Diana T F Lee

The Chinese University of Hong Kong, Hong Kong, Hong Kong

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Publications (63)131.04 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: AimsThis study investigated the clinical effects of a blood glycaemic control optimization programme (BGCOP) in patients with stress hyperglycaemia post hepatobiliary or pancreatic surgery.Background Stress-induced hyperglycaemia (SHG) can be observed in as high as 75% of critically ill patients, which can induce severe complications or adverse events. However, conventional intensive insulin therapy (CIIT) tends to induce hypoglycaemia and glucose variability.DesignThis study is a randomized, controlled, prospective clinical observation.Methods Eighty-six patients with postoperative SHG were randomly divided into a control and experimental groups. Participants in the control group underwent CIIT, while participants in the experimental group underwent blood glycaemic control optimization programme (BGCOP). A range of 7·8–10·0 mmol/L was designated as the target range for effective control of blood sugar. The validity index, adverse events and complications were compared between two groups.ResultsCompared to participants treated with CIIT, participants treated with BGCOP reached the target range of blood sugar levels more quickly (p = 0·000). The high glycaemic index (p = 0·000), incidence of hypoglycaemia (p = 0·011), and other adverse events as well as the incidence of abdominal infection (p = 0·026), incision infection (p = 0·044), and lung infection (p = 0·047) were significantly lower in participants who underwent the BGCOP than in patients treated with CIIT.ConclusionBGCOP can more effectively control blood sugar levels compared with CIIT in patients with SHG after hepatobiliary or pancreatic surgery.Relevance to clinical practiceThis study provides a direction for blood glycaemic control in patients with stress hyperglycaemia post hepatobiliary or pancreatic surgery.
    Nursing in Critical Care 10/2014; · 0.87 Impact Factor
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    ABSTRACT: Older adults with major chronic illnesses are very susceptible to influenza and its serious complications, but many do not obtain vaccinations. Little is known about factors associated with intention to obtain influenza vaccination among at-risk Chinese older adults in Hong Kong.
    Nursing Research 07/2014; 63(4):270-277. · 1.50 Impact Factor
  • Simon C. Lam, Diana T. F. Lee, Doris S. F. Yu
    Journal of the American Geriatrics Society 03/2014; 62(3). · 4.22 Impact Factor
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    ABSTRACT: To evaluate the sustaining effects of Tai chi Qigong in improving the physiological health for COPD patients at sixth month. A randomized controlled trial. Subjects were in three randomly assigned groups: Tai chi Qigong group, exercise group, and control group. The 206 subjects were recruited from five general outpatient clinics. Tai chi Qigong group completed a 3-month Tai chi Qigong program. Exercise group practiced breathing and walking as an exercise. Control group received usual care. Primary outcomes included six-minute walking distance and lung functions. Secondary outcomes were dyspnea and fatigue levels, number of exacerbations and hospital admissions. Tai chi Qigong group showed a steady improvement in exercise capacity (P<.001) from baseline to the sixth month. The mean walking distance increased from 298 to 349 meters (+17%). No significant changes were noted in the other two groups. Tai chi Qigong group also showed improvement in lung functions (P<.001). Mean forced expiratory volume in 1s increased from .89 to .99l (+11%). No significant change was noted in the exercise group. Deterioration was found in the control group, with mean volume decreased from .89 to .84l (-5.67%). Significant decreased in the number of exacerbations was observed in the Tai chi Qigong group. No changes in dyspnea and fatigue levels were noted among the three groups. Tai chi Qigong has sustaining effects in improving the physiological health and is a useful and appropriate exercise for COPD patients.
