Biomedical subjects

I Chi

Publications and source records attributed to I Chi.

At least 37 records · Page 2Linked to original sources

PubMed2001

Long-term care policy for elders in Hong Kong.

The context in which aged care policy is being developed in Hong Kong is characterized not only by rapid demographic aging and social change, but also by new political and administrative systems being built on a colonial legacy. This article begins with a description of the demographic profile and trends in population aging, noting particular differences in marriage and family formation that differentiate Hong Kong from other developed countries and that also show marked changes between generations. While past social policies can be credited with contributing to the achievement of high life expectancy in Hong Kong, these policies were unevenly developed, with little provision for income security in old age or for long-term care. Both issues have come to the fore in policy development in recent years, culminating in the formation of the Elderly Commission in 1997 and revitalizing the level of attention given to developing community care. A clear policy agenda has been drawn up to promote the development of a long-term care system, addressing issues of integration; role differentiation for assessment and service provision, including new contractual arrangements; quality assurance; and financing. The political and administrative changes are seen to present opportunities for containing residential care and forging a care system founded on community services.

Aged↗

PubMed2001

Stressful life events and depressive symptoms: social support and sense of control as mediators or moderators?

Depression is quite common among the elderly members of the Hong Kong Chinese society. This study examined the impact of a series of common stressful life events (SLEs) on change in depressive symptoms among the older people. The respondents were 411 people aged sixty years or older from a survey of a representative community sample of the elderly population in Hong Kong. Using multiple regression models, the authors found that sense of control acted as a mediator in the linkage between the number of SLEs and depressive symptoms, even after controlling sociodemographic, and physical health status were applied. In addition, the social support measured by Lubben Social Network Scale moderated the influence of the exposure to SLEs on depression. Findings suggest that sense of control and social support play distinguished and important roles in the stress-outcome relationship. Service implications were discussed based on these findings.

Aged↗

PubMed2001

Social support exchange among elderly Chinese people and their family members in Hong Kong: a longitudinal study.

This study examines the pattern of social support exchange between the elderly and their family members, focusing on financial aid and household care (both instrumental and emotional). The second objective of this study is to identify resource capacity factors (including education, physical health, and size of social network) that generate differences in the exchange of financial aid and household care between elderly people and their family members. The respondents were 213 people who had family members living in Hong Kong aged 70-years-old or older from a longitudinal study of a representative community sample of the elderly population in Hong Kong. Using multiple regression models, we found that the elderly subjects who received more household care from their family members were likely to provide more household care to their family members three years later, even after controlling for the impact of resource capacities; and the elderly subjects who provided more household care to their family members were more likely to receive more household care from their family members three years later. In assessing the impact of the resource variables on support exchange, functional disability and the number of close relatives were significantly associated with the amount of household care the old people provided, whereas the number of close family members were significantly associated with the amount of household care the old people received. Policy implications of the findings in this study were discussed.

Aged↗

PubMed2001

Social support and depression among elderly Chinese people in Hong Kong.

This study examines the association between social support and depressive symptomatology in a representative community sample of 1106 Chinese people in Hong Kong aged sixty years or older. Significant bivariate relationships were found between depression and all dimensions of social support including social network size, network composition, social contact frequency, satisfaction of social support, instrumental/emotional support, and helping others. Using multiple regression models, the authors found that at least one measure of these six dimensions of social support was associated with depressive symptomatology, even after controlling for socio-demographic, and functional disability. We found that social support from family is important for elderly Chinese people in Hong Kong, and satisfaction with support is a more important predictor of depression levels than other objective measures of network relationships. Lastly, it was found that material aid and instrumental support is more important in preventing depression for elderly individuals in Hong Kong than emotional support.

Aged↗

PubMed2001

The use of the Minimum Data Set. Home Care in a case management project in Hong Kong.

130 hospital-discharged elderly patients received our comprehensive assessment by using a Chinese Minimum Data Set-Home Care (MDS-HC). Our case manager developed and implemented care plans with reference to the computer-generated Clients Assessment Protocols. Results showed that the MDS-HC was sensitive to identify elderly persons' holistic needs, and helpful in formulating all-inclusive care plans.

Aged↗

PubMed2000

Stressful events and depressive symptoms among old women and men: a longitudinal study.

Depression is quite common among the elderly members of Hong Kong Chinese society. This study examined the impact of a series of common stressful life events (SLEs) on changes in depressive symptoms among the older people. The respondents were 260 people aged seventy years or older from a longitudinal study of a representative community sample of the elderly population in Hong Kong. Using multiple regression models, the authors found that, of eight SLEs examined, only widowhood was associated with depressive symptoms three years later, even after controlling sociodemographic, physical health status, and social support variables were applied. In addition, the SLE influenced the depression differently for men and women, as we found that the death of a spouse was associated with increased in depressive symptoms among elder women, and the moving out of children was associated with a decrease in depressive symptoms among old men. Finally, we also found a close relationship between number of SLEs and depression.

