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Biomedical subjects

P French

Publications and source records attributed to P French.

At least 37 records · Page 2Linked to original sources
PubMed1999

Patient-related barriers to cancer pain management in a palliative care setting in Hong Kong.

This article reviews a study of pain management and its barriers in Hong Kong. Using an interview technique, several measures were used to understand the level of concern in patients about pain, the patients' hesitancy in reporting pain, use of analgesics, and adequacy of medication for pain. A total of nine barriers were identified, which include "addiction," "tolerance," "side effects," "physician distraction," "good patient," "fear of injection," "time interval," "fatalism," and "disease progression." Thirty-nine interviews were carried out. The interviewees were all cancer patients with pain in a palliative setting in Hong Kong. When the findings in Taiwan and the United States were compared, it was found that the cancer patients in Hong Kong had a higher level of concern toward the patient-related barriers. It was also found that the level of concern was generally higher in the group with hesitancy in reporting pain and using analgesics. Last of all, this project also identified the educational needs of patients and health care workers in Hong Kong.

Adult↗
PubMed1999

The impact of hospice inpatient care on the quality of life of patients terminally ill with cancer.

This study explored the expectations and experiences of patients with terminal cancer in a hospice inpatient environment in an attempt to evaluate their quality of life and the impact of the care and services provided. A total of 52 patients terminally ill with cancer from 11 hospice units in Hong Kong participated in the study. Data were collected from patients by devising a Hospice Care Performance Inventory (HCPI), which was an interview schedule consisting of 25 items. The HCPI was developed after a review of the literature on the quality of life experienced by patients with advanced cancer and the aims of hospice units in Hong Kong. Each item was rated by the patient on a Likert scale in terms of its importance and the perceived effectiveness of the care provided. The study identified six issues in which expectations did not seem to match effectiveness. These issues indicated areas in which improvement could be attempted to enhance the quality of life for the patients. The most important was maximizing self-care and mobility. Two issues were identified in which effectiveness was high and importance to the patient relatively low. One of these issues was pain management, and the other was spiritual care.

Adaptation, Psychological↗
PubMed1999

The needs of the family of critically ill neurosurgical patients: a comparison of nurses' and family members' perceptions.

In this study, researchers identified the important needs of family members of critically ill neurosurgical patients and explored the relationship between needs and unmet needs as perceived by nurses and family members. A total of 52 family members and 36 nurses in three neurosurgical special care units in Hong Kong were asked to complete the Chinese version of the 45-item Critical Care Family Needs Inventory. The rank order of most important needs reported by family members indicates that the majority of needs are related to assurance; needs for support and comfort were much less important. When rating needs, nurses underrated most of the needs considered important by family members. Needs for proximity were also underrated in importance by nurses when compared to family ratings, and needs for support were heavily overrated by nurses. The needs for proximity were least met. An inverse relationship between nurses' ratings of importance and the frequency of unmet needs was demonstrated. The most important need that was also largely unmet was having a specific person call when unable to visit. The findings of this study indicate areas of unmet need that require additional nursing interventions.

Adolescent↗
PubMed1998

The effectiveness of tutorials in behavioural sciences for nurses: an action learning project.

As the first round of an action research project, this paper describes a between-methods triangulation process which examines the effectiveness of tutorials in a post-registration nursing degree course. The major concerns of the research team were with student learning approaches and student satisfaction. The research utilized a pre-/post-test experimental design as well as descriptive designs including non-participant observation of tutorials, tutor journal keeping and student interviews, to study the effects of a change from theory-based to learning process-based tutorials. The experimental design utilized the 'study process questionnaire' and the 'approaches to study inventory'. Two experimental groups showed a significant change in pre-/post-test scores. The qualitative data indicated that there were differences in the ways in which these two groups operated. The qualitative data also indicated that students were largely subscribing to achieving approaches and that satisfaction with tutorials was mainly related to relevance to the previous lecture as well as the perceived contribution to course assessment. As a consequence of this study it was concluded that the efficiency of tutorials could be increased by reducing the number of assignments, designing a set of specific tutorial activities that integrate theory and process, and having an explicit tutorial group formation policy.

