Biomedical subjects

Frances Kam Yuet Wong

Publications and source records attributed to Frances Kam Yuet Wong.

4 recordsLinked to original sources

PubMed2005

Nurse follow-up of patients with diabetes: randomized controlled trial.

AIM: This paper reports a study comparing the outcomes of diabetic patients undergoing either early discharge or routine care. BACKGROUND: The hospital is not the best place to monitor the glycaemic control of patients with diabetes with no other morbidity or complications. It is an unnatural environment in which diet is planned and the activity level is low. The hospital is also an expensive place in which to treat patients. METHODS: This randomized controlled trial was conducted in the medical department of a regional hospital in Hong Kong. A total of 101 patients who needed glycaemic monitoring, but who were otherwise fit for discharge, were recruited. The control group continued to receive routine hospital care. The study group was discharged early and received a follow-up programme which included a weekly or biweekly telephone call from a nurse. FINDINGS: When compared with the control group, the study group had a greater decrease in HbA1c at 24 weeks, although the statistical difference was marginal (7.6 vs. 8.1, P = 0.06), a higher blood monitoring adherence score at both 12 weeks (5.4 vs. 3.6, P < 0.001) and 24 weeks (5.3 vs. 3.5, P < 0.001), and a higher exercise adherence score at 12 weeks (5.3 vs. 3.4, P = 0.001) and 24 weeks (5.5 vs. 3.2, P < 0.001). The study group had a shorter hospital stay (2.2 vs. 5.9, P < 0.001), and the net savings were HK$11,888 per patient. CONCLUSION: It is feasible to integrate treatment into the real life environments of patients with diabetes, and nurse-led transitional care is a practical and cost-effective model. Nurse follow-up is effective in maintaining optimal glycaemic control and enhancing adherence to health behaviours. Management of glycaemic control is better done in the community than in the hospital.

Adult↗

PubMed2004

Problem-based learning: ancient Chinese educational philosophy reflected in a modern educational methodology.

Problem-based learning (PBL) has been widely adopted as a strategy by nurse educators all over the world. Many studies have been carried out to examine its process and outcomes. There are few studies discussing the relevance of PBL to students with different cultural background. This study reports the experiences of Chinese students in Hong Kong using PBL and explores if their experiences were compatible with the educational philosophy documented in traditional Chinese literature. The phenomenological approach was used in the treatment of data. The informants were students enrolled in the post-registration nursing degree programme at a university in Hong Kong during 1997-1998. A total of 94 journals were included in the analysis. Seven main themes emerged from the phenomenological analysis. They were the integration of knowing and doing, critical reflection and debate, individuality of learning, self-motivated learning, critical inquiry and independent thinking, timeliness of instruction and cooperative learning. This study provides evidence to show that PBL is an approach that is compatible with the Chinese way of learning. The result of this study shows that aspects of the modern PBL process harken back to an ancient Chinese learning philosophy that underpins Chinese learning today.

China↗

PubMed2004

Effects of nurse follow-up on emergency room revisits: a randomized controlled trial.

The emergency room (ER) is the gatekeeper of the hospital. It receives clients seeking help from the health care system, then refers them for necessary further care or, discharges them back into the community. A 1-year randomized control trial was conducted in an acute general hospital in Hong Kong to see if post-ER nurse follow-up helped to change health outcome and health care utilization. The intervention group received two follow-up calls from an experienced ER nurse, within 1-2 days and 3-5 days after ER discharge. The calls' content and the management options decisions were protocol driven. A total of 795 patients (intervention group=395, control group=400) completed the study. Bivariate analysis shows two significantly different variables between the intervention and control groups, improvement of the condition and ER revisit within 30 days. When other factors are controlled in a multivariate analysis using logistic regression, the effect of the intervention on re-visits to ER within 30 days is reversed. Gender, times of attending general practitioner after ER visits, and not considering other doctors are risks factors related to a higher chance of re-visiting ER within 30 days. Those who have an improved health condition and higher number of times attending general outpatient after ER visits are associated with a lower 30-day ER revisit rate. Nurse telephone follow-ups might have sensitized subjects to health care needs. Some subjects tended to use the ER as a primary care setting and some were doctor-shoppers. A more structured ER transitional model that incoporates nurse telephone follow-up and better interfacing between private and public health care sector, primary and tertiary care might help to decrease inappropriate ER use.

Aftercare↗

PubMedDate not supplied

Health problems encountered by dying patients receiving palliative home care until death.

Many of the studies reviewing the needs of the dying patient have used specified time points rather than following the patients through the last span of their lifetime, until death. This prospective study, using clinical records and nursing anecdotes, examined the health problems encountered by dying patients receiving home care from referral to home care until death. Thirty-two subjects were recruited in the study. The clinical records were content-analyzed using the Omaha system, and the anecdotes of the nurses were used to illuminate the numerical findings. This study reveals that patients who were discharged home were living in good environmental and social conditions. The physical symptoms were generally well controlled, except for dyspnea. The psychological aspects caused the most concern to patients, families, and healthcare professionals. The severity of the psychological signs and symptoms was moderate at the time of the initial visits, but improved toward the final visits. Understanding the needs of palliative home care patients can facilitate the healthcare team to plan care to support "good dying" of these patients.

Adult↗