Wallace Chi Ho Chan

Acceptance of Spousal Death: The Factor of Time in Bereaved Older Adults' Search for Meaning.

Response to the death of a spouse was examined by focusing on acceptance, which was conceptualized as both a process and an outcome. Grounded theory was applied to analyze the experience of 15 bereaved Hong Kong Chinese older adults. The main theme that emerged was time. Acceptance of spousal death was found to be related to the search for meaning in 2 time-related themes: timing of spousal death and paradoxical time perception. For paradoxical time perception, 2 subthemes were identified: truncation and daily isolation in time. For bereaved older adults, time-related meaning seeking may be best fostered by self-transcendence, (e.g., participation in volunteer work and social activities).

Clinical data-mining: Learning from practice in international settings

This article describes a practice-based, mixed-method research methodology – Clinical Data-Mining (CDM) – as a strategy for engaging international practitioners for describing, evaluating and reflecting upon endogenous forms of practice with the ultimate goal of improving practice and contributing to knowledge (Epstein, 2010). These knowledge contributions are perforce ‘local’, but through conceptual reflection and/or empirical replication they may also be ‘globalized’. More specifically, the article defines, describes, and details CDM methodology; discusses its strengths and limitations; and illustrates international applications in Australia, Hong Kong, Israel, New Zealand, and the United States. It also describes various infra-structural support platforms and CDM’s primary and secondary organizational benefits.

Factor Structure of the Multidimensional Orientation Toward Dying and Death Inventory Among Hong Kong College Students: A Preliminary Study

This study examines the factor structures of the Chinese version of the Multidimensional Orientation Toward Dying and Death Inventory (MODDI-F/chin), originally established in German language, in a sample of Hong Kong college students (n = 256). Both confirmatory factor analysis and exploratory factor analysis were performed to examine the factor structures of the MODDI-F/chin. The results showed that, identical to the German version, the MODDI-F/chin consisted of a 5-factor Fear domain and a 3-factor Acceptance domain. The fear of another persons dying was the weakest of the four factors in the Hong Kong sample but represented the first and strongest factor in the German sample of the original study. Although preliminary and not representative of mainland China, our results show that the factor structure of attitudes toward dying and death that had been established empirically with German people can be replicated with Chinese students of Hong Kong.

The Chinese Version of the Multidimensional Orientation toward Dying and Death Inventory (Moddi-F/Chin): An Introduction

Preliminary data on the test criteria of the Chinese version of the Multidimensional Orientation Toward Dying and Death Inventory (MODDI-F/chin) are presented. Data from a sample of Hong Kong college students (N = 256) revealed internal consistencies of the eight subtests between .68 and .91, on the whole favorable shape of frequency distributions, and evidence of construct as well as differential validity of the instrument. The use of the full set of 47 items is recommended for the time being.

A Cross-National Comparison of Hong Kong and U.S. Student Beliefs and Preferences in End-of-Life Care: Implications for Social Work Education and Hospice Practice

ABSTRACT In this mixed methods study, the authors explored differences and similarities in beliefs about death and dying as well as end-of-life care preferences among social work students in Hong Kong and the United States. A convenience sample of 176 social work students from Hong Kong and 58 from the United States was recruited to complete a quantitative questionnaire with three open-ended questions. Findings revealed differences as well as similarities in beliefs about death and dying and that a larger proportion of Hong Kong students as compared to U.S. students preferred curative rather than palliative care. Implications for social work education and hospice practice in both countries include the need for social work student and practitioner self-awareness in order to prepare for culturally competent practice and policies that are relevant across cultures.

