老年人再次住院的體驗的通用結構顯示他們避免不必要的再次住院，因為他們將住院護理視為紓緩呼吸困難的最後方法。當他們的呼吸困難惡化至無法忍受，他們會感受到從危病中活下來的迫切性。因著渴望生存的意識，他們尋求再次住院以即時消除緊迫的生命威脅。再次入院後，對於醫生漠視其住院護理的需要，他們感到無力。由於考慮到他們在日常生活中對家人的需求頗多，老年人以再次住院其間來減輕家庭負擔，因他們視這其間為唯一能減輕家庭負擔的機會。儘管老年人盡能力以避免再次入院，但他們依然需要住院護理，老年人逐漸意識到再次住院為無可避免。由於老年人對於老化的感知、醫生對慢性阻塞性肺病的解明、患病經驗和對疾病的相關知識以及相信命運的看法，他們更將再次住院合理化為無可避免並順從。接受再次住院為無可避免促成他們的態度轉變為活在當下。過去的經驗令他們對目前的生活感到滿意並希望活在當下。這個正面想法令他們將再次住院接納為生活的一部份。六個不變組成要素呈現於老年人的再次住院體驗當中。組成要素「避免不必要的再次住院」描述老年人如何管理慢性阻塞性肺病以避免再次住院。「渴望生存」解釋了他們尋求再次住院的原因。「感到被忽略和無力」以及「減輕家庭負擔的意識」敘述了他們再次住院的經驗。「順從再次住院」說明了他們對再次住院現象發生的理解，而「活在當下」說明了他們如何接納再次住院經驗。 / 對於再次住院的深入了解具體表現於老年人的經驗當中。是次研究結果強調，老年人再次住院是由他們的社會文化背景塑造而成的複雜經驗。對於老年人而言，再次住院的意義受到他們對順從性病人角色的假設、集體主義觀念、外部歸因以及過往的生活經驗所影響。雖然老年人似乎接受並適應再次住院，是次研究發現了他們在這現象中的需要。研究結果對於促進再次住院的中國老年人的健康帶來新的啟示。 / Tang, Wing Ki. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2015. / Includes bibliographical references (leaves 342-393). / Abstracts also in Chinese. / Title from PDF title page (viewed on 05, October, 2016). / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.

Wong, Mei Fung Florence. / Thesis (D.Nurs.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 178-208). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

隨著高效能抗病毒藥物治療的推出，愛滋病病患者的不良健康狀況得以逆轉。愛滋病病毒感染已不再是無藥可治的絶症，而是一種需要終生服藥的慢性疾病。但是，藥物的出現並未減輕疾病本身對病患者的心理健康打擊，例如被社會歧視，而藥物的副作用則被大量發現，藥物治療的進步並不一定能改善病患者的生活質素，而監測患者的生活質素便成為必要。但是，目前供病患者所使用的生活質素量表，均於推出高效能抗病毒藥物治療前或不久後發展而成，並在西方國家使用，因此，此項研究的目的是要發展和確認一份與本土文化和環境背景相關的生活質素量表，供香港的華藉愛滋病病毒感染者和病患者所使用。 / 此研究項目共分為三個階段。第一階段集中於項目產生，以質性研究方法探討愛滋病病毒感染者和病患者對生活質素含義和組成內容的看法。此階段共招募了36位參與者(30男、6女)進行面對面的單獨訪問。以主題分析方法，找出了10個生活質素的類別及65個項目，並以它們為藍本構成量表的項目庫。項目庫的表面效度和全面性經參與者的確認後，新的生活質素量表CHAQOL才成立。 / 第二階段集中於項目删減。此階段以統計方法為主導，删減多餘和缺乏一貫性的項目。從168位參與者的數據分析所得，保留40個項目便能使新量表達致最理想的內部結構和項目的一致性和變異性，結果並顯示香港華藉愛滋病病毒感染者和病患者的生活質素由六個因素模型構成，這包括：「生活滿意度」、「情緒健康」、「身體健康」、「羞辱和歧視」、「親密關係」和「抗病毒治療的信念」。 / 第三階段集中測試CHAQOL量表的心理計量特質，此階段新招募了239位參與者，再測試可信度的初試和複試相隔兩週進行，分析結果顯示，40個項目的加權卡帕係數為0.46至0.93，在六個範圍組內的相關係數為0.82至0.97。至於內部一致性可信度，克隆巴赫係數為0.63至0.93。這些結果皆顯露CHAQOL量表是可信的。至於效度方面，驗證性因素檢測結果支持CHAQOL量表是由六個因素模型構成的，而多項特質排列檢驗分析結果亦顯示CHAQOL量表有良好的項目會聚性，其在六個範圍組內的會聚成功率為75%至100%，與此同時，CHAQOL量表內的所有範圍組內的區分成功率為71%至100%，只有「情緒健康」範疇得到較不理想的區分成功率。CHAQOL量表在區分已知有差異組別上的表現良好，六個構成量表的範疇均能區分有不同臨床特徵的病患者的主觀感受，這包括病情、病徵和藥物治療副作用的嚴重程度。已被確認有效度的通用生活質素量表WHQOOL-BREF和HIV Stigma量表的子量表被用作檢測CHAQOL量表的同時效度，檢測結果顯示較強至中等強度的相關性只存在於CHAQOL量表的「滿意生活度」、「情緒健康」、「身體健康」的三個範疇和WHQOOL-BREF量表內的各個範疇，但不存在於CHAQOL量表內的餘下範疇，而類似的最強相關性關係也存在於HIV Stigma量表的子量表和CHAQOL量表內的「羞辱和歧視」範疇。總括來說，測試結果提供初步科學證據支持CHAQOL量表的信度和效度。 / With the introduction of highly active antiretroviral therapy (HAART), the health status of patients with acquired immune deficiency syndrome (AIDS) becomes reversible. The human immunodeficiency virus (HIV) infection is no longer an incurable fatal disease, but a chronic disease that requires lifelong treatment. However, the emergence of HAART does not lessen the detrimental impact of the disease on the psychosocial well-being of patients, such as the effect of social stigmatization. The side effects of HAART are also well documented. Therefore, the advancement in treatment not necessarily improves the quality of life (QOL) of patients and monitoring patients’ QOL becomes crucial. Nevertheless, existing QOL measures specifically for HIV/AIDS patients were developed either before or shortly after HAART, which were used in Western countries. Therefore, the aim of this study