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Tai Po, China

Fung A.W.T.,Chinese University of Hong Kong | Lam L.C.W.,Chinese University of Hong Kong | Lui V.W.C.,Tai Po Hospital
Aging and Mental Health | Year: 2010

Background: With increasing longevity, there is an increasing need for medical professionals to face situations in which explanation for decision on life-sustaining treatment (LST) would be required. Objectives: As advance decision making for LST in case of severe medical illness may be unfamiliar for most of the Chinese elders, we aim to explore if procedures adopted to enhance the exposure to the issue concerned would bring about improvement in knowledge toward decision for LST. Method: This was a cross-sectional study. The design was divided into three sections: (i) a pre-scenario knowledge assessment, (ii) scenario exposure (relating issues of LST using case vignettes), and (iii) a post-scenario assessment. The pre-and post-scenario assessment comprises 10 questions, exploring the understanding toward basic issues related to LST. The scenario exposure comprises two hypothetical case vignettes describing situations demanding decisions for LST. The knowledge level toward LST was assessed and compared before and after the presentation of the two vignettes. Results: One-hundred community dwelling older persons (aged over 60 years) were recruited. The scenario exposure improved the knowledge level of participants (paired samples t-test, p <0.05). Participants who were younger and better educated were more likely to perform better in the knowledge test (bivariate correlation and logistic regression, p 0.05). Conclusions: The results demonstrated that hypothetical scenarios may help to enhance and facilitate the understanding of LST. The study should be carried forward to explore the applicability of enhancement procedure to facilitate the decision making for advance directives and LST in the older community. © 2010 Taylor & Francis. Source

Chan S.C.C.,Hong Kong Polytechnic University | Chan A.P.S.,Tai Po Hospital
Journal of Spinal Cord Medicine | Year: 2013

Background: A tertiary spinal cord injury (SCI) center was established in the northern region of Hong Kong, China and a multidisciplinary SCI rehabilitation program was developed to reintegrate patients into the community. Objective: To investigate functional outcomes for Chinese people with SCI across a 1-year period. Design: Longitudinal prospective design. Methods: Thirty community-dwelling participants with traumatic SCI were recruited. Functional status was measured using functional independence measure (FIM) on admission, upon discharge, 1-month, 3-month, 6-month, and 1-year post-discharge. Information on use of assistive devices and life role were also obtained. Results: Twenty-three (76.67%) participants were men. Seventeen participants (10 with tetraplegia and 7 with paraplegia) were classified ASIA A, B, or C; 13 (7 with tetraplegia and 6 with paraplegia) were classified as ASIA D. Significant differences in FIM motor scores were only found between the tetraplegia group and three other diagnostic groups using Bonferroni post-hoc tests of repeated measure ANOVA (analysis of variance) (P < 0.05). Longitudinally, contrast tests of repeated measure ANOVA showed significant differences during the hospitalization period for all diagnostic groups. People in the ASIA D group showed significant functional improvement even after 1-year post-discharge (P < 0.05). At 1-year post-discharge, only two participants were engaged in either remunerative employment or academic pursuit. Conclusion: Despite functional status improvement, few people with traumatic SCI were re-engaged in productive life role 1 year after discharge. Studies with longer follow-up would be beneficial. © The Academy of Spinal Cord Injury Professionals, Inc. 2013. Source

Objective: Borderline personality disorder is an important but under-recognised clinical entity, for which there are only a few available diagnostic instruments in the Chinese language. None has been tested for its psychometric properties in the Cantonese-speaking population in Hong Kong. The present study aimed to assess the validity of the Chinese version of the Borderline Personality Disorder subscale of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders Axis II Personality Disorders (SCID-II) in Cantonese-speaking Hong Kong Chinese. Methods: A convenience sampling method was used. The subjects were seen by a multidisciplinary clinical team, who arrived at a best-estimate diagnosis and then by application of the SCID-II rater using the Chinese version of the Borderline Personality Disorder subscale. The study was carried out at the psychiatric clinic of the Prince of Wales Hospital in Hong Kong. A total of 87 patients of Chinese ethnicity aged 18 to 64 years who attended the clinic in April 2007 were recruited. The aforementioned patient parameters were used to examine the internal consistency, best-estimate clinical diagnosis-SCID diagnosis agreement, sensitivity, and specificity of the Chinese version of the subscale. Results: The Borderline Personality Disorder subscale (Chinese version) of SCID-II had an internal consistency of 0.82 (Cronbach's α coefficient), best-estimate clinical diagnosis-SCID diagnosis agreement of 0.82 (kappa), sensitivity of 0.92, and specificity of 0.94. Conclusion: The Borderline Personality Disorder subscale (Chinese version) of the SCID-II rater had reasonable validity when applied to Cantonese-speaking Chinese subjects in Hong Kong. © 2011 Hong Kong College of Psychiatrists. Source

