published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder that brings physical and psychological turmoil to patients. Neuropsychiatric (NP) involvement in SLE also complicates disease management compared with non-NP SLE. The joint pain caused by the dysfunctional inflammatory response, as well as the negative mood induced by the disease have been found to predict the patients’ quality of life. The primary goal of this study is to examine the mediation effect of negative mood on the relationship between pain and quality of life in patients with SLE based on a biopsychosocial approach. Results revealed that negative mood partially mediated the relationship between pain and the physical aspect of quality of life. On the other hand, negative mood completely mediated the relationship between pain and psychological health. The mediation relationship lends support to the biopsychosocial perspective that physical distress, psychological state, and one’s adaptive functioning are closely related. The secondary goal of this study is to explore the effect of NP involvement in patients with SLE on self-report variables, including perceived pain intensity, negative mood, fatigue, sleep quality, perceived cognitive difficulties, and quality of life in comparison with patients with non-NP SLE as well as with healthy controls. / published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

Objectives: To investigate the influences of dental treatment on change in oral health-related quality of life (OHQoL) among older adults, an instrument to measure oral health impacts on daily living (OHIDL) and the change in the impact after dental treatment was developed and validated. Methods: A qualitative study was conducted among older adults aged 55+ years. Information on their perceived oral health impacts was collected through semi-structured interview. The dimensions of OHIDL and the relevant items were identified through thematic framework approach. The OHIDL measured oral health impacts with intensity and bother measurements and the change in oral health impacts was assessed through transition scale. OHIDL was administrated through face-to-face interviews to older adults who attended dental clinics for general dental treatments at baseline and 1-3 months after the treatment. Construct validity was assessed through convergent, divergent and factorial validity. Criterion and longitudinal validity were investigated through assessing the correlation between the measurements and the global questions. Reliability was assessed through Cronbach’s α and test-retest correlation respectively. The relationships between oral health problems, perceived oral health impacts, dental treatment received, and change in the impacts were explored. Linear regression model was used to investigate the treatment effect in changing OHQoL. Results: In the qualitative study, 22 women and 17 men were interviewed (mean age: 72 years). Twenty items were generated and classified into seven domains: Cleansing, Eating, Speaking, Appearance, Social, Psychological, and Health & Finance. In the quantitative study, 306 subjects (mean age: 70 years) completed the interviews at baseline. Three items with over 90% of the subjects reported no impact and two items with poor discriminant validity (100% scaling error) were eliminated. Both intensity and bother measurements demonstrated good construct and criterion validity with the intensity measurement showing better performance and was selected in the OHIDL to reduce the respondents’ burden. At the follow-up evaluation, 56 subjects without receiving any treatment were excluded and 176 subjects were re-interviewed after the dental treatment. The transition scale showed good longitudinal validity. The Cronbach’s α coefficient of the intensity and transition measurements were 0.88 and 0.87, respectively. The test-retest correlation for each item as measured by intensity and transition measurement ranged from 0.35 to 1.00 and 0.28 to 0.998, respectively. Compared to baseline, the mean number of oral health problems was significantly decreased from 4.80 to 2.73 (p < 0.05). Most of the subjects rated the overall perceived oral health impacts as improved (58%), the total transition score ranged from -11 to 39 with a mean value of 4.79 (SD = 8.02), which was over the threshold of MCID (3.3). Patients who perceived more oral health impacts at baseline and had received endodontic treatment had more improvement in the perceived oral health impacts. Conclusion: OHIDL is valid and reliable in measuring the oral health impacts on daily life and the change of the impacts after dental treatment. In this study, after receiving dental treatment, older adults perceived fewer oral health problems and positive change in the oral health impacts on daily living. / published_or_final_version / Dentistry / Doctoral / Doctor of Philosophy

