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Gina Marie Mathew,1 Stephen M Strayer,1 David S Bailey,1 Katherine Buzzell,1 Kelly M Ness,1 Margeaux M Schade,1 Nicole G Nahmod,1 Orfeu M Buxton,1 Anne-Marie Chang1,2 1Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, PA, USA; 2College of Nursing, Pennsylvania State University, University Park, PA, USACorrespondence: Gina Marie MathewDepartment of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, 16802, USATel +1 (814) 863-7256Email gina.marie.mathew@gmail.comPurpose: The effects of sleep restriction on subjective alertness, motivation, and effort vary among individuals and may explain interindividual differences in attention during sleep restriction. We investigated whether individuals with a greater decrease in subjective alertness or motivation, or a greater increase in subjective effort (versus other participants), demonstrated poorer attention when sleep restricted.Participants and Methods: Fifteen healthy men (M±SD, 22.3± 2.8 years) completed a study with three nights of 10-hour time in bed (baseline), five nights of 5-hour time in bed (sleep restriction), and two nights of 10-hour time in bed (recovery). Participants completed a 10-minute psychomotor vigilance task (PVT) of sustained attention and rated alertness, motivation, and effort every two hours during wake (range: 3– 9 administrations on a given day). Analyses examined performance across the study (first two days excluded) moderated by per-participant change in subjective alertness, motivation, or effort from baseline to sleep restriction. For significant interactions, we investigated the effect of study day2 (day*day) on the outcome at low (mean− 1 SD) and high (mean+1 SD) levels of the moderator (N = 15, all analyses).Results: False starts increased across sleep restriction in participants who reported lower (mean− 1 SD) but not preserved (mean+1 SD) motivation during sleep restriction. Lapses increased across sleep restriction regardless of change in subjective motivation, with a more pronounced increase in participants who reported lower versus preserved motivation. Lapses increased across sleep restriction in participants who reported higher (mean+1 SD) but not preserved (mean− 1 SD) effort during sleep restriction. Change in subjective alertness did not moderate the effects of sleep restriction on attention.Conclusion: Vigilance declines during sleep restriction regardless of change in subjective alertness or motivation, but individuals with reduced motivation exhibit poorer inhibition. Individuals with preserved subjective alertness still perform poorly during sleep restriction, while those reporting additional effort demonstrate impaired vigilance.Keywords: sleep restriction, attention, interindividual differences, alertness, motivation, effort

Background: Patients who present to the emergency department (ED) with symptoms of potential acute coronary syndrome (ACS) can be safely discharged home after a coronary computed tomographic angiography (CTA) with a negative result. However, the duration of time for which a negative coronary CTA scan result can be used to inform decision making when patients have recurrent symptoms is not known. Objective: We examined patients who received more than 1 coronary CTA for evaluation of ACS to determine whether they had disease progression. Our main outcome was whether any patient had a maximal stenosis cross the threshold from noncritical (<50% maximal stenosis) to potentially critical disease. Methods: We performed a structured comprehensive record search of all coronary CTAs performed from 2005 to 2010 at a tertiary care health system. Low-to-intermediate risk ED patients who received 2 or more coronary CTAs, at least 1 from an ED evaluation for potential ACS, were identified. Patients who were revascularized between scans were excluded. We collected demographic data, clinical course, time between scans, and number of ED visits between scans. Record review was structured and done by trained abstractors. Our main outcome was progression of coronary stenosis between scans, specifically crossing the threshold from noncritical to potentially critical disease. Results: Overall, 32 patients who received repeat imaging were identified (median age, 45 years; interquartile range, 37.5-48; 56% female; 88% black). The median time between studies was 27.3 months (interquartile range, 18.2-33.2). Twenty-two patients did not have stenosis in any vessel on either coronary CTA, 2 studies showed increasing stenosis of less than 20%, and the rest showed "improvement" due to better imaging quality. No patient initially below the 50% threshold subsequently exceeded it (0%; 95% confidence interval, 0-11.0%). No patient had acute myocardial infarction or revascularization either between scans or within a year after the repeated imaging. Conclusion: Repeated imaging potentially may not be warranted within 2 years of a negative coronary CTA result. The low rate of progression from subcritical to critical disease is consistent with observations in patients who have had prior negative cardiac catheterizations. [ABSTRACT FROM AUTHOR]

