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Biomedical subjects

Chetwyn C H Chan

Publications and source records attributed to Chetwyn C H Chan.

At least 19 recordsLinked to original sources
PubMed2006

Evaluation of the chronic disease self-management program in a Chinese population.

OBJECTIVE: This study evaluated the 6-week Chronic Disease Self-Management Program (CDSMP) in Hong Kong. METHODS: A total of 148 subjects with chronic illness were recruited. Subjects were matched on duration of illness and gender, and then randomly allocated to experimental and comparison groups. The experimental group participated in the CDSMP, while the comparison group joined a Tai-Chi interest class in a mass-activity format. Subjects completed evaluation questionnaires before beginning their program and 1 week following the program. RESULTS: Analysis of covariance showed that the CDSMP participants demonstrated significantly higher self-efficacy in managing their illness, used more cognitive methods to manage pain and symptoms, and felt more energetic than the subjects in the comparison group. The CDSMP participants also demonstrated changes in their profile of coping strategies, having a tendency to adopt the cognitive methods of diverting attention, reinterpreting pain, ignoring sensations, and making positive self-statements. CONCLUSION: The short-term evaluation results showed that the CDSMP primarily increased the self-efficacy, exercise behavior, and application of cognitive coping strategies of the participants. PRACTICE IMPLICATION: The effect of the CDSMP in a Chinese population is similar to that found in studies in Western cultures, and the CDSMP could be applied effectively in a Chinese population.

Adaptation, Psychological↗
PubMed2006

Age-related differences in response regulation as revealed by functional MRI.

This fMRI study studied age-related differences in neural activities during response regulation. Twenty-one male participants from two age groups, a younger group and an older group (mean ages: 29.9 and 65.2 years, respectively), were scanned while performing a task with response compatibility manipulation. They were presented with a sequence of arrowheads that pointed either upward or downward. In the "Response Compatible" condition, they were required to press an up or a down button consistent with the direction of the arrowhead. In the "Response Incompatible" condition, they were required to press the button opposite to the arrowhead direction so that an upward arrow should elicit a down response, and vice versa. Findings showed age-related differences in response regulation in several brain regions, including the right frontal, the right cingulate, and the left inferior parietal cortexes. The findings suggested a higher level of neural activity in the right prefrontal and left inferior parietal regions during response regulation for the older adults than for the younger adults.

Adult↗
PubMed2006

The effect of a "training on work readiness" program for workers with musculoskeletal injuries: a randomized control trial (RCT) study.

BACKGROUND: This is a clinical randomized trail (RCT) to investigate the effects of a three-week training program on work readiness designed for musculoskeletal injured workers with long-term sick leave who had difficulties resuming their work role. The program was planned to help injured workers overcome the psychological and psychosocial problems and to facilitate their Work Readiness on Return to Work (RTW) based on the Employment readiness model. METHODOLOGY: A total of 64 injured workers were recruited and randomly assigned into the training (T) and control (C) groups. Observations were blinded between service providers and evaluators. A three-week intensive training on work readiness program was given to the T group while subjects in the C group were given advice on job placement by social workers in a community work health center. The training program was comprised of individual vocational counseling and group therapy using cognitive behavioral approach to alleviate symptoms of stress, pain and anxiety. The Chinese Lam Assessment of Stages of Employment Readiness (C-LASER), the Chinese State Trait and Anxiety Inventory (C-STAI) and the Short form of Health Survey (SF-36) were used to evaluate all subjects' psychological health status and behavioral changes on job readiness before and after the intervention. RESULTS: Subjects in the T group showed significant improvement in their work readiness (p < 0.05), level of anxiety (p < 0.05) and their self perception of health status measured by SF-36 (p < 0.02) when compared with subjects in the C group. Control of chronic pain, negative motivation, and anxiety level were some of the key behavioral changes found from the study. CONCLUSION: The TWR program appeared to improve injured workers' motivation and employment readiness. Further study on the employment outcomes of subjects is recommended.

Adult↗
PubMed2006

Event-related potentials during mental imagery of animal sounds.