Aged↗

PubMed1999

Sleep problems in Chinese elderly in Hong Kong.

BACKGROUND: To examine the sleep habits and one-year prevalence of sleep disturbance (difficulty in falling asleep, broken sleep and early morning wakening) as well as insomnia (subjectively inadequate or poor sleep) in an elderly Chinese population in Hong Kong. METHOD: In Phase 1, a representative sample of elderly aged 70 years or above were interviewed with a sleep questionnaire, and Cantonese versions of the Mini-Mental State Examination (CMMSE) and Geriatric Depression Scale(CGDS). In Phase 2, those with scores suggestive of cognitive impairment on CMMSE or depression on CGDS were interviewed by psychiatrists for making clinical diagnoses according to DSM IV. RESULTS: 1,034 elderly were interviewed in Phase 1. Occasional or persistent sleep disturbance were reported by 75% and insomnia in 38.2% of elderly. Slightly less than half of elderly with sleep disturbance complained of insomnia. Advancing age was associated with a higher rate of sleep disturbance while females had a higher rate of insomnia. Factors associated with sleep disturbance and insomnia included poor perceived health, past history of smoking, current depressive disorders, more chronic physical illness, more life events and more somatic complaints. Only 2.8% of the sample had taken sleeping pills within a one-year period. CONCLUSIONS: Sleep disturbance and insomnia are two separate but overlapping constructs and should be differentiated. Sleep disturbance is very common in the elderly and may be due to physiological changes with ageing. In contrast, those with a concommitant complaint of insomnia have impaired physical and mental health and may merit more medical attention.

Aged↗

PubMed1998

An epidemiological profile of elderly suicides in Hong Kong.

Suicide rates in Hong Kong increased with age, and the highest suicide rate occurred among the oldest age groups. Hong Kong has one of the highest elderly suicide rates in the world. The elderly suicide rate was four to five times above the average. Furthermore, gender differences were observed among different marital status groups. For example, single males had a much higher rate than single females and married males had a higher rate than their widowed counterparts. The suicide rate for an economically inactive person was six times higher than for an active one. Jumping has become increasingly common and seems to substitute for other methods of suicide. Winter months and the Chinese New Year period had the lowest suicide occurrence. Some explanations are given.

Adult↗

PubMed1998

Community attitudes toward living arrangements between the elderly and their adult children in Hong Kong.

For hundreds of years, Chinese societies have been living in extended family settings. However, the import of Western cultures and values are challenging the traditional Chinese practices in Hong Kong. This study assesses the community attitudes to living arrangements between elderly and their adult children in Hong Kong and to identify the factors which influence these attitudes. A random sample of 888 adult Hong Kong residents were telephone-interviewed. They were asked about their attitudes to living arrangements when they turned 60, if disabled and non-disabled. The relationship between these attitudes and the social and demographic characteristics of the respondents was also analyzed. Nearly 59% of the respondents preferred to live with their children if non-disabled. However, 43.5% of the respondents would be unlikely to want to live with their children if disabled. If non-disabled at 60, females, professionals or those who had lived overseas before preferred not to live with their children. Females also preferred not to live with their children if disabled at 60. Other factors, such as age, social class, education level and experience in living with elderly or looking after elderly had no effect on the respondents' preference. This study provides important information on the community attitudes to living arrangements between the elderly and their adult children in Hong Kong. These attitudes will shed light on the provision of housing and institutional care to elderly, as well as the family relationship and care pattern of the elderly in the future decades in Hong Kong and other communities which are undergoing rapid growth and 'Westernization'.

Journal Article↗

PubMed1998

A study of elderly suicides in Hong Kong.

Hong Kong has one of the highest rates of suicide among the elderly in the world. Most of the existing suicide prevention programs have had very little effect on the elderly, who rarely utilize these programs. This study aims to help in understanding the problem, so that effective prevention can be provided to this high-risk group of suicidal people. Specifically, the study (1) describes the characteristics of the suicidal elderly, (2) investigates the reason(s) why the elderly are in distress and become suicidal, and (3) formulates a policy and service model to reach the elderly high-risk group. This research project involves secondary data analysis. Police records on elderly suicide cases in 1992 were scrutinized to find out the major reason(s) for fatal death in the elderly. Our study points out those districts that are more crowded and have fewer medical and social facilities tended to have higher suicide rates. Most of the deaths occurred at home or nearby, and the suicidal elderly were alone before their death. The majority of elderly suicide victims suffered from chronic diseases. Very few of them, however, were totally dependent: About 40% of the cases had consulted medical practitioners, and 27% had consulted psychiatrists within one month before their deaths. Close to 70% of the cases had indicated to family members or other their suicidal thoughts, and many of them had revealed numerous suicidal indications. Both policy and practice issues are discussed in light of the findings.