STUDY OBJECTIVE: Although lay people often assume that severe pain is more commonly associated with worse outcomes, the relationship between pain severity and outcome for patients presenting with potential acute coronary syndrome has not been well described. We hypothesize that pain severity will not be associated with acute myocardial infarction or 30-day cardiovascular complications. METHODS: We conducted a secondary analysis of a prospective cohort study of patients presenting to the emergency department (ED) with potential acute coronary syndrome. Trained research assistants collected data, including demographics, medical history, symptoms, hospital course, and 30-day outcomes (record review and telephone). Pain score on arrival (0 to 10) was abstracted from nurses' triage documentation in the electronic record. Severe pain was defined as 9 or 10. The main outcomes were the prevalence of acute myocardial infarction during index visit and composite of death, acute myocardial infarction, revascularization including percutaneous coronary intervention, or coronary bypass artery grafting at 30 days. Multivariable modeling was prespecified to adjust for age, race, sex, pain duration, thrombolysis in myocardial infarction (TIMI) score, and mode of arrival. Data are presented as relative risk (RR) with 95% confidence intervals (CI). RESULTS: Patients (3,306) had pain documented (mean age 51.0 years; SD 12.6 years; 57% women; 66% black). Follow-up was 93%. By 30 days, 34 patients had died, 105 patients underwent revascularization (94 percutaneous coronary intervention, 14 coronary bypass artery grafting), and 111 patients experienced acute myocardial infarction. There was not a relationship between severe pain and acute myocardial infarction (RR 1.28; 95% CI 0.93 to 1.76) or 30-day composite outcome (1.19; 95% CI 0.91 to 1.56). After adjusting for potential confounding variables, we found that the prevalence of inhospital acute myocardial infarction was related to TIMI score (adjusted relative risk [aRR] 2.00; 95% CI 1.05 to 3.80), male sex (aRR 1.48; 95% CI 1.00 to 2.18), and arrival by emergency medical services (EMS) (aRR 1.73; 95% CI 1.13 to 2.63) but not age (aRR 1.42; 95% CI 0.68 to 2.95), white race (aRR 1.25; 95% CI 0.85 to 1.86), pain duration greater than 1 hour (aRR 1.36; 95% CI 0.89 to 2.07), or severe pain (aRR 1.43; 95% CI 0.91 to 2.22). Thirty-day composite outcome was related to male sex (aRR 1.53; 95% CI 1.16 to 2.01), white race (aRR 1.43; 95% CI 1.09 to 1.87), and higher TIMI score (aRR 2.24; 95% CI 1.39 to 3.60) but was not related to age (aRR 1.26; 95% CI 0.75 to 2.11), pain duration greater than 1 hour (aRR 0.8; 95% CI 0.60 to 1.06), EMS arrival (aRR 1.23; 95% CI 0.96 to 1.60), or severe pain (aRR 1.39; 95% CI 0.95 to 1.97). CONCLUSION: For patients who present to the ED with potential acute coronary syndrome, severe pain is not related to likelihood of acute myocardial infarction at presentation or death, acute myocardial infarction or revascularization within 30 days. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of the effectiveness of a purpose-designed education program in improving undergraduate nursing students' understanding and practice of infection control precautions. Background. The severe acute respiratory syndrome outbreak in 2003 highlighted that healthcare workers were under-prepared for such an epidemic. While many in-service education sessions were arranged by institutions in response to the outbreak, preservice nursing education has overlooked preparation for handling such infectious disease epidemics. Method. A quasi-experimental design was used and a 16-hour, purpose-designed infection control education programme was implemented for preservice nursing students in southern Taiwan. Self-administered questionnaires were distributed at three time points during the period September 2005 to April 2006 to examine the sustainability and effectiveness of the intervention. Results. A total of 175 preservice nursing students participated in the study. Following the education programme, students in the intervention group showed a statistically significant improvement across time in their knowledge of these precautions [F(2, 180) = 13.53, P < 0.001] and confidence in resolving infectionrelated issues [F(1.79, 168.95) = 3.24] when compared with those in the control group. Conclusion. To improve nursing students' capacity in responding to infectious epidemics, an educational programme that integrates the theme of infection precautions, learning theory and teaching strategies is recommended for all nursing institutes. [ABSTRACT FROM AUTHOR]

