Moon Fai Chan

Effect of music on depression levels and physiological responses in community-based older adults

Many people over the age of 65 do not regard depression as a treatable mental disorder and find it difficult to express themselves verbally. Listening to music can facilitate the non-verbal expression of emotion and allow peoples inner feelings to be expressed without being threatened. The aim of this study was to determine the effect of music on depression levels in elderly people. A randomized controlled study was conducted with 47 elderly people (23 using music and 24 controls) who completed the study after being recruited in Hong Kong. Blood pressure, heart rate (HR), respiratory rate (RR), and depression level variables were collected. In the music group, there were statistically-significant decreases in depression scores (P < 0.001) and blood pressure (P = 0.001), HR (P < 0.001), and RR (P < 0.001) after 1 month. The implication is that nurses may utilize music as an effective nursing intervention for patients with depressive symptoms in the community setting.

Investigating the knowledge, attitudes and practice patterns of operating room staff towards standard and transmission‐based precautions: results of a cluster analysis

AIMS To examine the relationship on knowledge, attitudes and practice levels of operating room staff towards the standard precautions and transmission-based precautions, and to identify profiles of them based on their demographic variables and their knowledge, attitudes and practices towards the standard precautions and the transmission-based precautions. RESEARCH METHOD During January 2006, 113 staff working in the operating room of a public hospital completed a self-reported questionnaire. Outcome measures. Demographic information, knowledge, attitudes and practices scores were collected. RESULTS Two-step cluster analysis yielded two clusters. Clusters 1 and 2 consisted of 50.4% (n = 57) and 49.6% (n = 56), respectively. Cluster 1 subjects were younger, had a higher educational attainment level and worked at a more senior level than Cluster 2 subjects. They reported good knowledge, positive attitudes and practices. Cluster 2 subjects were characterized by relatively poor knowledge, negative attitudes and practices. Significant differences towards standard and transmission-based precautions were found between clusters, except attitudes towards choosing protective personal equipment (p = 0.095) and practices on wearing gowns and eye shields/goggles (p = 0.759). Attitudes of Cluster 2 staffs were highly significant, but weakly correlated with practices (r(s) = 0.39, p < 0.05). CONCLUSION This study clearly profiles knowledge, attitudes and practice patterns of operating room staff, which may benefit healthcare educators in planning and developing appropriate educational programmes, may help organizations to provide a safe workplace climate and may aid healthcare workers to learn the importance of personal responsibility in preventing infectious disease transmission to patients, co-workers and even themselves. Relevance to clinical practice. To date, the only protection against infection is to minimize risk by modifying behaviour and practice patterns. Education and communication play a major role of the precautions. Tailoring interventions to fit different specific groups of operating room staff is needed to improve compliance with the standard and transmission-based precautions.

The effectiveness of music listening in reducing depressive symptoms in adults: A systematic review

OBJECTIVES We aim to review trials of the effectiveness of music listening in reducing depressive symptoms in adults, and identify areas requiring further study. BACKGROUND Little is known about the efficacy of music listening in the mediation of depressive symptoms. METHODS We systematically search 9 databases and reviewed 17 studies included randomized controlled and quasi-experimental trails of music listening in reducing depressive symptoms in adults. The Joanna Briggs Institute-Meta Analysis of Statistics Assessment and Review Instrument was used for quality assessment of included studies. RESULTS Music listening over a period of time helps to reduce depressive symptoms in the adult population. Daily intervention does not seem to be superior over weekly intervention and it is recommended that music listening session be conducted repeatedly over a time span of more than 3weeks to allow an accumulative effect to occur. CONCLUSIONS All types of music can be used as listening material, depending on the preferences of the listener. So, it is recommended that the listeners are given choices over the kind of music which they listen to. There is a need to conduct more studies, which replicate the designs used in the existing studies that met the inclusion criteria, on the level of efficacy of music listening on the reduction of depressive symptoms for a more accurate meta-analysis of the findings and reflect with greater accuracy the significant effects that music has on the level of depressive symptoms.

