A qualitative study on the roles and responsibilities of nurse consultants in Hong Kong.

This study aims to explore the roles and responsibilities of seven newly appointed nurse consultants (NCs) in various clinical specialties in Hong Kong as a pioneer project. Qualitative approaches using direct observation and semi-structured interviews were adopted with two full-day observations on the seven NCs plus 56 semi-structured interviews of NCs, nurses, doctors and patients. Five major NCs' roles and responsibilities had been identified, namely providing expert practice, initiating service development, leading education, guiding continuous quality improvement (CQI) and conducting research and providing evidence-based practice. The seven NCs within this study have by and large achieved building professional excellence, respect and trust within their own spheres. It is strongly recommended that the NC post be formally established in the new Nurses Career Structure to enable expert clinical nurses to develop a clinical career to contribute to service and patient care to its maximum.

Knowledge of and attitude to contraception among migrant woman workers in mainland China.

AIMS: The aims of this paper were to determine the level of knowledge and attitude of contraception and their relationships among Chinese migrant woman workers. BACKGROUND: Studies on psychosocial variables that lead to reproductive health behaviours among Chinese migrant woman workers in China remain limited. DESIGN: A cross-sectional, descriptive and correlational design. PARTICIPANTS: One hundred and ninety young woman workers of a factory in Guangdong, a representative city of factory base in mainland China, voluntarily participated in the study with a response rate of 63%. METHODS: Data were collected through self-administered questionnaires consisting of a socio-demographic sheet, the Contraceptive Knowledge Scale and the Contraceptive Attitude Scale. Pearson product moment correlation coefficient test was employed to examine the relationships between the contraceptive knowledge and attitude, with level of significance set at p<0·05. RESULTS: The Chinese migrant woman workers demonstrated lower contraceptive knowledge and less favourable contraceptive attitude compared with previous studies of adolescents in Taiwan and women seeking abortion in Hong Kong. Although it was a weak correlation, contraceptive knowledge was statistically associated with contraceptive attitudes among the respondents (r=0·276, p<0·001). Respondents' age, education level and working experience were significantly positively correlated with the contraceptive knowledge. CONCLUSIONS: Young Chinese migrant workers reported in the current study are found to be at higher sexual risk, when compared to the adolescents in Taiwan and Hong Kong women seeking abortion. Early educational intervention for reproductive health in particular contraception and its usage to these young women is indicated. RELEVANCE TO CLINICAL PRACTICE: Migrant woman workers in mainland demonstrated poor knowledge and unfavourable attitudes towards contraception, especially for the younger, single and less educated group. Greater effort is necessary to promote young migrant women's knowledge and attitude towards contraception and sexual health.

Psychosocial outcomes of Hong Kong Chinese diagnosed with acute coronary syndromes: a prospective repeated measures study.

BACKGROUND: Western studies have suggested that emotional stress and distress impacted on the morbidity and mortality in people following acute coronary events. Symptoms of anxiety and depression have been associated with re-infarction and death, prolonged recovery and disability and depression may precipitate the client's low self-esteem. This study examined perceived anxiety, depression and self-esteem of Hong Kong Chinese clients diagnosed with acute coronary syndrome (ACS) over a 6-month period following hospital admission. OBJECTIVES: To examine: DESIGN: A prospective, repeated measures design with measures taken on two occasions over a 6-month period; (1) within the 1st week of hospital admission following the onset of ACS and (2) at 6 months follow up. SETTING AND PARTICIPANTS: Convenient sample of 182 voluntary consented clients admitted with ACS to a major public hospital in Hong Kong who could communicate in Chinese, complete questionnaires, cognitive intact, and were haemodynamically stable and free from acute chest pain at the time of interview. METHODS: Baseline data were obtained within 1 week after hospital admission. The follow-up data was collected 6 months after hospital discharge. The Chinese version of the Hospital Anxiety and Depression Scale (HADS), State Self-esteem Scale (SSES), and Rosenberg's Self-Esteem Scale (RSES) were used to assess anxiety and depression, state self-esteem, and trait self-esteem, respectively. RESULTS: Findings suggested gender differences in clients' perception in anxiety, depression and self-esteem. Improvements in clients' perception of these variables were evident over the 6-month period following their acute coronary events. CONCLUSION: The study confirmed the western notion that psychosocial problems are common among coronary clients and this also applies to Hong Kong Chinese diagnosed with ACS. Further studies to explore effective interventions to address these psychosocial issues are recommended.

