Qualitative Protocol of Chinese Parents and Siblings Experiences of Managing Challenging Behaviours of Adult Persons with Intellectual Disability in Hong Kong and Northern China.

BACKGROUND: While the literature has highlighted the immense challenges in caring for family members, it is still unclear what the needs of family carers of persons with intellectual disability and challenging behaviours are and what has worked for them. This study aims to examine 60 parents' and siblings' experiences in managing the challenging behaviours of their adult family member with intellectual disability whilst living at home. METHODS: A qualitative grounded theory approach using semi-structured interviews will be adopted. Purposive sampling will be used to recruit family carers who live with adult persons with intellectual disability and use one community service in Hong Kong. Three special schools for persons with intellectual disability from northern China will be approached. RESULTS: This study will aim to provide an in-depth understanding of the experiences of family carers and compare the different circumstances they face when managing the challenging behaviours of their adult relatives with intellectual disability in their family home. CONCLUSIONS: Although this study targets adults with intellectual disability, the findings will provide a point of reference for adolescents and younger persons who exhibit demanding and challenging behaviours and live with their families. Recommendations can guide the development of appropriate strategies to strengthen services for family carers.

A Theory-Based and Culturally Aligned Training Program on Breast and Cervical Cancer Prevention for South Asian Community Health Workers: A Feasibility Study.

BACKGROUND: Cancer screening uptake among South Asian ethnic minorities is reported to be relatively low. An outreach program, led by community health workers (CHWs), may increase the minority group's awareness of the importance of cancer screening. OBJECTIVE: The aim of this study was to assess the feasibility and effectiveness of a theory-based, culturally sensitive program to train South Asian women in Hong Kong as CHWs. METHODS: A CHW training program, guided by the Empowerment Model and the Health Belief Model, was developed and implemented. Its feasibility was evaluated through the recruitment of South Asian women to the program and their satisfaction with it. Its effectiveness was assessed by a test of knowledge, the participants' self-efficacy and competence, and their readiness to work as CHWs. RESULTS: Five South Asian women were recruited to the training program. Outcomes included increased participants' knowledge of cancer and improved self-efficacy and competence in working as CHWs. All participants were highly satisfied with the program, although the addition of practical sessions in the South Asian community was suggested as a further improvement. CONCLUSION: It seems to be feasible to train South Asian CHWs to deliver interventions to promote their peers' awareness of breast and cervical cancer prevention, although challenges exist in recruitment of trainees. More hands-on practical opportunities as CHWs would likely increase their effectiveness. IMPLICATIONS FOR PRACTICE: The theoretical framework of our CHW training program and the incorporated cultural components could be useful for the development of future programs for training South Asian CHWs in delivering interventions on cancer prevention.

Experiences of aromatherapy massage among adult female cancer patients: A qualitative study.

AIMS AND OBJECTIVES: To explore the experiences towards aromatherapy massage use, and to examine the perceived benefits and adverse effects of aromatherapy massage among adult female cancer patients. METHOD: A qualitative research design was used. Fifteen women with cancer were recruited for semi-structured interviews. Sample recruitment was undertaken through cancer self-help groups and referrals of a private aromatherapy clinic by convenience sampling. The interview data were analysed by thematic analysis. RESULTS: All participants had a positive experience towards aromatherapy massage. The perceived benefits of aromatherapy massage included physical and psychological dimensions: overall comfort, relaxation, reduced pain, muscular tension, lymphoedema and numbness, improved sleep, energy level, appetite and mood. Interestingly, a few participants reported that aromatherapy massage helped to enhance self-acceptance and coping with their altered torso. No adverse effects were reported. The findings focused on four main themes that emerged: (i) an immediate effect that brings all-round comfort and reconnection to daily life; (ii) a pleasurable moment to forget the disease with aroma as a booster; (iii) a pampering experience of being cared for with a sense of dignity preserved; and (iv) communicating with the failing body. CONCLUSIONS: This study contributed by providing a better understanding in aromatherapy massage from female cancer patients' perspective which adds to the existing body of knowledge. The implications for nursing practice, education and future research were suggested. RELEVANCE TO CLINICAL PRACTICE: Aromatherapy massage seems to have both physical and psychological benefits for women with cancer. The findings elucidated a wide range of benefits that are perceived in such complex intervention, and the contextual factors that may influence these perceived benefits. This will inform future nurse-led quantitative research in the clinical setting. The study highlights the importance of touch towards a caring relationship and the provision of cancer care with a gender-specific approach. Exploring of the lived experience of aromatherapy massage and its meaning enables the healthcare professionals to gain insights into the needs, preferences and values for cancer care among female cancer population. While nurses play a crucial role in collaborating with cancer patients in the choice of CAM therapies, nurses should advise them to attend practising aromatherapists with recognised training and competency who should be members of aromatherapy professional associations. As aromatherapy is an unregulated profession, nurses may also advise oncology patients on the international guideline and institutional policies for aromatherapy massage use in the hospital setting. Nurses may broaden the caring repertoire by expanding their knowledge and skills in aromatherapy massage such as understanding the basic essential oils pharmacology, massage skills and therapy efficacy for symptoms management in cancer care. Oncology clinicians and nurses should support and guide patients' decision in the use of aromatherapy massage by providing evidence-based and comprehensive advice on the potential benefits, risks and related safety issues.