is to develop and validate a culturally and contextually relevant QOL measure for the Chinese people living with HIV/AIDS in Hong Kong (HK). / This study comprised three phases. Phase One focused on generating items for the QOL measure. Qualitative research methodology was adopted to explore the meaning and constituents of QOL from the perspective of HIV/AIDS patients. Thirty-six (30 male, 6 female) participants were recruited for face-to-face individual interviews. Using thematic analysis, 10 QOL categories were identified, and 65 items were devised to form an item pool. The face validity and comprehensiveness of the item pool was affirmed by the participants. The initial draft of new measure, named CHAQOL, was thus established. / Phase Two focused on item reduction. A statistically driven approach was adopted to eliminate any psychometrically redundant and incoherent items. Based on the data collected from 168 participants, 40 items were retained to give the optimal internal structure and item consistency and variability. This initial version suggested a six-factor model of QOL for the Chinese people living with HIV/AIDS of HK. The six factors are: "life satisfaction", "emotional well-being", "physical well-being", "stigma and discrimination", "intimate relationships", and "belief in antiretroviral therapy" (ART). / Phase Three focused on testing the psychometric properties of the CHAQOL. Another sample of 239 HIV/AIDS participants was recruited. The test and retest conducted two weeks apart. The weighted kappa values of 40 items ranged between 0.46 and 0.93 whereas the intraclass correlation coefficients of six QOL dimensions ranged between 0.82 and 0.97. For the internal consistency, Cronbach’s alpha ranged from 0.63 to 0.93. The results demonstrated CHAQOL to be reliable. In the evaluation of construct validity, the results of confirmatory factor analysis supported the six-factor model underlying CHAQOL. Multitrait scaling analysis showed that CHAQOL had good item convergent success rate ranging from 75% to 100% for the six subscales. All subscales of the CHAQOL, except the emotional well-being, had good item discriminant validity with an item discriminant success rate ranging from 71% to 100%. Known-group comparison indicated that the CHAQOL was able to distinguish the differences in all six QOL dimensions between Chinese HIV-infected people with different levels of disease severity, symptom severity and severity of ART-related side effects. The validated generic measure WHOQOL-BREF (HK) and the HIV Stigma subscale were used to examine the concurrent validity with the CHAQOL. Strong-to-moderate correlations were found only between the CHAQOL dimensions “life satisfaction, “emotional well-being, and “physical well-being, as well as the domains of WHOQOL-BREF (HK), but not for the remaining dimensions. Similarly, strongest correlations were found between the CHAQOL subscales “stigma and discrimination and the HIV stigma subscale. The results provide evidence on the reliability and validity of the CHAQOL. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Ho, Choi Fung. / "December 2012." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 244-272). