HKEC Symposium on Community Engagement IV Healthy ... · Chronic Disease Self-Management Programme Wong S3, Chan L S W1, Chan C1, Cheung D K C1, Wong R3, Hui E2, Li S F3 Department

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HKEC Symposium on Community Engagement IV

Healthy Community: We Can Make A DifferenceHKEC Symposium on Community Engagement IV

Healthy Community: We Can Make A Difference

Posters Presentation



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P.23 “Five Stars Health Five Stars Home” Project to Make a Different Life-style and Community Chan Y P Iris, Yip K Y Kannas Health and Care Service Department, Hong Kong Red Cross

P.24 Hospital Community Partnership Program on Mild Cognitive Impairment (MCI) and Early Stage of Dementia Care Cheung H T1, Luk Y F C1, Leung S N F1, Kwong M Y D1, Cheng W Y W2, Yu M W M2

Department of Occupational Therapy, Pamela Youde Nethersole Eastern Hospital 1 Occupational Therapy, Haven of Hope Community Rehabilitation Day Centre2

P.25 Power of Partnership – Nursing, Social Work and Volunteer in Community Lai S F1,2, Lam Y M 1, 2, Chan K F3

Community Nursing Service 1 Princess Margaret Hospital 2

Hong Kong Family Welfare Society 3

P.26 Home Cleansing and Furnishing Program for the Living Alone Elderly Lam K F Terry Occupational Therapy Department, Kwai Chung Hospital

P.27 The Effect of Music Participation on Quality of Life of Elderly People Lee Y Y 1, 2, Choi K Y 3, 4

Department of Orthopaedics and Traumatology1 United Christian Hospital2

School of Public Health, Li Ka Shing Faculty of Medicine3

The University of Hong Kong4

P.28 Extend Medical Care in Residential Care Home for the Elderly in HKEC Lui S F, Kong Samuel, Au Lina, Tsue Bonnie, Ho Y K Department of Psychiatry, Psychogeriatric Team Outreaching Service

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P.29 The Effect of Regular Health Qi-going Yi Jin Jing(HQGYJJ) on Measuring of Pain, Flexibility, Depression, Disability, Self-efficacy in Community Dweller (CD) Suffered from Chronic Non-specific Low Back Pain (CLBP): A Pilot Test Siu Y Y P1 , Professor Qin L1

Department of Orthopaedic and Traumatology, CUHK1

P.30 A Colorectal Cancer Education and Screening Program 2007 Sze W C 1, Yeung Y W 1, Lui Vicky 2, Ho Stephen 3

Department of Medicine and Geriatrics 1

Central Nursing Division2

Gastrointestinal Nurse 3

Caritas Medical Centre

P.31 Mid-term Evaluation of Integrated Advanced Psychiatric Empowerment to Clients of Admission Wards: (伴您同航)

Tsang H W , Yeung W S , Yu D F, Choi T K Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital

P.32 CADENZA Community Project: Chronic Disease Self-Management Programme Wong S3, Chan L S W1, Chan C1, Cheung D K C1, Wong R3 , Hui E2 , Li S F3

Department of Medicine and Therapeutics, The Chinese University of Hong Kong1, Shatin Hospital2

The Salvation Army3

P.33 Weight Management for DM Patients in the Community Wong Y M1,2, Fung K M2, Lau S L3, Wong K W4, AU K Y5

Dietetic Services1, St. James’ Settlement2, Pamela Youde Nethersole Eastern Hospital3, Tung Wah Eastern Hospital4, Ruttonjee Hospital5

P.34 An Exploratory Study on A&E Cases Handled by MSSU/PYNEH Woo P , Kwok K C , Pang D, Lai C, Tseung J Medical Social Services Unit



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“Five Stars Health Five Stars Home” Project to Make a Different Life-style and CommunityAuthor: Chan Y P Iris, Yip K Y KannasInstitution: Health and Care Service Department, Hong Kong Red Cross

