An Exploration of the Burnout Situation on Teachers in Two Schools in Macau.

To explore the burnout situation of teachers in two schools in Macau and to investigate any differences made of demographic characteristics. The relation of burnout on social problem solving and holistic health of teachers is also studied. A self reported questionnaire with the Chinese Maslach Burnout Inventory (C-MBI), Chinese Social Problem Solving Inventory (C-SPSI) and the Body-Mind-Spirit Well-Being Inventory (BMSWBI) were used. Totally 138 teachers participated in the study. With Hong Kong data as a reference, Macau teachers scored in the average range of burnout in emotional exhaustion and depersonalization but scored in the low range of burnout in personal accomplishment. Significance differences were found in some dimensions of burnout in age, marital status, teaching experiences, education background and satisfaction with income. Both C-SPSI and BMSWBI were found to be significantly negative correlated with emotional exhaustion and depersonalization and positive correlated with personal achievement. The findings identified those with greater degree of burnout, to whom more attention should be paid. The study also contributed to the limited literature on the quality of life of teachers in Macau. Finally, the findings added on the data base for comparison internationally among the Chinese population.

A quasi-experimental study on a community-based stroke prevention programme for clients with minor stroke.

AIM: The aim of this study was to determine the effectiveness of a community-based stroke prevention programme in (1) improving knowledge about stroke; (2) improving self-health-monitoring practice; (3) maintaining behavioural changes when adopting a healthy lifestyle for stroke prevention. BACKGROUND: People with minor stroke (or transient ischaemic attack) tend to under-estimate the long-term impact of this on their health. The challenge for nurses is to prevent subsequent strokes by finding ways to promote and sustain appropriate behaviours. Educational intervention is of paramount importance in equipping those at risk with relevant knowledge and self-care strategies for secondary stroke prevention. DESIGN: This study adopted a quasi-experimental design. METHOD: One hundred and ninety subjects were recruited, of whom 147 (77 in the intervention group and 70 in the control group) completed the study. Data were obtained at three time points: baseline (T0); one week after (T1) and three months after (T2) the intervention. The intervention programme consisted of eight weekly two-hour sessions, with the aims of improving the participants' awareness of their own health signals and of actively involving them in self-care management of their own health for secondary stroke prevention. RESULTS: Significant positive changes were found among participants of the intervention group in the knowledge on stroke warning signs (P < 0.001); treatment seeking response in case of a stroke (P < 0.001); medication compliance (P < 0.001); self blood pressure monitoring (P < 0.001) as well as lifestyle modification of dietary habits (reduction in salted food intake, P = 0.004). No significant improvement was found in walking exercise participation in the intervention group, yet a significant decrease was detected among the control group. CONCLUSION: This study found a three-month-sustained effect of positive changes in knowledge and skill from participants who undertook a nurse-led community-based stroke prevention programme. RELEVANCE TO CLINICAL PRACTICE: Effective educational intervention by professional nurses helped clients integrate their learned knowledge into their real-life practice. This empowering, that is, the taking of responsibility by clients for their own self-care management on a daily basis, affirms that patient education has moved beyond teaching people facts.

Evaluating the efficacy of an integrated curriculum on adolescent health and development for pre-service nursing education in Hong Kong.

BACKGROUND: An integrated adolescent curriculum on health and development (ADH) was implemented in a pre-service nursing programme in a university. AIM: This study examined the efficacy of an ADH curricular framework in improving the competency variables of student nurses in delivering ADH services. METHOD: The design of the study was quasi-experimental with the systematically designed ADH training curriculum as an intervention. Pre- and post-tests incorporating an experimental group and a control group for a sample of 101 student nurses were used. FINDINGS: Reports from 50 student nurses in the experimental group indicated that there was a significant increase from the pre-test to the post-test phase in the total score for the variables in the ADH Competency Checklist (Z=-5.71, p<0.001) and its four subscales: the professional development subscale (Z=-5.37, p<0.001), the psychosocial and physical well-being subscale (Z=-5.66, p<0.001), the health behaviours and lifestyles subscale (Z=-5.07, p<0.001), and the identity and reproductive health subscale (Z=-4.86, p<0.001). Significant changes were detected in the ADH competency variables for the control group in the post-test phase. CONCLUSION: The findings reveal that the systematic integration of ADH in the nursing curriculum had the positive impact of increasing the competency of student nurses for the examined variables.

Cardiovascular disease: application of a composite risk index from the Telehealth System in a district community.

Assessing a combination of cardiovascular disease (CVD)-risk factors may be a practical tool for risk assessment and for finding the high-risk group among local community members. This study examines the association between the number of CVD-risk factors, regardless of any specific combination with the CVD ambit, using data from 1,570 residents in Tsing Yi community (Hong Kong) who registered with the Telehealth System. A quantitative composite CVD Risk Index (CVDRI) with scores ranging from 0 to 6 included rankings for high systolic and diastolic blood pressure, presence of diabetes, body mass index (BMI), smoking, and age. Multivariate logistic regression was used to estimate odds ratios for the prevalence of CVD. Those with a CVDRI of 1, 2, or 3 and above were 1.7 [95% confidence interval (CI) = 1.34-3.99], 5.3 (95% CI = 3.60-7.90), and 10 times (95% CI = 6.41-15.50) more likely to have CVD, respectively, than those with a risk index of 0. Among the CVDRI components, high blood pressure had the greatest influence on CVD risk, followed by presence of diabetes and high BMI. In conclusion, a CVDRI based on existing health data from a Telehealth System was developed and used to identify local community members at risk of CVD. Nurse intervention may achieve greater reduction of CVD morbidity and mortality if multiple risk factors for the high-risk group are addressed at the same time.

An empirical analysis of the decision-making of limiting life-sustaining treatment for patients with advanced chronic obstructive pulmonary disease in Hong Kong, China.

OBJECTIVES: To understand the prognostic and quality-of-life considerations surrounding life-sustaining treatment decisions for patients with advanced chronic obstructive pulmonary disease (COPD) in Hong Kong China. METHODS: A documentary review of 49 COPD patients and 19 patient case studies from the medical departments of 2 hospitals were undertaken to examine the practices of DNI decision-making (do not perform mechanical ventilation and cardiopulmonary resuscitation). Statistical, event, and thematic analyses were conducted to delineate the prognostic and quality-of-life factors that shaped the not for intubation and mechanical ventilation (DNI) decisions. RESULTS: Three major treatment-limiting decision-making patterns existed in practice: 1) Patient-initiated and shared decision-making with physician (n = 14); 2) Physician-initiated and shared decision-making with the patient/family members (n = 24); and 3) Physician-initiated DNI decision-making with patient family, but without patient participation due to mental incapacity (n = 11). Prognostic considerations include physiological parameters, performance status, concomitant diseases, therapeutic regimens, and the utilization of medical services. Three major themes were delineated regarding the way in which the patients evaluated their life quality in the context of DNI status. They are prognostic awareness, illness burdens, and existential concerns. DISCUSSION: A decision-making framework used by patients/families/physicians to limit life-sustaining treatments in patients with advanced COPD is delineated. Observations regarding how treatment limiting decision-making for patients with advanced chronic illnesses can be improved in Hong Kong are discussed.