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese; appendixes includes Chinese. / List of Tables --- p.xviii / List of Figures --- p.xx / List of abbreviations --- p.xxi / List of APPENDICES --- p.xxii / Chapter Chapter 1 --- Introduction / Study Background --- p.1 / Epidemiological Background of HIV Infection --- p.3 / Overview on HIV/AIDS and Its Treatment --- p.4 / Pathogenesis --- p.4 / Disease Trajectory --- p.4 / HAART --- p.6 / Effects of HIV Infection on QOL --- p.6 / Role of Nurses in Enhancing QOL of HIV/AIDS Patients in HK --- p.8 / Aim of the Study --- p.9 / Significance of the Study --- p.9 / Chapter Chapter 2 --- Literature Review / Literature Search Strategy --- p.10 / Conceptualization and Measurement of Quality of Life (QOL) --- p.12 / QOL Concept Applied to Health Care --- p.12 / Attributes of QOL --- p.13 / Subjective construct --- p.15 / Objective indicators and proxy assessment --- p.16 / Cultural-specific and dynamic in nature --- p.17 / Multidimensional --- p.19 / Definition of QOL for health care practice. . --- p.21 / QOL Dimensions of People Living with HIV/AIDS --- p.22 / Physical Dimension --- p.23 / Overview on CD4 cell count and HIV disease stage --- p.24 / CD4 cell count --- p.24 / HIV disease stage --- p.25 / HIV-related symptoms in relation to physical health --- p.25 / CD4 cell count and disease stage in relation to physical health --- p.27 / HAART-related symptoms in relation to physical health --- p.28 / Psychological Dimension --- p.30 / Identity and adjustment --- p.30 / Uncertainty in treatment and disease outcomes --- p.32 / Psychological symptoms --- p.33 / Social Dimension --- p.35 / HIV-related stigma and discrimination --- p.36 / Outcomes of HIV disclosure on social and family relationships --- p.37 / Sexual Dimension --- p.40 / Spiritual Dimension --- p.42 / Summary on QOL Dimensions of People Living with HIV/AIDS --- p.43 / Evaluation of QOL --- p.45 / Property Requirements for Quantitative QOL Measures . --- p.46 / A Review of Generic Measures --- p.48 / MOS SF-36 --- p.48 / WHOQOL-BREF --- p.49 / Critique on generic measures --- p.50 / A Review of Disease-specific Measures --- p.51 / MOS-HIV --- p.54 / HOPES --- p.55 / FAHI --- p.56 / MQOL-HIV --- p.57 / HAT-QOL --- p.58 / Critique on disease-specific measures --- p.59 / Summary of Literature Review --- p.60 / Chapter Chapter 3 --- Methods / Operational Definitions --- p.63 / Aim of the Study --- p.64 / Study Design --- p.64 / Setting --- p.64 / Inclusion and Exclusion Criteria of the Sample --- p.66 / Phase One --- p.66 / Sampling Plan and Sample Size --- p.67 / Data Collection --- p.70 / Interview guide --- p.70 / Pilot study --- p.71 / Data Analysis --- p.72 / First: Familiarizing with the data --- p.72 / Second: Extracting initial codes --- p.72 / Third: Generating themes --- p.73 / Fourth: Reviewing the themes --- p.73 / Fifth: Defining and naming themes --- p.73 / Sixth: Comparing differences and similarities between groups --- p.74 / Measures to Ensure Rigour --- p.74 / First: Truth value and applicability --- p.75 / Second: Consistency --- p.75 / Third: Neutrality --- p.76 / Initial Draft of CHAQOL --- p.76 / Phase Two --- p.78 / Sampling Plan and Sample Size --- p.78 / Data Collection --- p.81 / Data Analysis --- p.82 / Revision and Scoring Method of CHAQOL --- p.84 / Phase Three --- p.86 / Main Study --- p.87 / Sampling plan --- p.87 / Sample size for the main study --- p.89 / Data Collection --- p.92 / Translation of the HIV Stigma Subscale --- p.94 / Data Analysis --- p.95 / Retest --- p.97 / Sampling size --- p.98 / Data Analysis --- p.98 / Ethical Consideration --- p.99 / Chapter Chapter 4 --- Findings Phase One of the Study / Introduction --- p.101 / Individual Interview --- p.102 / Demographic and Clinical Characteristics of Participants --- p.102 / Categories and Subcategories Identified in Phase One --- p.105 / Category: Perceptions of HIV Infection --- p.107 / First subcategory: threat of getting an incurable disease . --- p.107 / Second subcategory: worry about transmitting the disease to other people --- p.108 / Third subcategory: losing control over many things in life. --- p.108 / Fourth subcategory: having no future --- p.108 / Fifth subcategory: becoming a patient --- p.109 / Category: Adaptation and Coping --- p.109 / First subcategory: initial negative feelings --- p.110 / Second subcategory: confidence in overcoming difficulties --- p.110 / Third subcategory: acceptance of living with HIV --- p.111 / Fourth subcategory: letting negative feelings go --- p.111 / Fifth subcategory: thinking optimistically --- p.112 / Six subcategory: maintaining a calm and peaceful state of mind --- p.112 / Category: Perceptions of Physical Health --- p.113 / First subcategory: experiences of fatigue --- p.113 / Second subcategory: decline in physical strength --- p.113 / Third subcategory: satisfaction with present health status --- p.114 / Fourth subcategory: ability to maintain physical health --- p.114 / Fifth subcategory: worry about future health --- p.115 / Category: HIV Care Services --- p.115 / First subcategory: support from health care workers --- p.115 / Second subcategory: difficulties in scheduling regular follow-up --- p.116 / Category: Experiences in Stigma and Discrimination --- p.116 / First subcategory: worry about being regarded as shameful --- p.117 / Second subcategory: worry about being discriminated against --- p.117 / Third subcategory: worry about being estranged --- p.117 / Fourth subcategory: experiences in secrecy --- p.118 / Category: Experiences of ART --- p.118 / First subcategory: improving health status --- p.119 / Second subcategory: spoiling my appearance --- p.119 / Third subcategory: readiness for lifelong ART --- p.120 / Fourth subcategory: causing inconvenience to daily life --- p.120 / Fifth subcategory: tolerability of the side effects --- p.120 / Category: Effects of HIV on Family and Social Relationships --- p.121 / First subcategory: having a warm family --- p.121 / Second subcategory: having a regular intimate partner/spouse --- p.122 / Third subcategory: ability to take care of my family --- p.122 / Fourth subcategory: ability to maintain social relationships --- p.123 / Category: Perceptions of Sexual Relationships --- p.123 / First subcategory: avoidance of sexual activities --- p.124 / Second subcategory: satisfaction with present sexual life . --- p.124 / Category: Career and Financial Concerns --- p.125 / First subcategory: effect of HIV on my career --- p.125 / Second subcategory: having enough money to maintain my living standard --- p.125 / Third subcategory: worry about my living expenses for the future --- p.126 / Category: Pleasure and Contentment --- p.126 / First subcategory: living in preferred ways --- p.127 / Second subcategory: