Alexander Molassiotis

Factors associated with adherence to antiretroviral medication in HIV-infected patients.

The aim of the study was to assess adherence with antiretroviral medication in a sample of HIV patients in Hong Kong and identify predictors of adherence. The study used a cross-sectional correlational design. Adherence behaviour was assessed with the use of self-reports. Other scales assessed knowledge with HIV medication, coping, health locus of control, anxiety, depression and fatigue. A blood sample was also obtained to assess CD4+ counts and viral load. Sociodemographic characteristics and medical information were obtained from the medical records. A high adherence rate was found in this sample of 136 predominantly Chinese patients. There were only 13.7% of the patients being classified as non-adherent. Predictors of adherence included high self-efficacy in terms of being certain that the medication schedule will be followed all or most of the time as directed, low tension-anxiety scores, and low intensity of nausea and vomiting (R2=0.304). An expanded regression model revealed additional factors influencing adherence, including coping variables, pain and numbness in the hands and feet, age, disease stage, internal locus of control, fatigue, family support and taking medication twice daily. This model explained 49% of the variance in adherence. The results suggest that adherence is a multidimensional concept. Every effort should be made to assess in individuals those variables found to affect adherence and alter them whenever possible. Continuous support of patients and individualized medication programmes that will help patients adjust their treatment to their lifestyle are recommended.

The effects of an educational programme on the anxiety and satisfaction level of parents having parent present induction and visitation in a postanaesthesia care unit

Background: In Hong Kong, some hospitals have established the practice of Parental Presence Induction (PPI) and visitation in Postanaesthesia Care Units (PACU) for children receiving surgery. The literature indicates that parents reported extreme anxiety and discomfort after being present at induction of anaesthesia and suggests that it would seem appropriate to devise a programme of education to reduce anxiety for parents.

A pilot study on the effect of progressive muscle relaxation training of patients after stoma surgery

Eighteen patients who had undergone stoma surgery were assessed with respect to their anxiety level and self-reported quality of life (QoL) on three occasions; namely, immediately after surgery, 5 weeks after surgery, and 10 weeks after surgery. The patients were randomised into a control group (n = 10) and an experimental group (n = 8). A 20-min set of audiotaped instructions on progressive muscle relaxation training (PMRT) was given to the patients in the experimental group for home practice. Assessment instructions included the Chinese State-Trait Anxiety Inventory (C-STAI), the Quality of Life Index for Colostomy (QoL-Colostomy) and the Hong Kong Chinese version of the World Health Organisation Quality of Life Scale (WHOQoL). Results indicated that there was a significant decrease in both the C-STAI score (F = 4.66, P < 0.05) and the WHOQoL score (F = 4.74, P < 0.05) in the experimental group. Among the domains of WHOQoL, a significant difference was shown in physical health/independence and general perception of QoL, with the experimental group demonstrating better functioning. For the QoL-Colostomy, however, there was no significant difference between the control and experimental groups. The results suggest that the use of PMRT could enhance quality of life and decrease state anxiety in patients after stoma surgery.

Traveling through the cancer trajectory: social support perceived by women with gynecologic cancer in Hong Kong.

A qualitative research design was selected to gather data on the experiences of social support for Chinese women with gynecologic cancer. Eighteen women were recruited and interviewed at an oncology unit of a teaching hospital in Hong Kong. Content analysis of the interview data showed Chinese women with gynecologic cancer placed enormous emphasis on their human relationships. Family members were especially significant to them although not all identified their family relations as satisfactory or helpful. Their social network comprised 4 major sources, including family and friends, work and colleagues, health professionals, and religion and spiritual beliefs. Each network offered significant reciprocal relations, authoritative relations, or entrusting relations. The positive appraisal of the support function was linked to the Chinese value of food, work ethics, the Confucian and religious philosophy, whereas negative aspects of support, such as the stress of maintaining relationships and inadequate information, conjoined with the Chinese suppression of emotion and the busyness of health professionals. Future studies, including social relations as a determinant, should ensure a broad and multifunctional view of social support and acknowledge the cultural influences on the perspective of support.

Filipino domestic workers in Hong Kong: health related behaviors health locus of control and social support.

SUMMARY A total of 290 female Filipino domestic helpers residing in Hong Kong completed a concurrent cross sectional survey designed to provide an initial report of basic data which measured mental health symptoms, health-related behaviors, health locus of control and social support. The four top ranking symptoms of mental distress reported included waking in the early hours, loneliness, worry and taking a long time to get to sleep. In general, the level of health related behaviors was high, with a satisfactory diet and low rates of alcohol, nicotine and coffee consumption. However, few women surveyed had previously had a Pap smear. There were also low scores for other preventive health practices. Reinforcement for health behaviors was seen as either a matter of chance or being influenced by powerful others for two thirds of the women. The conclusion highlights the intersection between gender, immigration and social class by drawing attention to issues of acceptance and accessibility of healthcare services for immigrant within host countries. In addition, cultural directions for immigrant health education are outlined.

Hong Kong Chinese perceptions of the experience of unrelated bone marrow donation

This paper presents a qualitative perspective of the Chinese experience of unrelated bone marrow donation. A total population of 37 Chinese men and women, residing in Hong Kong who had donated bone marrow to an unrelated recipient were interviewed and asked their retrospective perceptions and experiences during the process of unrelated bone marrow donation. The majority was female (60%) and single (59.3%). The median age was 30.9 years. The main themes drawn from thematic content analysis included: association with bad and good fortune, religious concerns associated with complete bodies, barriers posed by the extended family, fulfilling personal identities linked to perceptions of altruism, reciprocity and generosity and the differences between the expectations and reality of the experience of bone marrow donation. These accounts indicate how, for Chinese populations, the act of body fluid donation cannot be isolated from the experiences of life-long immersion in the dominant social and cultural processes of the time. In addition, Confucian notions of the body, the power of body fluids to pollute, the importance of blood and bones as sources of vital energy and the process of bodily transference into the after life are highlighted. Furthermore, what is also identifiably Chinese is that donation is more of a self-fulfilling act than a social act with very little familial or social recognition being accorded in the public world. The conclusion highlights how donors entered into the decision to donate with little awareness of the long-term consequences. The process, however, was seen by the donors to be beneficial. A compelling argument is made for more educational and emotional support regarding the experience of bone marrow donation from Hong Kongs formal service providers.