Reviewing the trends of nursing doctoral thesis research in Hong Kong

This review aimed to analyze the trends and contributions of nursing doctoral theses produced in Hong Kong. A total of 56 nursing doctoral theses were included in this review. The most often studied topic was cardiovascular rehabilitation care (n = 9, 16%). More recently, the most often studied topics has been health technology advancements in nursing care (n = 6, 10.7%). The common trend of study methods was to be quantitative in nature. Of the total, 35 out of 56 were quantitative studies. Half were experimental/ quasi-experimental research studies (n = 28, 50%). For theoretical foundations or applications, the majority (n = 21, 36%) of doctoral theses had no specific theoretical/conceptual models as study frameworks. This trend indicates that there is space for improving the theoretical and philosophical foundation of nursing research in Hong Kong. For the contributions of doctoral thesis research, Hong Kong nursing scholars place more emphasis on direct enhancement of clinical practice or the improvement of patient outcomes. This review provides concrete evidence of the status of nursing research and knowledge development in Hong Kong nursing.

Examining advanced nursing practice in Hong Kong and Guangzhou

Objective:There were studies evaluating advanced nursing practice independently in the mainland and Hong Kong Special Administrative Region of China,but there was no attempt to make a comparison of practice between them.This study employed a case study method to examine and compare advanced nursing practice in Hong Kong and Guangzhou.Method:Purposive sampling method was used to recruit 24 advanced practice nurses(APN)who came from the specialty of medical,surgical and pediatric in Hong Kong and Guangzhou.A questionnaire survey and semi-structured interview were conducted to solicit quantitative and qualitative data for exploring the structure-process-outcome of advanced nursing practice.The structure component explored the factors influencing advanced nursing practice.The process part examined APN role components and illustrations of exemplary advanced nursing practice.The outcomes described outcome indicators that best reflected advanced nursing practice.Findings:Findings revealed that in the structure domain,APN education and career development,team approach in healthcare,and support from management,physicians and professional associations were important contextual factors for APN development in both cities.For the process domain,participants had at least 80%of their time practicing independently/interdependently and were engaged in APN activities including direct/indirect patient care,research/project work,initiation of staff and patient protocols.All participants demonstrated competencies with impacts on patient,service and profession in their description of exemplary practice.Participants from both cities ranked patient-related outcomes as top indicators for their advanced nursing practice.Conclusion:This study has revealed that APNs in Guangzhou and Hong Kong shared similar work involvement and impacts and their demonstrated competencies were on par with international counterparts.Continued efforts need to be put in establishing formal APN education,clear clinical career pathway and title protection to empower nurses to provide optimal care to the fullest extent that they are prepared for.

Analysis of the Current Situation and Risk Factors of Lower Respiratory Tract Infection among ICU Patients in Guizhou,China During 2019-2022

Objective:This study aims to explore the prevalence,features,and risk factors of lower respiratory tract infections(LRTIs)in the intensive care unit(ICU)of a newly established hospital in Zunyi City.The goal is to devise strategies for preventing LRTIs in the ICU of new hospitals,thereby mitigating the incidence of nosocomial LRTIs in ICU patients.Methods:A case-control study was conducted from March 2019 to December 2022 to investigate the incidence rate of LRTIs in the ICU of a newly constructed hospital in Zunyi City.Patients with LRTIs constituted the case group,while those without LRTIs constituted the control group,where a 1:1 matching principle was adhered to.A single-factor chi-square(χ2)test was employed to analyze the risk factors,with independent risk factors being explored using a multivariate logistic regression analysis.Results:A total of 169 strains of pathogenic bacteria were isolated,comprising 66.28%gram-negative bacteria,17.75%gram-positive bacteria,and 15.97%fungi.The most prevalent pathogens included Acinetobacter baumannii(43.20%),Candida albicans(10.65%),and Pseudomonas aeruginosa(8.88%).Of the 82 strains infected by multidrug-resistant bacteria in patients with LRTIs,81.7%were carbapenem-resistant Acinetobacter baumannii,9.8%were multidrug-resistant Pseudomonas aeruginosa,and 6.1%were carbapenem-resistant Escherichia coli.Identified risk factors included smoking history,total hospitalization days,ICU stay length,hypoproteinemia,indwelling gastric tube,intubation type,duration of mechanical ventilation,usage of antibacterial drugs,and administration of protein drugs(P<0.05).Multivariate logistic regression analysis demonstrated that these factors were independent risk factors for nosocomial LRTIs in ICU patients(P<0.05).Conclusion:ICU patients in our hospital were mainly infected by carbapenem-resistant Acinetobacter baumannii.To prevent LRTIs in patients,tailored preventive measures should be developed and the rational use of antibacterial drugs should be promoted.

