Oncology nursing: professional development as a clinical specialty in Hong Kong

Cancer is a major health problem world-wide. Therefore, it is not surprising that cancer is identified as the top priority disease group for an improvement programme by the Hospital Authority in Hong Kong. Laser therapy for patients with nasopharyngeal carcinoma, for example, is evidence of the advancement of the scientific and technological developments for cancer treatment. Furthermore, the establishment of the Cancer Centre has provided ample opportunities for clinical practices and research studies. In response to the proclamation of the 'urgent need for the establishment of a cancer society in every country' by Searle in 1990, the Oncology Care Society of Hong Kong, which aims to promote both cancer education and cancer research, was established in 1993. Adopted from the core curriculum of the European Oncology Nursing Society, the specialist course of cancer nursing care was first implemented in Hong Kong in 1993 and the nurse specialist is now a permanent part of nursing career structure in Hong Kong. This paper attempts to review the development of oncology nursing in Hong Kong according to these factors and to find ways to improve the current situation.     

CD4(+) T cells tolerized ex vivo to host alloantigen by anti-CD40 ligand (CD40L:CD154) antibody lose their graft-versus-host disease lethality capacity but retain nominal antigen responses

Health care reform in Hong Kong in the 1990s has brought about dramatic change to the nursing discipline. This paper reports an ethnographic study which aimed at exploring the transformation of nursing in a regional hospital in Hong Kong during this period of reform. In the study, the restructuring of nursing work, its associated dynamics and resulting impacts upon the nursing profession were examined. A methodological triangulation approach to data collection encompassing interviews, participant observation and review of documents was used. The findings in this study suggest that the majority of nurses working in the case study hospital continue to be subject to medical dominance and are under management control. The emphasis on cost-effective care has however, fostered qualified nurses to claim more ownership of their professional judgement and autonomy. The health care reform has confirmed the status of two newly established groups of nurses, the nurse specialists and nurse managers. The development of the nursing profession is found to be closely connected to its work development. The preparation of the new generation of nurses, as revealed in this study, needs to emphasize the cognitive dimension of the professional competence. Some nurses need to be further educated in specialist practice and clinical management to maximize the contribution of nursing in health care delivery.     

Cultivating a moral sense of nursing through model emulation

This paper reports part of a longitudinal research project, which sought to capture students' conceptualization of caring practice as they progressed to different levels of study in a nursing diploma programme in Hong Kong. Model emulation was found to be an effective means of focusing students' learning processes on the moral aspects of nursing practice. The theory of model emulation from a Chinese perspective and how it is applied to create a learning context to allow students to acquire a moral sense of nursing are discussed. The participating students are invited to be sincere enquirers in the pursuit of the good embedded in practice through introspective self-examination and dialogue. They are asked to describe and share their experience of positive and negative examples of nursing in written accounts. Van Kaam's phenomenological method was adopted to explicate the good and bad constituents of nursing from these examples, with the students assuming an active role in the explication process. The explication reveals that the students were able to articulate the good and bad practices in a variety of patient care situations.     

B cell mitogenic activity of house dust mite, Dermatophagoides farinae, antigens

Hong Kong, Taiwan, Singapore, and Malaysia are initiating health care reform to meet the changing demands of populations with improved socioeconomic status and access to modern technologies and who are living longer than in previous generations. Hong Kong, in particular, is facing a unique set of circumstances as its people prepare for the transition in 1997 from a British colony to a Special Administrative Region of China. While spending only 4% of its gross domestic product on health care, it has a large and regulated public hospital system for most inpatient medical care and a separate, loosely regulated private health care system for most outpatient medical care. In 1993 the Secretary for Health and Welfare of Hong Kong initiated a year-long process to debate the pros and cons of 5 fundamental programs for health care reform. After a year of open consultation, options were chosen. We describe the Hong Kong health care system, the fundamental changes that have been adopted, and lessons for reformers in the United States.     

