Pathway of psychiatric care in Hong Kong

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Patient-clinician communication and needs identification for outpatients with schizophrenia in Hong Kong: Role of the 2-COM instrument

Objectives: To assess perceived needs of schizophrenic outpatients in Hong Kong, and the effectiveness of clinicians in identifying those needs; and to explore the use of a self-rated instrument to enhance needs identification. Participants and Methods: The two-way communication checklist was completed by 70 outpatients before consultation. Their clinicians were either given the checklist during the consultation (2-COM group, n = 36), or were unaware of the patients' answers and independently completed the checklist (needs awareness group, n = 34). A standard care group (n = 35) was included for comparison. Consultation time and patient satisfaction were also recorded. Results: The major concern of patients was information about their illness and treatment (59%). In the needs awareness group, under-recognition of patients' needs by clinicians was observed in various domains. Consultation time (mean, 5.6 minutes) correlated with the number of needs identified by clinicians. The 2-COM group showed a trend towards higher satisfaction compared to the standard care group, although this did not reach statistical significance. Conclusions: Clinicians may under-identify problems perceived by patients due to time constraints and other factors. The use of a structured questionnaire may facilitate effective needs identification in a busy outpatient clinic. © 2008 Hong Kong College of Psychiatrists.link_to_subscribed_fulltex

Associations Between Wisdom and Well-Being: A New Insight for Caregiver Empowerment?

Conference Theme: Capacity Building in Dementia CareOral Presentation (OP1): Caring for CaregiversObjectives: This cross-sectional study examined the relation between wisdom and psychological well-being among dementia family caregivers. Caregiving burden has a direct negative impact as stipulated in the infamous stress and coping model. Nevertheless, some caregivers are able to maintain their well-being despite with the demanding tasks. Accumulation of knowledge and experience amid the caring process perhaps assimilate into caring wisdom, which could help the caregiver to relief the stress or even restore their well-being. Methods: A cohort of 100 dementia family caregivers in Hong Kong were referred from the public health institutions and community service units using convenience sampling. They completed guided questionnaires and interviews. Predictors for well-being such as caregiving burden, behavioural problems of the care recipients, social support for the carer, coping strategies and wisdom were measured. Results: Caring people with dementia of more behavioural problems was related to more caregiving burden (p<0.01). Conclusion: Interventions that aim to enhance the well-being of dementia caregivers should concentrate on improving their wisdom, so that greater exposure to caregiving stress does not translate into greater distress. The wisdom construct could be incorporated into the model to explain caregiver resilience

Advocating Policy Support for Community Dementia Service in Tuen Mun District, Hong Kong

Conference Theme: Capacity Building in Dementia CareOral Presentation (OP6): Community Dementia ServiceObjectives: The present study aimed to obtain the evidence to advocate the policy support for the community dementia support service in Tuen Mun district from both users’ and professionals' perspectives. Methods: The present study adopted a mixed research method including a cross-sectional structured interview survey targeted on the dementia informal caregivers, and a focus group targeted on the patients, caregivers, medical and allied health professionals. Results: 100 informal adult caregivers were recruited from December 2012 to February 2013. The majorities of the caregivers were female (73%), children (50%) and spouse (42%) of the dementia patients. They took care of the patients for an average of 5.9 years, and spent on the average of 13.8 hours. 46% perceived without sufficient skills of dementia care. They expressed that the most useful community services were the day respite and emergency placement service (66.6%), and day care centers (51.8%). However, about 90% of patients who were in need did not receive such services. Their affordability to such public services was about $1000. In addition, 78% of caregivers also showed mild to moderate depressive symptoms. They ought to set-up the dementia-specific residential care homes (62%), and establish the dementia-specific day care (57%) and respite (56%) services. These findings were consistent with the views of participants in the focus group. The importance of the effective collaboration between hospital care and community support service in HK is being advocated. Conclusion: Further policy support on current dementia care is to be advocated to meet the Needs of the patients in HK