To investigate the neural correlates of imagined animal sounds, event-related potentials (ERPs) were recorded while subjects were presented with (1) animal pictures without any imagery instruction (control) or (2) animal pictures with instructions to imagine the corresponding sounds (imagery). The results revealed imagery effects starting with an enhancement of the P2, possibly indexing the top-down allocation of attention to the imagery task, and continuing into a more positive-going deflection in the time window of 350-600 ms poststimulus, probably reflecting the formation of auditory imagery. A centro-parietally distributed late positive complex (LPC) was identified in the difference waveform (imagery minus control) and might reflect two subprocesses of imagery formation: sound retrieval from stored information and representation in working memory.

Adult↗
PubMed2006

Motor relearning programme for stroke patients: a randomized controlled trial.

OBJECTIVE: To study the efficacy of the motor relearning approach in promoting physical function and task performance for patients after a stroke. DESIGN: Matched-pair randomized controlled trial. SETTING: An outpatient rehabilitation centre in Hong Kong. PARTICIPANTS: Fifty-two outpatients with either a thrombotic or haemorrhagic stroke who completed either the study or control group. INTERVENTIONS: The patients received 18 2-h sessions in six weeks of either the motor relearning programme or a conventional therapy programme. MAIN OUTCOME MEASURES: The Berg Balance Scale, the Timed Up and Go Test, the Functional Independence Measure (FIM), the modified Lawton Instrumental Activities of Daily Living (IADL) test, and the Community Integration Questionnaire. RESULTS: Patients in the motor relearning group showed significantly better performance on all but the Timed Up and Go Test when compared with the control group (F(1,150) = 6.34-41.86, P < or = 0.015). The interactions between group and occasion were significant on all five outcome measures, indicating that the rates of change across time between the motor relearning and control groups differed (F(3,150) = 3.60-33.58, P < 0.015). CONCLUSION: The motor relearning programme was found to be effective for enhancing functional recovery of patients who had a stroke. Both 'sequential' and 'function-based' concepts are important in applying the motor relearning approach to the rehabilitation of stroke patients.

Analysis of Variance↗
PubMed2005

Factors contributing to officers' fatigue in high-speed maritime craft operations.

The purpose of this study was to investigate the difference in the level of fatigue induced by high-speed maritime craft operation between the day- and night-shift officers. The demographic and work-related factors that contribute to fatigue were also explored. A total of 93 high-speed maritime craft officers participated in the survey, of whom 35 worked a day shift (Mean age=48.3 years) and 58 worked a night shift (Mean age=45.8 years). Fatigue experience was measured with the Chinese version of the Swedish Occupational Fatigue Inventory (SOFI-C) at the beginning, in the middle and at the end of the work shift. Information on age, work experience, perceived voyage difficulty and duty schedule was obtained. The study found that the night-shift officers seemed to manifest an overall higher level of perceived fatigue than the day-shift officers, while the day-shift officers demonstrated a fatigue carry-over effect across the two workdays. Besides the shift pattern, age, experience in operating high-speed maritime craft and perceived voyage difficulty were the significant factors contributing to the officers' fatigue experience. The finding that the fatigue experience associated with high-speed maritime craft operation has a rapid and accumulative nature suggests that different occupational safety and health guidelines should be devised for these two groups of officers.

Administrative Personnel↗
PubMed2005

Prose memory deficits associated with schizophrenia.

Memory of contextual information is essential to one's quality of living. This study investigated if the different components of prose memory, across three recall conditions: first learning trial immediate recall, fifth learning trial immediate recall, and 30-min delayed recall, are differentially impaired in people with schizophrenia, relative to healthy controls. A total of 39 patients with schizophrenia and 39 matched healthy controls were recruited. Their prose memory, in terms of recall accuracy, temporal sequence, recognition accuracy and false positives, commission of distortions, and rates of learning, forgetting, and retention were tested and compared. After controlling for the level of intelligence and depression, the patients with schizophrenia were found to commit more distortions. Furthermore, they performed poorer on recall accuracy and temporal sequence accuracy only during the first initial immediate recall. On the other hand, the rates of forgetting/retention and recognition accuracy were comparable between the two groups. These findings suggest that people with schizophrenia could be benefited by repeated exposure to the materials to be remembered. These results may have important implications for rehabilitation of verbal declarative memory deficits in schizophrenia.