Behavioral Sciences↗
PubMed1998

Counselling issues in familial hypertrophic cardiomyopathy.

To illustrate the variable clinical presentations and rates of progression in familial hypertrophic cardiomyopathy (FHC), phenotypes and genotypes were compared in three FHC families with different genetic defects. In the first family, the FHC abnormality was a protein truncating mutation (Gln969X) in the cardiac myosin binding protein C gene. The second family had a missense change (Asn755Lys) in the same gene. A missense mutation (Arg453Cys) in the cardiac beta myosin heavy chain gene was present in the third family. Penetrance associated with the Gln969X defect was 27% in the age range 0 to 40 years. This was considerably less than the 93% penetrance (0 to 40 years) observed in the two families with missense mutations. The variable penetrance in FHC, as well as the unpredictability of sudden cardiac death, complicates clinical diagnosis and management, including genetic counselling. Although a genetic disease with a predominantly adult onset, there are counselling issues in FHC which set it aside from other adult onset disorders.

Adolescent↗
PubMed1998

Reasons for HIV antibody testing: plus ca change?

Patient records in a central London genitourinary medicine (GUM) clinic relating to HIV testing were examined and compared for the 3 months immediately before and after World AIDS Day (WAD) in 1994, according to gender and sexual orientation, and the reasons given for testing. Additionally, patient-identified risk was compared with counsellor-identified risk in each case in 1994. Findings were compared with data from the initial HIV awareness campaign in 1986-87. In the 1994 study period, there were no significant differences in overall numbers attending or gender of test-seekers before and after WAD, or proportions of heterosexual, bisexual and gay test-seekers across the time periods. Within each of these groups, gay test seekers were significantly more likely to be HIV positive than heterosexuals, although there were no differences in numbers found positive in each group before and after WAD. Thirty-five per cent (n=268) reported a history of safer sex only, 32% (n=247) said 'sometimes', and 33% (n=249) said 'no'. Overall, the main reasons given for HIV test-seeking included having part of a sexual health screen, having episodes of unprotected sex and/or casual partners, concern over partner's status/monogamy, and intravenous drug user (IDU) contact. Reasons for testing in 1994 reflected greater awareness of HIV transmission compared to 1986-87, although only one-third of those tested reported a history of safer sex.

AIDS Serodiagnosis↗
PubMed1997

A randomized trial of enhanced therapy for early syphilis in patients with and without human immunodeficiency virus infection. The Syphilis and HIV Study Group.

BACKGROUND: Reports of neurosyphilis and invasion of cerebrospinal fluid by Treponema pallidum in patients with human immunodeficiency virus (HIV) infection have led to doubts about the adequacy of the recommended penicillin G benzathine therapy for early syphilis. METHODS: In a multicenter, randomized, double-blind trial, we assessed two treatments for early syphilis: 2.4 million units of penicillin G benzathine and that therapy enhanced with a 10-day course of amoxicillin and probenecid. The serologic and clinical responses of patients with and without HIV infection were studied during one year of follow-up. RESULTS: From 1991 through 1994, 541 patients were enrolled, including 101 patients (19 percent) who had HIV infection but differed little from the uninfected patients in their clinical presentations. The rates at which chancres and rashes resolved did not differ significantly according to treatment assignment or HIV status. Serologically defined treatment failures were more common among the HIV-infected patients. The single clinically defined treatment failure was in an HIV-infected patient. Rates of serologically defined treatment failure did not differ according to treatment group (18 percent at six months with usual therapy; 17 percent with enhanced therapy). T. pallidum was found at enrollment in the cerebrospinal fluid of 32 of 131 patients (24 percent) and after therapy in 7 of 35 patients tested. None had clinically evident neurosyphilis, and the rate of detection of T. pallidum did not differ according to HIV status. CONCLUSIONS: After treatment for primary or secondary syphilis, the HIV-infected patients responded less well serologically than the patients without HIV infection, but clinically defined failure was uncommon in both groups. Enhanced treatment with amoxicillin and probenecid did not improve the outcomes. Although T. pallidum was detected in cerebrospinal fluid before therapy in a quarter of the patients tested, such a finding did not predict treatment failure. The current recommendations for treating early syphilis appear adequate for most patients, whether or not they have HIV infection.

