Ka-Huen Yip

The nursing implications of burn injuries extend beyond the immediate health concerns over the loss of skin integrity, the presence of scarring, and the psychological impacts on patients due to disfigurement. Non-fatal burns may lead to long-term disabilities, hence advanced nursing care may be required to prevent such outcomes. In Hong Kong, advances have been made to ensure that sophisticated nursing services and care are in place for affected patients. This chapter discusses how burn injuries are managed at different levels within a publicly funded acute care framework, explains how professional competencies regarding burn care are developed among burn care nurses, delineates the roles of medical technology in supporting wound assessment, explains the application of novel dressing materials for various burn wound conditions, and outlines how the establishment of nurse-led clinics can promote the continuity of care for patients with burn injuries. Written with an international perspective with the authors’ practice experiences in Hong Kong (China), this chapter provides evidence-based reference for registered nurses in general, specialty nurses, nurse practitioners, and nurse consultants worldwide.

Aims: To explore the impact of the coronavirus disease 2019 pandemic on the health‐related quality of life (HRQoL) of breast cancer survivors.Design: We utilized a qualitative descriptive approach to facilitate interviews among 25 participants, all of whom are survivors of breast cancer and have received treatment in Hong Kong within the preceding 3 years.Methods: Content analysis was performed to understand how patients' HRQoL views and experiences changed during coronavirus disease 2019 pandemic.Results: The results included six themes delineating the impact of the coronavirus disease 2019 pandemic: (i) survivor sensitivities in pandemic times, (ii) coping and conditioning in pandemic times, (iii) transforming work and home dynamics in pandemic times, (iv) cognitive resilience and adaptation to the COVID‐19 protective measures, (v) social resilience in pandemic times and (vi) healthcare adaptation and coping in pandemic times.Conclusion: This study provides insights into the experiences and challenges of breast cancer survivors during the coronavirus disease 2019 pandemic. Some survivors had new physical and psychological symptoms, including fear and anxiety, isolation, pain, lymphoedema and burnout, which potentially have long‐term impact upon HRQoL.Implications for the profession and/or patient care: This study highlights the unique challenges faced by breast cancer survivors during the coronavirus disease 2019 pandemic, including accessing healthcare services and the impact of social isolation. Healthcare providers should consider the holistic needs of breast cancer survivors in the provision of health care and develop supportive interventions, including telehealth services and online support groups, to address these challenges and improve their HRQoL.Impact: Surgery aimed at treating breast cancer or reducing its risk generally influences the appearance of breast areas and donor sites. The continuing effects of these changes on body image and HRQoL are well‐reported, although studies have ineffectively examined the initial experiences of women regarding their postoperative appearance, particularly during the pandemic.Reporting method: The checklist of consolidated criteria for reporting qualitative research (COREQ) was utilized.Patient or public contribution: A small selection on breast cancer survivors contributed to the design of this study, in particular the content of the semi‐structured interviews.

Non-invasive prenatal testing (NIPT) demonstrates superior performance compared to conventional screening methods currently available within Hong Kongs public healthcare system. Nevertheless, the substantial costs associated with NIPT render it inaccessible for much of the population, leading to ethical debates surrounding public funding. A conflict emerges between the imperative to allocate limited resources efficiently and the obligation to uphold ethical principles of equity and reproductive autonomy within the public healthcare system. Adopting a utilitarian-based approach, this chapter initially presents three central arguments suggesting that NIPT can be ethically integrated into the public healthcare system. Subsequently, the discussion examines the challenges associated with incorporating NIPT into Hong Kongs strained public healthcare system. To address these challenges, we propose two potential solutions: (1) introducing NIPT as a second-tier screening test for high-risk pregnancies, or (2) offering NIPT through public-private partnerships, which would alleviate the demand on public sector resources. Implementing a nominal fee for NIPT adheres to the principle of impartiality in public resource allocation, ensuring equitable decision-making without favoring specific population groups. Ultimately, the future of NIPT in Hong Kong necessitates expanding its availability, enhancing its accuracy, and incorporating it into comprehensive prenatal care. This approach will support the reproductive autonomy of pregnant women and promote accessible healthcare.