Introduction:Due to the impact of SARS and increasing concerns of disease prevention, “Five Stars Home Five Stars Health” was first launched at Tai Po in 2003, and then Tuen Mun, Kwai Tsing in 2004, 2006 respectively. There are five core health elements of promoting healthy life-style, including “Healthy Habits”, “Healthy Diet”, “Healthy Body”, “Healthy Mind” and “Healthy Home-Setting”. In 2008, in response to the external causes of morbidity and mortality, a refreshed strategy with three new elements is proposed, including “Safety Awareness”, “Disaster Preparedness” and “Rescue Readiness”, incorporated into the health education.

Purpose of the Project:The project aims at advocating a healthy life-style, raising the awareness of public hygiene and building a healthy and safe community joint hands with community parties.

Material & Methods:This project is operated in a model setting with a self review scheme. Families are trained as health ambassadors with health and safety knowledge. A “Health Guide Book” and VCD are given after making pledges to adopt healthy life-style. To facilitate them to follow the healthy life-style, a series of health activities such as health talk, health check and exhibition are given. Meanwhile, healthy friends network is established and “Healthy Friends News” will be distributed quarterly to them. Finally, self evaluation will be carried out to assess their behavourial change of life-style.

Results:The project has been running over 5 years. 2,051, 4,225 and 6,778 families have made the pledges to adopt a healthy life-style in Tai Po, Tuen Mun and Kwai Tsing respectively. 5,417 families have joined as Red Cross “Healthy Friends”. 852 health ambassadors have been trained. The evaluation survey (2008) of this project indicates that approximate 90% participants of three districts have high score in healthy and safety knowledge.

Conclusions:This project has been running in a sustaining stage with strong base of supporters. The community health promotion approach has been well-received through community participation, community empowerment and inter-sectoral collaboration. As infectious disease and external cause of injuries caused by man-made or natural disaster are still needed to be taken into concern, continuous health promotion with more penetrating approach are required. A more comprehensive evaluation and development are expected in the near future.

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Hospital Community Partnership Program on Mild Cognitive Impairment (MCI) and Early Stage of Dementia CareAuthor: Cheung H T1, Luk Y F C1, Leung S N F1, Kwong M Y D1, Cheng W Y W2, Yu M W M2

Institution: Department of Occupational Therapy, Pamela Youde Nethersole Eastern Hospital 1 and Occupational Therapy, Haven of Hope Community Rehabilitation Day Centre2

Introduction:There is increasing population of clients with MCI and dementia. Early detection and intervention are crucial and recommended in order to slow down the cognitive deterioration and enhance the quality of life of the clients and their carers under homecare. Thus, there is an increasing demand of such service. However, the majority of these clients rely on hospital services, and the demand on occupational therapy (OT) is significant. To cope with this, a pilot partnership program between OT Department of HA and NGO was launched. This is also an enhancement of continuity of care from hospital to community and decrease service demand of HA.

Purpose of Study:To provide a seamless rehabilitation services to MCI and early dementia clients and their carers under home care through the hospital-community interface. Integrated treatment package included cognitive assessment and training, lifestyle modification, self-management techniques and carers’ educationTo study the progress of cognitive function, ADL function and carer stress in MCI and early dementia patients.

Materials and Method:1. Collaborating Partners• Pamela Youth Nethersole Eastern Hospital (PYNEH) & Haven of Hope - Community Rehabilitation Day Centre (HOH

- CRDC)2. Eligible participants• Clients with diagnosed as MCI or Dementia with preserved ADL function.3. Format• An integrated program with 1 session conducted at OT, PYNEH, • following 4 group sessions conducted at OT, HOHCRDC plus individual session with client and carers• 1 individual follow-up session half-year later at OT, HOHCRDC4. Outcome Measures:• Mini-mental State Examination (MMSE)• Chinese Version of the Disability Assessment for Dementia (CDAD)• Barthel Index• Zarit Burden Interview

Results:Total 24 clients recruited to this program, while 14 patients had completed. Statistically significant (p=0.03) improvement showed on the scores of ADL function and carer stress; while MMSE scores were not.