Adult↗
PubMed2005

Neural correlates of feigned memory impairment.

While initial neuroimaging studies have provisionally identified activation in the prefrontal (including the anterior cingulate) and parietal regions during lying, the robustness of this neuroanatomical pattern of activation across forms of stimuli, genders, and mother tongues remains to be demonstrated. In this paper we report the results of three studies designed to test the reproducibility of the brain activation previously observed during feigned memory impairment. A total of twenty-nine right-handed participants, divided into three cohorts, participated in three different studies of feigned memory impairment. Findings indicate that bilateral activation of prefrontal and parietal regions was invariant across stimulus types, genders, and mother tongues, suggesting the general importance of these regions during malingering and possibly deception in general. In conjunction with earlier imaging findings, these three studies suggest that the prefrontal parietal network provides a robust neuroanatomical foundation upon which future dissimulation research may build.

Adult↗
PubMed2005

Prose memory in patients with idiopathic Parkinson's disease.

BACKGROUND: The findings of previous studies have suggested that verbal memory impairments were observed in people suffering from Parkinson's disease (PD). Very few studies have examined the comprehensive profile of prose memory deficits that challenges people with PD. METHODS: Prose memory of 19 patients with PD was examined. Their performance in three constructs, namely recall accuracy, temporal sequence, and distortions, during immediate, delayed and recognition trials was studied. RESULTS: The patients with PD performed significantly worse in recall accuracy and temporal sequencing of information in the immediate recall trial. During the recognition trial, they made more false alarms than their healthy counterparts. CONCLUSIONS: Our findings confirm that the performance of people with PD in immediate recall of a prose was impaired. However, the level of performance in subsequent learning and delayed recall trials became comparable to that of the normal controls. The deficit remaining after multiple learning trials was the significantly high false alarms committed in the recognition trial. Our findings highlight the importance of qualitative analysis, in addition to quantitative evaluation, of prose memory in PD.

Aged↗
PubMed2005

Prevalence of hypertrophic scar formation and its characteristics among the Chinese population.

Each year in Hong Kong, about 350,000 surgical procedures are conducted for various types of conditions. Previous review indicated that the prevalence of hypertrophic scar among Caucasians ranged from 15% to 63% and that the incidence was even higher among non-Caucasians. This study aims to find out the prevalence rate of hypertrophic scar among the Hong Kong Chinese population after standardized surgical procedures. A systematic and objective scar measurement protocol is implemented in this study. The spectrocolorimeter, Miniscan XE plus was used to measure the scar pigmentation based on the theory of the CIE colour model. The tissue ultrasound palpation system (TUPS) was employed to measure scar thickness. From May 2001 to December 2003, 154 patients, who received surgical intervention at the Department of Orthopaedics and Traumatology of a large regional hospital, were invited to join a scar-screening test. One hundred and fifteen patients (74.67%) were found to have signs of hypertrophic scar based on thickness, pliability, pigmentation and vascularity (using the Vancouver scar scale (VSS) score). One hundred and one patients consented to have more comprehensive scar assessment. Results indicated that the scar thickness was 4.91+/-1.03 mm. Compared with the adjacent normal skin, the color of hypertrophic scar was significantly different in terms of lightness (d.f.=100, t=-19.36, p<0.01), redness (d.f.=100, t=15.75, p<0.01) and yellowness (d.f.=100, t=-11.48, p<0.01) using paired t-test analysis. Fourtysix point five percent and 33.7% among patients reported pain (2.19+/-2.74) and itchiness (1.47+/-2.53) over the scar. The objective scar assessments showed that more than 70% of scars had increase in thickness and pigmentation after surgery. More than 40% of patients reported pain and itchiness. The results showed that more than 70% of the scars in the HK Chinese population had become hypertrophic in terms of pigmentation, thickness and physical symptoms such as pain and itchiness 1 month after the surgical intervention. More long-term follow up study should be done to find out the prevalence and that it is essential to provide early intervention before the scar becomes problematic in management.

Adolescent↗
PubMed2005

The cerebellum's involvement in the judgment of spatial orientation: a functional magnetic resonance imaging study.

