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Severe acute respiratory syndrome (SARS) is a highly infectious disease, with high potential for transmission to close contacts, particularly among healthcare workers. This is the first systematic study investigating hospital nurses' physical and psychological health status and the kinds of healthcare used-stratified by the level of contact with SARS patients-during the 2003 outbreak in Hong Kong. Nurses in moderate-risk areas appeared to have more stress symptoms than those working in high-risk areas. It is essential to design hospital support systems and occupational health policy to promote the psychological well-being of nurses during future outbreaks of emerging infections.

This study assessed the gender and age differences in smoking cessation among the Chinese youth and identified factors associated with quitting smoking. This was a clinic based cross-sectional study with longitudinal components among 129 Chinese young smokers. All services in the clinic including one week's supply of nicotine replacement therapy (NRT) were free. We used structured questionnaires at baseline and at 1, 3 and 12 months. The analysis was by intention-to-treat basis. At 12 month follow up, the 7 day point prevalence quit rate (abstinence from tobacco smoking during the 7 days preceding the follow up) was 19% (25/129) and 36% (25/69) among all the attendees and among those who were successfully followed up, respectively. There was no significant gender or age differences in the quitting outcome but females and the older youth reported more withdrawal symptoms. Not reporting any withdrawal symptoms at 3 months follow up and adherence to use NRT for at least 4 weeks were significant predictors of quitting. A clinic-based smoking cessation service among Chinese young smokers produced an acceptable quit rate with no gender and age difference, indicating that a more general quit smoking approach could be taken for the youth.

To achieve greater coverage of elderly smokers and to shift entire populations toward cessation, the provider-client interface could be broadened beyond physicians to include nurses and social workers, who can be formally trained to provide such services. We carried out a population-based training needs assessment of the latter two groups in Hong Kong.Three thousand seven hundred eligible hospital-based nurses and 2,258 social workers who had elderly clients in Hong Kong were recruited in a knowledge, attitude, and practice (KAP) cross-sectional survey. We used multivariable logistic regression to identify predictors for two key outcomes-"initiation and advice" (ask and advise) and "follow-through" (assess, assist and arrange), based on the U.S. Agency for Health Care Policy Research framework.One thousand eight hundred forty-three (49.8%) nurses and 1,499 (66.4%) social workers responded. Nurses reported a much higher level of engagement in smoking cessation activities than social workers in all five steps of the AHCPR framework (P0.001). Nurses (mean score=2.99+/-0.40 on a 4-point Likert scale) had more positive attitudes to tobacco control and smoking cessation counseling compared to social workers (mean score=2.79+/-0.41; P0.001), whereas the latter group perceived themselves as more competent in handling such practice (mean score(nurses)=2.36+/-0.52, mean score(social workers)=2.51+/-0.39; P0.001). Both attitudinal and self-perceived competence scores predicted incremental gains in the likelihood of offering "follow-through" interventions in addition to those observed for "initiation and advice" actions.Our findings highlight a large degree of unmet need in Hong Kong's hospital-based nurses and social workers who work with the elderly regarding smoking cessation service provision and training. Future research should focus on developing and evaluating programs that encourage nurses and social workers to provide cessation interventions to exert a much greater collective impact than doctors can alone.

There is a wealth of literature demonstrating that clinical nursing education is an important part of the baccalaureate programme in preparing students for entry into the nursing profession. While much attention has been given to the factors that can affect learning outcomes in the clinical environment, student and teacher perceptions of the relationship between assessment and learning has remained an under-researched area. The purpose of this study was to explore the perceptions about what students learned and how they learned during their clinical practicum, and to examine the role played by assessment in influencing student learning. Data were collected through a series of focus group interviews with groups of nursing students, graduates, and teachers. It was revealed that students' learning during the clinical practicum was, to a large extent, affected by their perceptions of the assessment tasks. As a result, they adopted a surface approach to learning and focused on preparing for the assessment tasks to the detriment of their learning. Assessment, in this study, exerted what has been described as a negative "backwash" effect on learning. Since assessment may also foster student learning in a positive way, suggestions are offered as to what can be done to bring about a positive "backwash" effect.