Development of advanced nursing practice in China: Act local and think global

This paper discusses the development of advanced nursing practice in China in the context of global development.The scope of nursing is evolving over time,with increasing demands for the management of complex healthcare situations at individual,community and system levels.These demands are aggravated by the specialization of medical practice,with advanced treatment plans and patients requiring care in focused areas.The qualifications and competencies of the initial entrants into nursing practice are not adequate to deal with these demands.Advanced nursing practice(ANP)developed first in response to service demands,and education programs were introduced to prepare nurses for practicing at a higher level.This paper will first review the historical development of ANP in China,followed by a discussion of the differentiation of competence levels in nursing practice and the classification of specializations.It concludes by exploring how education in combination with experience protected by regulation of practice can support nurses to gradually evolve from registered nurse,specialty nurse to advanced practiced nurse.

Nurse-led cancer care:A scope review of the past years (2003-2016)

Nursing practice has been expanded greatly with time passing by.One innovative form of nursing practice is nurse-led care.The term“nurse-led care/service”has been introduced in nursing discipline for years as early as in 1960s[1].Later,several nurse-led services were reported in 1980s and 1990s[2-7].The common characteristics in these units were that the nurses provided additional things to improve patients'care,and the standard of practice was extremely high[8].The accelerating development of nurse-led care was triggered by the health care system reform in United Kingdom(UK)around 2000.In 1999,the UK government document‘Making a difference’was published[9],under the pressure of redesigning services to reduce waiting time and medical cost and to meet shortfalls in junior medical staffing[10].Since then,nurse-led care has been reported in increasing studies[11].

Women's experiences of formula feeding their infants:an interpretative phenomenological study

Objective: This study aimed to explore the experiences of women in the process of formula feeding their infants. The World Health Organization has emphasized the importance of breastfeeding for infant health. After decades of breastfeeding promotions,breastfeeding rates in Hong Kong have been rising consistently; however, the low continuation rate is alarming. This study explores women's experiences with formula feeding their infants, including factors affecting their decision to do so.Methods: A qualitative approach using an interpretative phenomenological analysis(IPA) was adopted as the study design. Data were collected from 2014 to 2015 through individual in-depth unstructured interviews with 16 women, conducted between 3 and 12 months after the birth of their infant. Data were analyzed using IPA.Results: Three main themes emerged as follows:(1) self-struggle, with the subthemes of feeling like a milk cow and feeling trapped;(2) family conflict, with the subtheme of sharing the spotlight; and(3) interpersonal tensions, with the subthemes of embarrassment,staring, and innocence. Many mothers suffered various stressors and frustrations during breastfeeding. These findings suggest a number of pertinent areas that need to be considered in preparing an infant feeding campaign.Conclusions: The findings of this study reinforce our knowledge of women's struggles with multiple sources of pressure, such as career demands, childcare demands, and family life after giving birth. All mothers should be given assistance in making informed decisions about the optimal approach to feeding their babies given their individual situation and be provided with support to pursue their chosen feeding method.

Interprofessional Team-Based Learning: A Revealing Process for Cultivating Professional Identity among Nursing Students

Background: Nurses are significant healthcare team members. It is vital to examine their gains in an interprofessional education (IPE). Purpose: We aimed to examine the perceived benefits of interprofessional team-based learning (IPTBL) on the entry level nursing students. Methods: Content analysis was adopted to identify categories in the reflections of the entry-level undergraduate nursing student IPTBL experiences. Results: There were 205 (male = 34) undergraduate nursing students (response rate 82.2%) participating in the present study. In line with the Interprofessional Education Collaborative Report (IPEC) core competencies, four categories were identified: 1) Values/Ethics for Interprofessional Practice, 2) Roles/Responsibilities, 3) Interprofessional Communication, and 4) Teams and Teamwork. A new category emerged—individual learning outcomes. Conclusion: Through IP interactions and the expectation of the IP team, the nursing students had built confidence and defined the nurses’ roles.