Conclusion:This project could demonstrate a successful hospital-community partnership that allows better utilization of resources. Clients could receive comprehensive treatment and follow-up that maximized their function; and their carers are empowered on taking care of their demented family members without institutionalization. This partnership program will be continued in order to serve more MCI and dementia clients and carers whereas one more assessment tool – Montreal Cognitive Assessment (MoCA) will be used for the MCI clients.



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Power of Partnership - Nursing, Social Work and Volunteer in CommunityAuthor: Lai S F1,2, Lam Y M1,2, Chan K F3

Institution: Community Nursing Service1, Princess Margaret Hospital2, Hong Kong Family Welfare Society3

Introduction:The Kwai Tsing Safe Community and Healthy City initiative started in 2000. The settings approach was adopted to promote safety and health in the community. In 2005, a Safe and Healthy Estate Project was launched in Cheung Ching Estate together with the Pilot of Family Nurse Practitioner (FNP) to serve a population of 18,000 with poor, aged and under-privileged people.

Purpose of the Project:To test the effectiveness of nursing and social work collaboration in local community.To establish Family Ambassador Volunteer Team to support vulnerable families in the local community.

Method:The FNP is a Nurse Specialist stationed in Cheung Ching Estate, helping individuals and families to cope with illness, chronic disability and in times of stress; giving advice on lifestyle and behavioral risk factors; to assist families with matters concerning health and illnesses. A social worker (SW) worked closely with FNP in the estate, she was responsible to establish networks by liaise with local community organizations and recruit volunteers as Family Ambassadors (FA). The FA after receiving training on communication skills, simple health assessment, home visit skills, first aid, community resource, home safety knowledge, they were paired up and provided support to vulnerable families.

Result:From year 2005 to 2008, FNP with SW and other health professionals had conducted 8 classes of FA Training Program. Total 183 FA accredited with school students, housewife, retired, employed and unemployed persons. There were 206 families received FA supports, including simple health checking, cooking, shopping, escorting, housekeeping, haircutting, homework guiding and computer skill training. Among these families, 72 service users were transformed to become FA to service other vulnerable families. People with chronic diseases were also pulling together to form support groups such as the Chronic Obstructive Pulmonary Disease Support Group and Diabetic Mellitus Support Group.

Conclusion:Based on the model, local networks were built; vulnerable families were supported during their critical time, in the aspects of health and social issues. These families were transformed into Family Ambassadors to help other families. The model of Family Nurse Practitioner collaborates with Social Worker in local community to build up neighborly ties is effective to assimilate hidden community resource to be serviceable.

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Home Cleansing and Furnishing Program for the Living Alone ElderlyAuthor: Lam K F, TerryInstitution: Occupational Therapy Department, Kwai Chung Hospital

Introduction:People who suffered mental illness and the living alone elderly both were the deprived populations in Hong Kong. For the mental patient, they used to be stigmatized by others due to their strange behaviour and psychotic feature due to the nature of mental illness. While for the living alone elderly, they were usually stratified at the lower social class due to financial hardship, limited social support and loss of money-earning ability. The ideas of this program originated from the cleansing campaign during SARS period in 2003 and was further refined in 2004. At that time, with the strong support by a local enterprise – IKEA, we piloted to train up psychiatric patients with simple furnishing skills and conducted service work for the elderly people in the community. Though the activities were small in scale, the results were quite rewarding, both for the psychiatric patients and the needy families. This initial success energized us to further expand and intensify the service. With the support of a grant from S.K. Yee Medical Foundation in 2006, this new project named “Home Cleansing and Furnishing Program for the Living Alone Elderly” commenced in May 2006 and completed in August 2008.