Age Distribution↗

PubMed1998

Prevalence of dementia in Chinese elderly in Hong Kong.

This study examines the prevalence of dementia in elderly Chinese aged 70 years and older in Hong Kong using a two-phase design. In phase 1, 1,034 elderly were interviewed with the Cantonese version of the Mini-Mental State Examination. Those who scored below the cutoff points and a subsample of those with scores in the normal range were interviewed in phase 2 to identify those with dementia. The overall weighted prevalence of dementia in our subjects was 6.1 +/- 0.7%, which is at the lower end of the range of rates reported in whites. Alzheimer's disease (AD) accounted for 64.6% and vascular dementia, 29.3%. Our results, together with previous studies in Chinese populations, suggest that the rates of AD in Chinese are low compared with those in whites. Substantial differences are possible in the epidemiology of dementia across cultures related to interactions of genetic and environmental factors.

Age Distribution↗

PubMed1998

Health promotion for the elderly persons in Hong Kong.

By the year 2000, there will be one million elderly persons in Hong Kong. With the rise of an older population, the cost of health care is likely to increase. Studies conducted in Hong Kong have shown that over 30% of health care expenditure is spent on the elderly. Unless steps are taken to slow the onset of chronic illnesses in elderly people, health care expenditure will increase rapidly in the future. The present paper describes strategies that have been adopted for promoting a healthier elderly population in Hong Kong. The paper also reports the results of an evaluative study on the largest health promotion program for older people in Hong Kong. It seems to show that health promotion activities may have the potential to save lives, delay institutionalization, and improve life satisfaction.

Aged↗

PubMed1996

Norplant implants acceptability and user satisfaction among women in two African countries.

An analysis of 350 users of Norplant contraceptive subdermal implants from six centers in two African countries (Ghana and Nigeria) indicates that method acceptability remained high among the women who used the method for five years. Overall, 90.1% of the 155 five-year users in these countries reported having a very favorable experience and 9.9% a favorable experience with Norplant implants. Ease of use was cited by 56.1% and duration of use by 13.6% of the women as the most liked characteristics of the method at study completion after five years. Menstrual disturbance was the least liked aspect, by 41.9% of the women. On average, women who discontinued early from the study had fewer living children and were more likely to desire additional children at method adoption than those who completed five years of use; the differences were statistically significant. Differences in level of education and previous use of contraception were not found to be statistically significant between completers and non-completers. Differences in age were not significant in Nigeria, but were marginally significant in Ghana, with completers being older than non-completers. Of the clients who completed this study, 79.2% indicated a desire to continue with contraception and 43.9% planned to have a second set of implants inserted. These findings have important implications for counseling, method access and service sustainability in African countries.

Adult↗

PubMed1995

Life satisfaction and associated factors in older Hong Kong Chinese.

OBJECTIVE: To determine life satisfaction and its association with physical, functional, socioeconomic, psychological, and social support characteristics in Hong Kong Chinese aged 70 years and older. DESIGN: Cross-sectional study. SETTING: Territory-wide random sample of persons aged 70 years and older. SUBJECTS: A total of 843 men and 714 women were selected by random sampling, stratified by age and sex, from the Old age and Disability Allowance Register, after exclusion of subjects with cognitive impairment. MEASUREMENTS: Life satisfaction was assessed by the subjects' response to the question "Are you satisfied with life", using a 0 to 10-point linear scale. They were also asked to name the most important factor contributing to life satisfaction. Information was also obtained regarding physical health, functional ability, depressive symptoms, and socioeconomic factors. RESULTS: There was a weak association between score and age. Health, adequate income to meet living expenses, and caring relatives were rated the most important factors (> 65%). Some of these factors were also those associated with a high life satisfaction score. Factors associated with a life satisfaction score greater than 6 points were higher social class and educational attainment, adequate income to meet living expenses, satisfactory living arrangement, Christianity, good social support, participation in social activities, functional independence, good self-perceived health, good hearing and vision, daily exercise, absence of recurrent falls, and low depressive symptom score. Multiple logistic regression identified having two or more relatives and tertiary education as positive associated factors, whereas inadequate income to meet expenses, dissatisfaction with living arrangement, nonparticipation in religious group activities, and a high depressive symptom score were negative associated factors. CONCLUSION: In older Chinese, social factors such as the support provided by family members, as well as adequate income to meet living expenses, play a role equal to that of physical factors in contributing to life satisfaction.