The Effects of <i>Ganoderma lucidum</i>on Initial Events Related to the <i>Bacillus Calmette-Guérin</i>Efficacy and Toxicity on High-Risk Uroepithelial Cells: An <i>in Vitro</i>Preliminary Study

A novel prophylactic regimen is demanded for preventing bladder cancer recurrence, because of the high side-effect tolls of conventional adjuvant Bacillus Calmette-Guérin (BCG) immunotherapy, in addition to its only moderate efficacy. In vitro and animal studies have demonstrated the anti-cancer properties of a medicinal mushroom called Ganoderma lucidum (GL). In this study, a pre-malignant human uroepithelial cells (HUC-PC) model was utilized to compare the effectiveness between ethanol extract of GL (GLe) and BCG on interleukin-6 (IL-6) secretion and lactate dehydrogenase (LDH) cytotoxicity. Additionally, parameters relevant to the BCG efficacy and safety, including free soluble fibronectin (FN) and cell-surface glycosaminoglycans (GAGs) levels were tested, following the exposure of GLe to the cells. GLe at 100 μg/ml and BCG at 4.8 × 107 CFU were shown to induce equivalent levels of IL-6, suggesting the potential synergism, while the tested concentrations of GLe were non-cytotoxic. During the initial four hours of GLe exposure, the free FN concentrations in harvested media were significantly reduced that might facilitate the binding of BCG for uroepithelial internalization to enhance BCG efficacy. Furthermore, the cell membrane-bound GAGs levels of HUC-PC cells were significant increased in response to GLe to suggest cellular protection from BCG infection. In summary, current findings suggest the potential additive synergism of GLe with the BCG efficacy, as well as its protective effects, and thus reducing the BCG toxicity.

A randomized controlled trial of topical tea tree preparation for MRSA colonized wounds

Background:The prevalence of MRSA(Methicillin-resistant Staphylococcus aureus)colonized wounds in home care residents is expected to grow continuously as a result of the substantial proportion of older people requiring institutionalized care due to chronic disease and declining functional status,which contribute to more frequent skin breakdown and wound formation.Tea tree oil has been claimed to have anti-bacterial,analgesic and anti-inflammatory effects that have been suggested in many in-vitro studies to have good efficacy against MRSA.The aims of this study were to evaluate the effectiveness of 10%topical tea tree preparation to eradicateMRSA and to ascertain its influence on wound healing forMRSA-colonized wounds.Methods:It was a randomized controlled trial,single-blind study.Those with stage II or above MRSA-colonized wounds and who had given their informed consent formed the sample.The determined sample sizewasbasedonthe effect size of our previouspilot study,whichwas 0.46.Five outcome measurements were taken for the MRSA bacterial count and wound healing condition at baseline and at 1-week intervals during the 4-week dressing intervention period.Results:Thirty-two participants were recruited from two non-government nursing homes,16 in the control group and 16 in the tea tree oil group.The control group residents received routine saline gauze dressing,while the tea tree oil group residents received the 10%topical tea tree preparation dressing.In the tea tree oil group,all chronic wounds that had previously been delayed in healing were healed within 28 days without adverse reaction.MRSA was also completely eradicated in 14(87.5%)out of 16 wounds in the group receiving the 10%topical tea tree preparation.