A diachronic study of the language of chiropractic.

This study investigates how the language of chiropractic has changed over time. A collection of material, published up until approximately 1950 and consisting of textbooks, monographs and lecture notes from Canadian Memorial Chiropractic College, was analyzed to identify commonly occurring words and phrases. The results were compared to a corpus of recent articles from the Journal of the Canadian Chiropractic Association. This permitted the identification of words which were over-represented in the historical literature and therefore likely have become somewhat archaic or represent themes which are of less import in the modern chiropractic literature. Words which were over-represented in the historical literature often referred to anatomical, pathological and biomechanical concepts. Conversely, words which were comparatively over-represented in the modern chiropractic literature often referred to concepts of professionalism, the clinical interaction and evidence-based care. A detailed analysis is presented of trends in the use of the conceptually important terms subluxation and adjustment.

Cette étude examine l'évolution du langage de la chiropratique au fil du temps. Une collection de documents, publiés jusqu'à environ 1950 et comprenant des manuels, des monographies et des notes de cours du Canadian Memorial Chiropractic College, a été analysée pour relever les mots et expressions fréquemment rencontrés. Les résultats ont été comparés aux corpus d'articles récents du Journal de l'Association chiropratique canadienne. Cela a permis de détecter des mots qui étaient surreprésentés dans la documentation ancienne, et, donc, susceptibles de devenir quelque peu archaïques ou de représenter des thèmes qui sont moins importants dans la documentation chiropratique moderne. Les mots qui étaient surreprésentés dans la documentation ancienne se rapportaient souvent à des concepts anatomiques, pathologiques et biomécaniques. À l'inverse, les mots qui ont été relativement surreprésentés dans la documentation chiropratique moderne se rapportaient souvent aux concepts du professionnalisme, de l'interaction clinique et des soins factuels. Une analyse détaillée des tendances de l'utilisation des termes importants sur le plan conceptuel, subluxation et ajustement, est présentée.

Baccalaureate nursing students' perceptions of peer assessment of individual contributions to a group project: a case study.

A group project is a common method of assessment in higher education worldwide. The use of an adjunct peer assessment (PA) scheme as a means to award marks for individual student contributions to a group project has increased. However, nursing students' perceptions of PA have not been well studied. This paper examines baccalaureate nursing students' perceptions of PA in assessing individual contributions to a group project. Using a case study design with both quantitative (an anonymous survey with 123 students), and qualitative methods (six focus group interviews with 21 students), data were collected from students in a baccalaureate nursing programme. Merging of quantitative and qualitative findings indicated that students overall had positive perceptions of PA, especially its ability to reduce 'free-riding'. However, students also had some interpersonal and operational concerns about the PA implementation process. Based on the findings, we recommend: (1) further developing students' abilities to assess the contributions of others to the task and relationship functions in group work; and (2) adopting a confidential online system for submission of PA forms.

Quantitative corpus-based analysis of the chiropractic literature - a pilot study.

In this pilot study, a collection of peer-reviewed articles from the Journal of the Canadian Chiropractic Association was analyzed by computer to identify the more commonly occurring words and phrases. The results were compared to a reference collection of general English in order to identify the vocabulary which is distinctive of chiropractic. From texts with a combined word count in excess of 280,000, it was possible to identify almost 2,500 words which were over-represented in the chiropractic literature and therefore likely to hold special importance within this domain. Additionally, readability statistics were calculated and suggest that the peer-reviewed chiropractic literature is approximately as challenging to read as that of nursing, public health and midwifery. Certain words widely considered to be of importance to the profession, for example "subluxation and adjustment," were not particularly prevalent in the literature surveyed.

Living with chronic heart failure: a review of qualitative studies of older people.

AIM: This paper is a report of a systematic review of qualitative studies of how older people live with chronic heart failure. BACKGROUND: Chronic heart failure is a global epidemic mainly affecting an ageing population. Understanding how older people live with this disease is important to help promote their adjustment to the distressing illness experience. DATA SOURCES: Eligible studies published in 1997-2007 were identified from several databases (Medline, CINAHL, PsycINFO and Sociological Abstracts). A manual search was conducted of bibliographies of the identified studies and relevant journals. REVIEW METHODS: Two researchers independently reviewed the studies and extracted the data. Key concepts from the papers were compared for similarities and differences. The transactional model of stress was used to guide data synthesis. FINDINGS: Fourteen qualitative studies were identified. Most described the illness experiences of older people with chronic heart failure and associated coping strategies. There was some emerging work exploring the adjustment process. The findings indicated that living with chronic heart failure was characterized by distressing symptoms, compromised physical functioning, feelings of powerlessness and hopelessness, and social and role dysfunction. There were gender differences in the way the disease was conceived. Adjustment required patients to make sense of the illness experience, accept the prognosis, and get on with living with the condition. CONCLUSION: Empowering older people to manage chronic heart failure, instilling hope and bolstering support system are means of promoting successful adjustment to the disease. Further research needs to explore the cultural differences in the adjustment process.