Background: Evidence indicates self-management programmes based on improving self-efficacy in managing diabetes can reduce the risk of a further cardiac event. Many current cardiac rehabilitation or diabetes self-management programmes do not address the needs of people with both type 2 diabetes and a critical cardiac condition in their transition from coronary care unit (CCU) to home. Aims/Methods: The aim was to develop and pilot test a Cardiac-Diabetes Self-Management Program (CDSMP) using an experimental design. Findings/Conclusion: Results demonstrated the feasibility of the CDSMP for CCU patients with type 2 diabetes in their transition to home, and a full study is warranted. [ABSTRACT FROM AUTHOR]

Aim. This study reports on nursing students' current capacity to handle standard and additional infection-control precautions in terms of their knowledge, application skills and confidence. Background. These precautions are recommended as the guidelines for preventing infections and ensuring occupational safety. As nursing students undertake patient care during clinical practice, their knowledge of and ability to apply these precautions with confidence should be examined before they enter the clinical field. Method. A specific tool, the Infection Control Evaluation, was developed and distributed. Design. A cross-sectional survey involving a sample of preservice nursing students was conducted in southern Taiwan. Results. The results were based on an 88% response rate and indicated that the level of knowledge concerning standard and additional precautions was low among Taiwanese nursing students. Their ability in applying these precautions in clinical practice also appeared to be inadequate. Conclusions. Such findings indicate that Taiwanese preservice nursing students require a comprehensive foundation course in infection-control precautions before they enter the clinical environment. This will help to ensure their protection and that of their patients. Relevance to clinical practice. As the findings highlight the importance of providing such education for students before they undertake any clinical work, the information provided here can help nursing educators and academics to develop a specific program. [ABSTRACT FROM AUTHOR]

Aim. This paper reports the results of a study evaluating an implementation programme in improving nursing home staff's knowledge of and adherence to an individualized music protocol for older people with dementia. Background. The major barriers to evidence-based practice identified by nurses are the lack of knowledge and skills on implementing evidence-based practice. Some evidence supports the effectiveness of implementation strategies in facilitating practice change among healthcare professionals but need further testing. Little is known about what is the best way to facilitate nursing home staff's adoption of evidence-based care. Methods. A one-group pre-post test design was used with a convenience sample of 17 nursing staff from a long-term care facility. The implementation programme consisted of interactive education, reminders, a local opinion leader and audit. Data on nursing staff's knowledge of music protocol were collected by the music knowledge questionnaire and their adherence to the protocol was assessed by an audit checklist at baseline and week four after the implementation programme. Results. There was a significant improvement in nursing staff's knowledge ( p < 0·001) of the music protocol. The improvement was greater among nurse aides; however, the improvement between the nurse group and the nurse aide group was not significantly different ( p > 0·05). The mean level of their adherence to the protocol improved from nil at baseline to 72·35% on the post-test. Conclusions. An innovative implementation programme consisting of interactive education, reminders, use of a local opinion leader and audit led to an improvement in nursing home staff's knowledge of and adherence to an individualized music protocol in dementia care. Relevance to clinical practice. Multifaceted implementation strategies with careful consideration of local circumstances may be essential in promoting uptake of evidence-based practice among nursing staff in long-term care settings. [ABSTRACT FROM AUTHOR]