Purpose of the Project:For the mentally ill, the project helped them to gain opportunities to make use of what they had learned in their work rehabilitation and contributed to the society. It was really important to employ this enabling and interactive approach to help the mentally ill to become givers, not merely receivers in their rehabilitative pathways. In fact, such kind of empowerment significantly improved their self-image, self-efficacy and eased their re-integration to the community. For the living alone elderly, they achieved not only a better quality of living condition upon furnishing service, but most importantly, it was also expected they would develop a positive and accepting attitude towards the mentally ill.

Material & Methods:A coach expert in decorative work was recruited. He was responsible for teaching home furnishing skills and conducted a specialized modular training program. The program consisted of basic decorative skills, occupational safety precautions and social skills elements. In, day and out psychiatric patients who showed interested in the project had been screened and recruited in the training program. Only those successfully passed the practical tests had be qualified as the out-reaching team member and be responsible to conduct the on-site home furnishing service in the community.

Results:Total 38 living alone elderly were benefited from the project. 120 psychiatric patients received formal home furnishing skills and after screening and assessment, 23 of them passed the practical tests and had the opportunities to have real practice in community. Regarding the vocational outcome, 9 patients engaged in decoration work through either open / supported employment, 2 patients further studies at Vocational Training Centre and most of the remaining trainees had attended sheltered workshop after joining the project.

Conclusions:The project demonstrated a win-win situation for both psychiatric patients and the needy living alone elderly. The vitality of patients had been promoted as they showed significant improvement in their self-confidence, self-efficacy and personal image. Their unfailing effort and attitude deeply impressed the elderly and the community agencies, even for those who showed much worries and rejection at the very beginning. The elderly and community partners gradually changed their views on the psychiatric patients and started to make appreciations to them. This sparkling chemistry between psychiatric patients and general public was hardly seen in traditional treatment and was definitely important in their recovery pathway, which made community re-integration of psychiatric patients became much possible.



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The Effect of Music Participation on Quality of Life of Elderly People Author: Lee Y Y 1, 2, Choi K Y 3, 4

Institution: Department of Orthopaedics and Traumatology1, United Christian Hospital2, School of Public Health, Li Ka Shing Faculty of Medicine3, The University of Hong Kong4

Introduction:Elder’s quality of life (QoL) can be improved by preparation of transition into old age. However, depression due to this transition is common in the elderly population and its impact on older adults along with its usual treatment should merit our attention as population ages. In fact, most of them do not notice it as a treatable emotional disturbance and find it difficult to express themselves verbally. Listening to music, as a vehicle of feeling, can facilitate the nonverbal expression of emotion, reach people’s inner feeling without being threatening, and it can be a tool for emotional catharsis.

Purpose of the Project:The paper reports a study to determine the effects of music on physiological response and quality of life of community-dwelling older Chinese people in Hong Kong.

Material & Methods:A randomized controlled study was conducted from February to June 2007 in a community centre in Hong Kong. A total of 66 elderly people (31 using music - listening intervention and 35 controls), aged from 65 to 90 years were randomly assigned to undergo either 30-minute music intervention or a rest period. Using a repeated measures design with a pretest and three posttests, physiological variables [systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (P) and respiratory rate (RR)] and QoL variables were collected before the music intervention as baseline data at week 1 and at weekly posttests. Quality of life was analyzed in terms of physical (PCS) and mental (MCS) component summaries and its eight subscales: physical function (PF), daily role activities limitation due to physical problem (RP), bodily pain (BP), general health (GH), vitality (VT), social function (SF), daily role activities limitation due to emotional problem (RE) and mental health (MH). While controlling for age and gender using repeated measures analysis of covariance (RM ANCOVA) and analysis of covariance (ANCOVA).

