Conceptualising the spirituality of Chinese older adults: a Delphi study

Free Paper Session II : Mental Health / End-Of-Life CareINTRODUCTION: Service provision in geriatric health and social care is increasingly guided by holistic principles, in which many aspects, including physical, psychological, social, and spiritual aspects, are equally emphasized to enhance well-being and enrich life. However, little is known about the degree of consensus among multidisciplinary professionals in the Chinese context on the central components of spirituality that most promote spiritual well-being among Chinese older adults. This study is intended to identify the core components of ...published_or_final_versio

Conceptualizing and assessing spirituality among Chinese elders: towards evidence-based practice

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Development and validation of a spirituality scale for Chinese elders: a mixed approach

Free Paper Presentation 5 – Geriatric Assessment: no. F5-4會議主題:「 卓越康齡服務 - 倡議、前進與成果 」Conference Theme: 3As in Aged Care- Advocacy, Advancement and AchievementpostprintThe 8th World Congress on Long Term Care in Chinese Communities and Asian Ageing Development Conference, Hong Kong, 24-26 November 2011

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

A Process Model of Spiritual Well-being of Chinese Older

Session Name: Spirituality in AsiaConference theme: East Meets West: Expanding Frontiers and DiversityOral presentationSession Theme: Existential and Philosophical Concerns in Death and Dyin

Measuring transcednence among Chinese older adults: a spiritual approach

Session 1070 (Poster)This journal suppl. contains 2011 GSA Annual Scientific Meeting AbstractsOBJECTIVE: Spiritual care is one of the key elements of the holistic care perspective. In our previous studies, we reflected that spirituality among Chinese older adults should be understood in a context of nonreligious lifestyle. This study aims to validate the spirituality measure, Transcendence Scale for Chinese Elders (TSCE). METHOD: The draft version of TSCE was developed based on focus groups, in-depth interviews and a Delphi process. Together with other standardized measures, including World Health Organization Quality of Life measures (WHOQoL), Purpose in Life (PIL), and Positive and Negative Affect Scale (PNAS), the 16-items, 5-point TSCE draft was administered to 825 older adults in Hong Kong and Shanghai. RESULTS: Face and content validity of TSCE were established during a Delphi process. Confirmatory factor analysis identified a six-item, one-factor model that showed satisfactory model fit indexes (SRMR=.036, C-CFI=.953, R-RMSEA=.063). The internal consistency reliability of the 6-item TSCE was satisfactory as indicated by Chronbach’s alpha of .70. TSCE also showed satisfactory criterion-related reliability as indicated by having moderate correlation with PNAS (r=.47), Purpose in Life (r=.35), and psychological well-being as measured by WHOQoL (r=.35). CONCLUSION: TSCE was developed to measure transcendence among Chinese older adults’ spirituality. Results of the present study showed that TSCE was a reliable and valid measure that assesses transcendence among the Chinese older population in which the social cultural context is featured by non-religious, relationship-oriented and interdependent self-construct. Implications for how to enhance spirituality among Chinese older adults will be discussed.link_to_OA_fulltextThe 64th Annual Scientific Meeting of the Gerontological Society of America (GSA), Boston, MA., 18-22 November 2011. In The Gerontologist, 2011, v. 51 suppl. 2, p. 32

Enhancing spiritual well-being among Chinese older adults: A self-help empowering approach

http://www.kwnc.edu.mo/web/90th_anniversary/calendar/worldcongress/e_congress_intro.ht

The effectiveness of the Spiritual Enhancement Group for Chinese elders: evidence from a quasi-experiment

Free Paper Presentation: II - Mental HealthConference Theme: Promoting Choices and Frontiers in Elder Car