Adult↗
PubMed1997

Which pressure sore risk calculator? A study of the effectiveness of the Norton scale in Hong Kong.

This study aimed to evaluate the effectiveness of the Norton score in predicting the likely occurrence of pressure sores compared to the Waterlow scale in Hong Kong. Two elderly care wards (one male and one female) were chosen, the sample size was 185 and the mean age of subjects was 80.4. Each newly admitted patient was assessed using both the Norton calculation and the Waterlow calculation. At the end of the research, there were eight patients who had sore formation. The results indicated that the Norton score identified six out of the eight patients while the Waterlow identified seven of them. The Waterlow calculation, however, seems to have misidentified 72 patients as being in the 'at risk group'. In view of a fear of the misdirection of resources the Norton score was found to be the better of the two and its use in the elderly care units in this study should be continued until a better scoring system is found.

Aged↗
PubMed1997

The prevalence and cause of occupational back pain in Hong Kong registered nurses.

It is well known that many patient-oriented tasks contribute to occupational back pain in nurses and this is borne out by previous studies. In order to know whether the incidence of back pain and the contributing factors are the same in Hong Kong, a descriptive study was adopted to investigate the situation locally. This study explored the prevalence and perceived contributing factors of back pain, utilizing a non-experimental survey approach. Baseline data for this study were gathered by means of a questionnaire. The questionnaire elicited characteristics of the subjects' history and contributing factors to back pain. Of 47 nursing staff at an acute care hospital, the reported occurrence of some form of back pain during their career was found to be 80.9%. Approximately one-third of nurses with back-pain experienced pain at least once a month. The top two dynamic factors contributing to back pain were lifting patients and transferring patients. Meanwhile, stooping was identified as the most common static factor contributing to back pain. In addition of those who had experienced some form of back pain, 92.1% stated that they have never reported their back pain to their employers. Contributing factors such as transferring patients from bed to chair and lifting patients within bed without assistance indicate poor practice which should be eliminated by the existence of continuing in-service education.

Adult↗
PubMed1997

Education in the practicum: a study of the ward learning climate in Hong Kong.

The major concern of this study was the quality of education in the practice setting in Hong Kong. Its purposes were to gain an understanding of how local Hong Kong student nurses perceive their practice experience, and to examine the quality of student nurses' practice experience in the light of an educational paradigm. A broad qualitative approach derived from some of the philosophical perspectives of phenomenology was adopted. The target population were those student nurses studying on hospital-based pre-registration programmes in Hong Kong. The total number of informants was 16, two from each of the eight schools of nursing. The semi-structured interview method using open-ended questions was used to collect data. All the interviews were conducted in Cantonese, being transcribed into Chinese and then into English. In order to provide some validity check on the adequacy of the translated interview transcripts, back-translation was carried out. Both structural analysis (latent content analysis) and content analysis (manifest content analysis) were used to analyse the interview data. The 11 themes identified indicated that the practice experience was not an educational experience because the learning methods did not advance student nurses' intellectual development. Students were only equipped with knowledge which enabled them to act as model operators who were expected to carry out routines in an unreflective fashion. The issues of developing an effective clinical curriculum and creating a supportive clinical learning environment are discussed. It is argued that the associated problems are likely to be repeated, if not exacerbated, as baccalaureate nursing programmes are developed if the profession fails to address the issues reported in the current study. The mere transfer of nursing preparation to tertiary education cannot itself solve the problems existing in nursing education in Hong Kong.

Curriculum↗
PubMed1996

International comparison of baccalaureate nursing degrees: collaboration in qualitative analysis.

