香港心理衞生期刊 三十六卷 第一期 二０一０年夏 Hong Kong Journal of Mental Health Volume 36 No.1 Summer 2010
Message from Issue Editor
Parenting Stress and the Effectiveness of Behavioural Treatment on Non-responsive Medicated Chinese Children with AD/HD
Raymond W S Chan, S F Hung Kwai Chung Hospital Kathy C K Lee Child Assessment Centre, Department of Health M F Wong Kowloon Hospital |
Abstract
| Aim: It is established that around 30% of children with AD/HD are non-responsive to medication. Behavioural treatment and parent training is a treatment option, but there has been limited demonstration of its effectiveness in this particular group of non-Western cultures. The present before-after study investigated whether a sample of such children in the Chinese setting would benefit from behavioural treatment; second, whether parent training would lower parenting stress, and how this might relate to improvements in the child symptoms. Methods: Nineteen non-responsive medicated Chinese boys with AD/HD, from a routine clinical practice centre in Hong Kong, were assigned to 20 sessions of group-based behavioural treatment programme. Parent training groups were conducted in parallel for the parents, over 10 sessions. Parent-rated assessments of child and parent symptoms were conducted immediately before and after treatment. Results: Child AD/HD symptoms improved significantly post-treatment. Whilst the reduction in overall parenting stress was not significant, any reduction was found to be significantly accounted for by improvement in oppositional-defiant symptoms. Conclusion: Behavioural treatment and parent training appears to be a viable treatment option for Chinese children whose AD/HD does not respond to medication. Further controlled trial evidence is required to generalise and extend the findings. |
摘要
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行為治療於專注力不足/過度活躍症兒童及其家長壓力之成效探討 目的：約三成患有專注力不足/過度活躍症的孩童對藥物治療沒有理想的反應，故此西方醫學漸以行為治療及家長訓練作為治療專注力不足/過度活躍症之研究核心。本文除了探視此等治療模式於改善行為徵狀的成效外，亦延伸至家長的管教壓力及模式。 方法：19名對藥物治療沒有反應之孩童及其家長於同時段分別接受了行為治療及家長訓練。 結果：行為治療及家長訓練成功減少了行為徵狀。但於減低家長在管教中的整體壓力卻沒有明顯成效。而在眾行為問題之中，只有減低孩童的對抗、反叛行為對家長壓力有顯著的改善作用。 |
Keywords
| attention deficit hyperactivity disorder, behavior therapy, parenting training |
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The Comprehensive Child Development Service for Early Identification and Management of Postnatal Depression : Service Data of a Regional Hospital in Hong Kong
Bonnie W M Siu Hesione M T Chow Shirjolina S P Kwok M L Koo P W Poon Castle Peak Hospital |
Abstract
| Ten to fifteen percent of recently delivered women suffer from postnatal depression. Postnatal depression can adversely affect the well-being of the woman, the development of her child, and the harmony of her family as a whole. One of the major service components of the Comprehensive Child Development Service (CCDS) in Hong Kong is the early identification and management of postnatal depression. After the implementation of CCDS in Hong Kong since 2005, postnatal women are screened routinely at Maternal and Child Health Centre (MCHC) for depression with the Chinese version of the Edinburgh Postnatal Depression Scale. Those screened positive would be seen at MCHCs by psychiatric nurses who will refer in need women to psychiatrist directly. CCDS was found to have served the purpose of managing postnatal depression early. It is worthwhile to extend CCDS to other districts in Hong Kong so that more family can be benefited from the service. |
摘要
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兒童身心全面發展服務計劃下的及早識別和處理產後抑鬱症：香港一所醫院的服務數據 百份之十至十五產後的婦女會患上產後抑鬱症。產後抑鬱症能對患病者本身、其子女的成長、及其家庭的和諧造成負面的影響。香港的兒童身心全面發展服務計劃的其中一個主要服務範疇是及早識別和處理產後抑鬱症。自從在2005年香港推行了兒童身心全面發展服務計劃後，產後母親於生產後二個月會在母嬰健康院填寫愛丁堡產後抑鬱量表，以篩查是否患上產後抑鬱症。經篩查後的可能患上產後抑鬱症個案會被轉介致精神科護士作評估及處理。精神科護士會直接轉介有需要的個案致精神科醫生。數據指出兒童身心全面發展服務計劃能及早識別和處理產後抑鬱症。將兒童身心全面發展服務計劃推廣到香港的其它區域能讓更多的家庭得益。 |
Keywords
| postnatal depression, early identification, screening |
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Dementia Caregivers Training Program for Improving Caregiving Self-Efficacy – A Quasi-Experimental Study
Natalie Y Y Lai Cycbie C M Mok Department of Occupational Therapy, Castle Peak Hospital |
Abstract
| Objectives: To explore the difference of caregiving self-efficacy among dementia caregivers who received caregivers training and who did not. Method: Eighteen caregivers were recruited in a regional relatives support group by purposive sampling. Caregiving self-efficacy was measured and compared between those received training (n = 10) and those did not (n = 8) using static group comparison. Results: Caregiving self-efficacy for handling obstructive behaviour and controlling upsetting thoughts showed significant difference among caregivers of two groups while there was no significant difference in caregiving self-efficacy for obtaining respite. Conclusions: Caregiving self-efficacy was better in those caregivers received dementia caregivers training program. Apart from equipping the caregivers with the skills and knowledge on disease management, the training program probably had a certain contribution on reinforcing the positive thoughts and beliefs of caregivers. More robust studies with well-study design were indicated. |
