•From 1200 telephone interviews, the COVID-19 vaccine acceptance rate was 37.2%.•Acceptance rate was the highest in adults aged 18–24 years then increased with age.•Government recommendation was the ...strongest predictive factor of vaccine acceptance.•A key obstacle of acceptance included lack of confidence on vaccine manufacturers.•These predictors provide evidence-based formulation of vaccination strategies.
Vaccines for COVID-19 are anticipated to be available by 2021. Vaccine uptake rate is a crucial determinant for herd immunity. We examined factors associated with acceptance of vaccine based on (1). constructs of the Health Belief Model (HBM), (2). trust in the healthcare system, new vaccine platforms and manufacturers, and (3). self-reported health outcomes.
A population-based, random telephone survey was performed during the peak of the third wave of COVID-19 outbreak (27/07/2020 to 27/08/2020) in Hong Kong. All adults aged ≥ 18 years were eligible. The survey included sociodemographic details; self-report health conditions; trust scales; and self-reported health outcomes. Multivariable regression analyses were applied to examine independent associations. The primary outcome is the acceptance of the COVID-19 vaccine.
We conducted 1200 successful telephone interviews (response rate 55%). The overall vaccine acceptance rate after adjustment for population distribution was 37.2% (95% C.I. 34.5–39.9%). The projected acceptance rates exhibited a “J-shaped” pattern with age, with higher rates among young adults (18–24 years), then increased linearly with age. Multivariable regression analyses revealed that perceived severity, perceived benefits of the vaccine, cues to action, self-reported health outcomes, and trust in healthcare system or vaccine manufacturers were positive correlates of acceptance; whilst perceived access barriers and harm were negative correlates. Remarkably, perceived susceptibility to infection carried no significant association, whereas recommendation from Government (aOR = 10.2, 95% C.I. 6.54 to 15.9, p < 0.001) was as the strongest driving factor for acceptance. Other key obstacles of acceptance included lack of confidence on newer vaccine platforms (43.4%) and manufacturers without track record (52.2%), which are of particular relevance to the current context.
Governmental recommendation is an important driver, whereas perceived susceptibility is not associated with acceptance of COVID-19 vaccine. These HBM constructs and independent predictors inform evidence-based formulation and implementation of vaccination strategies.
Patient experience reflects quality of care from the patients' perspective; therefore, patients' experiences are important data in the evaluation of the quality of health services. The development of ...an abbreviated, reliable and valid instrument for measuring inpatients' experience would reflect the key aspect of inpatient care from patients' perspective as well as facilitate quality improvement by cultivating patient engagement and allow the trends in patient satisfaction and experience to be measured regularly. The study developed a short-form inpatient instrument and tested its ability to capture a core set of inpatients' experiences. The Hong Kong Inpatient Experience Questionnaire (HKIEQ) was established in 2010; it is an adaptation of the General Inpatient Questionnaire of the Care Quality Commission created by the Picker Institute in United Kingdom. This study used a consensus conference and a cross-sectional validation survey to create and validate a short-form of the Hong Kong Inpatient Experience Questionnaire (SF-HKIEQ). The short-form, the SF-HKIEQ, consisted of 18 items derived from the HKIEQ. The 18 items mainly covered relational aspects of care under four dimensions of the patient's journey: hospital staff, patient care and treatment, information on leaving the hospital, and overall impression. The SF-HKIEQ had a high degree of face validity, construct validity and internal reliability. The validated SF-HKIEQ reflects the relevant core aspects of inpatients' experience in a hospital setting. It provides a quick reference tool for quality improvement purposes and a platform that allows both healthcare staff and patients to monitor the quality of hospital care over time.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Traditional food systems are under pressure from various stressors, including climate change which is projected to negatively alter the abundance of marine species harvested by coastal First Nations ...(FNs) in British Columbia (BC).
To model the potential impacts of the climate-related declines in seafood production on the nutritional status of coastal BC FNs. In addition, we projected potential changes in nutrient intakes, under different scenarios of substitution where traditional seafood is replaced with alternative non-traditional foods.