A Comparative Study of Chinese, American and Japanese Nurses’ Perceptions of Ethical Role Responsibilities

This article reports a survey of nurses in different cultural settings to reveal their perceptions of ethical role responsibilities relevant to nursing practice. Drawing on the Confucian theory of ethics, the first section attempts to understand nursing ethics in the context of multiple role relationships. The second section reports the administration of the Role Responsibilities Questionnaire (RRQ) to a sample of nurses in China (n = 413), the USA (n = 163), and Japan (n = 667). Multidimensional preference analysis revealed the patterns of rankings given by the nurses to the statements they considered as important ethical responsibilities. The Chinese nurses were more virtue based in their perception of ethical responsibilities, the American nurses were more principle based, and the Japanese nurses were more care based. The findings indicate that the RRQ is a sensitive instrument for outlining the embedded sociocultural factors that influence nurses’ perceptions of ethical responsibilities in the realities of nursing practice. This study could be important in the fostering of partnerships in international nursing ethics.

Effectiveness of music intervention on the quality of life of older people

AIM This paper is a report of a study of the effect of music on the quality of life of community-dwelling older Chinese people in Hong Kong. BACKGROUND Older peoples quality of life can be improved by preparing for the transition into old age. Listening to music, as a vehicle for feeling, can facilitate the non-verbal expression of emotion, reaching peoples inner feelings without being threatening, and it can be a tool for emotional catharsis. METHOD A randomized controlled trial design was conducted from in 2007 in a community centre in Hong Kong. A total of 66 older people (31 in music group and 35 in control group), aged from 65 to 90 years were randomly assigned to undergo either a 30-minute music intervention or a rest period for 4 weeks; quality of life outcomes were then measured. RESULTS Quality of life improved weekly in the music group, indicating a cumulative dose effect, and a statistically significantly better quality of life was found over time in each sub-score for those in the music group compared with the controls. However, in the music group, there were no statistically significant improvements of quality of life in each sub-score over the 4 weeks. CONCLUSION Being engaged in music activities can help a person to connect with their life experiences and with other people, and to be more stimulated. Music is a non-invasive, simple and inexpensive therapeutic method of improving quality of life in community-dwelling elders.

Damage accrual, cumulative glucocorticoid dose and depression predict anxiety in patients with systemic lupus erythematosus

The burden of anxiety in patients with systemic lupus erythematosus (SLE) compared to those with other inflammatory rheumatological conditions is unclear. We aimed to compare the frequency and level of anxiety between patients with SLE, rheumatoid arthritis (RA), and gout and healthy individuals and explore independent predictors for anxiety in SLE patients. Consecutive patients with SLE, RA and gout and healthy individuals who were age and sex matched with the SLE group were evaluated for anxiety using the Hospital Anxiety and Depression Scale (HADS). Sociodemographic and disease-related variables were compared between all groups. Predictors for anxiety were studied by regression models, with construction of a prediction model for the presence of anxiety in SLE patients by the receiver operating characteristic (ROC) analysis. Amongst 271 subjects studied, 60 had lupus, 50 had gout, 100 had RA and 61 were healthy controls. The frequency and level of anxiety were significantly higher in SLE patients than patients with gout, RA and healthy controls. SLE per se was independently associated with higher HADS-anxiety score after controlling for potential confounders. Logistic regression model showed that higher damage accrual, higher cumulative glucocorticoid dose, depression and fewer regular medications predicted anxiety in SLE patients, with an accuracy of 90% by the ROC analysis.

Investigating the physiological responses of patients listening to music in the intensive care unit

AIMS To determine whether definable subtypes exist within a cohort of patients listening to music with regard to their physiological patterns and to compare whether associated factors vary between subjects in groups with different profiles. BACKGROUND The intensive care unit (ICU) is one of the most stressful environments for patients among various clinical settings in a hospital. ICU patients are not only compromised by illness but also faced with a wide range of stressors. DESIGN A repeated-measures design was conducted with one music group. METHOD One hundred and one patients were recruited in three intensive care units in Hong Kong. There were two main outcome variables: demographic characteristics and physiological outcomes. RESULTS A cluster analysis yielded two clusters. Patients in cluster 1 typically experienced relatively low therapeutic effects from listening to music. There were more males, of a younger age but more educated and employed than patients in cluster 2, and they represented 41.6% of the total respondents. Cluster 2 comprised almost 58.4% of this study sample and they reported high therapeutic effects of music. There were more females in this group as well as more older people and they mainly used a ventilator in the intensive care unit. CONCLUSION Our study shows that music may have a more positive effect on groups of patients whose profile is similar to that of the patients in cluster 2, than for patients such as those in cluster 1. A clear profile may help health professionals to design appropriate care therapy to target a specific group of patients to improve their physiological outcomes. RELEVANCE TO CLINICAL PRACTICE The implication of this study is that music therapy should be provided to patients as a relaxation technique if they are willing to accept it, and the selection of music should be based on their preferences. Information should be given to patients so that they can understand how music therapy works and they should be encouraged to focus their attention on listening to the music to maximise its benefits.

