Thesis (M.S. in human nutrition)--Washington State University, December 2009. / Title from PDF title page (viewed on Feb. 11, 2010). "Program in Nutrition and Exercise Metabolism." Includes bibliographical references.

Thesis (Ph. D.)--University of Texas at Austin, 2002. / Vita. Includes bibliographical references.

Thesis (Ph. D.)--University of Texas at Austin, 2001. / Vita. Includes bibliographical references (leaves 255-293). Available also in a digital version from Dissertation Abstracts.

Age-related macular degeneration (AMD) causes vision impairment which is not recoverable under existing treatment options. It has been a major leading cause of blindness in the aged population. To ameliorate the self-care ability for AMD patients, educational interventions to mediate negative impacts of the disease on quality of life have become a research interest. Current practice in the proposed Hong Kong setting, Elderly Health Centre A and Elderly Health Centre B, depends on nurses giving general advice which is lack of scientific support and non-specific to AMD. Purpose of this dissertation is to translate the best evidence to practice for improving the care of older adults with AMD in the proposed setting. Evidences showed that self-management education programmes were effective in improving emotional distress and self-efficacy. Electronic searches located 9 relevant RCTs of high level and methodologically strong evidences. Data was extracted into tables of evidence. Data summary and synthesis was presented. Assessment on the implementation potential indicated that the SEP was worth to try in the local setting. Twelve recommendations for the practice guidelines of SEP were presented and a communication process to facilitate the change in a top-down approach was introduced. A pilot study plan in Centre A followed by a main study in Centre A and Centre B was presented. A total of 98 elderly patients with AMD will be recruited as 10 SEP groups. Approximately 1.8 years will be used to finish the main study. Outcomes will be measured at the 6th week follow-up. ‘Emotional distress’ will be measured as primary outcome and ‘self-efficacy’ will be measured as secondary outcome. ‘Client satisfaction’, ‘staff satisfaction’ and the ‘utilization rate of the innovation’ will also be assessed in evaluation. A two-tailed paired (one-sample) t-test will be adopted for analysis, with a 95% confidence interval. The basis for effectiveness for the outcome measurements and basis for adoption of the clinical guidelines were stated. Adoption of the developed guidelines in the local setting will optimistically improve the substantial clinical outcomes for AMD patients, mediating the negative impacts of vision impairment or vision loss on their quality of life. / published_or_final_version / Nursing Studies / Master / Master of Nursing

With ageing population in Hong Kong, the prevalence of osteoarthritis is expected to be increasing. The most common type of osteoarthritis is osteoarthritis of knee. Osteoarthritis adversely affects physical activities, social activities and quality of life. It causes socioeconomic burdens and has become a more prominent public health issue in Hong Kong. Self-management of this irreversible health problem in the daily living is crucial to those elders suffering from osteoarthritis. However, no evidence-based guidelines on self-management education for elders with knee osteoarthritis have been formed. The objectives of this paper are to review literatures on the effectiveness of self-management program and to formulate evidence-based guidelines on self-management education for Chinese older adults with knee osteoarthritis. The literature review showed that self-management program was an effective measure to improve self-efficacy for self-management and to reduce pain among the elders with knee osteoarthritis. The assessment on the implementation potential of the self-management program showed that self-management program could be transferred to the community-dwelling Chinese elders with knee osteoarthritis and was found to be feasible for implementation in Elderly Health Centers in Hong Kong. The benefits of self-management program outweigh the costs for the implementation of such a program. The proposed self-management program would mainly provide the elders with the self-management skills, osteoarthritis related information and exercise practice in group sessions. There would also be follow-up telephone coaching. Guidelines for implementing the proposed self-management program are shown in this thesis. Implementation plan was formulated to propose communication strategies to initiate and sustain the implementation of the proposed self-management program. Pilot test was designed to test the feasibility of the program. Evaluation plan was developed to evaluate the effectiveness of the program in improving self-efficacy for self-management and reducing osteoarthritis pain for Chinese older adults with knee osteoarthritis. In sum, self-management program was found to be effective in improving self-efficacy for self-management and reducing pain among the elders with knee osteoarthritis. The guidelines on the proposed self-management program could support the evidence-based self-management education for Chinese older adults with knee osteoarthritis in Hong Kong. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Physical inactivity has been widely regarded as a leading cause of non-communicable chronic diseases such as type 2 diabetes mellitus (T2DM) and hypertension. Physical activity (PA) has been shown to be the most effective self-care behaviour in alleviating T2DM, an incurable chronic disease. Previous behavioural modification programs intended to encourage and maintain PA behaviour among middle-aged and older patients with T2DM have had inconsistent results. PA has remained as a recommended diabetes self-care behaviour with the lowest compliance rate in many regions of the world. This thesis proposes a program focusing on health literacy (HL) as a means to nurture T2DM patients’ ability to navigate, read, understand, process, comprehend and act on health information, and thereby modify PA behaviour. This approach is proposed for three reasons: (1) the flood of available health information of varying quality affects patients’ decision making with regard to self-care behaviour; (2) the high prevalence of low HL in the US, Europe, and Asia affects the comprehension of self-care behaviour programs; (3) because 50% of older T2DM patients are impaired cognitively due to the impact of aging and hence have difficulty in carrying out suitable self-care behaviour without proper guidance. All of these factors can influence the effectiveness of PA behavioural modification programs designed to help middle-aged and older T2DM patients make self-care decisions based on sound health information according to their level of HL. This thesis reviews existing HL-oriented programs and models and validates the instrument used to examine the effects of a culture-, language-, disease- and age-specific, theory-based, HL-oriented program on PA behaviour among middle-aged and older patients with T2DM. In the study, 324 middle-aged and older Chinese T2DM patients recruited from two hospital diabetes centres in Hong Kong were divided randomly into intervention and control groups. The intervention group participated in an HL-oriented program on PA behaviour. The program significantly improved the mean of PA behaviour of patients in the intervention group from a sedentary level (under 1,000 average Metabolic Equivalents/minutes/week; 4463 mean number of steps per week) to an internationally acceptable standard (over 2,000 average METs-minutes/week; 7459 mean number of steps per week), and this improvement was maintained at three- and six-month follow-ups. The PA behaviour of the control group actually subsided. This study showed that a program addressing and nurturing patients’ ability to explore, understand and manage health information on T2DM and PA was effective in improving the PA behaviour of middle-aged and older adults with T2DM. This thesis is the first study to use objective measurements to evaluate the effect of a culture-, language-, disease- and age-specific, theory-based, HL-oriented program on PA behaviour. It extends the generalizability of culture and language-sensitive HL oriented programming from the United States (where previous HL studies were conducted) to China. The study can serve as a model for future investigations of self-care behaviour among patients with different chronic illnesses in various regions of China. / published_or_final_version / Nursing Studies / Doctoral / Doctor of Philosophy

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Thesis (Ph. D.)--University of Missouri-Columbia, 2004. / Typescript. Vita. Includes bibliographical references. Also available on the Internet.

Thesis (Ph. D.)--Ohio State University, 2004. / Title from first page of PDF file. Document formatted into pages; contains 27 p. Includes bibliographical references (p. 21-24). Available online via Ohio State University's Knowledge Bank.

Thesis (Ph. D.)--University of Missouri-Columbia, 2004. / Typescript. Vita. Includes bibliographical references. Also available on the Internet.