Aloysius Chow

Health-related quality of life and social support among Chinese patients with coronary heart disease in mainland China

Aim: This study aimed to explore and identify the relationship between health-related quality of life (HRQoL) and perceived social support among Chinese patients with coronary heart disease (CHD) in mainland China. Methods: A descriptive correlational study was conducted with a convenience sample of 200 Chinese patients with CHD recruited from the cardiac outpatient departments of two university-affiliated hospitals in Xi’an, China. The Chinese Mandarin versions of the Short-form 36-item health survey (CM:SF-36) and the Medical Outcomes Study Social Support Survey (CM:MOS-SSS) were administered to assess HRQoL and perceived social support. Results: The results indicated that Chinese patients with CHD reported a poorer HRQoL and lower social support compared with their Western and Hong Kong counterparts. Multiple regression analyses identified four significant predictors of deteriorated physical health (increasing age, co-morbidity with heart failure or hypertension, and smoking status) and two significant predictors of poor mental health (co-morbidity with heart failure and perceived social support). Conclusions: Health status and social support in Chinese people with CHD should be routinely assessed and, where feasible, addressed through appropriate individually tailored interventions.

An education booklet to aid cardiac patients' recovery at home

BACKGROUND Hospital and home-based cardiac rehabilitation programmes improve the health outcomes of cardiac patients. Both types of programmes include patient education as a core component. However, many patients do not attend cardiac rehabilitation programmes for a variety of reasons. In Singapore, where cardiac rehabilitation is comparatively uncommon, patient education is usually delivered face-to-face by healthcare professionals because educational materials designed specifically for cardiac patients recovering at home are not available. AIM This paper describes the development of a patient education booklet designed to aid recovery at home after a myocardial infarction in Singapore. METHODS The conception and development of this evidence-based Heart Recovery Education Booklet was based on patient need and current clinical guidelines pertaining to cardiac rehabilitation and planned in consultation with specialists such as cardiologists, psychiatrists and physiotherapists. RESULTS The booklet is a patient resource to aid recovery at home after an myocardial infarction. It is interactive, based on identified need and aims to guide and assist the patient in performing their usual activities of daily living and adhering to treatment regimens, including exercise. CONCLUSION This booklet is a resource for patients with myocardial infarction and healthcare professionals and its effectiveness in improving health-related quality of life, psychological status and coronary risk profile is to be tested in a randomized controlled trial. IMPLICATIONS FOR NURSING AND HEALTH POLICY Policy makers in health and nursing must find ways of developing and implementing cardiac rehabilitation programmes that aid recovery from myocardial infarction. This education booklet offers one way to do this.Background Hospital and home-based cardiac rehabilitation programmes improve the health outcomes of cardiac patients. Both types of programmes include patient education as a core component. However, many patients do not attend cardiac rehabilitation programmes for a variety of reasons. In Singapore, where cardiac rehabilitation is comparatively uncommon, patient education is usually delivered face-to-face by healthcare professionals because educational materials designed specifically for cardiac patients recovering at home are not available. Aim This paper describes the development of a patient education booklet designed to aid recovery at home after a myocardial infarction in Singapore. Methods The conception and development of this evidence-based Heart Recovery Education Booklet was based on patient need and current clinical guidelines pertaining to cardiac rehabilitation and planned in consultation with specialists such as cardiologists, psychiatrists and physiotherapists. Results The booklet is a patient resource to aid recovery at home after an myocardial infarction. It is interactive, based on identified need and aims to guide and assist the patient in performing their usual activities of daily living and adhering to treatment regimens, including exercise. Conclusion This booklet is a resource for patients with myocardial infarction and healthcare professionals and its effectiveness in improving health-related quality of life, psychological status and coronary risk profile is to be tested in a randomized controlled trial. Implications for nursing and health policy Policy makers in health and nursing must find ways of developing and implementing cardiac rehabilitation programmes that aid recovery from myocardial infarction. This education booklet offers one way to do this.

Fear of intimacy with helping professionals and its impact on elderly Chinese

The present study aimed to investigate the attitudes of Chinese older adults toward seeking help from healthcare professionals, and its impact on their self‐care ability and medication adherence.

Predictors of Health-Related Quality of Life Among Patients With Myocardial Infarction

This cross-sectional correlational study aimed to examine health-related quality of life (HRQoL) and its predictors among patients with myocardial infarction (MI). One hundred and twenty-eight outpatients with MI were recruited from a university hospital. The 12-item Short-Form Health Survey version 2, Myocardial Infarction Dimensional Assessment Scale (MIDAS), and Hospital Anxiety and Depression Scale (HADS) were used to measure the study variables. Compared with the findings of similar studies of patients with MI, this sample, despite having significant coronary risk factors, reported generally better HRQoL. Predictors of physical HRQoL included low monthly household income, whereas predictors of mental HRQoL included ex-smoker, alcohol use, hypertension, anxiety, and depression. Special attention may need to be given to those people with a low income level, who are ex-smokers, use alcohol, or have hypertension, anxiety, or depression.

