香港心理衞生期刊 三十五卷 第二期 二００九年冬 Hong Kong Journal of Mental Health Volume 35 No.2 Winter 2009
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The Development of Psychogeriatric Services in Hong Kong
C L Lam Department of Psychiatry, North District Hospital S W Li Department of Old Age Psychiatry Castle Peak Hospital Helen F K Chiu Department of Psychiatry The Chinese University of Hong Kong |
Abstract
| Psychogeriatrics is one of the youngest subspecialties in psychiatry. The development of local psychogeriatric services followed the British model. In 1991, the first communityoriented and multidisciplinary psychogeriatric service was established by theDepartment of Psychiatry of the Chinese University of Hong Kong. Nowadays, a wide range of specialized psychogeriatric services are provided by seven psychogeriatric teams in Hong Kong. The Elderly Suicide Prevention Program and the Community Outreach Service to the private care homes are important “developmental milestones” of local psychogeriatric services. This article describes the origin, history of development and challenges of local psychogeriatric services. |
摘要
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老齡精神科服務在香港的發展 老齡精神科是精神病學中最稚齡的次專科領域。本區老齡精神科服務是仿傚英國的模式。香港中文大學精神科在一九九一年建立了第一所以社區導向的跨科老齡精神科服務。目前大部份的老齡精神科專科服務都是由香港老齡精神科的七支醫療隊伍提供。老人自殺速治計劃及社區實踐服務是本區家居護廷伸老齡精神科服務發展非常重要的里程碑。這篇文章描述本區老齡精神科服務的發展起源，精神科服務的歷史背景及所面對的挑戰。 |
Keywords
| Psychogeriatric services, development, Hong Kong |
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Sexuality and Ageing: The Ignored Desire
Matthew Yau School of Public Health, Tropical Medicine & Rehabilitation Sciences James Cook University |
Abstract
| Life-span of the elderly has been increased due to improvements in medical technology and a better quality of life which promotes longevity. Sexual expression can play an important role in the maintenance of an older person’s well-being even under institutional care. However, misconceptions, ignorance and hesitation among elderly clients, their partners and health professionals have created barriers for the ageing person to achieve a fully sexual and satisfying life. This paper aims to clarify the misconceptions and myths surrounding sexuality and ageing through empirical evidence as documented in the literature. It also highlights the current reactions of health professionals towards the ignored desires, the sexual needs and concerns, of their elderly clients. It is postulated that providing more knowledge to elderly individuals on sexuality, the more positive attitudes and sexual activities will be reported by them. Furthermore, when working with elderly clients to confront the sexual concerns or problems, health professionals need to challenge their own sexual attitudes and values that may impact on elderly sexuality. They also need to increase their working knowledge to assist elderly clients to resolve challenging sexual concerns or problems in the final stage of the life-span. |
摘要
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醫療科技的改善，及人類生活質素的提升，人的壽命也隨著增加。即使在護老院舍中，性表達在長者的晚年幸福生活中扮演一個重要的角色。 可是，包括醫療專業人士在內，各人的誤解、忽略和猶豫變成長者達至性愉悅和滿足生活的障礙。本論文的主要目的是藉各有關的研究結果澄清在「長者與性」的話題上各種謬傳與錯誤觀念，並顯示現今醫療專業人士對長者性事和需要的忽略。當服務長者面對性問題或疑惑時，醫療專業人士不單需要挑戰自已的性態度及觀念，更需要增加性知識以幫助長者，處理他們在人生最後階段裡富挑戰性的性事問題。 |
Keywords
| Sexual Health, Chinese Culture, Intimacy, Later Life |
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Searching for a missing element of the concept of holistic health: The conceptualization of spiritual illness and its implications for the well-being of older people
Richard K C Lau Sally W C Chan The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong |
Abstract
| Although the World Health Organization (WHO) does not formally refer to spiritual health in its constitution, it seems to accept that health among the older people has a spiritual aspect. Studies conducted in recent decades have examined the issues of spiritual well-being, spiritual health, spiritual assessment, spiritual healing, and spiritual care. However, there has been hardly any research on or discussion of spiritual illness over the same period. This paper provides a preliminary definition of spiritual illness that is grounded in both theory and practice. As the concept of spiritual illness gains formal recognition, so too will the physical, mental, social, and spiritual well-being of older people (or all people) be enhanced by the appropriate clinical diagnosis, referral, and treatment of people who suffer from spiritual illness. |