Nasopharyngeal carcinoma research in Hong Kong in the past decade

OBJECTIVE: To review the research carried out in Hong Kong on nasopharyngeal carcinoma (NPC) over the past 10 years. METHODS: The literature published in Hong Kong over the past 10 years on nasopharyngeal carcinoma were reviewed in the light of other important international publications on the same subject. RESULTS: The research carried out in Hong Kong covers etiology, natural behavior, treatment and prognosis of NPC. These studies not only elucidated the different aspects of NPC, many of these new findings will also guide future directions of research. CONCLUSIONS: Major efforts have been made to research into the various aspects of NPC with important findings which will translate into better treatment results. As this tumor is uncommon in other parts of the world, continued efforts to improve the prevention, early diagnosis, treatment and care of this tumor are required in China.     

Society stress and peptic ulcer perforation

To examine the relationship between society stress and peptic ulcer perforation, time-trend analysis was performed on the annual incidence of perforated peptic ulcer per 100,000 population in Hong Kong during the years 1962-85, when Hong Kong, as a developing city, went through significant socio-economic and political changes, and the trend was correlated with specially designed and validated society stress scores estimated annually during the same period. The society stress scores were derived independently by two expert panels blinded to the purpose of the study, one selecting and categorizing negative news events for Hong Kong during this period, and the other weighing the categories and scoring the impact of the news on Hong Kong. The incidence of perforation increased significantly during the years and manifested three distinct peaks, which coincided with the worst economic recession in Hong Kong, the influx of mainlander Chinese and Vietnamese boat people, and the Sino-British negotiation on the sovereignty of Hong Kong after 1997. Both linear and autoregression analysis, the latter taking into consideration point fluctuations in rates, showed that perforation rates correlated significantly with the society stress scores (r = 0.57, P < 0.002). The peak effects and the significant correlations indicate that an association exists between society stress and peptic ulcer perforation, and suggest that chronic society stress plays an important role in the aetiology of this condition, although the relatively low r value also suggests the presence of other aetiological factors.     

Age differences in the likelihood of destructive anger responses under different relationship contexts: A comparison of mainland and Hong Kong Chinese.

This brief report examined how the likelihood of destructive anger responses varied with age across relationship contexts. Seventy-six older adults and 100 younger adults from Hong Kong and Mainland China reported their responses to anger-eliciting scenarios elicited by a kin, a close or a casual friend. Results indicated that compared with their younger counterparts, older Hong Kong Chinese were less likely to report direct aggression toward kin, but older Mainland Chinese were more likely to do so. Older Hong Kong Chinese were less likely to report malevolent and fractious motives than were younger Chinese across all relationships; Older Mainland Chinese were less likely to do so only in friendship. Findings have implications for conceptualizing age-related emotion regulation across relationships and cultures. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Drivers for Adopting Public Private Partnerships—Empirical Comparison between China and Hong Kong Special Administrative Region

The private sector has long been involved in delivering public sector projects, whether its role has been as a partner or just as a contractor for the government. Over recent years the interest in adopting public private partnerships (PPPs) has increased internationally. Many research studies have presented positive reasons for the governments and the private sector to welcome this form of procurement, rather than continue adopting the traditional options. This paper aims to explore and compare the key drivers for adopting PPP in China and the Hong Kong Special Administrative Region (referred to as Hong Kong from here onwards). An empirical questionnaire survey was conducted in both of these administrative systems and survey respondents were invited to rate their perceptions on the importance of 15 different drivers identified. Eighty-seven completed survey questionnaires were returned for analysis. The findings indicated that respondents from China rated economy-related drivers higher, whereas Hong Kong respondents tended to rate efficiency-related drivers higher. China’s demand for more public infrastructure and services has imposed great pressure on the government’s budget, and therefore economic drivers were rated higher. On the other hand, with adequate financial reserve in hand and budget surplus over recent years, Hong Kong has tended to prefer paying for projects upfront, and hence efficiency was regarded more significantly. Among the 15 drivers, both of the respondents from China and Hong Kong selected, “provide an integrated solution (for public infrastructure/services)” and “solve the problem of public sector budget restraint” to be within the top three drivers. Despite the general agreement on the ranking pattern, the results of independent two-sample t-test showed that China and Hong Kong shared very different views on the driver “reduce the total project cost.” This driver was ranked rather high by the mainland Chinese respondents, but much lower by the Hong Kong respondents. This finding can be construed that economic drivers are in general rated higher in China as compared to that in Hong Kong.     