Psychometric testing of the Chinese Mandarin version of the Mental Health Inventory among Chinese patients with coronary heart disease in Mainland China

This study aimed to develop a Chinese Mandarin version of the Mental Health Inventory (CM:MHI). The English version MHI was translated into Chinese (simple Chinese character) using the forward-backward translation method while establishing the semantic equivalence and content validity. A convenience sample of 204 coronary heart disease (CHD) patients was recruited to evaluate the internal consistency, concurrent validity and construct validity of the CM:MHI. Forty patients completed the CM:MHI to evaluate the test-retest reliability after 2 weeks. The CM:MHI demonstrated good semantic equivalent rate (92%) and satisfactory content validity index (0.91). The internal consistency was acceptable for total and all subscales with Cronbachs alpha greater than 0.70, with the exception of the subscale of Emotional Ties (Cronbachs alpha = 0.64). The test-retest reliability was also satisfactory with intraclass correlation coefficients higher than 0.75. The concurrent validity was acceptable with significantly strong correlations between the CM:MHI and the Chinese Mandarin versions of Short Form 36 Health survey and Hospital Anxiety and Depression Scale. Confirmatory factor analysis further supported the five-factor structure of the CM:MHI. The CM:MHI demonstrated to be a valid and reliable measure for assessing psychological distress and well-being in Chinese-speaking CHD patients.

A Meta-Synthesis of Children's Experiences of Postoperative Pain Management

BACKGROUND Ineffective management of postoperative pain in children has been reported widely. To improve the effectiveness of postoperative pain management for children, it was necessary to conduct a systematic review to better understand the current knowledge of childrens experiences of their postoperative pain management. AIMS The aim of this review was to update and synthesize current qualitative research of postoperative pain management based on childrens experiences. METHODS Qualitative studies published between January 1990 and July 2014 were searched from the electronic databases of CINAHL, MEDLINE, MedNar, ProQuest, PsycINFO, Scopus, ScienceDirect, Sociological Abstracts, and Web of Science. A broad range of search keywords and a three-step search strategy were used. Meta-syntheses were used to summarize the findings from the included studies. RESULTS Nine qualitative studies were included. Three meta-syntheses from 22 categories based on 72 findings were generated: (a) Children experienced various negative emotions related to postoperative pain, and could assess and express their pain but need their parents as advocates; (b) apart from pain medication, various nonpharmacological strategies to relieve childrens postoperative pain were employed by children, parents, and nurses; and (c) suggestions from children for their parents and nurses to better relieve postoperative pain. LINKING EVIDENCE TO ACTION This review provided preliminary support for increasing the provision of information and education for children and their parents about postoperative conditions, pain, and pain relief strategies. Nurses should also be encouraged to employ more nonpharmacological pain-relieving strategies and build rapport with children and their parents. Future intervention studies are needed to improve childrens postoperative experiences.

Psychometric testing of the Chinese Mandarin version of the MacNew Heart Disease Health‐related Quality of Life questionnaire for patients with myocardial infarction in mainland China

Tools to measure the quality of life of Chinese myocardial infarction (MI) patients in mainland China are small in numbers. For this study, 210 Chinese patients with MI were recruited to examine the psychometric properties of the Chinese Mandarin version of the MacNew Heart Disease questionnaire. Thirty-five participants managed to complete the retest after 2 weeks. The MacNew Heart Disease questionnaire had acceptable internal consistency, test–retest reliability and concurrent validity. The principal components analysis identified three factors which accounted for 56.6% of the variance. The MacNew Heart Disease questionnaire demonstrated good reliability and validity to be used as a health status measurement tool, and is ready for clinical use in the assessment of the quality of life of Chinese MI patients in mainland China.Tools to measure the quality of life of Chinese myocardial infarction (MI) patients in mainland China are small in numbers. For this study, 210 Chinese patients with MI were recruited to examine the psychometric properties of the Chinese Mandarin version of the MacNew Heart Disease questionnaire. Thirty-five participants managed to complete the retest after 2 weeks. The MacNew Heart Disease questionnaire had acceptable internal consistency, test-retest reliability and concurrent validity. The principal components analysis identified three factors which accounted for 56.6% of the variance. The MacNew Heart Disease questionnaire demonstrated good reliability and validity to be used as a health status measurement tool, and is ready for clinical use in the assessment of the quality of life of Chinese MI patients in mainland China.