Despite lower‐limb amputation being common among patients with diabetic foot ulcers, few studies have qualitatively investigated the patients' perspectives. Therefore, this study aimed to explore the thoughts and experiences of patients with diabetic foot ulcers regarding lower‐limb amputation in Hong Kong. A phenomenological study using individual, semi‐structured interviews was conducted with 18 participants with foot ulcers recruited in Hong Kong between July and September 2022. The interviews were audio‐recorded, transcribed verbatim, and analysed using an interpretative phenomenological approach and a constant comparison strategy. The results highlighted four substantial themes: (a) coping or being alone and taciturn, (b) altered appearance impacting one's sense of maintaining social relations, (c) thoughts about self‐efficacy and encountering a new normal, and (d) the possibility of a reduced gap in physical consequences between the old and new self. This study provided different perspectives of patients with a history of diabetic foot ulcers, even in cases where lower‐limb amputation has not yet been performed. The results demonstrate that lower‐limb amputation is considered a forbidden topic. This makes it culturally difficult for Chinese patients to discuss the matter with healthcare authorities and family members. Healthcare workers should be aware of how they communicate regarding lower‐limb amputation.

The COVID-19 pandemic has greatly impacted the healthcare system. In the pediatric unit, stress, uncertainty, and many unexpected challenges for many parents were frequently reported. Research has shown that parents had less contact with their children during the pandemic due to hospital restrictions. However, it is unknown how parents perceived their experiences in a pediatric unit. This study aimed to describe the lived experiences of parents who had a child in the pediatric unit during the pandemic. A qualitative descriptive approach was used to investigate parents’ experiences of having children admitted to the pediatric unit during the pandemic in Hong Kong. Eight Chinese parents participated in the interview. Three major themes emerged: (1) parents’ pediatric ward experiences during COVID-19 were emotionally isolating and overwhelming, (2) the family and family-centered care were disrupted, and (3) interactions with pediatric providers intensified or alleviated emotional distress. Integrating the above themes of experiences of emotional distress was the main characteristic of the parents’ experiences during the pandemic. Therefore, policymakers should understand the lived experiences of parents of children diagnosed with COVID-19 and should make prompt decisions to deal with both parental concerns and safety issues.

As new mothers are understandably concerned about COVID-19 and its high rate of infection, they are often unsure if they should breastfeed their infants. In general, hospitals do not allow direct breastfeeding by mothers with an active infection of SARS-CoV-2. Some neonatal units in Hong Kong maintain safe practices by isolating infants and mothers for at least 7 to 14 days, even if the infant remains SARS-CoV-2 negative. During isolation, mothers encourage the expression of milk to maintain milk duct patency and to prepare for lactation when they and their infants are discharged. Infants are fed formula milk by cup feeding with added supplements based on the recommended daily feeding volume for neonates and their appetite during hospitalization. At present, data that indicates COVID-19 could be transmitted from mother to infant postnatally through breastfeeding are insufficient. Major organizations recommend that mothers should breastfeed exclusively for the first 6 months, and thereafter continue to provide their infants with breast milk up until the age of two or beyond. With new findings arising from research, updated information is important to reassure mothers that breastfeeding at home during the COVID-19 pandemic is safe and recommended for both the mother and the infant.