BACKGROUND: The introduction of unrestricted visiting hours has led to the encouragement of parents to stay with and participate in the care of their hospitalised child. In order to stay with the hospitalised child, parents have to be away from home or work, which in turn impacts on their personal and family life. However, no published study on parents' experiences of childcare participation during paediatric hospitalisation has been found for a Chinese population. OBJECTIVES: This study explored Chinese parents' experiences of their participation in taking care of their hospitalised child. DESIGN: A qualitative exploratory design was adopted to capture parents' experiences of participation. SETTINGS: The study was conducted in four paediatric wards of a regional acute general hospital in the New Territories, a major geographical region of Hong Kong. PARTICIPANTS: Nineteen parents (16 mothers and three fathers) who had a child hospitalised for more than 48h and identified themselves as staying comparatively longer with the child than their counterpart were recruited. METHODS: Data were collection by tape-recorded semi-structured interview. RESULTS: Four major categories that illustrated parents' experiences of participation in childcare were identified: reasons for staying with the child, rescheduling of family's routine, expectations of nurses, and comments on facility provisions. The findings highlight parents' desire for participation in caring for their hospitalised child, their unexpressed needs for communication and concern about the non-monetary costs of participation. CONCLUSIONS: Most parents viewed accompanying their hospitalised child as an unconditional aspect of being a parent and had a strong desire for participation. Parents' need for communication and emotional support during their participation of childcare in paediatric unit are universal. As Chinese parents are passive in seeking help, nurses should take the initiative in assessing their needs and offering them support accordingly. [ABSTRACT FROM AUTHOR]

AIMS AND OBJECTIVES: This paper reviews study findings of preferred music on agitated behaviours for older people with dementia and provides implications for future research and practice. BACKGROUND: Music has been suggested as a feasible and less costly intervention to manage agitated behaviours in older people with dementia. However, no review of the literature focusing on study findings of preferred music on agitated behaviours in older people with dementia had been reported. METHODS: A review was undertaken using electronic databases with specified search terms for the period of 1993-2005. The references listed in the publications selected were also searched for additional studies. RESULTS: Eight research-based articles met the inclusion criteria and were included in the review. The preferred music intervention demonstrated positive outcomes in reducing the occurrence of some types of agitated behaviours in older people with dementia. The findings from these studies were relatively consistent in finding improvement in agitated behaviours although the findings in one study did not reach statistical significance. The small sample sizes and some variations in the application of the preferred music intervention mean that caution is needed in drawing conclusions from these studies. CONCLUSIONS: This review highlights that preferred music has positive effects on decreasing agitated behaviours in older people with dementia; however, the methodological limitations indicate the need for further research. RELEVANCE TO CLINICAL PRACTICE: Findings from the review highlight the beneficial outcomes of preferred music in reducing agitated behaviours for older people with dementia. The incorporation of preferred music has the potential to provide a therapeutic approach to the care of older people with dementia. [ABSTRACT FROM AUTHOR]

AIMS: This paper reports a study examining the quality of life of clients following hospital admission with acute coronary syndrome in Hong Kong and their use of cardiac rehabilitation. BACKGROUND: Coronary heart disease is a major source of mortality and morbidity in Hong Kong. Western studies have suggested that participation in cardiac rehabilitation improves the quality of life of clients with coronary heart disease yet the use of cardiac rehabilitation has been reported to be low. Better understanding is needed of the psychosocial status of these clients in Hong Kong and their use of cardiac rehabilitation services. METHODS: A prospective, pretest-post-test study was carried out, with data collected over a period of 6 months with convenience sample of 182 participants. Baseline data were obtained within one week after hospital admission for individuals experiencing ACS. The second phase of data collection commenced at 6 months after hospital discharge. Total period of data collection took over 12 months between 2002 and 2003. The Chinese version of the SF-36 was used to assess quality of life, and demographic data and the extent to which clients participated in the cardiac rehabilitation programme were assessed. RESULTS: Only 25% of the participants attended at least one session of the cardiac rehabilitation programme. Significant improvement occurred in all clients' perceived quality of life 6 months following initial hospital admission. No significant group differences in perceived quality of life were found according to whether or not clients used the cardiac rehabilitation services. CONCLUSION: Improvement in perceived health-related quality of life was evident over a 6-month period. Yet our findings suggested that participation in the cardiac rehabilitation programme did not have any apparent effects in subjects' perceived quality of life. Further studies using both generic and disease-specific health-related quality of life instruments, as well as the inclusion of control group, are recommended. Continual improvement in cardiac rehabilitation programmes, and consideration of alternative modes of delivery other than the traditional attendance at hospital outpatient services, are also recommended. [ABSTRACT FROM AUTHOR]