Patterns of psychological test usage in Hong Kong in 1993.

The authors surveyed test usage among 50 clinical and educational psychologists in Hong Kong and compared results with those of previous surveys in Hong Kong, China, and the United States. Although testing trends in Hong Kong have remained relatively unchanged, especially regarding the use of intellectual tests and simple projective measures, the use of specific self-administered psychiatric rating scales appeared to rise above that of the time-consuming multiscale personality inventories. Neuropsychological batteries and vocational inventories remained infrequently used. The constraints posed by translation and renorming and the need for test development with the collaboration among psychologists in different Chinese societies are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Galvanic vestibular stimulation in humans: effects on otolith function in roll

All autopsy reports from 1990-1994 inclusive of the Department of Pathology, University of Hong Kong and the Wales Institute of Forensic Medicine were examined and cases of death due to massive pulmonary embolism were noted. The incidence of this condition was calculated and found to be insignificantly lower in the Hong Kong series than the Welsh series by statistical analysis, both in the crude incidence in all autopsies and when correcting for different case mixes in the two locations. The majority of cases in both locations were in the over-60 age group. The study helps refute the longstanding belief among Hong Kong physicians that fatal massive pulmonary embolism is rare in Hong Kong (with approximately 98% Chinese population) in comparison with a predominantly Caucasian population.     

Factors influencing adjustment of patients suffering from nasopharynx carcinoma--implications for oncology social work

A longitudinal study has been conducted in Hong Kong to identify important factors that affect short-term adjustment of patients suffering from nasopharynx carcinoma (NPC). A total of 125 newly diagnosed NPC patients were interviewed in the diagnostic phase, the number dropping to 119 in the treatment phase, and 111 in the post-treatment phase. Data were gathered by a pre-tested structured measuring instrument via face-to-face interviews. Those patients with poor adjustment in each phase of the illness were found to have higher perceived stress; they tended to interpret their illness as more threatening and less controllable, and they employed problem-focused coping less frequently but used emotion-focused coping more frequently. The health locus of control and the overall perceived social support had differential effects on short-term adjustment in different phases of the illness. Current stress was identified to be the most important factor accounting for patients' adjustment in the treatment phase, while adjustment in the post-treatment phase was predominantly accounted for by previous adjustment. Based on the results of this study, a new model of practice is proposed for oncology social workers in Hong Kong, which is proactive, comprehensive, preventive and stage-specific. This model of practice is applicable to other countries like USA.     

Hong Kong nurses' health-related behaviours: implications for nurses' role in health promotion

The health-related behaviors of a random sample (n = 92) of Hong Kong nurses were assessed by a questionnaire written either in English or in English and Chinese. Hong Kong nurses reported negligible smoking or alcohol use, low levels of breast self-examination, cervical screening behaviour and regular exercising, seat belt use and driving within the speed limit. The sample reported high levels of making efforts to avoid foods high in cholesterol, eating foods high in fibre and eating fruit daily. Dental hygiene was reported to be high. Just over half the sample reported sleeping 7-8 hours each night and eating breakfast daily. Most nurses reported maintaining their body weight at a healthy level and eating snacks between meals. The English language version of the questionnaire produced a slightly better response rate than the bilingual questionnaire. The results are discussed with reference to previous studies of females' health-related behaviours in Hong Kong and elsewhere. The implications for Hong Kong nurses' role in health promotion is discussed.     