The coronavirus disease 2019 (COVID-19) outbreak in 2020 has led to several changes and disturbances in the daily lives of the general public. Particularly for new (first-time) mothers, there has been a significant impact on the practices of raising and feeding their babies. Social distancing measures everywhere have made mothers hesitant to breastfeed their babies anywhere else but at home. Combined with the fear of being infected with COVID-19, the present situation has created unprecedented barriers for breastfeeding mothers to accessing various types of support: emotional, instrumental, informational, and appraisal. There has been no research on the influence of the pandemic on social support regarding breastfeeding in Hong Kong. This study aimed to explore the social support and impact of COVID-19 on mothers breastfeeding their babies. Semi-structured interviews were conducted with 20 currently breastfeeding women in Hong Kong. Colaizzi’s seven-step method was used for data analysis. Two key themes emerged from the interview data: (1) positive influences on breastfeeding support during COVID-19 and (2) negative influences on breastfeeding support during COVID-19. Our findings may help mothers prepare to breastfeed their babies in places other than their homes.

During an infectious disease pandemic, patients may experience various psychological issues. Few studies have focused on survivors’ experiences in Hong Kong. This study aimed to assess the psychological impacts of coronavirus disease 2019 (COVID-19) on survivors during admission to and discharge from COVID-19 wards using a descriptive phenomenological design. Purposive sampling was used to recruit 20 participants aged 30–77 years recently discharged from an isolation ward at an acute care facility and transferred to a community center specializing in pulmonary rehabilitation. Sampling was performed from 1 March 2022 to 3 April 2022. Semi-structured in-person interviews were conducted and transcribed verbatim; data analysis was performed using Colaizzi’s approach. The patients experienced two exclusive psychological phases during and after admission. The analysis of the patients’ experiences revealed three themes: (i) navigating uncertainties with mixed feelings and emotions during admission, (ii) adjusting to normal daily life after discharge, and (iii) self-growth after discharge. Our findings may provide empirical evidence for formulating pre-emptive strategies to mitigate the long-term psychological impacts of COVID-19. This investigation is timely and internationally relevant, and policymakers can use these findings to make informed decisions when developing guidelines for structuring the care of patients with COVID-19 during and after hospitalization. Based on our findings, we recommended that psychological support, particularly the provision of time to address patients’ concerns, may be integrated into the care of patients with COVID-19. Additionally, the structure of care may extend beyond the biomedical aspects of the illness to encompass the emotional and social dimension of the patients. To reduce stigmatization, we advise that public health authorities release clear information timely to clarify the misconceptions of the local community.

A universal community testing programme (UCTP) was initiated by the government of the Hong Kong Special Administrative Region of the People's Republic of China, as part of a territory‐wide initiative to enhance the control of the coronavirus disease (COVID‐19) pandemic, to facilitate the early identification of asymptomatic patients in the community‐transmission chain. The authors (who were also engaged in this programme) observed that, at the end of their 6‐hour shift, most of the HCPs sustained medical device‐related pressure injuries (MDRPI), frequently on their faces, over the bridge of their nose, the upper cheeks, above the ears, lower jaws, and chin that caused pain and erythema. In this study, our team examined whether two different types of dressing (light silicone foam dressing and soft silicone perforated tape dressing) applied on the anatomical locations (including the bridge of the nose, upper cheek, above the ears, and lower jaw) would enable the wearer to pass the quantitative respirator fit testing that was conducted using a PortaCount Pro+ Respirator Fit Tester 8038. We also investigated if any skin reactions occurred after the participants worn the respirator with our applied dressing materials for 240 minutes in a safe laboratory setting. Lastly, we collected the qualitative feedback concerning how the participants felt about the performance of our dressing materials in preventing MDRPI associated with the prolonged use of tight‐fitting FFRs. A small convenience sample of HCPs (n = 24) who participated in the UCTP was recruited. We randomly selected 12 participants for one type of dressing, and the rest for the second type of dressing. Quantitative fit testing showed an adequate seal of the respirators with the use of both types of thin dressings that were available in the clinical settings. All of the participants except one tolerated the dressings for prolonged use without any report of adverse skin reactions. Our findings may move a step forward in assisting the process of developing feasible pre‐emptive skincare practice guidelines to reduce MDRPI during the prolonged use of nanofiber bacterial surgical respirators.