Winsome Lam

Parenting approaches and digital technology use of preschool age children in a Chinese community

BackgroundYoung children are using digital technology (DT) devices anytime and anywhere, especially with the invention of smart phones and the replacement of desktop computers with digital tablets. Although research has shown that parents play an important role in fostering and supporting preschoolers’ developing maturity and decisions about DT use, and in protecting them from potential risk due to excessive DT exposure, there have been limited studies conducted in Hong Kong focusing on parent-child DT use. This study had three objectives: 1) to explore parental use of DTs with their preschool children; 2) to identify the DT content that associated with child behavioral problems; and 3) to investigate the relationships between approaches adopted by parents to control children’s DT use and related preschooler behavioral problems.MethodsThis exploratory quantitative study was conducted in Hong Kong with 202 parents or guardians of preschool children between the ages of 3 and 6 attending kindergarten. The questionnaire was focused on four aspects, including 1) participants’ demographics; 2) pattern of DT use; 3) parenting approach to manage the child’s DT use; and 4) child behavioral and health problems related to DT use. Multiple regression analysis was adopted as the main data analysis method for identifying the DT or parental approach-related predictors of the preschooler behavioral problems.ResultsIn the multiple linear regression model, the ‘restrictive approach score’ was the only predictor among the three parental approaches (B:1.66, 95% CI: [0.21, 3.11], p < 0.05). Moreover, the viewing of antisocial behavior cartoons by children also significantly increased the tendency of children to have behavioral problem (B:3.84, 95% CI: [1.66, 6.02], p < 0.01).ConclusionsSince preschool children’s cognitive and functional abilities are still in the developmental stage, parents play a crucial role in fostering appropriate and safe DT use. It is suggested that parents practice a combination of restrictive, instructive and co-using approaches, rather than a predominately restrictive approach, to facilitate their child’s growth and development. Further studies are needed to explore the parent-child relationship and parents’ self-efficacy when managing the parent-child DT use, to develop strategies to guide children in healthy DT use.

Implications for school nursing through interprofessional education and practice

AIMS AND OBJECTIVES To explore the interprofessional collaboration between nursing and social work professionals in their delivery of health services for schoolchildren. BACKGROUND Interprofessional education has long been recommended as a way to meet the need for effective collaboration in school health service with a view to improving the quality of health care. No local study in Hong Kong has looked specifically at how nursing and social work professionals carry out school health services through interprofessional education and practice. Therefore, an examination was conducted of collaboration on a community-based school caring project. DESIGN A qualitative design was employed, using semi-structured interviews, field observation and field debriefing. METHODS Seven nursing students and five social work students were recruited and interviewed in 2011. The transcripts were analysed using qualitative content analysis. RESULTS Three themes were identified: (1) early identification of childrens needs through interprofessional collaboration for health promotion, (2) prompt referral for schoolchildren in need, and (3) comprehensive planning and implementation of school health service. CONCLUSION The strength of collaborative work between nursing and social work professionals is that it helps to identify and address these complex health needs of children. Healthcare providers are hence able to develop a fuller understanding of childrens problems, which in turn enables them to provide appropriate and effective health promotion interventions. RELEVANCE TO CLINICAL PRACTICE The development of interprofessional education for school health services should be envisaged by the local higher educational institute and policy makers to reduce childrens risk-taking behaviours and promote their health and well-being. Health educators and health policy makers can better understand how interprofessional education and collaboration can promote children health service for regional and national policy and practice.

Participatory action research: Involving students in parent education

Competition for scarce clinical placements has increased requiring new and innovative models to be developed to meet the growing need. A participatory action research project was used to provide a community nursing clinical experience of involvement in parent education. Nine Hong Kong nursing students self-selected to participate in the project to implement a parenting program called Parenting Young Children in a Digital World. Three project cycles were used: needs identification, skills development and program implementation. Students were fully involved in each cycles planning, action and reflection phase. Qualitative and quantitative data were collected to inform the project. The overall outcome of the project was the provision of a rich and viable clinical placement experience that created significant learning opportunities for the students and researchers. This paper will explore the students participation in this PAR project as an innovative clinical practice opportunity.