    Complementary therapies in medicine 12/2013; 21(6):585-94. · 1.95 Impact Factor
  • Lai Wah Lam, Diana T F Lee, Ann T Y Shiu
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    ABSTRACT: The nature of end-stage renal disease and the need for continuous ambulatory peritoneal dialysis require patients to manage various aspects of the disease, its symptoms and treatment. After attending a training programme, patients are expected to adhere to the renal therapeutic regimen and manage their disease with the knowledge and skills learned. While patients are the stakeholders of their health and related behaviour, their perceptions of adherence and how they adhere to their renal therapeutic regimen remains unexplored. To understand adherence from patients' perspectives and to describe changes in adherence to a therapeutic regimen among patients undergoing continuous ambulatory peritoneal dialysis. This study used a mixed methods design with two phases - a survey in phase I and semi-structured interviews in phase II. This paper presents phase II of the study. The study was conducted at a renal unit of an acute hospital in Hong Kong. Based on the phase I survey results, maximum variation sampling was employed to purposively recruit 36 participants of different genders (18 males, 18 females), ages (35-76 years), and lengths of dialysis experience (11-103 months) for the phase II interviews. Data were collected by tape-recorded semi-structured interviews. Content analysis was employed to analyse the transcribed data. Data collection and analysis were conducted simultaneously. Adherence was a dynamic process with three stages. At the stage of initial adherence, participants attempted to follow instructions but found that strict persistent adherence was impossible. After the first 2-6 months of dialysis, participants entered the stage of subsequent adherence, when they adopted selective adherence through experimenting, monitoring and making continuous adjustments. The stage of long-term adherence commenced after 3-5 years of dialysis, when participants were able to assimilate the modified therapeutic regimen into everyday life. The process of adherence was dynamic as there were fluctuations at each stage of the participants' adherence. With reference to each stage identified, nursing interventions can be developed to help patients achieve smooth transition throughout all the stages.
    International journal of nursing studies 10/2013; · 1.91 Impact Factor
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    ABSTRACT: Objectives. To evaluate the sustaining effects of Tai Chi Qigong (TCQ) in improving the psychosocial health in chronic obstructive pulmonary disease (COPD) patients in the sixth month. Background. COPD affects both physical and emotional aspects of life. Measures to minimize patients' suffering need to be implemented. Methods. 206 COPD patients were randomly assigned into three groups: TCQ group, exercise group, and control group. The TCQ group completed a three-month TCQ program, the exercise group practiced breathing and walking exercise, and the control group received usual care. Results. Significant group-by-time interactions in quality of life (QOL) using St. George's respiratory questionnaire (P = 0.002) and the perceived social support from friends using multidimensional scale of perceived social support (P = 0.04) were noted. Improvements were observed in the TCQ group only. Conclusions. TCQ has sustaining effects in improving psychosocial health; it is also a useful and appropriate exercise for COPD patients.
    The Scientific World Journal 01/2013; 2013:425082. · 1.22 Impact Factor
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    ABSTRACT: Caregivers of relatives with Alzheimer's disease are highly stressed and at risk for physical and psychiatric conditions. Interventions are usually focused on providing caregivers with knowledge of dementia, skills, and/or support, to help them cope with the stress. This model, though true to a certain extent, ignores how caregiver stress is construed in the first place. Besides burden, caregivers also report rewards, uplifts, and gains, such as a sense of purpose and personal growth. Finding benefits through positive reappraisal may offset the effect of caregiving on caregiver outcomes. Two randomized controlled trials are planned. They are essentially the same except that Trial 1 is a cluster trial (that is, randomization based on groups of participants) whereas in Trial 2, randomization is based on individuals. Participants are randomized into three groups - benefit finding, psychoeducation, and simplified psychoeducation. Participants in each group receive a total of approximately 12 hours of training either in group or individually at home. Booster sessions are provided at around 14 months after the initial treatment. The primary outcomes are caregiver stress (subjective burden, role overload, and cortisol), perceived benefits, subjective health, psychological well-being, and depression. The secondary outcomes are caregiver coping, and behavioral problems and functional impairment of the care-recipient. Outcome measures are obtained at baseline, post-treatment (2 months), and 6, 12, 18 and 30 months. The emphasis on benefits, rather than losses and difficulties, provides a new dimension to the way interventions for caregivers can be conceptualized and delivered. By focusing on the positive, caregivers may be empowered to sustain caregiving efforts in the long term despite the day-to-day challenges. The two parallel trials will provide an assessment of whether the effectiveness of the intervention depends on the mode of delivery. Chinese Clinical Trial Registry (http://www.chictr.org/en/) identifier number ChiCTR-TRC-10000881.