Results:Using repeated measures ANCOVA, music resulted in significantly better QoL scores in terms of MCS and PCS, as well as significantly better eight subscale scores compared with controls over time. And, there was statistically significant improvement in RP for the music group over 4 weeks, and multiple comparisons indicated that there were statistically significant differences at week 2 vs. week 3 and week 2 vs. week 4. Quality of life improved weekly in the music group, indicating a cumulative dose effect, whereas, there was a progressive decline in the control group. Also, there were no significant changes for all physiological parameters over the four time points, but differences were found between two groups in SBP at week 4 and RR at week 2, week 3 and week 4.

Conclusions:Music therapy is a non-invasive and inexpensive intervention. This study indicates that music listening is an effective nursing intervention in improving quality of life of elderly people in community settings. It implicates that music can help nurses to build therapeutic relationships with elderly people. Nurses are encouraged to use music as part of their holistic caring for elderly people.

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Extend Medical Care in Residential Care Home for the Elderly in HKECAuthor: Lui S F, Kong Samuel, Au Lina, Tsue Bonnie, Ho Y KInstitution: Department of Psychiatry, Psychogeriatric Team Outreaching Service

Introduction:This program is an integration of medical and nursing service to cover Residential Care Home for the Elderly (RCHEs), especially those homes with over 200 places for monitor their demented client’s drug compliance and improved behavioral and psychological symptoms.

Purpose of the Project:The program aims to conduct the dementia assessments and to provide platform for holistic rehabilitation of the elderly through participation.

Material & Methods:1. Community education program to increase public awareness in dementia:

a. One educational talk hold on 26 Jul 08, around 50 participants including health professionals, social workers and informal carers attended

b. Contents including the management of behavior and psychological symptoms of dementia (BPSD) and outcome measures of the program

2. Collaborative care model in RCHEs for demented elders:• Develop an Electronic Template of Nursing Discharge Summary and Care Plan to facilitate coordinated and establish IT

infrastructure and implement hand-held medical records in RCHEs• Joint medical appointment with Physician and psychiatric nurse to conduct mental assessment on complicated cases

3. Integrated rehabilitation program for demented elderly:• Staff training and educational kit on care of dementia, and community resources are distributed to participants• 6 sessions of multidisciplinary group intervention on care of dementia is introduced such as memory training, reality

orientation and reminiscence provided to newly diagnosed patient with dementia• Assessment including Mini-mental state examination, Geriatric Depression Scale and Quality of Life and on-site Follow-

up Nurse Consultation to monitor client’s progress

Results:Primary outcome is build up gradually to around 8 RCHEs in clusters and provide 1,400 home visit attendances at 1Q09.

Conclusions:The program may better prioritization of resources based on risk levels to shorten the long waiting time in OPD (Psy) and more collaborative care delivery together with RCHEs staffs for earlier interventions of dementia.



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The Effect of Regular Health Qi-gong Yi Jin Jing (HQGYJJ) on Measuring of Pain, Flexibility, Depression, Disability, Self-efficacy in Community Dweller (CD) Suffered from Chronic Non-specific Low Back Pain (CLBP): A Pilot TestAuthor: Siu, Y Y P1, Professor Qin L1

Institution: Department of Orthopaedic and Traumatology, CUHK1,

Introduction:Deconditioning in both physical and psychological inactivity to one who suffered from CLBP which characterized by a loss of spinal mobility, reduction of muscle strength and with frequent anxiety and depression. The aim of health Qi-gong is promoting the circulation of Qi and energy within the body for pain relief and symptom reduction that Qi is cultivated through mental regulation, breathing regulation and postural regulation. The HQGYJJ characterized with its full range of movement of the spine with waist as the axis.

Purpose of the Project:The objectives of the study were to determine the effectiveness of regular HQGYJJ to CD with CLBP compared with a control group.

Material & Methods:The study was a pre and post-test design. Seventeen female subjects with age 46 to 68 from Regeneration Society were randomly assigned to either HQGYJJ group or control group. HQGYJJ group consisted of a 8 weeks of training program. Trunk flexibility by sit-and-reach test, pain intensity by numerous rating scales, depressive feeling by the Beck depression inventory-II and disability to activities of daily living tasks by the Oswestry disability index, Self-efficacy by Pain self-efficacy Questionnaire were served as outcome indicators. Mann-Whitney U test were used to compare the demographic data and outcomes between the two groups; Wilcoxon signed rank tests were used to compare the pre and post-test outcome for each group. Software SPSS 15.0 for Windows was used for statistical analysis.