Health promotion interventions to prevent early childhood human influenza at the household level: a realist review to identify implications for programmes in Hong Kong

AIMS AND OBJECTIVES To identify factors affecting the delivery of health promotion interventions to prevent early childhood human influenza at the household level. BACKGROUND Yearly, influenza epidemics seriously affect all age groups, particularly those with weakened immune systems, including children. Influenza is transmitted easily from person to person through droplet and direct contact. Maintaining personal hygiene, avoiding close contact with the infected person and proper hand washing are recommended as the most effective means of preventing the transmission of influenza. However, it is not clear what programme-related mechanisms and contexts are crucial to the successful delivery of interventions in the home. This study systematically reviewed published research studies to identify factors influencing the effective delivery of health promotion programmes targeting influenza in a household. DESIGN Realist review. METHODS A realist review methodology was selected to examine what interventions are effective in preventing and managing influenza at the household level and in what circumstances. A structured search of the peer-reviewed primary research literature was undertaken using a defined search protocol. RESULTS Eight studies were retrieved for the analysis. Mechanisms impacting on intervention delivery were identified, including timing of implementation, programme reach, organisational and healthcare worker involvement, mode and place of delivery, contact with infected person, health practice compliance and sustainability at home. CONCLUSION These findings suggest contextual factors that could be identified through ecological approaches to health promotion that are crucial for policymakers to consider when designing interventions. RELEVANCE TO CLINICAL PRACTICE The active involvement of community nurses through an integrated household visiting programme may help to better deliver family-based health promotion interventions to prevent illnesses such as influenza in children.

Understanding parental participation in health promotion services for their children

The aim of this research was to explore parental participation in child health promotion services within a Hong Kong community. There are many elements influencing the effect of health promotion services. One is the extent of parental participation. However, research in this area is limited. Focus group data were content analyzed. Six themes were conceptualized. They are Equity, Equality, Evolution, Engagement, Consultation, and Continuity. We concluded that a strategic approach in partnership with families is required for health promotion activities for children. The findings contribute to an understanding of the crucial factors for the promotion of parental participation in health promotion services.

Patients' perceptions of their experiences with nurse-patient communication in oncology settings: A focused ethnographic study

Background The nursing shortage and its impact on patient care are well-documented global issues. Patients living with cancer as a chronic illness have many psychosocial problems and often lack adequate support as a result of ineffective nurse-patient communication. A review of the literature on factors influencing the delivery of psychosocial care to cancer patients indicates that the delivery of psychosocial care in routine cancer nursing within a biomedical healthcare system has not been widely explored. Objective To explore patients’ perceptions of their experiences with nurse-patient communication in an oncological clinical environment. Method A focused ethnographic study was undertaken in two oncology wards of a hospital in Hong Kong. Data were collected through observations of the ward environment, the activities and instances of nurse-patient communication, semi-structured interviews with patients, and a review of nursing documents. Results Two main themes were identified: 1. Nurses’ workload and the environment and 2. Nurse-patient partnership and role expectations. Within these two themes were related subthemes on: Sympathy for the busy nurses; Prioritizing calls to the nurses; Partnership through relationship; Nurses’ role in psychosocial care; and Reduction of psychosocial concerns through physical care. Conclusions Many cancer patients do not expect to receive psychosocial care in the form of emotional talks or counseling from busy nurses, but appreciate the attention paid by nurses to their physiological and physical needs. Nurse-patient partnerships in cancer care may reduce the potential workload of nurses. The psychosocial needs of cancer patients could be optimized by providing good physical care through effective communication within a time-constrained oncology setting.

The role of culture in relation to the seasonal influenza prevention practices of Hong Kong Chinese parents with preschool children