Age Factors↗

PubMed1994

An analysis of the personal reasons for discontinuing IUD use.

The objective of this study was to evaluate possible factors associated with discontinuing use of TCu 380A IUDs due to personal reasons among 2748 users. Overall, a total of 88 subjects discontinued using the TCu 380A IUD within 12 months postinsertion for personal reasons. The most common reasons were planned pregnancy (32%) and husband or family opinion against IUD use (26%). The gross cumulative 12-month life table discontinuation rate for all personal reasons was 4.0 per 100 women. Having no education and/or living in a rural area were the sociodemographic characteristics associated with an increased risk of discontinuation for personal reasons. Effective and regular counseling about IUD use, especially among illiterate women, may help prevent IUD discontinuations related to personal reasons.

Attitude↗

PubMed1994

The prevalence of depressive symptoms and predisposing factors in an elderly Chinese population.

In a survey of elderly Chinese aged 70 years and over living in Hong Kong selected by stratified random sampling, the prevalence of depression was determined using the 15-item Geriatric Depression Scale using a cut-off point of 8 (sensitivity 96.3% and specificity 87.5% for this population). Subjects with moderate to severe cognitive impairment (CAPE I/O score < or = 7) were excluded. There were 877 men and 734 women. The adjusted overall prevalence for this population was 29.2% for men and 41.1% for women. The prevalence increased with age in men and was higher in women than in men. Univariate analysis identified many factors in the following areas that were associated with depression: socioeconomic characteristics, functional ability, physical health and social support. Stepwise logistic regression identified 16 factors predictive of depression: socioeconomic characteristics, such as borderline living expenses and dissatisfaction with living arrangement; poor social support, such as absence of an informal carer when ill, few relatives to turn to, and infrequent contact with neighbours and friends; functional disability, as indicated by a Barthel Index < 15, urinary incontinence and inability to do housework; and poor physical health--poor self perceived health, poor vision, difficulty with chewing, history of mental illness, frequent hospital admissions and increased level of symptoms such as poor memory, constipation and dizziness. Some of these factors may be amenable to intervention, and such measures may be important in reducing the high prevalence of depression in elderly people.

Aged↗

PubMed1994

The physical, mental, and social health status of older Chinese: a cross-national study.

This article reports data on 16 indicators of the physical, mental, and social health status of older Chinese living in Beijing, Guangzhou, and Los Angeles. Both the frequency distributions of these indicators and their factor structures are different among the three cities. These differences may have implications for the planning of public health services. Either they are the result of differences in the way in which people in each of these cities think about illness or they are the result of differential experiences with disease. Although these data cannot resolve this issue, both the frequency distributions and the severity ratings for nine chronic diseases also differed markedly among the three cities.

Activities of Daily Living↗

PubMed1993

What we have learned from recent IUD studies: a researcher's perspective.

Many studies published on intrauterine devices (IUDs) during the last six years have consistently reported findings in favor of IUD use. Notable among these findings are: IUDs are not abortifacients; newly developed IUDs are highly effective and the efficacy is long-lasting; IUDs can be safely used by most lactating women, with lower removal rates attributable to bleeding and/or pain; and immediate postplacental IUD insertion reduces the risk of expulsion usually associated with postpartum insertion. Most importantly, in apparent contrast to results often reported in the late 1960s through the early 1980s, recent findings show that IUDs per se, especially the medicated ones, are not associated with an increased risk of pelvic inflammatory disease (PID), nor are they associated with an increased risk of ectopic pregnancy or subsequent infertility. There are still issues concerning IUD use that are controversial in spite of numerous studies. Should some of the contraindications currently listed for IUD use be modified according to the newer findings? Is the risk of uterine perforation increased when the IUD is inserted in lactating women? Do IUD tails increase the risk of PID? Does oral use of antibiotics at IUD insertion help prevent postinsertion PID? There are also issues that have not been sufficiently addressed and more information from empirical studies is needed. These include: the effect of the insertor's skill on IUD performance; IUD use in nulliparous as well as in older women; the relationship between IUD use and chlamydia infection; and long-term IUD use and safety, including actinomycosis, etc. Answers are also needed by administrators facing difficult programmatic decisions. For instance, should programs involving massive IUD removal be implemented as many IUD-wearing women are approaching or passing menopause? Similarly, are large programs to remove less-effective devices and replace them with newer and more effective IUDs advisable? This article reviews the state-of-the-art findings from recent IUD studies on the above issues.

Contraindications↗