Being Old Does Not Necessarily Mean Being Inactive: Health Profile of Elderly Athletes versus Community-Dwelling Older Adults

Introduction: According to the records of the Hong Kong Athletic Gala for the Elderly, some sports events have been won by the same group of elderly participants for several consecutive years. What made these elderly athletes different from others? Method: This was a retrospective quantitative study. The health profile data on a total of 125 elderly participants were collected. 36 and 29 were the winners and losers of the Hong Kong Athletic Gala for the Elderly between 2008 and 2010, respectively. The remaining 60 were non-participants. The non-participants came from six elderly centers in different districts in Hong Kong. Health profile parameters were measured using the Health-Promoting Lifestyle Profile II, which is used to measure healthy behaviors such as physical activity level, nutrition, stress management, health responsibility, interpersonal relations and spiritual growth. Results: About 41.7% (n = 15) and 80.0% (n = 48) of the elderly (mean age = 74 ± 9.0) in the winner and non-participant groups with chronic diseases. There were significant

The Implications of Artificial Intelligence on Infection Prevention and Control: Current Progress and Future Perspectives

The rapid advancement of artificial intelligence(AI)has significantly impacted infection prevention and control,particularly amid the coronavirus disease 2019(COVID-19)pandemic(1).AI techniques such as machine learning(ML),deep learning,and natural language processing(NLP)have successfully transformed infection prevention and control strategies(1).These technologies have enhanced our understanding of infectious diseases,facilitated disease transmission prediction,and improved public health emergency responses(2).

Comprehensive and personalized approach is a critical area for developing remote cardiac rehabilitation programs

In the evolving landscape of cardiac rehabilitation(CR),adopting digital technologies,including synchronous/real-time digital interventions and smart applications,has emerged as a transformative approach.These technologies offer realtime health data access,continuous vital sign monitoring,and personalized educational enhanced patient self-management and engagement.Despite their potential benefits,challenges and limitations exist,necessitating careful consideration.Synchronous/real-time digital CR involves remote,two-way audiovisual communication,addressing issues of accessibility and promoting home-based interventions.Smart applications extend beyond traditional healthcare,providing real-time health data and fostering patient empowerment.Wearable devices and mobile apps enable continuous monitoring,tracking of rehabilitation outcomes,and facilitate lifestyle modifications crucial for cardiac health maintenance.As digital CR progresses,ensuring patient access,equitable implementation,and addressing the digital divide becomes paramount.Artificial intelligence holds promise in the early detection of cardiac events and tailoring patient-specific CR programs.However,challenges such as digital literacy,data privacy,and security must be addressed to ensure inclusive implementation.Moreover,the shift toward digital CR raises concerns about cost,safety,and potential depersonalization of therapeutic relationships.A transformative shift towards technologically enabled CR necessitates further research,focusing not only on technological advancements but also on customization to meet diverse patient needs.Overcoming challenges related to cost,safety,data security,and potential depersonalization is crucial for the widespread adoption of digital CR.Future studies should explore integrating moral values into digital therapeutic relationships and ensure that digital CR is accessible,equitable,and seamlessly integrated into routine cardiac care.Theoretical frameworks that accommodate the dynamic quality of real-time monitoring and feedback feature of digital CR interventions should be considered to guide intervention development.

中国和英国精神科医生对儿童多动行为症状的评估比较

目的 :比较不同文化背景的精神专科医生在评估多动症儿童各种症状表现时的一致程度 ,探讨文化对儿童多动症诊断可能产生的影响。方法 :使用单独或集体行为观察清单 ,让两地的精神科医生对儿童多动症的各种表现进行症状评估 ;所有的评估者均观察同一录像带上患儿的行为表现 ;对其评定结果进行统计和比较。结果 :儿童独自活动观察量表的 12项中有 11项症状条目评定结果类似 ,有 3项英国医生的评分高于中国医生 ,有 9项中国医生评分高于英国医生 ,其中 1项具有显著性差异。结论 :对行为表现和症状认知的文化差异可能使流行病学的研究出现不同的结果 ,即使使用统一的诊断标准和症状评分量表作为诊断工具 ,不同文化背景的国家 。

Establishment of the Psychometric Properties of a Disaster Resilience Measuring Tool for Healthcare Rescuers in China:A Cross-Sectional Study