Abstract Aims and objectives: To explore the role of culture in the seasonal influenza prevention practices of Hong Kong Chinese parents with a healthy preschool child. Background: Cultural values and norms significantly influence parents’ health preventive practices and related health promotion strategies. Most research is concerned with influenza prevention and focuses on the factors affecting vaccination uptake, the use of facemasks and effective hand hygiene. There is limited research exploring the influence of culture on the seasonal influenza prevention practices of parents with a young child in Hong Kong. Design: Mixed methods using a multiple-case study approach. Methods: Purposive intensity sampling was employed to recruit 20 parents with children under five years old. A thematic analysis was employed to examine the qualitative interview data and the quantitative data were analysed descriptively. The data were then integrated to provide a more rigorous comprehension of parents’ cultural seasonal influenza preventive practices. Comparisons were conducted across the 20 cases and patterns examined. Results: Five themes were identified. They were sharing beds; boiling white vinegar to kill air-born germs; diet therapy to enhance health; self-prescribed Chinese medication to manage a child’s cold symptoms; and the co-use of Western and traditional Chinese medications to prevent seasonal influenza. Conclusions: The findings indicate that a pluralistic approach to health promotion should be considered to ensure the likelihood that families accept, support and comply with health advice in seasonal influenza prevention. The delivery of culturally appropriate health promotion requires a close partnership between nurses and parents.

Factors affecting the willingness of nursing students to receive annual seasonal influenza vaccination: A large-scale cross-sectional study

Nursing students are at high risk of exposure to vaccine-preventable diseases such as seasonal influenza. However, due to the limited number of studies conducted in this area, the prevalence and factors affecting annual seasonal influenza vaccination (ASIV) uptake remain unclear. This was a large-scale cross-sectional survey study conducted among 902 nursing students in different years of study. The questionnaire was developed based on the Health Belief Model (HBM), and logistic regression was used to determine the predictors of ASIV uptake. The results of our study reveal that only 15.2% of nursing students declared having the vaccine in the previous year, and that ASIV uptake was self-reported. ASIV uptake was associated with perceived susceptibility (odds ratio=2.76), perceived seriousness (odds ratio=2.06) and perceived barriers (odds ratio=0.50). The odds of receiving ASIV were 17.96times higher for those participants having had ASIV at least once than those who had not received ASIV in the previous five years. In addition, the odds of receiving ASIV were 4.01times higher for masters than undergraduate students. Our study concludes that the ASIV uptake among nursing students is low. In order to increase vaccination uptake in subsequent years, future studies should promote vaccination based on HBM, focusing on nursing students in undergraduate studies by emphasizing not only vaccination knowledge, but also their social responsibility to protect patients. Influenza vaccination can be viewed as an ethical professional responsibility and a patient safety issue, as well as being an infection control strategy.

Approaches to better engage parent-child in health home-visiting programmes: A content analysis.

Home visiting is an evidence-based strategy used to enhance child and family health outcomes. Such primary healthcare endeavours demand the full participation of individual and families. We conducted a review to identify approaches to planning, executing and assessing home-visiting health promotion interventions to determine how parents and children can be best engaged. A structured search (2000–2015) was undertaken using a defined search protocol. The quality of the papers was assessed using standard appraisal tools. Sixteen studies were retrieved. A content analysis of the findings sections of the papers was undertaken and guided by the eight phases of the PRECEDE-PROCEED health promotion planning framework. The analysis found that while all the PRECEDE assessment areas were represented no studies included all phases. Parents and children did not appear to be actively involved in undertaking the assessments and evaluation of the home-visiting health promotion programmes. The findings suggest that there is a need to develop a consistent home-visiting approach that includes comprehensive assessments in the planning phases and parent and child involvement at each step of programme development, implementation and evaluation. This approach enables the development of tailored and sustainable health promotion intervention in order to achieve optimal child health outcomes.

Approaches to better engage parent-child in health home-visiting programmes : a content analysis

Home visiting is an evidence-based strategy used to enhance child and family health outcomes. Such primary healthcare endeavours demand the full participation of individual and families. We conducted a review to identify approaches to planning, executing and assessing home-visiting health promotion interventions to determine how parents and children can be best engaged. A structured search (2000–2015) was undertaken using a defined search protocol. The quality of the papers was assessed using standard appraisal tools. Sixteen studies were retrieved. A content analysis of the findings sections of the papers was undertaken and guided by the eight phases of the PRECEDE-PROCEED health promotion planning framework. The analysis found that while all the PRECEDE assessment areas were represented no studies included all phases. Parents and children did not appear to be actively involved in undertaking the assessments and evaluation of the home-visiting health promotion programmes. The findings suggest that there is a need to develop a consistent home-visiting approach that includes comprehensive assessments in the planning phases and parent and child involvement at each step of programme development, implementation and evaluation. This approach enables the development of tailored and sustainable health promotion intervention in order to achieve optimal child health outcomes.