    Trials 07/2012; 13:98. · 2.12 Impact Factor
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    ABSTRACT: Foot and toenail problems are prevalent among older adults. The importance of foot care is often overlooked, however, because the associated problems are often considered to be minor. These "minor" problems often result in unnecessary distress and complications for older adults. This study aims to develop and examine the effects of a foot and toenail care protocol on promoting foot health in older adults. It includes a thorough assessment of foot health, footwear conditions, and specific self-care ability. On the basis of the assessment, an individualized nursing care plan was devised. It has been found that the implementation of the care protocol can help to increase the awareness of nurses and older adults with regard to foot health and that some foot and toenail problems can be identified earlier and better managed.
    Geriatric nursing (New York, N.Y.) 06/2012; · 0.92 Impact Factor
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    ABSTRACT: Compression therapy is not common for venous leg ulcer patients in Hong Kong. This randomized controlled trial compared the clinical effectiveness of compression bandaging using four-layer bandaging (4LB) or short-stretch bandaging (SSB) and usual care (moist wound healing dressing without compression). The 24-week study looked at venous leg ulcer patients aged >60 years in a community setting. The primary parameter was time to ulcer healing. Secondary parameters were ulcer area and pain reduction comparing week 0 (start) vs week 24 (end), measuring results per group and between groups. Intention-to-treat analysis involved descriptive statistics, survival analysis, and repeated measures analysis of variance. The log-rank test was used for univariable analysis. All withdrawn patients had a negative outcome score over the whole study duration. Of 321 patients who received randomized treatment, 45 (14%) did not complete the 24-week study period. At 24 weeks, Kaplan-Meier analysis on healing time was statistically significant (P < .001) in favor of the compression groups. The mean (SD) healing time in the SSB group (9.9 [0.77]) was shorter than that of the 4LB group (10.4 [0.80]) and the usual care group (18.3 [0.86]). Pain reduction was significant (P < .001) for the compression-treated groups only. Compression bandaging was more effective than usual care without compression. Both compression systems were safe and feasible for venous ulcer patients in a community setting in Hong Kong.
    Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 03/2012; 55(5):1376-85. · 2.98 Impact Factor
  • Doris S F Yu, Diana T F Lee
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    ABSTRACT: To identify the pattern of somatic presentation of depression among older Chinese by examining the association between medically unexplained somatic symptoms and depression. The population comprised 1433 Chinese 65 years or older recruited from 11 older community centres distributed across the three main territory regions of Hong Kong. Data were collected between January and December 2008, with a response rate of 72.3%. Data on socio-demographic background, medical profile and somatic symptoms were collected. The Mental Health Inventory (five-item) was used for depression screening. Medically unexplained somatic symptoms were defined as those not explained by any known medical pathology. The prevalence of depression among older Chinese was 16.5%. They reported more frequently than did the non-depressed six medically unexplained somatic symptoms. After being adjusted for age, living arrangements, social support, financial strain, major stressful life events and chronic illness, depression was found to be significantly associated with all medically unexplained somatic symptoms (odds ratio: 1.667-2.268). Indeed, depressed older people were more likely to have multiple symptoms than were the non-depressed, the odds ratio increasing from 2.64 (95%CI: 1.884-3.717) for two co-existing symptoms to 4.521 (95%CI: 1.872-10.917) for six symptoms. Older Chinese with depression were more likely to have multiple medically unexplained somatic symptoms, particularly fatigue, insomnia, loss of appetite and gastro-intestinal problems. Health care professionals need to be aware of this pattern of somatization and take active steps to rule out any underlying psychological etiology.