A functional magnetic resonance imaging (fMRI) study was conducted to integrate the clinical observations of the impaired judgment of spatial orientation of cerebellar patients with recent theoretical discoveries about the role of the cerebellum in cognitive functions. Ten normal healthy male right-handed Chinese postgraduates consented to participate in this study. The experimental task employed was a modified version of Benton's Judgment of Line Orientation Test, administered in a blocked fMRI study. The findings indicated activation of the cerebellar regions, the Hemisphere Lobules IV, VI and Crus I, while the subjects were performing the experimental task of the judgment of the orientation of lines. Furthermore, cortical regions were activated, including the bilateral precuneus (BA 7), the extrastriate regions (BA 19), and the bilateral prefrontal regions (BA 9, 10, 44, 46). The imaging data confirmed that the activity of the cerebellum is associated with judging spatial orientation. The theoretical and clinical implications of the findings are discussed.

Adult↗
PubMed2005

Would discussion on patients' needs add value to the rehabilitation process?

The objective of this study was to examine the effect of therapists' methods of addressing patients' problems (based on assessment results and discussions of patients' needs compared with assessment results only) on the level of agreement, between patients and therapists, over patients' daily living problems. A comparative design was adopted to examine the five most important daily living problems identified by patients and their occupational therapists. Twelve occupational therapists and five stroke patients of each therapist under in-patient rehabilitation were recruited. Thus, a total of 60 patients were recruited. Content analyses of the therapists' methods of analysing their patients' problems revealed that eight therapists had discussed their patients' needs with their patients (66.7%) and four relied on the assessment results (33.3%). The kappa statistics showed that a higher agreement of daily living problems was identified for the patients of those therapists who had held discussions (kappa=0.76; P<0.001). The results suggested that therapists should take their patients' needs into account in the planning of interventions. If therapists could help their patients to carry out their future life roles, it would lead the patients to better participate in the rehabilitation process.

Activities of Daily Living↗
PubMed2005

Chronic disease self-management program for Chinese patients: a preliminary multi-baseline study.

This study reports the preliminary findings on the effects of the Chronic Disease Self-management Program on a group of Chinese participants who suffered from chronic diseases. A total of 23 participants were recruited in a multi-baseline study protocol. Their self-management behaviors, self-efficacy and health status were captured over three baseline assessments and one post-test assessment. The results indicated significant increases in the performance of stretching exercises, the management of cognitive symptoms and communication with physicians. Their self-efficacy in terms of these aspects was found to be significantly increased. However, changes in other aspects of self-management which required more special skills and coordination with outside agencies were not significant. The changes in the physical and mental statuses of the participants were also not significant. It was observed that the positive effects of the program could be attributed to traditional Chinese beliefs of 'self-discipline' and a welcoming response towards self-efficacy strategies. Further studies should adhere to standards of a randomized clinical trial and further examine the mechanisms underpinning the changes in self-management behaviors among Chinese people with chronic diseases.

Activities of Daily Living↗
PubMed2005

Changes in psychosocial and work-related characteristics among Clubhouse members: a preliminary report.

The aim of this study was to explore the changes in work-related abilities of members after attending the Clubhouse program for 12 weeks. The extent to which the changes would contribute to members' performance on simulated work tasks was also investigated. A total of 39 people with mental illnesses, primarily schizophrenia, attending Phoenix Clubhouse participated in the study. Seventeen were newly recruited members to the Clubhouse. The other 22, who served as the control group, were existing members who had been attending the Clubhouse for more than three months. All the participants were assessed by the McCarron-dial System (Observational Emotional Inventory-Revised, McCarron Assessment of Neuromuscular Development), Cognistat, Chinese Work Personality Profile, WHO Disability Assessment Schedule and WHOQOL-Bref-HK at the baseline and 12 weeks after attending the Clubhouse program. They were required to complete a set of simulated work tasks after 12 weeks. New members showed significant improvement in emotional-coping abilities (impulsive-frustration and depression-withdrawal) and work personality (task orientation, social skills, and team work) after attending the Clubhouse program for 12 weeks. The increase in emotional-coping skills (depression-withdrawal) was found to contribute to better performance on typing tasks, whereas emotional coping (anxiety) contributed to better performance on cleansing tasks. Three months' participation in the Clubhouse program appears to have positive effects on emotional-coping abilities and work personality. The emotional-coping abilities were found to predict good performance in simulated clerical and maintenance jobs. Recommendations and suggestions for further research are discussed.