Results:In HQGYJJ group, 8 subjects with mean(S.D.) age 57.6(5.1) found significantly decreased in median(range) most painful intensity in this week from 5(3.0-8.0) to 3.5(1.0-5.0) of numerous rating scales (p=0.043) and increased in median(range) trunk flexibility from 22.8cm(16.5-34.1) to 28.5cm(19.3-35.3) in sit and reach test (p=0.030). In compare with 9 subjects in control group with mean(S.D.) age 56.0(8.5), HQGYJJ group shown significant lower in pain intensity (most painful in this week p=0.036, least painful in this week p=0.027) and higher self-efficacy (p=0.21) than control group.

Conclusions:HQGYJJ help CLBP in reducing pain intensity, improving trunk flexibility and self efficacy, so it may serve as a community home program to help CLBP subjects to integrate into the community.

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A Colorectal Cancer Education and Screening Program 2007Author: Sze W C 1, Yeung Y W 1, Lui Vicky 2, Ho Stephen 3

Institution: Department of Medicine and Geriatrics 1, Central Nursing Division2, Gastrointestinal Nurse 3, Caritas Medical Centre

Introduction:Colorectal cancer (CRC) is the second commonest cancer in Hong Kong. Awareness of this cancer is important and screening is recommended. One of the tools is faecal occult blood test (FOBT). A colonoscopy will be performed in positive cases. In this project, we used a newer immuno-test which was more specific for human haemoglobin.

Purpose of the Project:1. To raise awareness of CRC in Sham Shui Po (SSP) region.2. To perform CRC screening by using FOBT.

Materials and Methods:Four Non-Government Organizations (NGOs) were invited to co-organize this program, namely The Neighbourhood Advice-Action Council Shamshuipo District Elderly Community Centre; Ho Kin District Community Centre for Senior Citizens (sponsored by Sik Sik Yuen); Caritas Shamshuipo District Elderly Centre (Cheng Shing Fung); Community Rehabilitation Network of The Hong Kong Society for Rehabilitation; together with our hospital. We got funding from Shamshuipo District Council. Posters, pamphlets and newsletters were distributed in SSP region since mid of July, 2007. Health seminars were held from July to August 2007.

Results:A total of 325 individuals with age 45 to 82 participated. 81 male and 244 female were recruited with mean age of 66. 9 participants (positive rate of 2.76%) had positive FOBT results, followed by colonoscopies. A 76 years old gentleman was diagnosed to have early CRC with curative surgery done in Nov, 07. Another 45 years old gentleman was diagnosed to have multiple colonic polyps with one harboring adenocarcinoma. Laparoscopic sigmoidectomy was then performed. 6 subjects were diagnosed to have colonic polyps with polypectomy during same session of colonoscopies. One participant was diagnosed haemorrhoid only.

Conclusion:This was a pilot project concerning a community based CRC screening. Two subjects were found to have early CRC. Others were found to have colonic polyps which were believed to be precursors of CRC.



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Mid-term Evaluation of Integrated Advanced Psychiatric Empowerment to Clients of Admission Wards: (伴您同航)Author: Tsang Ho Wing , Yeung Wai Song , Yu Dick Fung, Choi Tuk KwanInstitution: Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital

Program:An “Integrated Advanced Psychiatric Empowerment (伴您同航)” had been piloted for 23 months to a group of psychiatric clients with acute admission to facilitate recovery and secure post-discharge adaptation to community .