    International Journal of Geriatric Psychiatry 02/2012; 27(2):119-26. · 3.09 Impact Factor
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    Ann T Y Shiu, Diana T F Lee, Janita P C Chau
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    ABSTRACT: This article is a report on a study to explore the development of expanding advanced nursing practice in nurse-led clinics in Hong Kong. Nurse-led clinics serviced by advanced practice nurses, a common international practice, have been adopted in Hong Kong since 1990s. Evaluations consistently show that this practice has good clinical outcomes and contributes to containing healthcare cost. However, similar to the international literature, it remains unclear as to what the elements of good advanced nursing practice are, and which directions Hong Kong should adopt for further development of such practice. A multiple-case study design was adopted with six nurse-led clinics representing three specialties as six case studies, and including two clinics each from continence, diabetes and wound care. Each case had four embedded units of analysis. They included non-participant observation of nursing activities (9 days), nurse interviews (N = 6), doctor interviews (N = 6) and client interviews (N = 12). The data were collected in 2009. Within- and cross-case analyses were conducted. The cross-case analysis demonstrated six elements of good advanced nursing practice in nurse-led clinics, and showed a great potential to expand the practice by reshaping four categories of current boundaries, including community-hospital, wellness-illness, public-private and professional-practice boundaries. From these findings, we suggest a model to advance the scope of advanced nursing practice in nurse-led clinics. The six elements may be applied as audit criteria for evaluation of advanced nursing practice in nurse-led clinics, and the proposed model provides directions for expanding such practice in Hong Kong and beyond.
    Journal of Advanced Nursing 11/2011; 68(8):1780-92. · 1.69 Impact Factor
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    ABSTRACT: To describe the relationship between self-appraised problem-solving abilities and psychological distress, burden and perceived social support in informal, family stroke caregivers. Previous research suggests that self-appraised problem-solving abilities play a significant role in the well-being of family caregivers of patients with chronic illness. However, little is known about its role in caregivers of stroke survivors. Prospective correlational study. One week before discharge, 103 family caregivers of survivors of a first stroke were assessed for their perceived problem-solving abilities, social support, anxiety, depression and physical well-being. At three months postdischarge, 85 of these caregivers (83% retention) were reassessed on the same measures. In addition, their levels of burden and perceived difficulties were also measured. Using multiple regression, overall self-appraised problem-solving abilities and its subscale 'confidence in problem-solving' at one week before discharge were significant predictors of caregiver perceived social support (R(2) = 29%) and perceived physical well-being (R(2) = 42%) at three months postdischarge. Other relationships were non-significant. Caregivers' perceived social support and physical well-being were significantly predicted by confidence in problem-solving. This study is timely given the challenges facing health systems in Hong Kong to effectively manage chronic illness through family-centred care. The significant relationships between caregiver self-appraised problem-solving, perceived social support and well-being suggest that interventions maximising caregiver confidence in problem-solving might be valuable in supporting family caregivers of stroke survivors. Nurses working with families caring for stroke survivors both close to discharge and in the early transition stages back at home may be in an ideal position to offer this support.
    Journal of Clinical Nursing 06/2011; 21(1-2):232-42. · 1.23 Impact Factor
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    ABSTRACT: To present the best available research evidence on eye irrigation methods for ocular chemical burns to facilitate better-informed clinical decisions. Randomized, quasi-randomized controlled trials and observational studies comparing the effectiveness of eye irrigation methods among adults or children as an active form of emergency treatment for ocular chemical burns were reviewed. Electronic databases in English and Chinese were searched from inception to June 2010. Two reviewers made independent decisions on whether to include each publication in the review and critically appraised the study quality independently. Given the clinical and methodological diversity among the studies, the review findings are presented in a narrative form. Four studies involving 302 adults and children were identified. The results of this review indicate that patients who underwent irrigation with tap water immediately following alkali burns at the scene of injury had significantly better clinical and ocular outcomes. The evidence also suggests that in hospital settings, more patients preferred balanced saline solution (BSS) plus than other irrigation fluids. Irrigation with diphoterine was found in one study that resulted in better ocular outcomes following grade 1 and 2 ocular burns. With regard to duration of eye irrigation, patients with ocular chemical burns treated with prolonged irrigation reported shorter duration of treatment at hospital and absence from work. The results should be treated with caution, as there were significant differences between the comparison groups in some studies. IMPLICATIONS AND CONCLUSIONS: As prompt eye irrigation with tap water immediately after alkali burns had better outcomes, it would be important to commence eye irrigation immediately after burns are sustained. In this review, irrigating fluids including normal saline, lactated Ringer's, normal saline with sodium bicarbonate added, BSS Plus, and diphoterine solutions all yielded positive ocular outcomes suggesting for its use in hospital settings.