BACKGROUND: In previous studies comparing patient-controlled-analgesia and intramuscular pain management have been unable to provide conclusive evidence of the benefits of either method of postoperative pain control. AIM: The purpose of the study was to compare the efficacy and cost-effectiveness of intravenous patient-controlled-analgesia with intermittent intramuscular morphine for Chinese women in the first 24 hours following elective gynaecological surgery. METHODS: A randomized control design was used. The main outcomes were level of pain and cost for the two types of pain management. Participants indicated their level of pain at rest and when deep breathing or coughing on a 100 mm Visual Analogue Scale, on seven occasions within 24 postoperative hours. Costs for the two types of pain management were based on the costs of equipment, drugs and nursing time. RESULTS: A total of 125 women participated in the study. Mean pain level over the 24 hours in the patient-controlled-analgesia group was significantly lower than in the intramuscular group (P < 0.001). Mean pain level over the seven occasions for the patient-controlled-analgesia group was 11.83 points (95% CI 7.14-16.52) lower when at rest and 11.73 points (95% CI 5.96-17.50) lower during motion than the intramuscular group. Cost per patient was $81.10 (Hong Kong) higher for patient-controlled-analgesia than for intramuscular pain management. Women in the patient-controlled-analgesia group had significantly greater satisfaction with pain management than those in the intramuscular group (P < 0.001), but reported significantly more episodes of nausea (P < 0.05). CONCLUSIONS: While patient-controlled-analgesia was more costly, it was also more effective than conventional on-demand intramuscular opioid injections after laparotomy for gynaecological surgery. [ABSTRACT FROM AUTHOR]

AIM: The aim of this study was to determine the effects of using videotaped vignettes in promoting nursing students' critical thinking abilities in managing different clinical situations. BACKGROUND: The impetus for undertaking this study came from recognition of the need to develop the level of students' critical thinking within clinical nursing practice. Eight videotaped vignettes that simulated clinical situations were developed to promote baccalaureate nursing students' critical thinking abilities in managing clinical situations. Guidelines were also developed to stimulate students' discussion. DESIGN/METHODS: A pre-test/post-test design was employed to determine the effectiveness of videotaped vignettes in promoting critical thinking skills among these students. A final sample of 83 students completed all the pre-test and post-test questionnaires on critical thinking skills and nursing knowledge test specific to a vignette. RESULTS/FINDINGS: The findings indicate that students' post-test knowledge scores were significantly higher than the pre-test knowledge scores. While the post-test critical thinking skill test scores were slightly higher than those of the pre-test for the students, the difference was not significant. One reason for such findings may be the limited exposure students had to these new types of videotaped vignettes. After the course had been completed both students and teachers were asked to reflect and to indicate their level of satisfaction with the new approach. There was overall satisfaction with the new approach to teaching clinical skills as reflected in the interview data from both teachers and students. CONCLUSIONS: While there were positive outcomes in terms of helping students to relate nursing principles to clinical situations, more time for students to learn using videotaped vignette in tutorial hours remains a challenge for teachers in planning the lectures. [ABSTRACT FROM AUTHOR]