The study design is a mixed-method approach that combines two datasets: projected scenarios of climate-related change on seafood catch potential for coastal BC FNs and data derived from the cross-sectional First Nations Food, Nutrition, and Environment Study. The consumption of seafood was estimated using a food frequency questionnaire among 356 FNs. The contribution of seafood consumption to protein, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), vitamins (A, B12, D, niacin), and minerals (zinc, selenium and iron) requirements was assessed using Dietary Reference Intakes (DRIs).
Traditional seafood consumption provided daily recommendations of EPA+DHA (74-184%) and vitamin B12 (84-152%) and substantial levels of niacin (28-55%), selenium (29-55%), vitamin D (15-30%) and protein (14-30%). Projected climate change was estimated to reduce the intakes of essential nutrients by 21% and 31% under 'strong mitigation' (Representative Concentration Pathway, RCP2.6) and 'business-as-usual' (RCP8.5) climate change scenarios, respectively, by the year 2050 relative to 2000. The hypothetical substitution of seafood with selected alternative non-traditional foods does not provide adequate amounts of nutrients.
Traditionally-harvested seafood remains fundamental to the contemporary diet and health of coastal BC FNs. Potential dietary shifts aggravated by climate-related declines in seafood consumption may have significant nutritional and health implications for BC FN. Strategies to improve access to seafood harvest potential in coastal communities are needed to ensure nutritional health and overall well-being and to promote food security and food sovereignty in coastal FNs.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The World Health Organization advocates the goal of universal coverage of health systems to ensure that everyone can avail the services they need and are protected from the associated financial ...risks. Governments are increasingly engaging and interacting with the private sector in initiatives collectively referred to as public-private partnerships (PPPs) to enhance the capacity of health systems to meet this objective. Understanding the values that motivate partners and demonstrating commitment for building relationships were found to be key lessons in building effective PPPs; however there, remain many research gaps. This study focusses on the practice of PPPs at the inter-organisational (meso) level and interpersonal (micro) level in Hong Kong Special Administrative Region (HKSAR). The influence of the structural components of different PPPs on stakeholder interpretation and actions, as well as the eventual outcomes of the PPPs, is examined, in terms of a realist evaluation, which applies a context–mechanism–outcome configuration as the research methodology. Seven key factors initiating commitment in a partnership, critical for sustainable PPPs, were identified as follows: (1) building of trust; (2) clearly defined objectives and roles; (3) time commitment; (4) transparency and candid information, particularly in relation to risk and benefit; (5) contract flexibility; (6) technical assistance or financial incentive behind procedural arrangements; and (7) the awareness and acceptability of structural changes related to responsibility and decisions (power and authority).
•Definition and conceptualization of PPPs are inconsistent in different countries.•Heterogeneity of PPPs in different contexts is important during evaluation.•Realist evaluation was recommended methodology to better understand the impact of PPPs.•7 key factors were identified for the role of PPP in strengthening health system.
To reduce avoidable hospital readmissions, effective discharge planning and appropriate post discharge support care are key requirements. This study is a 3-staged process to develop, pretest and ...pilot a framework for an effective discharge planning system in Hong Kong. This paper reports on the methodology of Delphi approach and findings of the second stage on pre-testing the framework developed so as to validate and attest to its applicability and practicability in which consensus was sought on the key components of discharge planning.
Delphi methodology was adopted to engage a group of experienced healthcare professionals to rate and discuss the framework and components of an effective discharge planning. The framework was consisted 36 statements under 5 major themes: initial screening, discharge planning process, coordination of discharge, implementation of discharge, and post discharge follow-up. Each statement was rated independently based on 3 aspects including clarity, validity and applicability on a 5-point Likert-scale. Statement with 75% or above of participants scoring 4-5 on all 3 aspects would be included in the discharge planning framework. For those statements not reaching 75% of consensus in any one of the aspect, it would be revised or discarded following the group discussion, and be re-rated in another round.