Moderating effect of communication difficulty on the relationship between depression and pain: a study on community-dwelling older adults in Hong Kong

Objectives: This study examined the relationship between depression and pain, and the moderating effect of communication difficulty on this relationship, among community-dwelling older adults in Hong Kong. Method: We used logistic regression to analyze secondary data regarding 12,402 Chinese older adults applying for long-term care service in Hong Kong in 2012. Results: Approximately 30% of participants were depressed and 37% experienced communication difficulty. Depression was associated with increased pain. Communication difficulty was found to moderate the relationship between depression and pain. Pain scores increased more when individuals who experienced communication difficulty reported being depressed, compared to those who did not experience communication difficulty. Conclusion: The moderating effect of communication difficulty may be explained by the interaction between depression and communication difficulty. Participants who were depressed and concurrently experienced communication difficulty may be more likely to catastrophize their pain and may tend to report or experience more pain. Health care professionals need to be aware of the different effects of communication difficulty on the pain experiences of older adults. Psychosocial intervention may be provided to minimize older adults’ communication barriers to pain management.

Learning pattern of social work students: a longitudinal study

Abstract Research on learning patterns of social work students is scare. This longitudinal study addresses this issue by employing mixed methods of quantitative and qualitative study design to understand the learning pattern of students throughout their undergraduate social work studies. Six rounds of quantitative data collected by structured questionnaires and four rounds of qualitative data collected by focus group interviews have been conducted at an interval of every 6 months to track the learning pattern and to evaluate the continuous impacts of social work education on students. Results indicate that although students’ evaluation on the curriculum was positive and with significant difference in mean scores, paired sample t-tests found no significant difference between time 1 and 6 of all outcome variables. With regard to students’ change in attitude, acquisition of knowledge and skills, results indicate a ‘U-shape’ trend and a fluctuating learning pattern with a rebound in different outcome variables toward the end of the three-year study. Qualitative data echoes the findings and reveals that students go through the confused freshman stage, to disillusioned in practicum and finally with enriching experience upon graduation. The paper discusses meanings and implications of student learning pattern to social work education.

Perceived challenges in pediatric palliative care among doctors and nurses in Hong Kong

Abstract This study aims to examine perceived challenges, including knowledge, skills, self, and work environment, of professionals in providing pediatric palliative care (PPC) in Hong Kong and the differences in perceived challenges between groups. A total of 680 pediatric doctors and nurses participated in the survey. They tended to perceive the provision of PPC as difficult and considered “advanced skills” (those dealing with death-related issues) challenging. Findings indicate that nurses, professionals who are less experienced, do not have children, and have not received palliative care training perceived a higher level of challenges in providing PPC. Implications for training and support are discussed.

Self-competence in death work among health and social care workers: a region-wide survey in Hong Kong

BackgroundAccording to the Quality of Death Index, Hong Kong is lagging behind many other Western and Asian countries in the category of palliative and healthcare. To ensure the provision of high-quality palliative care, it is important to explore the self-competence of health and social care workers in coping with death work including palliative care. This region-wide study aims to assess the level of self-competence with a validated Self-Competence in Death Work Scale (SC-DWS) and examine its correlates.MethodsThe SC-DWS was administered to a cross-sectional convenience sample of health and social care workers across eight healthcare institutions between January and October 2016. Total scores for the 16-item SC-DWS and its Existential and Emotional subscales were calculated. We then examined sociodemographic variables (e.g., age, profession, place of employment) in relation to the total and subscale scores using multiple linear regression. Coding was conducted on responses to a final open-ended question asking about the personal views of the workers towards their self-competence in death work.ResultWe collected data from 885 health and social care workers. Mean score of the SC-DWS was 60.16 (range: 16 – 80), while its Existential and Emotional subscales scored 37.90 (range: 10 – 50) and 14.46 (range: 4 – 20) respectively. Four categories of personal view towards self-competence in death work including (1) personal resources; (2) existential challenges and coping; (3) emotional challenges and coping; and (4) personal recommendations on improving self-competence were identified. In multivariate analyses, workers aged 50 or above, divorced, working in Hospice A, Rehabilitation Hospital B (where a quality improvement initiative in end-of-life care was implemented) and Acute Hospital B (a Christian institution with strong caring culture) and with personal bereavement experience had significantly higher scores, whereas nurses scored significantly lower than less-educated personal care assistants.ConclusionThere is still room for improvement in self-competence in death work among health and social care workers, particularly the young, nurses and those working in acute hospitals. Future initiatives should involve identifying barriers in individual healthcare institutions. Training of the provision of palliative care is necessary.