AIMS: The present study was designed to determine the psychosocial correlates of fluid compliance among patients receiving haemodialysis at two Hong Kong renal dialysis centres. BACKGROUND: There has been little consistency in the findings of correlations among any psychosocial variables and compliance behaviour. There is a need to further study these variables in an attempt to predict haemodialysis patient compliance to fluid restriction. METHODS: Ninety-two Chinese haemodialysis patients completed the Center for Epidemiological Studies Depression Scale (CES-D), The Multidimensional Health Locus of Control Form C Scale (MHLC), the Social Support Questionnaire, Short Form Scale (SSQ6) and a self-designed socio-demographic questionnaire. Daily interdialytic weight gain (DIWG) measure was used as an indicator of fluid compliance. RESULTS: The prevalence of compliance behaviour of Chinese haemodialysis patients was higher than that reported in western studies. There were significant negative correlations found between DIWG and total score on internal health locus of control and social support satisfaction score. However, internal health locus of control did not predict a significant portion of the DIWG variance. Significant predictors of DIWG included satisfaction with social support, comorbidity and monthly family income. Satisfaction with social support was the largest predictor of DIWG. CONCLUSIONS: The present findings suggest that assessing family income, comorbidity, and satisfaction with social support may be useful in identifying haemodialysis patients potentially at risk for difficulties in compliance with fluid restriction. [ABSTRACT FROM AUTHOR]

This study was conducted to examine the knowledge of and attitudes toward sex of 178 Chinese secondary school students in Hong Kong. The data were collected using a questionnaire that comprised three parts: the Chinese version of the Mathtech Knowledge Test, the Chinese version of the Mathtech Attitude and Value Scale, and a demographic sheet seeking sociodemographic information. In general, students demonstrated a low level of sexual knowledge, especially in relation to adolescent marriage, the probability of pregnancy, and adolescent sexual activity. With regard to attitudes, students indicated positive attitudes toward importance of family and importance of birth control. Male students in comparison with their female counterparts had a higher level of agreement with premarital intercourse and the use of pressure and force in sexual activity. [ABSTRACT FROM AUTHOR]

PURPOSE/OBJECTIVES: To identify the relationship between family caregivers' reported difficulty in managing caregiver tasks and ages of caregivers and patients. DESIGN: Cross-sectional, descriptive survey. SETTING: A hospice homecare program in Hong Kong. SAMPLE: Twenty-nine Chinese family caregivers who had experienced at least weekly caregiving responsibility for more than two months and were able to read and understand Chinese. METHODS: Respondents completed a caregiver task inventory. Four homecare nurses assisted in the distribution and collection of questionnaires. MAIN RESEARCH VARIABLES: Caregiver tasks and age and patient age. FINDINGS: Caregivers' age was negatively correlated with reported difficulty in overall tasks and in interpersonal ties. The patients' age was negatively correlated with reported difficulty in direct care to patients, intrapersonal tasks, and overall tasks. CONCLUSIONS: The younger the caregiver, the more difficulty he or she experienced in the caregiving role, particularly in the maintenance of social and family ties. Caregivers of younger patients experienced more difficulty in most aspects of caregiving tasks. More research with a larger sample size is required to fully investigate the effect of age on the family caregiving experience and the validity of the caregiver task inventory. IMPLICATIONS FOR NURSING PRACTICE: Nursing support and preparation to younger caregivers and caregivers of younger patients are suggested in the practice of palliative home care. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore empirically whether undergraduate nursing students at a selected university in Hong Kong display a disposition towards critical thinking. The California Critical Thinking Dispositions Inventory (CCTDI) was used to measure the key theoretical aspects of the overall dispositional dimension of critical thinking. A cross-sectional descriptive design was used to examine 122 Chinese students who were completing their 1st, 2nd and 3rd year of a university baccalaureate nursing programme. In the majority of sub-scales of CCTDI, students showed a negative disposition towards critical thinking. A one-way ANOVA indicated that year 3 students scored significantly lower than their junior counterparts (P < 0. 001). Pearson product moment correlation coefficient yielded a significant positive relationship between critical thinking dispositions and term grade point average (P < 0.05). Consistent with the findings of western studies, the students scored lowest on the truth-seeking sub-scale and highest on the inquisitiveness. Discussion of the findings with regard to nursing education, curriculum and research is delineated. [ABSTRACT FROM AUTHOR]