Purpose of the Project:To enable client acquire basic knowledge of mental health;To enable client develop basic coping skill of community adaptation;To enable clients develop networking with community health service;

Methodology:Ward nurses screen and recruit suitable clients to a range of advanced empowerment scoping from mental health, emotional wellness, family support and community resources. Each empowerment program is provided by expertise of respective fields and 5 NGOs. After preliminary stage of pilot, the collaborating partners had been expanded from 8 to 14 disciplines across hospital and community that enrich the scope and better serve uniqueness of clients.

Results:79% attendants discharged. 21% readmitted & 56% of readmitted cases had been discharged over 6 months before current admission. Besides, the late discharged clients were mostly of resistant psychotics that needed extensive rehabilitation. Among discharged cases, most of them had been referred to ComCare service to secure sustainable community support, early relapse detection and contingent measures.Table 1: Clinical Outcomes of Integrated Advanced Psychiatric Empowerment (伴您同航)

Conclusions & Recommendations:The empowerment (1) equip clients with a wider spectrum of skills and knowledge, (2) enhance transitional adaptation from hospital to community and (3) enable earlier networking with community health agencies during hospitalization that promote community reintegration. The integrated multi-disciplines collaboration taps resources across hospital and community by structured platform in focused manner is an exemplar of sustainable contemporary psychiatric rehabilitation that had never been realized in local practice before. The novelty and efficacy should not be overlooked in the history of psychiatry and community engagement.

Number %

1. Total number of inpatients attended the empowerment N = 339 100%

2. Number of discharged after empowerment n= 267 79%

3. Readmitted n= 72 21%

4. Readmitted < 6 months n= 72 27%

5. Readmitted < 3 months n= 62 86%

6. Readmitted > 6 months n= 40 56%

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CADENZA Community Project: Chronic Disease Self-Management ProgrammeAuthor: Wong S3, Chan L S W1, Chan C1, Cheung D K C1, Wong R3, Hui E2 & Li S F3

Institution: Department of Medicine and Therapeutics, The Chinese University of Hong Kong1, Shatin Hospital2

The Salvation Army3

Introduction:• To cope with the growing concerns of the excessive reliance on medial service, a two-year practice research project,

CADENZA Community Project: Chronic Disease Self-Management Programme (CDSMP) to promote self-management among the aging population is initiated by The Salvation Army and Shatin Hospital.

• CDSMP is one of the Community Projects under “CADENZA: A Jockey Club Initiative for Seniors”, funded by The Hong Kong Jockey Club Charities Trust to explore innovative and sustainable service models to cope with changing needs of seniors. An evidence-based model developed by Dr. Kate Lorig of Stanford University and self-efficacy theory is adopted.

Purpose of the Project:• To establish elder lay-leaders as the major force of the Self-management Mobilization Movement and develop a sustainable

locally based CDSMP delivery model to empower elders in managing their own health;• To help elders manage the symptoms brought by chronic disease and thus to minimize the use of health service and prevent

early institutionalization.

Material & Methods:• 40 elder lay-leaders have received training and implemented the CDSMP to more than 200 elders since December 2007. • A non-randomized controlled trial to be carried out at Tai Po and Shatin districts. The analysis will cover two aspects:

- Compare the effectiveness of staff and elder-lay leaders;- Compare the differences on elders receiving CDSMP training and those with no training.

Results:• The enthusiastic involvement of elder lay-leaders has provided elders with good demonstration of taking more initiative in

pursuing healthy lifestyle other than solely reliance on the medical model. • Our preliminary results show that participants have significant improvement in psycho-social outcome measures such as

cognitive symptom management, communication with physician, self-efficacy, self-rated health and psychological well-being. The final result will be released in October, 2009.

Conclusions:A territory-wide movement among aging population is expected to enhance their self-efficacy in managing symptoms brought by chronic disease and thus minimize overusing health service.