    Worldviews on Evidence-Based Nursing 06/2011; 9(3):129-38. · 1.35 Impact Factor
  • Karis K F Cheng, Diana T F Lee
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    ABSTRACT: Most elderly patients with cancer suffer from a multitude of intense physical and psychological symptoms regardless of the stage of disease. The current paper describes the prevalence of pain, fatigue, insomnia, and mood disturbance, alone and in combination in elderly cancer patients, as well as the inter-correlations among these four symptoms, and the relationship of the symptom cluster to functional status and quality of life (QoL) during cancer therapy. This cross-sectional study used secondary data from a convenience sample of 120 patients, 65 years of age and older, with colorectal, lung, head/neck, breast, gynecological, prostate or esophageal cancer receiving chemotherapy or radiotherapy. Measuring instruments included the Karnofsky Performance Scale (KPS), the respective items from the Chinese version of the Symptom Distress Scale (SDS-C), and the Functional Assessment of Cancer Therapy-General (FACT-G [C]). The influence of the symptom cluster on patients' functional status and QoL was determined by hierarchical multiple regression. Twenty percent and 29.2% of patients reported co-occurrence of any two and any three symptoms of pain, fatigue, insomnia, and mood disturbance, respectively. About one-third of patients (31.2%) reported co-occurrence of all of the four symptoms. The inter-correlations among pain, fatigue, insomnia, and mood disturbance were mild to moderate (r=0.29-0.43, p<0.01). In terms of functional status, the KPS showed a moderate negative correlation with the four symptoms (r=-0.29 to -0.55, p<0.01). Correlations between the FACT-G (C) subscale/total scores and symptom cluster showed moderate negative correlations (r=-0.23 to -0.55, p<0.01). About 8.7-52.9% of variance in functional status and QoL is explained by the symptom cluster of pain, fatigue, insomnia, and mood disturbance in elderly cancer patients receiving cancer therapy after adjustment for gender, age, co-morbidity, stage of disease, and treatment modality. Our results suggest that pain, fatigue, insomnia, and mood disturbance are highly prevalent in elderly patients who undergone cancer therapy. These four symptoms may occur in a cluster and may negatively influence elderly patients' functional status and QoL during cancer therapy.
    Critical reviews in oncology/hematology 05/2011; 78(2):127-37. · 5.27 Impact Factor
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    ABSTRACT: To identify omissions in hand hygiene practice and glove use among hospital workers in Hong Kong. Hospital-acquired infection is the commonest complication affecting hospitalised patients. Even though research evidence suggests that hand hygiene and proper glove use are the most important ways to prevent the spread of disease and infection, compliance with both are reported to be unacceptably low. An observational study of hospital workers in one acute and two convalescence and rehabilitation hospitals in Hong Kong was conducted. The participating clinical areas included the medical and surgical wards, accident and emergency department and intensive care unit. Hand hygiene practice and glove use amongst 206 hospital health and support workers, stratified according to years of working experience, were observed. The number of observed episodes for hand hygiene was 1037 and for glove use 304. Compliance with hand hygiene was 74.7% and with glove use 72.4%. In approximately two-third of episodes, participants washed their hands after each patient contact; though, 78.5% failed to rub their hands together vigorously for at least 15 seconds. The major break in compliance with glove use was failure to change gloves between procedures on the same patient. In 28.6% of observed glove use episodes, participants did not wear gloves during procedures that exposed them to blood, body fluids, excretion, non-intact skin or mucous membranes. Significant differences in performance scores on antiseptic hand rub were found between the two types of hospital and on glove use between the three groups of work experience: ≤ 5, 6-10, >10 years. Education and reinforcement of proper hand hygiene practice and glove use among hospital health and support workers is needed.