Twenty-nine family caregivers of terminally ill cancer patients in Hong Kong were asked about their perceived difficulty in managing caregiver tasks. Results showed that the level of difficulty in handling the three main aspects of tasks, that is the direct care, intrapersonal tasks, and interpersonal ties, were similar (chi2 = 0.71, P > 0.05). The individual tasks identified as extremely difficult included compensation for personal time (31%), updating knowledge of reimbursement mechanism (20.7%), and emotionally accepting the likelihood of a progressive downward course of illness (17.2%). Mann-Whitney tests indicated that caregivers who had a shorter duration of caregiving experience perceived significantly greater difficulty in direct care (P < 0.05), intrapersonal tasks (P < 0.05), and overall tasks (P < 0.05). These findings indicate the need for the provision of counselling and educational support for these caregivers. [ABSTRACT FROM AUTHOR]

The validity of studies using translated instruments may be questioned when there is a lack of attention to and/or minimal explanation of the procedures used for determining the equivalence between the primary and secondary language tool. Ensuring equivalence of a translated Chinese version of the Menstrual Distress Questionnaire is an important prerequisite for identifying culturally specific expressions of concepts under investigation and for cross-cultural comparisons. This paper examines the principles and procedures for determining equivalence of translated tools and their application to the development of an equivalent Chinese version of the Menstrual Distress Questionnaire. Translation and back-translation were used to develop a Chinese version of the Menstrual Distress Questionnaire. Bilingual university students completed both versions of the Menstrual Distress Questionnaire. Most of the Menstrual Distress Questionnaire items had an acceptable Kappa of >0.4. Intraclass correlation coefficients indicated moderate to high levels of equivalence for total scores and all scales. Improvement in the translation of some items is needed to further enhance the equivalence of the Chinese version of the Menstrual Distress Questionnaire. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to determine changes in the work nature of nurses after the introduction of Health Care Assistants (HCAs). Background: HCAs with a role similar to those adopted in the UK of assisting the nurse were piloted in a teaching hospital in Hong Kong. Method: A quasi-experimental design was used to compare the observed activities of HCAs and nurses in four wards of a teaching hospital, before and after the introduction of HCAs. As the amount of staff activity is influenced by the amount of work, patient dependency data were gained from record reviews and nurse interviews. Findings: HCAs in orthopaedic and medical wards provided more basic care than those in surgical and gynaecological wards. Nurses in wards with HCAs performed significantly fewer activities than nurses in control wards. Conclusions: HCAs presence accounted for a reduction in both direct and indirect care provided by nurses. Overall, HCAs provided more basic than technical and indirect care. [ABSTRACT FROM AUTHOR]

With the implementation of Project 2000 in the UK the traditional student nurse workforce has largely been replaced by health care assistants (HCAs). This study was carried out in Hong Kong at a time when university-based nurse education is gradually being introduced. Evaluation of a HCA pilot programme in an acute care hospital in Hong Kong provided the opportunity to examine the work of HCAs and hospital-based student nurses during the gradual introduction of university-based nurse education. The data used in this paper were drawn from a larger study evaluating the use of HCAs. The observational data collected at two phases after the introduction of HCAs were analysed using Kruskal-Wallis one way analysis of variance. No significant differences were found in the total amount of all types of activity performed by SNs and HCAs. However in the direct care type of work HCAs performed significantly more basic care and less technical activity than any level of student at phase 1 (P < 0.001) and phase 2 (P < 0.001). These differences in the work undertaken suggest that qualified staff do not perceive SNs and HCAs as equally unqualified. Thus the replacement of SNs with HCAs alone is likely to lead to a notable change in the role of qualified staff in terms of their direct and indirect care activities and in the amount of time spent delegating and supervising unqualified staff. [ABSTRACT FROM AUTHOR]