Adult↗
PubMed2005

Validation of the Chinese version of the Oswestry Disability Index.

This study aimed to collect evidence on the structural and substantive validity, and test-retest reliability of the Chinese version of the Oswestry Disability Index (CODI). Seventy-nine patients suffering from chronic low back pain were assessed with the CODI. The results of explorative factor analysis primarily suggested a single-factor structure with nine out of 10 items (factor loading = 0.66-0.79). The sex life item was found to load on a different factor. The Cronbach's alpha of all 10 items was 0.81 (p<0.05). When the sex life item was removed from the analysis, the alpha value was increased to 0.89 (p<0.05). The test-retest reliability was estimated based on 56 participants who completed two administrations of CODI in 48 hours. The intraclass correlation coefficient (ICC) computed for the total CODI scores was 0.86 (95% C.I. = 0.81-0.91). The reliability estimated for the item scores using Kappa statistics ranged from a high of k=0.80 for the sitting item to a low of k=0.49 for the traveling item. Kappa statistics were not available for three items. The Chinese version of the Oswestry Disability Index demonstrated satisfactory validity and test-retest reliability, and so could be considered as an appropriate instrument for assessing chronic back pain-related disability in Chinese patients in Hong Kong. Further research should address the cross-cultural and measurement issues in regard to sex life in order to further improve the test content of the instrument.

Adult↗
PubMed2005

Factors affecting vocational outcomes of people with chronic illness participating in a supported competitive open employment program in Hong Kong.

OBJECTIVES: This study aimed to analyze the ability of the Patient Retraining and Vocational Resettlement (PRAVR) program to enhance the vocational outcomes of individuals with chronic illness, and to study the socio-demographic factors associated with successful vocational outcome. STUDY DESIGN: A retrospective study of 548 individuals with various types of chronic illness who enrolled in the program between 1995 and 2003. Their socio-demographic data and their employment outcome after a six-month job skills retraining and job settlement service were collected for analysis. RESULTS: The program was found to enhance the vocational outcomes of patients who completed the program. Logistic regression identified significant factors predicting successful vocational outcomes. For the male patients, the chances of employment were higher if the onset of illness had occurred at least 10 years before (odd ratios = 0.326). For the female patients, the chances of employment were higher if they had been unemployed for less than 1 year (odd ratio = 3.8). CONCLUSIONS: The PRAVR program is able to enhance the vocational outcomes of people with chronic illness in Hong Kong. The factors which were found to relate to successful employment were unique to the local situation. Further studies should explore these factors in a more in-depth manner.

Adult↗
PubMed2004

Structural stability and reliability of the Swedish occupational fatigue inventory among Chinese VDT workers.

The aim of the present study was to test the structural stability and reliability of the Swedish occupational fatigue inventory (SOFI) for use in a group of Chinese visual display terminal (VDT) workers. A qualified translator was recruited to translate the Chinese version of the SOFI (SOFI-C). The content validity was established with 12 bilingual practitioners and seven professional experts. The translated SOFI was administered to 104 sedentary workers on two occasions with an interval of 60 min. Most of them were female (80.8%) and they had a mean age of 34.5 years. Fifty-one percent of them reported using a VDT for 4h or more at work. Exploratory factor analysis revealed a five-factor solution, which was comparable to the original latent factors. Cronbach's alpha for the five-factor scales was between 0.88 and 0.95. The test-retest reliability was satisfactory with intra-class correlations ranging from 0.69 to 0.83. The workers who used a VDT for 4h or more had significantly higher SOFI scores than those who used one for less than 4 h (p = 0.007 - 0.046). The results indicated that the SOFI-C was valid and reliable for measuring fatigue among Chinese sedentary workers. The satisfactory structural stability suggested that cultural influences on the construct of fatigue were not strong. Its characteristics of discrimination of the sedentary workers who had high VDT exposure suggested that the SOFI-C would be a useful instrument for prevention and intervention programs designed for work-related injuries in the workplace.

Adult↗