Allopurinol reduces bacterial translocation, intestinal mucosal lipid peroxidation, and neutrophil-derived myeloperoxidase activity in chronic portal hypertensive and common bile duct-ligated growing rats

The Chinese population in Hong Kong has a low incidence of invasive Haemophilus influenzae type b(Hib) disease, as well as carriage of the microorganism. Likely stimuli for the natural antibodies to Hib, which might protect against Hib infection, are cross-reactive antigens of bacteria like Escherichia coli K 100. Our aim was to determine the isotype and idiotype distribution and cross-reactivity of natural antibodies against Hib capsular polysaccharide (CP) in healthy Hong Kong Chinese. Titration of 20 sera by ELISA showed IgG antibodies reacting with Hib CP in all individuals. The antibodies were mainly IgG2, and their avidity index ranged widely. Isoelectric focusing (IEF) combined with immunoblotting showed patterns of IgG2 antibody clones against the CP of Hib and E. coli K 100 which were similar in 10 cases. Absorption with Hib CP only eliminated some bands in two sera. Absorption with K 100 CP did not remove any anti-Hib CP bands. In three sera additional clones of antibodies reacting to K 100 CP only, disappeared after absorption with this CP. Spectrotypic analyses of IgG antibodies reacting with anti-Hib idiotype 1 (Id-1) revealed stronger IEF patterns with bands in differing locations compared with anti-Hib CP antibodies. The strong reactivity of serum IgG, IgA and IgM antibodies with monoclonal anti-Hib Id-1 was confirmed by ELISA. This reactivity was not abolished after absorption of the sera with either Hib CP, or K 100 CP. The data indicate a high prevalence of Id-1 among Hong Kong Chinese. However, only one individual had Id-1 antibodies specific for Hib CP, judging from absorption experiments. Others had much lower activity of Id-1 anti-Hib CP antibodies compared with the total IgG Id-1, suggesting that Hong Kong subjects have Id-1-positive antibodies in their serum which are not specific for Hib CP. This is consistent with the nature of Id-1, which is a marker of A2VL region usage rather than a marker of a Hib CP paratope. We suggest that natural antibodies reacting with Hib CP in healthy Hong Kong Chinese are the product of exposure to some cross-reactive antigen(s), different from both Hib and E. coli K 100 CP.     

Age differences in the sixth personality factor: Age differences in interpersonal relatedness among Canadians and Hong Kong Chinese.

Cross-cultural studies on personality in which a combined etic-emic approach has been used have found a 6th personality factor--Interpersonal Relatedness--in addition to the usual Big Five. The authors examined age differences in Interpersonal Relatedness among Canadians and Hong Kong Chinese after statistically controlling for the Big Five. Age differences in some aspects of Interpersonal Relatedness were found among Hong Kong Chinese but not among Canadians, suggesting that development of some personality characteristics may differ across cultures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptions of parenting in mainland China, Taiwan, and Hong Kong: Sex differences and societal differences.

Variations in parenting in Chinese families were examined with data from adults in mainland China, Taiwan, and Hong Kong. Ss completed questionnaires that assessed their perceptions of their mothers' and fathers' warmth and control during their childhood. Results revealed sex differences in perceptions of parenting that were comparable in the 3 societies. Mothers generally were perceived as warmer and as less controlling than fathers. Perceptions of parenting also differed for sons and daughters. Daughters perceived their fathers as warmer and as less controlling than did sons. Differences among the 3 societies existed in adults' perceptions of their parents' overall warmth and control. Hong Kong adults perceived both parents as less warm and more controlling than did Taiwan and mainland China adults. These findings have implications for future research on Chinese families and for an understanding of cultural influences on parenting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chinese Values and Stressors of Construction Professionals in Hong Kong

The construction industry has been recognized as a stressful industry, and a great deal of stress is placed on various construction professionals (CPs). However, due to the different “values” among CPs in Hong Kong, susceptibility to stressors varies from individual to individual. People who grow up and live in different cultural environments have different values and this leads to different perceptions of stressors. This study aims to investigate the impact of Chinese values on the stressors of CPs in Hong Kong, one of the main cities in China. To achieve this aim, factor analysis, Pearson correlation analysis, and structural equation modeling were applied based on the survey data collected from CPs in Hong Kong. Four types of Chinese values and eight stressors are identified. The results reveal that: (1) social conventions value alleviate role ambiguity and poor workgroup relationship; (2) value of disciplined work ethos triggers work overload, although it alleviate poor workgroup relationship and work underload; (3) value of conservative personality alleviates work overload; (4) interpersonal integration value has indirect impacts on the various stressors; and (5) the objective poor working environment stressor has significant impact on the poor workgroup relationships and role ambiguity of individual CPs.