Objective To report the effectiveness of a health education intervention provided by nurses to prevent second-hand smoke exposure in sick children in Hong Kong. Data sources A clinical trial, international and national government reports, and research studies. Conclusion Exposure to second-hand smoke is associated with significant morbidity and mortality. Nursing interventions to reduce exposure are critical and need further study. Implications for nursing practice Nurses are in a vital position to carry out health education about the health risks associated with second-hand smoke exposure and to protect the child from such exposure.

Objectives To review international nursing involvement in tobacco control and discuss opportunities and challenges to enhance nurses’ participation in decreasing tobacco-related morbidity and mortality. Data sources Published literature and published and unpublished material developed by nurses in their tobacco control initiatives. Conclusion Worldwide, nurses have been involved in tobacco control. However, many opportunities remain for involvement in the areas of education, research, and practice. Implications for nursing practice There are numerous opportunities for nurses throughout the world to enhance their involvement in tobacco control.

Background This past year there was an outbreak of Severe Acute Respiratory Syndrome (SARS) in Hong Kong. During that time we investigated the clinical features, treatment, and nursing care of 36 patients and reported on 12 of these patients' perceptions of their illness experience. Purpose The purpose of this article is to describe the clinical features, treatment, nursing care and perceptions of the illness experience of patients with SARS in Hong Kong in order to better inform nurses caring for patients with this highly contagious and potentially lethal disease. Method We abstracted data from the medical and nursing records on the clinical features, treatment and nursing care of 36 patients (21 women, 15 men) in whom SARS was diagnosed and who were admitted to the Queen Mary Hospital in Hong Kong between March 15 and April 15, 2003. A review of the hospital's policy and procedures on infection control was also undertaken. Semi-structured interviews were conducted with 12 of the patients to elicit their perceptions of the illness experience. Findings The most common symptoms were cough (83%), dyspnea (80.6%), malaise (69.4%) and fever (61%). Less common symptoms included headache (38.9%), diarrhea (38.9%), dizziness (30.6%), myalgia (25%), chills (19.4%), nausea and vomiting (19.4%) and rigor (the occurrence of a sensation of hot-and-cold and shivering in addition to teeth chattering and bed shaking) (8.3%). All 36 patients received a combination of corticosteroids and ribavirin. The patients were at risk of drug-related adverse reactions and deterioration of respiratory function, and nursing vigilance was required. Conclusion Nursing patients with SARS was challenging as the disease was highly contagious and potentially lethal, and not much was known about this disease. In addition to the use of frontline treatment, infection control and sensitivity to individual responses to sudden and catastrophic illness were required to support these patients. From this outbreak of SARS, we have learned the importance of infection control in containing and controlling the disease. Other lessons included the need to strengthen the surge capacity in our hospitals and support health care workers during the crisis.

There is increasing emphasis on community-based health care. Evaluation of both government and non-government maternal and child care services in Hong Kong is a key objective for future development. The Kwun Tong Community Health Project, one of the Government's subsidy services, aim is to help in the rapid growth of the community so as to recognize needs, and to resolve health care issues. The present paper examines the findings of a consumer evaluation of three community health centers in the Kwun Tong Community Health Project, regarding clients' satisfaction towards the accessibility, information, use, medical consultation, perceptions of health problems of infants and cost of services provided. There was overall satisfaction expressed by the clients regarding health maintenance officers and the services provided. Provision of comprehensive family-focused care, including child and women's health was highly recommended. Parents' participation in decision-making about care and discussion about the child's health care plan were recognized as important issues to consider. Provision of play facilities and more flexible hours of operation were found to be beneficial in improving client's satisfaction. Finally, continuing education of the health maintenance officers was recognized as pertinent for them to update their knowledge while providing health education to the clients.

The health care system in Hong Kong has historically been steeped in the biomedical paradigm. Health care reform, however, is finally putting health promotion on the agenda of governments and health care providers. As the largest group of providers in Hong Kong, nurses must assume a leadership role in the transition of the current illness-focused system to one that emphasizes health and promotes wellness. For nurses to take up the challenge of health promotion, they need to acquire the requisite knowledge and skills. Nursing curricula must emphasize this new paradigm and provide opportunities for students to develop expertise in health promotion and disease prevention. This article describes a health-promotion initiative carried out by 1st-year students in an undergraduate nursing program in Hong Kong. The health-promotion project aims to prepare graduates who will be able to meet health care needs and function effectively in the future health care system. Not only will these nurses be capable of becoming future leaders of the health-promotion movement in Hong Kong, they are also contributing to the health and wellness of Hong Kong citizens.