A total of 24 participants participated in the consensus-building process. In round one rating, consensus was achieved in 25 out of 36 statements. Among those 11 statements not reaching consensus, the major concern was related to the "applicability" of the statements. The participants expressed a lack of manpower, skills and time in particular during weekends and long holidays in carrying out assessment and care plans within 24 h after admission. There were also timeliness and availability issue in providing transportation and necessary equipment to the patients. To make the statements more applicable, the wordings of some of the statements were revised to provide greater flexibility. Due to the lack of a statement in clarifying the role of the members of the healthcare professional team, one additional statement on the role and responsibility of the multidisciplinary team members was added. The first theme on "initial screening" was further revised to "initial screening and assessment" to better reflect the first stage of discharge planning process. After two rounds of rating process, all the 36 statements and the newly added statement reached consensus
A structured, systematic and coordinated system of hospital discharge system is required to facilitate the discharge process to ensure a smooth patient transition from the hospital to the community and improve patient health outcome in both clinical and social aspect. The findings of this paper provide a reference framework helping policymakers and hospital managers to facilitate the development of a coherent and systematized discharge planning process. Adopting a Delphi approach also demonstrates the values of the method as a pre-test (before the clinical run) of the components and requirements of a discharge planning system taking into account of the local context and system constraints, which would lead to improvements to its applicability and practicability. To confirm the applicability and practicability of this consensus framework for discharge planning system, the third stage of process of development of the discharge planning framework is to apply and pilot the framework in a hospital setting to evaluate its feasibility, applicability and impact in hospital including satisfaction from both the perspectives of staff and patients.
Celotno besedilo
Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Aims
This study explored the impact of menopause on sexual health and marital relationships, the associated factors and the support needed among middle‐aged and older women.
Background
Although women ...experiencing menopause are more vulnerable to sexual health and marital problems, few studies have addressed this topic.
Design
A mixed methods design was used, comprising primarily quantitative methods with a qualitative component to evaluate the impact of menopause on sexual health.
Methods
Eligible women from community‐based women centre in Hong Kong were recruited for a survey. The Female Sexual Function Index (FSFI) was used to evaluate sexual function and risk factors for developing sexual dysfunction. Purposively selected women were invited to participate in in‐depth individual interviews to explore the impact of menopause on sexual health, the barriers encountered and the desired support.
Findings
In total, 540 respondents completed the survey with response rate of 59.7% where 30 respondents participated in the in‐depth individual interview. The prevalence of sexual dysfunction in the overall respondents and postmenopause were 85.1% and 91.2% respectively. Depression was found as a strong factor associated with sexual dysfunction. The qualitative data showed that menopause had a considerable negative impact on women's sexual lives. Vaginal dryness and low sexual desire were most commonly reported. Knowledge, financial support and family understanding were important to helping women manage menopause.
Conclusion
This study gives further knowledge for healthcare providers and policy makers to develop appropriate strategies and deliver suitable services to improve the quality of sexual health of menopausal women.
Healthcare professionals are highly susceptible to adverse psychological outcomes amid the COVID-19 pandemic due to their job duties. As the largest part of the healthcare workforce, growing ...attention has been paid to nurses' adjustments to the pandemic. Despite the distress, recent studies found that nurses could still experience positive changes (i.e., adversarial growth, AG) during the pandemic. Research on the general populations has indicated that individuals' stress responses, coping resources, and coping strategies are associated with their AG during the pandemic. This study examined how sociodemographic characteristics, secondary traumatic and posttraumatic stress, coping resources, and coping strategies were associated with AG among nurses in Hong Kong amid the fifth wave (i.e., the most disastrous wave) of the COVID-19 pandemic.
Recruited through local nursing associations between May 24 and June 13, 2022, 209 nurses in Hong Kong completed an online questionnaire measuring the abovementioned variables.
Hierarchical regression results found that those affiliating with a religion, having participated in mental health-related workshops, higher levels of secondary traumatic stress (STS), social support, job satisfaction, plus more frequent emotional processing were associated with higher AG (βs ranging from 0.15 to 0.31,
s < .01).
Nurses did report AG during the fifth wave of the COVID-19 pandemic in Hong Kong. To promote AG among those nurses, future interventions should enhance nurses' understanding about the potential impact of STS on their well-being, solicit their interpersonal and work-related coping resources, plus facilitate their use of effective coping strategies. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Background
An international valuation protocol exists for obtaining societal values for each of the 3125 health states of the five-level EuroQol-five dimensions (EQ-5D-5L) questionnaire. A feedback ...module (FM) that can be related to theoretical models used in behavioral economics was recently included in this protocol.