Perception of hospital learning environment: a survey of Hong Kong nursing students.

The last two decades have seen widespread changes to nurse education but the clinical field remains an essential and invaluable resource in preparing students for the reality of their professional role, supporting the integration of theory and practice, and linking the 'knowing what' to do with the 'knowing how' to deliver care. The clinical learning environment represents a vital element of nurse education that needs to be measurable and warrants further investigation. This survey study examined Hong Kong nursing students' perception of the social climate of the clinical learning environment. Participants were invited to complete the two versions, the Actual and Preferred Forms, of the Clinical Learning Environment Inventory following the completion of their clinical field placement. Two hundred eighty one Actual Forms and 243 Preferred Forms returned. SPPS version 11 was employed to analyse data with descriptive and inferential statistics. It was found that there were significant differences between students' perceptions of the actual clinical learning environment and the ideal clinical learning environment they desired. The study highlights the need for a supportive clinical learning environment which is of paramount importance for students in clinical practice.

Associations between student learning outcomes from their clinical placement and their perceptions of the social climate of the clinical learning environment.

The aim of this study was to investigate the associations between student learning outcomes from their clinical placement and their perceptions of the social climate of the clinical learning environment. The Clinical Learning Environment Inventory (CLEI) was used to collect data. The final sample group consisted of 108 second-year nursing students undertaking clinical placement in 14 metropolitan hospitals in South Australia. Findings from the study suggested that students' perceptions of the outcomes of their clinical placement are strongly associated with all five scales of the CLEI namely; Individualisation, Innovation, Involvement, Personalisation and Task Orientation. It is interesting to note that student who perceived the outcomes of their clinical placement as greatly positive, have placed high expectations on the scale, Task Orientation. The study also found that there were significant differences between students' perceptions of the actual clinical learning environment with their preferred clinical learning environment. The value of this study lies in the resulting implication for nursing education and future research. A better understanding of what constitutes quality clinical education from the students' perspective would be valuable in providing better educational experiences.

The relationship between student learning outcomes from their clinical placement and their perceptions of the social climate of the clinical learning environment.

RATIONALE: Clinical learning is an integral part of nursing education; yet, clinical education has been problematic. Various studies have suggested that not all practice settings are able to provide nursing students with a positive learning environment. In order to maximize nursing students' clinical learning outcomes, there is a need to examine the clinical learning environment. AIM: To investigate the relationship between student learning outcomes from their clinical placement and their perceptions of the social climate of the clinical learning environment. METHOD: The Clinical Learning Environment Inventory was used to collect data in the survey study. Returning of the completed questionnaires implied consent to participate. The final sample group consisted of 108 second-year nursing students undertaking clinical placement in 14 metropolitan hospitals in South Australia. RESULTS: Findings from the study suggested that students' perceptions of the outcomes of their clinical placement are strongly associated with allfive scales of the CLEI namely; Individualisation, Innovation, Involvement, Personalisation and Task Orientation. It is interesting to note that students who perceived the outcomes of their clinical placement as greatly positive, have placed high expectations on the scale, Task Orientation. The study also found that there were significant differences between students' perceptions of the actual clinical learning environment with their preferred clinical learning environment. IMPLICATIONS: The value of this study lies in the resulting implication for nursing education and future research. A better understanding of what constitutes quality clinical education from the students' perspective would be valuable in providing better educational experiences.

Acute coronary syndromes: cardiac rehabilitation programmes and quality of life.

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.