摘要
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雖然世界衛生組織仍然未將「靈性健康」正式加入於其憲章之中，世衛似乎接受長者健康應該有靈性的層面。在以往數十年的學術研究裡，對靈性健康、靈性評估、靈性治療，及靈性照顧等觀念都有相當多的探討。但在同一時段裡，卻鮮有關於靈性疾病的學術探討或研究。這篇文章初步為靈性疾病提供理論上及操作上的定義。當靈性疾病這個觀念被正式確認後，透過為患有靈性疾病的人士提供適當的臨床診斷、轉介及治療，長者（甚至全人類）的身體、精神、社交及靈性健康便能得以提升。 |
Keywords
| spiritual health, spiritual illness, holistic concept of health |
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Pain and Depression among Hong Kong Chinese Older Adults with Knee Osteoarthritis
Nelson W S Chow K L Chou Department of Social Work and Social Administration, University of Hong Kong |
Abstract
| The aim of this study was to examine the relative contribution of pain, functional disability, sleep problems, and restricted social activity to depression among Chinese older adults with knee osteoarthritis. Cross-sectional analysis of data was conducted from a random sample of 201 older adults with knee osteoarthritis who were interviewed by well-trained interviewers. Almost one third (31.8%) of the 201 subjects reported elevated level of depressive symptoms assessed by Geriatric Depression Scale. Logistic regression analyses revealed that pain and social activity were significantly related to depression, while pain and restricted social activity were persistently associated with depression. This is of particular clinical importance because effective intervention could be developed to enhance social activity, which could break the link between pain and depression in this group of older patients. |
摘要
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是項研究旨在檢視痛楚、行動不便、失眠、及社交生活限制等對患有膝關節炎的長者在情緒抑鬱上的影響。二百零一位患有膝關節炎的長者接受了我們訓練有素的訪問員面談式訪問。長者抑鬱量表(Geriatric Depression Scale) 顯示大約有三成受訪者有嚴重的抑鬱癥狀。邏輯回歸分析 (logistic regression) 顯示只有痛楚及社交生活限制對受訪者的抑鬱癥狀有影響。這結果有積極的臨床意義，顯示若能有效減少痛楚或提高長者的社交生活，均會減低患有膝關節炎長者情緒上的抑鬱。 |
Keywords
| knee pain, depression, elderly Chinese |
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A Controlled Trial of a Nurse-led Psychoeducation Program for Families of People with Dementia
W T Chien The School of Nursing Faculty of Health & Social Sciences, The Hong Kong Polytechnic University Sally W C Chan The Nethersole School of Nursing Faculty of Medicine, The Chinese University of Hong Kong |
Abstract
| Taking care of a family member with dementia may have adverse psychosocial health effects on the family caregivers. Preliminary evidence indicates that psychosocial interventions could be effective in improving family caregivers’ mental health and delaying the illness deterioration and institutionalization of individuals with dementia. The randomized controlled trial reported here tested the effectiveness of a nurse-led dementia family psychoeducation program (NLPP) on caregivers’ and patients’ health outcomes over a 15-month follow-up period. The participants were 80 Chinese families living with and caring for a relative with dementia at home (40 each in the intervention group and the routine care group, with the latter serving as the controls). The results show that the intervention group realized significantly greater improvements in the patients’ symptoms and institutionalization rates, and in the caregivers’ quality of life and burden, over the 15-month follow-up period when compared with the routine care group. These findings suggest that this psychoeducation program can improve the psychosocial functioning of Chinese dementia patients and their caregivers. Further research is recommended to explore the therapeutic components of the family program. |
摘要
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護士主導的老人痴呆症家屬精神教育課程的隨機對照實驗 老人痴呆症對家屬心理社交的負面影響，初步科研實據顯示，心理社交上的干預措施能夠有效改善照顧家屬的精神健康及減低病者病情的惡化和住院的需要。這項隨機對照實驗主要是測試一個護士主導的老人痴呆症家屬精神教育課程對照顧家屬和病者的健康效果。這項實驗的參加者是八十位中國香港老人痴呆症患者及其照顧家屬 (治療組、對照組各四十個家庭)，這些家庭參予精神教育課程或慣常護理服務後會被跟進十五個月。在跟進期結果顯示，與對照組比較，治療組在病者的病徵和入院率及照顧家屬的生活質素和負擔上都有顯著改善。實驗結果為這項精神教育課程對中國老人痴呆症病者及其照顧家屬的精神健康療效提供實證。作者建議繼續探討精神教育課程的療效成份及其功能。 |
Keywords
| Controlled Trial, Nurse-led Psychoeducation Program, Families of People with Dementia. |
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Mental Health Reform in England
Professor Louis Appleby National Director for Mental Health, England Professor of Psychiatry, University of Manchester |
| Transcript of the presentation at the 4th Dr. Gerald Choa Memorial Lecture of the Mental Health Association of Hong Kong delivered on 7th January 2009. |
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