Objectives
Our objective was to assess the impact of using an FM to estimate an EQ-5D-5L value set in Hong Kong.
Methods
EQ-5D-5L health states were elicited using a composite time trade-off (C-TTO) and a discrete-choice (DC) experiment. Use of the FM according to participant characteristics and the impact of the FM on the number of inconsistent C-TTO responses were assessed. We employed a main-effects hybrid model that combined data from both elicitation techniques.
Results
In total, 1014 individuals completed the survey. The sample was representative of the general Chinese Hong Kong population in terms of sex, educational attainment, marital status, and most age groups but not for employment status. The use of the FM reduced the number of C-TTO inconsistencies. Participant characteristics differed significantly between those who used and did not use the FM. The model without a constant resulted in logical consistent coefficients and was therefore selected as the model to produce the value set. The predicted EQ-5D-5L values ranged from −0.864 to 1.
Conclusions
The use of an FM to allow participants to exclude C-TTO responses reduced the number of inconsistent responses and improved the quality of the data when estimating an EQ-5D-5L value set in Hong Kong.
EQ-5D-5L valuation studies previously reported many inconsistent responses in time trade-off (TTO) data. A number of possible elements, including ordering effects of the valuation tasks, mistakes at ...the sorting question, and interviewers’ (learning) effects, may contribute to their inconsistency.
This study aimed to evaluate the effect of two modifications on consistency of TTO data in The Netherlands (NL) and Hong Kong (HK): (1) separating the valuation of the Better than Dead (BTD) and Worse than Dead (WTD) states; and (2) Implementation of feedback (FB) module by offering an opportunity to review TTO responses.
A crossover design with two study arms was used to test the effect of the modifications. In each jurisdiction, six interviewers were involved where half the interviewers started using the standard version, and the other half started with the split version. Each version was switched after every 25 (NL) or 30 (HK) interviews until 400 interviews were completed.
In the NL and HK, 404 and 403 respondents participated, respectively. With the use of the FB module, the proportion of respondents with inconsistent responses was lowered from 17.8% to 10.6% (P < 0.001) in NL and from 31.8% to 22.3% (P = 0.003) in HK. The result of separating the valuation of BTD and WTD states was not straightforward because it reduced the inconsistency rate in NL but not in HK.
The results support implementation of the FB module to promote the consistency of the data. The separation of the BTD and WTD task is not supported.
BACKGROUND:The causal relation between human papillomavirus (HPV) and cervical cancer has enabled HPV self-sampling to be envisaged as a possible screening method.
OBJECTIVES:The aim of this study is ...to explore the acceptability and reliability of HPV DNA self-sampling as an alternative option for cervical screening among female sex workers.
METHODS:Sixty-eight participants carried out self-sampling for HPV testing, gave a clinician-obtained sample for HPV testing, and a Papanicolaou test. After the samplings, the participants were questioned on the acceptability of the tests.
RESULTS:Most participants (65.6%) preferred to adopt HPV DNA self-sampling in the future; in particular, those without previous experience of Papanicolaou tests marginally significantly preferred self-sampling (86.7%, P = .055). The overall crude agreement in HPV detection rates between clinician and HPV DNA self-sampling was 85.3% (58/68), with a κ of 0.69 (95% confidence interval, 0.51–0.87). The sensitivity and specificity of self-collected samples were 66.7% and 66.1%, respectively, and the positive and negative predicted values were 24.0% and 92.5%, respectively. The prevalence of HPV was slightly higher in self-collected samples (39.7%, 27/68) than in clinician-collected samples (36.8%, 25/68). The participants expressed positive attitudes toward self-sampling but were less confident in their skills of self-sampling compared with clinicians (70.6% versus 91.2%).
CONCLUSIONS:The findings showed that self-sampling could be incorporated into current cervical cancer screening approaches.
IMPLICATIONS FOR PRACTICE:Self-sampling could potentially increase compliance to cervical cancer screening and thus reduce the morbidity and mortality from cervical cancer. Further research and education on self-sampling will be required for women of diverse backgrounds.
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