    Journal of Clinical Nursing 05/2011; 20(9-10):1319-28. · 1.23 Impact Factor
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    ABSTRACT: Effective self-care is the cornerstone of the successful management of heart failure (HF). The European Heart Failure Self-care Behaviour Scale is a brief, reliable and valid scale to measure this important construct among patients with HF. Although the EHFScBS has been translated to different languages, no Chinese version is available. Indeed, previous findings investigating the psychometric properties of EHFScBS indicated ambiguity of the conceptual structure of this scale. The aim of this study was to translate the European Heart Failure Self-care Behaviour Scale (EHFScBS) into Chinese and to test its psychometric properties in the Chinese patients with HF. The EHFScBS (English Version) was translated to Chinese using Brislin's forward and backward translation method. Panel review was used to examine its semantic equivalence and content validity. The EHFScBS (Chinese Version) was then tested with a convenience sample of 143 Chinese HF patients who attended a specialist clinic from January to September 2007. The content validity index (CVI) of the EHFScBS (Chinese version) was satisfactory (Item CVI=0.96; Scale CVI=0.89), with Cronbach's alpha 0.82. Convergent validity was supported by a moderate relationship, statistical significant with a measure for social support (r=-0.36, p<0.001). However, the findings did not support the hypothesised three-factor structure of the EHFScBS (Chinese Version). Instead, all items except one fit well a two-factor structure to measure help-seeking and regimen-complying behaviours. The adequate psychometric properties and clear conceptual structure of EHFScBS (Chinese Version) warrant its use in Chinese patients with HF.
    International journal of nursing studies 10/2010; 48(4):458-67. · 1.91 Impact Factor
  • Linda Y K Lee, Diana T F Lee, Jean Woo
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    ABSTRACT: To determine the psychosocial effect of Tai Chi on nursing home residents. Moving into a nursing home usually imposes a certain degree of psychosocial challenge to older people. However, there is limited evidence suggesting a promising intervention that can promote the psychosocial health for this group. Although previous studies suggest that Tai Chi has the potential to enhance psychosocial well-being, existing evidence is deemed scarce and thus imposes a limitation on drawing out conclusions on this matter. Non-equivalent pretest-posttest control group design. A convenience sample of 139 residents from six nursing homes in Hong Kong was recruited for this study. The experimental group (n = 66) participated in a 26-week Tai Chi programme, while the control group (n = 73) continued its normal daily activities. The outcome measures included state self-esteem, the physical and mental component of health-related quality of life, social support network and social support satisfaction. Resident satisfaction was identified as a covariate because it demonstrated significant correlation with the outcome variables and, likewise, showed significant difference between the two study groups at baseline. Doubly multivariate analysis of covariance was performed to examine the effect of the intervention. Results indicate significant Group x Time interactions, with the experimental group experiencing significant improvement in the composite outcome of state self-esteem, the physical component of health-related quality of life and the mental component of health-related quality of life across the 26-week study period [F(6, 131) = 2.61, p = 0.02)]. No significant changes were detected regarding the effect of the Tai Chi programme on social support. Tai Chi practice is beneficial for nursing home residents. Tai Chi has unique characteristics that are particularly suitable in the practice of health exercise for nursing home residents. The inclusion of Tai Chi in residential care practice for older people is recommended.
    Journal of Clinical Nursing 04/2010; 19(7-8):927-38. · 1.23 Impact Factor
  • Diana T F Lee
    International Journal of Older People Nursing 03/2010; 5(1):3-4.