Introduction Evidence had shown that nicotine replacement therapy (NRT) is effective to help smokers quit. Many studies reported a positive linear relationship between adherence and cessation rates however, adherence to NRT among unmotivated smokers is uncertain. Methods Chinese smokers who aged ≥18, had no intention to quit within 4-week and had no contraindication to NRT were recruited and randomly allocated to Group A1, A2 and B in a RCT. Only Group A1 and A2 were provided 8-week free NRT. We reported 8-week adherence rate to NRT at 3-month and reasons for non-compliance among subjects in Group A1 and A2. Results From October 2004 to April 2007, 1154 smokers were recruited (Group A1=479; A2=449; B=226). Subjects in Group A1 and A2 (n=928) were 42.0±10.3 year-old and smoked 19.6±9.4 cigarettes daily on average. We contacted 797 subjects (85.9%) for 3-month follow-up, but those who did not receive 8-week free NRT (n=115; 14.4%) were removed from the analysis. 55.4% (378/682) used NRT as the recommended regime, 41.6% (284/682) did not fully comply with the prescription and 3.0% (20/682) even did not use it. Among 304 (n=284+20) who did not comply, “Forget to use” (24.0%) and “Side effects” (14.5%) are the two most cited reasons for non-compliance. Conclusion The adherence rate in this study is more encouraging compared to a local study (20%) which only provided 1-week free NRT. Thus, providing the entire course of free NRT seems to yield an improved NRT adherence among unmotivated Chinese smokers.

BACKGROUND: Despite smoking cessation can largely improve cancer prognosis and quality of life, many patients continued smoking after the diagnosis of cancer. This study aims to test the effectiveness of a smoking cessation intervention using risk communication approach to help cancer patients quit smoking, and to improve their health related quality of life. METHODS: A cluster randomized controlled trial will be employed. Cancer patients who continued smoking after the diagnosis of cancer and have medical follow-up at the out-patient clinics of the five acute hospitals in Hong Kong will be invited to participate. Subjects in the experimental group will receive (1) health warnings of smoking based on a special designed leaflet; and (2) a patient-centred counseling from nurse counselors with emphasis on risk perceptions of smoking to cancer prognosis. Additionally, they will receive two more telephone counseling at 1-week and 1-month. Control group receive standard care and a generic self-help smoking cessation booklet. Outcomes measure include (a) self-reported and the biochemically validated quit rate, (b) patient's smoking reduction by at least 50 % compared to baseline, (c) quit attempt(s), (d) change in the intention to quit, (e) change in risk perceptions of smoking, and (f) change in health related quality of life. DISCUSSION: This study will make an important contribution to evidence-based practice by testing the effectiveness of a tailored smoking cessation intervention for cancer patients. The results will support the development of clinical practice guidelines to promote smoking cessation in cancer patients to improve their prognosis and quality of life., published_or_final_version

Background The relative contribution of long term care facilities (LTCFs) and hospitals in the transmission of methicillin-resistant Staphylococcus aureus (MRSA) is unknown. Methods Concurrent MRSA screening and spa type analysis was performed in LTCFs and their network hospitals to estimate the rate of MRSA acquisition among residents during their stay in LTCFs and hospitals, by colonization pressure and MRSA transmission calculations. Results In 40 LTCFs, 436 (21.6%) of 2020 residents were identified as ‘MRSA-positive’. The incidence of MRSA transmission per 1000-colonization-days among the residents during their stay in LTCFs and hospitals were 309 and 113 respectively, while the colonization pressure in LTCFs and hospitals were 210 and 185 per 1000-patient-days respectively. MRSA spa type t1081 was the most commonly isolated linage in both LTCF residents (76/121, 62.8%) and hospitalized patients (51/87, 58.6%), while type t4677 was significantly associated with LTCF residents (24/121, 19.8%) compared with hospitalized patients (3/87, 3.4%) (p Conclusions Our data suggest that MRSA transmission was more serious in LTCFs than in hospitals. Infection control should be focused on LTCFs in order to reduce the burden of MRSA carriers in healthcare settings.