being able to do enjoyable things --- p.127 / Third subcategory: having somebody to share the happiness and sorrow --- p.127 / Fourth subcategory: sense of contentment --- p.128 / Comparisons of Similarities and Differences of Findings Identified by Different Groups of Participants --- p.129 / Comparing the Key Descriptions --- p.130 / First: male versus female --- p.130 / Second: those aged less than 40 years versus those aged 40 years or above --- p.131 / Third: AIDS patient versus non-AIDS patient --- p.131 / Comparing the Categories and Subcategories --- p.132 / Initial Draft of CHAQOL --- p.133 / Forming of Item Pool --- p.133 / Face Validity and Pilot Test of CHAQOL --- p.136 / First: verification of the importance of CHAQOL Items --- p.137 / Second: pilot test of the CHAQOL --- p.140 / Third: feedback and comments on CHAQOL --- p.143 / Summary --- p.144 / Chapter Chapter 5 --- Results Phase Two of the Study / Introduction --- p.145 / Phase Two of the Study --- p.146 / Demographic and Clinical Characteristics of Participants --- p.148 / Pattern of Missing Data --- p.150 / Item Reduction --- p.153 / First: Exploratory Factor Analysis --- p.153 / Second: Internal Consistency Analysis --- p.161 / Third: Variability Analysis --- p.165 / Fourth: feedback of participants --- p.168 / Summary --- p.168 / Chapter Chapter 6 --- Results Phase Three of the Study / Introduction --- p.170 / Pilot Study --- p.171 / Phase Three of the Study --- p.173 / Demographic and Clinical Characteristics of the Participants --- p.175 / DH versus HA Participants --- p.177 / Sample versus Study Population of DH Clinic --- p.177 / Psychometric Properties of CHAQOL --- p.179 / Variation and Missing Response --- p.179 / Results of all participants --- p.179 / Results of subgroup analysis --- p.183 / Subscale Score Distributions and Internal Consistency --- p.186 / Test and Retest Reliability --- p.189 / Item Convergent and Discriminant Validities --- p.191 / Confirmatory Factor Analysis --- p.199 / Concurrent Validity --- p.202 / Known-group Comparisons --- p.204 / Summary --- p.208 / Chapter Chapter 7 --- Discussion / Introduction --- p.211 / Perception of QOL among Chinese People Living with HIV/AID --- p.211 / Dynamic Nature --- p.212 / Cultural Specificity --- p.213 / Spirituality and emotional well-being --- p.214 / Intimate relationship --- p.215 / Stigma and discrimination --- p.216 / Comparing the QOL Dimensions of CHAQOL with Existing Commonly Used QOL Measures --- p.218 / Psychometric Properties of CHAQOL --- p.221 / Adequacy of the Coverage of Items --- p.221 / Item generation --- p.221 / Item reduction --- p.222 / Evidence for Reliability --- p.223 / Test and retest stability --- p.223 / Internal Consistency --- p.224 / Evidence for Validity --- p.224 / Confirmatory Factor Analysis --- p.225 / Multitrait scaling analysis --- p.226 / Known-group comparisons --- p.227 / Concurrent validity --- p.228 / Item Variation and Missing Response --- p.229 / Item Variability --- p.229 / Missing Response --- p.230 / Representativeness of Samples --- p.231 / Limitations of the Study --- p.234 / Conclusion --- p.236 / Chapter Chapter 8 --- Introduction / Implications to the Nursing Practice --- p.237 / Recommendations for Future Studies --- p.239 / Overall Conclusion --- p.242 / Reference --- p.244 / Appendices --- p.273