  • Doris S F Yu, Diana T F Lee, Jean Woo
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    ABSTRACT: This paper is a report of a study conducted to examine the effects of a relaxation training programme on the health-related quality of life of Chinese patients with chronic heart failure. Despite the substantial evidence indicating the beneficial effects of relaxation therapy on the health-related quality of life of various cardiac populations, the value of this intervention in patients with chronic heart failure remains uncertain. Even less is known about its therapeutic effects in Chinese culture. A total of 121 Chinese patients with chronic heart failure and over 60 years of age were recruited in 2002-2003 and randomly allocated to a relaxation training programme (n = 59) or an attention-control intervention (n = 62). The training included two relaxation training sessions, one skill revision workshop, twice daily relaxation self-practice and biweekly telephone follow-up. The World Health Organization Quality of Life questionnaire was completed at hospital discharge and at the 8th and 14th weeks after discharge. Repeated measures analysis of covariance indicated that those who attended the relaxation training programme reported statistically significantly greater improvement in psychological (P = 0.007, eta(2) = 0.043) and social (P = 0.016, eta(2) = 0.035) health-related quality of life than those who received the attention-control intervention over the evaluative period. Comparing outcomes at timepoints showed that the statistically significant group differences in the improvement of psychological and social health-related quality of life occurred mainly during the first evaluative endpoints. Relaxation techniques are beneficial to the emotional and social health-related quality of life of Chinese patients with chronic heart failure. Combining this intervention with other treatment modalities may produce a more substantial improvement in their health-related quality of life.
    Journal of Advanced Nursing 02/2010; 66(2):392-403. · 1.69 Impact Factor
  • Doris S F Yu, Diana T F Lee, Ng Wai Man
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    ABSTRACT: Fatigue is a complex phenomenon associated with multiple antecedents and detrimental consequences. Although this symptom is prevalent in the older population, it is not easily recognized by nurses and has been under treated. The purpose of this review is to describe the existing research on fatigue on older adults with focus on the lived experience of fatigue, factors related to such fatigue experience and the impact of fatigue on overall health. A systematic search of the literature was undertaken to identify research evidence on fatigue among the older population. Three databases (i.e. OvidMedline, CINAHL and PsycINFO) were searched, resulting in 15 eligible studies. Three aspects about the fatigue phenomenon in older people were identified: the lived experience of fatigue, relating factors of fatigue, and impact of fatigue on overall health. The key findings suggest that fatigue is an overwhelming experience constrains physical capacity and the energy reserve required for appropriate functioning and social participation, as well as worsens their morbidity and mortality outcomes. Yet, its heterogeneous etiologies and multi-dimensional manifestations pose a huge challenge on its diagnosis and treatment. Indeed, there was inadequate research-base evidence on fatigue management for older people. This gap in literature may imply that this problem is poorly recognized and under-treated in older people. The findings highlight that fatigue is a substantial problem in older people that deserves early recognition and prompt treatment. Nurses need to be sensitive to the risk factors of fatigue in the older population and conduct a comprehensive fatigue assessment on the high risk case. Although this review only identified limited research-base evidence, the findings do give directions to the development of interventions for fatigue management for older people.
    International journal of nursing studies 07/2009; 47(2):216-28. · 1.91 Impact Factor

Publication Stats

773 Citations
131.04 Total Impact Points


  • 1996–2014
    • The Chinese University of Hong Kong
      • • The Nethersole School of Nursing
      • • Faculty of Medicine
      • • Department of Nursing
      Hong Kong, Hong Kong
  • 2012
    • The Hong Kong Institute of Education
      • Department of Psychological Studies (PS)
      Hong Kong, Hong Kong
  • 2007–2010
    • The Open University of Hong Kong
      • School of Science and Technology
      Hong Kong, Hong Kong
  • 2004
    • The Hong Kong Polytechnic University
      • School of Nursing
      Hong Kong, Hong Kong