Leung G.T.-Y.,Tai Po Hospital | Leung K.F.,Queen Elizabeth Hospital | Lam L.C.W.,Chinese University of Hong Kong
East Asian Archives of Psychiatry | Year: 2011

Objectives: To develop a classification to describe leisure activities of elderly Hong Kong Chinese based on the functions fulfilled, namely: intellectual, physical, social, and recreational. Methods: A focus group comprising care-for-the-elderly professionals was invited to identify leisure activities commonly practised by elderly Chinese in Hong Kong. An independent panel of occupational therapists in the field of geriatrics and psychiatry was invited to classify the activities into physical, intellectual, social, and recreational categories based on their professional opinion in the context of local practice. The classification was then validated against the opinions of a non-depressed elderly convenience sample with relatively preserved cognition. Results: A total of 33 types of activities were identified, of which 13 were classified as intellectual, 8 as social, 9 as recreational, and 3 as physical. The 3 types of physical activities (mind-body exercise, strenuous aerobic exercise, and stretching and toning exercise) were further divided into different subtypes. Conclusions: An easy-to-understand classification of late-life leisure activities among Chinese has been developed. © 2011 Hong Kong College of Psychiatrists. Source

Tang X.L.,Chinese University of Hong Kong | Qin L.,Chinese University of Hong Kong | Kwok A.W.,Chinese University of Hong Kong | Zhu T.Y.,Chinese University of Hong Kong | And 6 more authors.
Osteoporosis International | Year: 2013

Compared to controls, HR-pQCT at distal radius of SLE patients on chronic glucocorticoid (SLE/GC) revealed reduced bone area, vBMD, deteriorated microarchitecture, and unevenly distributed stresses limited to cortical bone. Despite similar trabecular quality, whole bone strength decreased in patients. These alterations may partly explain high fracture rates in SLE/GC. Introduction: To assess bone geometric, densitometric, microarchitectural, and biomechanical properties in patients with systemic lupus erythematosus (SLE) on long-term glucocorticoid (GC) (SLE/GC) as compared with healthy controls. Methods: A total of 180 female SLE patients and 180 healthy controls were in this cross-sectional study to assess areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry. High-resolution peripheral quantitative computed tomography (HR-pQCT) and microfinite element analysis (μFEA) was performed at distal radius. Results: In addition to significantly lower aBMD at femoral neck, total hip and lumbar spine, cortical area, average volumetric BMD (vBMD) and cortical vBMD also significantly reduced by 5.3, 5.7, to 1.9 % in SLE patients, respectively. Deteriorations of cortical microarchitecture were pronounced in patients, with 6.3 % reduction in cortical thickness and 13.6 % higher in cortical porosity. Local stresses were more unevenly distributed through cortical bone in patients. SLE/GC patients had decreased whole bone stiffness, estimated failure load, and apparent modulus. Parameters related to trabecular bone density and microarchitecture were comparable between patients and controls. Conclusion: In SLE/GC patients, despite a reduction in bone area, vBMD and deteriorated microarchitecture and unevenly distributed stresses limited to the cortical compartment, whole bone strength decreased. HR-pQCT and μFEA were promising in elucidating the potential underlying pathophysiology of bone loss and propensity to fracture in SLE/GC and provide us additional information about alterations of bone quality which might better predict fracture risk beyond aBMD in SLE/GC. © 2012 International Osteoporosis Foundation and National Osteoporosis Foundation. Source

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