This study examined the effectiveness of a hope-based intervention on hope, subjective well-being, goal attainment and degree of goal internalization in a sample of primary 6 students from Hong Kong. Participants were randomly assigned to either intervention condition or control condition. Results from ANCOVAs suggested that there were no main intervention effects on hope and on goal attainment. However, participants benefited from internalizing their self-set goal in the intervention. Concerning the intervention effect on subjective well-being, significant interaction was found. Consistent with the dynamical systems model, regression analyses demonstrated that participants with high initial pleasant affect was more responsive to the intervention and benefited the most in terms of latter pleasant affect. In addition, it was found that goal attainment was significantly associated with subjective well-being and hopeful thinking. Possible explanations for the inconsistent findings with previous studies are provided. Implications for future research on hope-based intervention are also discussed. / published_or_final_version / Educational Psychology / Master / Master of Social Sciences

Background Insomnia is a common and increasing illness among general population all over the world. With insomnia, patients would more likely to have physical, social dysfunction and mood disorders, and even have increased risk of accidents. Therefore, identifying the harm of insomnia and improving the quality of life of patients are very important. Objectives The objective of this systematic review is to evaluate quality of life in patients affected with insomnia. Particularly focuses on the following two question: 1) How insomnia impact quality of life in patients with insomnia. 2) What factors affect quality of life among people with insomnia, such as demographic factors, physical and psychological factors. Methods Systematic reviewing the articles from 1990 to 2013 in PubMed and Medline, which evaluated the quality of life in patients affected with insomnia, using the keywords “insomnia” AND “quality of life”. Results and Discussion There were 9 articles have been included in this review. The year were ranged from 1998 to 2012,8 out of 9 papers had the average age ranged from 42-57 year old. Insomnia significantly related to all of the eight domains and PCS,MCS of QOL negatively, and both of the severity of insomnia and the number of sleep problems have negative impact on QOL. Moreover, regarding the factors which affect QOL of patients, older, female, not married, smoking, drinking, psychiatric disorders and without treatment were associated with lower QOL. Furthermore, regarding the future directions, in Hong Kong the application of the results in this review is appropriate but still need more studies which evaluating the associated factors of insomniacs’ QOL with validated Chinese version QOL measures. Conclusion There was a negative relationship between insomnia and quality of life, and the severity of insomnia and the number of sleep problems had negative impact on quality of life. Particularly, older, female, single statuse, smoking, drinking, psychiatric disorders had negative influence on patients’s QOL. Regarding the control strategies, using appropriate medical treatment under physician guidance, consultation of mental disorders, increasing the public awareness of the harm of insomnia play a pivotal role in reduce the impairment of insomnia. / published_or_final_version / Public Health / Master / Master of Public Health

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This study explored the effects of the Canterbury earthquakes of 2010 and 2011 on different areas of quality of life (QOL) for children and adolescents with disabilities. Using a survey developed from the Quality of Life Instrument for People with Developmental Disabilities – Short Version (QOL-PDD-SV) (Brown, Raphael & Renwick, 1997) and The World Health Organisation Quality of Life - (WHOQOL)-BREF, parents or caregivers were asked to identify what level of importance and satisfaction their child or adolescent placed on areas of QOL including physical health, psychological health - stress levels and coping ability, attachment to their neighbourhood, friends, family, leisure activities, community access and schooling. They were also asked to determine what level of impact the earthquakes had had on each area of their child or adolescent’s life and overall quality of life in the aftermath of the earthquakes. A total of 31 parents of 22 males and 9 females between the ages of 2.5 years to 19 years of age (mean age: 12.6 years) responded. The results were collated and analysis was run to measure for the effect of age, gender and geographical location. The results found that the earthquakes affected nearly every area of QOL for the children and adolescents. The biggest impact on the children’s psychological health and their ability to cope It was observed that younger children (<13) were more likely to record improved or lessened effects from the earthquakes in psychological health areas. However, the areas of social belonging and friendships were the least affected by the earthquakes. Female children were more likely to indicate higher scores for social belonging after the earthquakes. Many parents observed that their children developed improved coping skills over the earthquake period. The findings in this study offer a better understanding of how earthquakes can affect the quality of life children and adolescents with disabilities.

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