Service Content & Service Flow:

Training

Steering Committee

Service and Research

CADENZA

The Salvation Army

Shatin Hospital

13 elder-led groups

SA Coaching Team to support elder

lay-leaders

26 Study Groups

13 staff-led groups

Master Training

Placement Groups

Lay-leader Training

26 Study Groups (250 elders at Tai Po)

26 Control Groups (250 elders at Shatin)



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Weight Management for DM Patients in the CommunityAuthor: Wong Y M1,2, Fung K M2, Lau S L3, Wong K W4, Au K Y5

Institution: Dietetic Services1, St. James’ Settlement2, Pamela Youde Nethersole Eastern Hospital3, Tung Wah Eastern Hospital4, Ruttonjee Hospital5

Introduction:DM is a prominent disease in H.K. Many patients do not achieve optimal outcomes and demonstrate poor compliance. Without proper management, it may lead to various complications. Daily care of the patient and the ability of patients to make decisions about goals, therapeutic options, and self-care behaviors and to assume responsibility for daily diabetes care are crucial for the success. Through behavioral changes like attaining healthy weight, proper diet and physical activities, the risk of most complications can be reduced.

Purpose of the Project:It is a collaboration project between HKEC hospitals and St. James’ Settlement, which aims to equip patients with practical skills for dietary care in the daily living to acquire healthy lifestyle for better health and DM control.

Material & Methods:It consists of 6 workshops instructed by dietitian and fitness trainer covering weight management diet principles, home exercises, supermarket tour, eating out, festival eating and health assessments. Through activity participations, patients will have a better understanding of healthy eating and food choices. The experience will help them to attain a healthy lifestyle. Participants are required to hand in weekly dietary records for evaluation. Pre- and Post-physical assessment will be conducted for comparisons.

Results:The program started in Oct.,07 and 7 classes have been held with around 100 participants. Over half of the participants have their body weight, fat mass, waist and H’stix reduced. The most successful participant has her body weight, fat mass and waist reduced by 3.2kg, 6.8kg(5%) and 11.5cm respectively. Moreover, 82% of the participants are very satisfied with the program, especially for the enhancement of their knowledge and awareness on food selection and dietary management.

Conclusions:Effective DM management requires active patient involvement. With the required knowledge, awareness, practical skills, support and collaborative goal setting, patients are empowered for lifestyle changes which results in better weight control and DM management.

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An Exploratory Study on A&E Cases Handled by MSSU/PYNEHAuthor: Woo P , Kwok K C , Pang D , Lai C , Tseung J Institution: Medical Social Services Unit

Introduction:The Medical Social Services Unit is responsible for providing social services to all in-patients of PYNEH including those treated in A&E Department (A&E). Among the referrals from A&E, there are four types of cases, namely Battered Spouse, Deliberately Self-Harm, Emotions and Family Relationship of which the reason of admission is closely related to personal and or family problems which requires social work input. After crisis intervention and brief counseling, Medical Social Workers will obtain consent from patients so as to refer them to community partners including Integrated Family Service Centre (IFSC), Family and Child Protective Services Unit (FCPSU) and Medical Social Services Unit (Psy D) (MSSU/Psy D) for follow-up services.

Purpose of the Project:This is an exploratory study of A&E cases handled by MSSU/PYNEH with purpose to examine whether cases with follow-up services from community partners will have better social rehabilitation in terms of lower re-admission rate to A&E.

Material & Methods:The approach of data mining and analysis is adopted to examine four types of A&E referrals with personal and or family problems handled by MSSU/PYNEH during the period of January 2008 to June 2008. A survey is conducted to draw a profile on A&E re-admission for comparison purpose.

Results:The result is expected to confirm our hypothesis that cases with follow-up services from community partners will have lower re-admission rate to A&E.

Conclusions:The social services for those cases with social problems admitted to A&E are vital. With follow-up services from the community partners, cases would have better social rehabilitation shown by lower re-admission rate.

Documents

HKEC Symposium on Community Engagement IV Healthy ... · Chronic Disease Self-Management Programme Wong S3, Chan L S W1, Chan C1, Cheung D K C1, Wong R3, Hui E2, Li S F3 Department