Predictors of change in quality of life of family caregivers of patients near the end of life with advanced cancer

Background: Caregiving for a person with cancer at end of life can be stressful physically and emotionally. Understanding the predictors of change in family caregivers’ quality of life (QoL) is important in facilitating the development of interventions to help these family caregivers. Objective: The aim of this study was to examine the change in QoL of family caregivers of home hospice patients in Singapore near the end of life with advanced cancer from baseline to after 2 months. Methods: This was a longitudinal survey. Ninety-three caregivers were surveyed. Instruments included the Caregiver Quality of Life Index–Cancer, Social Support Questionnaire, and Spiritual Perspective Scale. Results: Caregivers’ spiritual-related interactions scores increased from baseline to 2 months using paired t test (t = 2.33, P = .02). Multivariate regression analysis showed that caregivers with higher social support satisfaction (&bgr; = .60, P = .000) and who had a religion predicted (&bgr; = .55, P = .001) higher QoL. Caregivers of patients diagnosed with breast cancer and cancer in the female reproductive organs (&bgr; = −.33, P = .03) predicted lower QoL. Conclusion: This study elucidated the importance of caregivers’ social support satisfaction during their caregiving journey. There is a need to enhance spiritual care for caregivers. Implications for practice: Support for caregivers could be increased by organizing mutual support groups and having volunteers to befriend caregivers. Spiritual care could be enhanced by regular assessment of spiritual needs, offering open discussions and sharing on spirituality and religion, and facilitating contacts with religious groups if caregivers required.

Attitudes and skills of Hong Kong Chinese medicine practitioners towards computerization in practice: a cluster analysis.

Abstract The objective was to determine whether definable subtypes exist within a cohort of Hong Kong Chinese medicine practitioners (CMPs) as related to computer use in their clinical practices based on their skills, attitudes, and background factors. Data were collected using a structured questionnaire. The sample of 954 CMPs was recruited in Hong Kong. The study employs personal and demographic variables, attitudes, and a skills scale. A cluster analysis yielded three clusters. Each cluster represents a different profile of Hong Kong CMPs on computer use in their clinical practices. A clear profile of Hong Kong CMPs may benefit healthcare professionals in appropriate education or assistance to prompt the use of computers by CMPs, an officially recognized profession.

Investigating factors associated with depression of vitiligo patients in Singapore

AIMS To explore the depression level of a group of vitiligo patients in Singapore and to identify factors associated with depression. BACKGROUND Unlike most internal illness, skin disease is often immediately visible to others and therefore people suffers from dermatological conditions may suffer psychological consequences. DESIGN A descriptive survey was conducted during the period October 2009-August 2010 in Singapore; 145 vitiligo patients aged 21+  completed a structured questionnaire. METHODS Three main outcome variables were employed in the study: demographic characteristics, clinical and psychosocial outcomes. RESULTS Among the patients, 17·2% (n = 25) had been identified as depressed. Multiple logistic regression analyses were used to identify a model to predict vitiligo patients who will have depression. The results showed that females (p = 0·05), aged below 50 years old (p = 0·016), having 5+ years of illness (p = 0·021) and with low self-esteem (p = 0·002) and poor quality of life scores (p = 0·004) were significant risk factors for depression. CONCLUSION Providing a suitable health care consultation for vitiligo patients may reduces depressive symptoms and maintaining their psychological health may be crucial for preventing suffering from depressive symptoms. Apart from the findings, these conclusions resonate with recent Singapore guidance on managing depression in vitiligo patients. This stresses the importance of prevention, early detection and stepped care with a multifaceted approach to management. RELEVANCE TO CLINICAL PRACTICE It is important to regularly screen for depressive symptoms among vitiligo patients. Focusing on vitiligo patients with enhancing self-esteem and improving quality of life should help in both the prevention and recognition of onset of depression among vitiligo patients.