摘要
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準實驗研究－老年痴呆症照顧者訓練課程於改善照顧者自我效能的應用 目的：本研究旨在探索曾接受訓練及未曾接受訓練的照顧者在其自我效能的區別。 方法：通過立意取樣的方法，十八名來自一地區性老年痴呆症家屬互助小組的照顧者接受採訪並比較他們於照顧患者的自我效能。 結果：曾接受訓練的照顧者於處理擾亂性行為及控制負面思想的自我效能比未曾接受訓練的為高。照顧者訓練課程除能增進照顧者對痴呆症的認識及照顧技巧外，亦於強化照顧者的正向思想起了一定作用。本文建議進行更多相關研究以助減輕照顧者壓力。 |
Keywords
| dementia, caregivers training program, caregiving self-efficacy |
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Working with the Mental Health Service Users and their Family with Systemic Family Nursing Approach
P S Kwong Castle Peak Hospital |
Abstract
| Studies find that interaction among family members affect the rehabilitation process of the mentally ill. Also, mental illness disrupts the life of the family, and creates burden to the family. The mutual understanding and acceptance within the family provides a stable environment that promotes rehabilitation and prevents relapse for the ill member. Psychiatric nurses work closely with the mentally ill and their relatives daily. With training in systemic family nursing, they are competent in helping the mentally ill and their relatives to cope with their emotions influenced by the illness through identifying their strengths and work through their difficulties. In this article, the author illustrates a case and demonstrates how to apply the systemic family nursing assessment and intervention to help a patient and his parents to deal with the attack of auditory hallucination. |
摘要
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運用「系統家庭護理模式」協助精神健康服務使用者及他們的家庭 研究顯示精神病患與家人之間的相處會影響患者的復康進度。精神病亦為患者的家庭帶來沉重的負擔。彼此的體諒和包容能促進康復及防止復發。精神科護士需與患者及其家人接觸。「系統家庭護理」訓練能提昇護士確認患者「家庭力量」的能力，使他們一起解決困難和處理情緒困擾。作者透過個案分享「系統家庭護理」評估及介入如何協助患者和他的家人處理聽幻覺所帶來的困擾。 |
Keywords
| family nursing, family nursing intervention, mentally ill |
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Domestic Violence: What Should We Know and What Can We Do as a Mental Health Professional?
K W Chow Forensic Psychiatric Team, Castle Peak Hospital |
Abstract
| Domestic violence has recently become an area of major concerns among social and clinical services providers. As mental health professionals, we can help prevent occurrence of domestic violence by recognizing the predictors of violence in our psychiatric patents. We can also help the victims who suffered from trauma in domestic violence. In this paper, the predictors of domestic violence in psychiatric patients and the psychological impact on the victims of domestic violence will be discussed. |
摘要
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家庭暴力：作為精神健康的專業人士，什麼是我們應該了解和應該從事的呢？ 近年，香港家庭暴力的個案不斷增加。作為醫護人員的一份子，我們希望從評估中，預早可發現及預防精神病患者對於家人的暴力行為；更希望幫助及治療家庭暴力中的受害人。這篇文章會指出一些導致家庭暴力的危險因素，及提出受害人可能患上的情緒問題。 |
Keywords
| violence, domestic violence, mental illness |
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Interface of Mental Health and Family Medicine
W K Lee Kwai Chung Hospital |
Abstract
| The mental health service demand is on rising trend globally. Common mental disorders imply great DALYs and societal economic burden. WHO and WONCA found interfacing mental health with family medicine as viable, cost-effective, affordable service model for common mental disorders with good health outcomes. Similar result was echoed by studies in United States. Similar service models have been implemented in the 10-year Mental Health Service Reform in United Kingdom and Australia with good outcomes. The pilot project of this new service model in a public GOPC in Hong Kong proved its cost-effectiveness and filtered out these patients from utilization of higher specialist care, which can focus more on the management of severe mental disorders. The mental health care model for the full spectrum of mental disorders in Hong Kong can be outlined in a service pyramid with collaborative care among community partners, family medicine and mental health professionals. |
摘要
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揉合精神健康及家庭醫學 全世界的精神科服務需求有上升趨勢，常見精神病對社會造成巨大的傷殘調整生命年和經濟負擔。世界衛生組織証實：揉合精神健康和家庭醫學是一個可負擔、可持續和具成本效益的治療常見精神病的嶄新服務模式，美國、英國和澳洲已實踐這個服務模式，並且取得佳績。香港於一間普通科門診部也試行這項服務模式，証實具成本效益，並且減少這類病人使用精神科門診服務的需要，從而令精神科門診可以更集中處理重性精神病患者。透過社區服務夥伴、家庭醫學和精神科跨專業界別的合作，香港醫療機構可以繪畫一個服務金字塔，照顧不同的精神病患者。 |
Keywords
| common mental disorders, mental health, family medicine |
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香港青少年吸毒情況
石丹理教授 香港理工大學應用社會科學系講座教授 禁毒常務委員會主席 |
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香港心理衞生會於二零零九年十二月十四日舉行第十二屆邱大斌先生紀念講座的謄本 |
Abstract
| Adolescent Substance Abuse in Hong Kong Professor Daniel T.L. Shek analyzed the data and phenomenon of the youth drug abuse problem in Hong Kong and explored the anti-drug education and the drug testing scheme carried out by the Government. He also discussed the risk factors of drug abuse among teenagers through the ecological approach, and analyzed the efficiency of the anti-drug policy of foreign countries. By holding the talk, he hoped that the public can ponder the future direction of anti-drug measures in Hong Kong and join together to alleviate the youth drug abuse problem. |
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