This paper describes a study which investigated the perceived similarities and differences of a selection of baccalaureate nursing degrees from different continents. An international research team was formed, and by using a modified version of the Delphi process and nominal group techniques the group undertook a qualitative analysis of curriculum documents. The major areas analysis were: aims, content, methods and assessment. Under these headings the group produced a list of key issues supported by a number of indicative statements by collating the independent analyses undertaken by each of the team members. Examples of findings are that critical thinking and personal development are most obvious in aims but that the progression of curricula may not achieve this, there are differences in 'western' and 'asian' orientations to the concept of personal autonomy. Sciences are valued more than arts or humanities. The lecture method as well as practice placement dominate the teaching methods. Transcultural nursing is not significant except where there are two therapeutic ideologies in existence. Assessment methods are largely summative. The findings have application in the development of credit transfer and international exchange schemes. The conclusions highlight areas of special considerations when designing such schemes.

China↗
PubMed1995

Long-lasting enhancement of synaptic excitability of CA1/subiculum neurons of the rat ventral hippocampus by vasopressin and vasopressin(4-8).

Vasopressin (VP) is axonally distributed in many brain structures, including the ventral hippocampus. Picogram quantities of VP injected into the hippocampus improve the passive avoidance response of rats, presumably by enhancing memory processes. Vasopressin is metabolized by the brain tissue into shorter peptides, such as [pGlu4,Cyt6]VP(4-9) and [pGlu4,Cyt6]VP(4-8), which preserve the behavioral activity but lose the peripheral activities of the parent hormone. Using brain slices, we investigated whether VP or VP(4-8) affects excitatory postsynaptic potentials (EPSPs) and/or membrane responses to depolarization in neurons of the CA1/subiculum of the ventral hippocampus. The EPSPs were evoked by stimulating the striatum radiatum of the CA1 field; the membrane responses were elicited by current injections. Exposure of slices for 15 min to 0.1 nM solution of these peptides resulted in an increase in the amplitude and slope of the EPSPs in 21 neurons (67%) tested. No consistent change in either the resting membrane potential or the input resistance of the neurons was observed. The peptide-induced increase in EPSPs reached a maximum 30-45 min after peptide application. In 14 of these neurons (66%), the peptide-induced increase in EPSPs remained throughout the entire 60-120 min washout period. In the remaining 7 neurons (33%), the initial increase in EPSPs amplitude was followed by a gradual decline to the pre-administration level. The increase in EPSP amplitude was often, but not always, associated with a decrease in the threshold and increase in the number of action potentials in response to depolarizing current injection. Suppression of GABAA receptor-mediated inhibition and N-methyl-D-aspartate (NMDA) receptor-mediated excitation did not prevent the effects of VP and VP(4-8) on the EPSP amplitude or the threshold for action potentials. The results demonstrate that 0.1 nM concentrations of these neuropeptides can elicit a long-lasting enhancement of the excitability of CA1/subiculum neurons of the ventral hippocampus to excitatory, glutamatergic synaptic input. This novel action of VP and its metabolite in the ventral hippocampus may be the physiological action, mediating the memory-enhancing effect of these peptides.

Animals↗
PubMed1995

Collegiality, adaptation and nursing faculty.

Many nurse educators in the United Kingdom are currently faced with the challenge of change, of leaving the culture of the British National Health Service and integrating into the culture of tertiary education. This paper reports on a study of the process of developing collegial relationships in the context of a new collaboration to develop a combined curriculum for nurses within a tertiary institution. The aims of the study were to analyse this process of integration and to identify the conditions that enhanced the development of collegiality between members of the nursing group. The case study centred on the analysis of data collected on video during unstructured interviews with the five members of the group. Data were analysed using Burnard's method of thematic content analysis. The paper argues that during the transition from the National Health Service to tertiary education, individual nurse educators and their managers must address problems related to issues such as 'ingroupism', nursing the students, perceived difference between nurse academics and other academics, and expectations of power-relationships.

Education, Nursing↗