The aim of this study was to test the validity and reliability of a tool for measuring the disaster resilience of healthcare disaster rescuers.A cross-sectional study involving 936 healthcare disaster rescuers of the Sichuan Disaster Response Team was conducted to establish the psychometric properties of the disaster resilience measuring tool(DRMT).Item analysis,exploratory factor analysis,confirmatory factor analysis,and correlation analysis were adopted to analyze the data.Item analysis showed that all but three items had the critical ratio over 3,which indicates adequate discriminability for inclusion in the measuring tool.The exploratory factor analysis showed that 65.93%of the total variance was explained by four factors—self-efficacy,social support,positive growth,and altruism.The confirmatory factor analysis showed goodness of fit for the four-factor model:CMIN/DF(2.846),GFI(0.916≥0.90),CFI(0.949≥0.90),AGFI(0.891≥0.80),and RMSEA(0.063≤0.08).Criterion validity demonstrated significant associations of the DRMT and the Connor-Davidson Resilience Scale(P<0.01,r=0.566).Convergent validity was established by correlation with stress(P<0.05,r=-0.095),depression(P<0.01,r=-0.127),posttraumatic stress disorder-PCL-C(P<0.05,r=-0.100),compassion satisfaction(P<0.01,r=0.536),and burnout(P<0.01,r=-0.330).The DRMT demonstrated adequate internal consistency(Cronbach’s alpha>0.84)and stability over the two-week study period(intraclass correlation coefficient>0.85),and a cut-off point of 61 was suggested.The disaster resilience measuring tool has satisfactory psychometric properties and is a valid,reliable,and valuable instrument for assessing disaster resilience in healthcare rescue workers.The scale needs to be tested further among other populations and those from other cultures.

Critical Care(重症照顾):概念分析

目的"Critical Care"(重症照顾)和"Intensive Care Unit"(重症监护室)这两个术语在实际工作中描述一个医疗场所时经常被互换使用。对"Critical Care"的口语化使用使得其准确定义具有挑战性。本文旨在对"Critical Care"进行概念分析,制定其操作性定义(operational definition),明确其内涵。方法采用Walker和Avant八步法来指导本研究。检索数据库(CINAHL、Scopus、PubMed、ProQuest Dissertation Abstracts和Med line in EBSCO)中"Critical Care"相关文献,包括1990--2022年以英文撰写发表的质性和量性研究论文。结果.共检索到439篇论文,其中47篇符合纳人标准。"Critical Care"的概念属性包括:1)对疾病/损伤的不适应;2)收治标准;3)高精医疗技术;4)专业的医疗护理人员。前因是疾病/损伤进展到危急状况,患者身体和心理功能都明显下降,后续影响是死亡或存活(有或没有ICU治疗后综合症)。结论重症监护环境的高技术含量特性使关于“Critical Care"的描述更具挑战性。对此术语进行概念分析有助于明确其内涵和范围,为未来研究提供参考,促进相关评估工具的开发,深入了解重症监护环境中的医疗护理工作本质。

Healthcare Services Demand in Post-disaster Settings:The 2014 Earthquake in Ludian County,Yunnan Province,China

Healthcare relief teams dispatched to rural areas often face difficulties due to limited initial and ongoing health information in the affected community.The present study investigated patterns of healthcare service demand for a rural displaced population in a post-disaster situation.Three weeks after the 2014 Ludian County earthquake,the Institute for Disaster Management and Reconstruction(IDMR) at Sichuan University and Hong Kong Polytechnic University organized a disaster nursing team to support the rural community in Longtoushan,at the epicenter of the earthquake.A cross-sectional,records-based study of 2484 records obtained from a temporary hospital in Longtoushan(for the period of 14 September-1 October 2014) was conducted.The daily number of records by patients' sociodemographic characteristics and medical diagnoses were plotted on a time series graph to explore the temporal change during the study period.Findings indicate that healthcare service demand from younger age groups was higher than that of the older adult group.Three major health problems were observed:respiratory disease,skin problems,and ear,eye,and throat(EET) problems.All of these very real health problems are chronic issues that require long-term care.They are not health issues directly related to the disaster emergency itself.Yet disaster relief nursing teams were selected on the basis of their ability to cope primarily with traumatic disaster-related injuries.The existing practice of teaming up disaster relief professions might not be optimal.To better understand the healthcare needs of a displaced population,short- and long-term planning is needed.Planning will allow disaster response professionals to better organize and deploy healthcare personnel to manage the above-listed problems in a postdisaster situation.

Nurses’job embeddedness and turnover intention:A systematic review and meta-analysis

Objective:This study aimed to review the relationship between job embeddedness and turnover intentions among nurses and explore the effects of the Job Embeddedness Scale,number of years in the career,education,and marital status on this relationship.Methods:The review was conducted by searching the China Knowledge Resource Integrated Database(CNKI),Weipu Database(CQVIP),China Biology Medicine(CBM),Wanfang Database,PubMed,Web of Science,Embase,CINAHL,and APA-PsycNet for articles on nurses’job embeddedness and turnover from intention up to March 2024.The research quality was evaluated using the Agency for Healthcare Research and Quality(AHRQ)assessment criteria.The review protocol has been registered on PROSPERO[CRD42023483947].Results:The results of this review included 47 studies consisting of 15,742 nurses from seven countries worldwide.A moderate negative correlation was found between job embeddedness and turnover intention(r=0.487).Furthermore,on-the-job embeddedness(r=0.527)was more negatively associated with turnover intention than off-the-job embeddedness(r=0.234).The highest negative correlation was found between sacrifice and turnover intention(r=0.460),while the lowest was for the link(r=0.185).Furthermore,the relationship between job embeddedness and its dimensions with turnover intention was affected by different job embeddedness scales,number of years in the career,education,and marital status(P<0.05).Conclusion:This systematic review and meta-analysis analyzed the relationships between nurses’job embeddedness,dimensions,and turnover intention.Meanwhile,subgroup analysis and meta-regression explored the factors influencing these relationships.It is an important reference for nurse managers to promote nurse retention.

Dual ultra-wideband(UWB)radar-based sleep posture recognition system:Towards ubiquitous sleep monitoring

Sleep posture monitoring is an essential assessment for obstructive sleep apnea(OSA)patients.The objective of this study is to develop a machine learning-based sleep posture recognition system using a dual ultra-wideband radar system.We collected radiofrequency data from two radars positioned over and at the side of the bed for 16 patients performing four sleep postures(supine,left and right lateral,and prone).We proposed and evaluated deep learning approaches that streamlined feature extraction and classification,and the traditional machine learning approaches that involved different combinations of feature extractors and classifiers.Our results showed that the dual radar system performed better than either single radar.Predetermined statistical features with random forest classifier yielded the best accuracy(0.887),which could be further improved via an ablation study(0.938).Deep learning approach using transformer yielded accuracy of 0.713.

Corrigendum to‘Dual ultra-wideband(UWB)radar-based sleep posture recognition system:Towards ubiquitous sleep monitoring’[Engineered Regeneration 4(2023)36-43]

The authors regret that the name of the ethic committee that approved the study and the reference number was omitted from the published paper.In this research,all participants signed an informed consent after receiving an oral and written description of the experiment before the start of the experiment.The study was approved by the Human Subjects Ethics HSEARS20210127007.

X-reality for phantom limb management for amputees:A systematic review and meta-analysis

Phantom limb is a disabling neuropsychiatric condition among amputees resulting in pain and disturbance that impact their functions,quality of life,and autonomy.While pharmacological approaches appeared to be ineffec-tive,the emergence and integration of X-reality,including virtual reality,augmented reality,and mixed reality,might elevate the effectiveness of mirror therapy in managing phantom limb.The objective of this study is to review X-reality for managing phantom pain.A systematic search was conducted on PubMed,Scopus,Web of Science,PsycINFO,Embase,and CINAHL.Sixteen(n=16)studies containing 66 lower-limb and 53 upper-limb amputees were included for the review over the thematic framework of amputee characteristics and intervention designs,while thirteen(n=13)studies were further proceeded for the meta-analysis.We found eleven studies on virtual reality(n=11),four studies on marker-based augmented reality(n=4)and one study on mixed reality(n=1)with a total of 40 game/task themes involving,motor skills,motor control,and stimulus-sensing.Regardless,all these interventions adopted the movement representation strategies with different techniques.Overall,the X-reality interventions reduced the pain level of the amputees(mean difference:-2.30,95%CI,-3.38 to-1.22),especially the virtual reality subgroup(mean difference:-2.83,95%CI,-4.43 to-1.22).However,there were substantial heterogeneity and partially explained by the subgroup analysis on publication year.The strength of evidence was limited by case reports and case series in this review.