基層健康護理

Dr Arkers WONG (Assistant Professor) received a donation of over HK$11 million from the Li Ka Shing Foundation to carry out a project aimed at training female food delivery workers from Food Angel (惜食堂) to perform basic health checks for older adults living alone in the community.

After undergoing training, the female delivery workers will be equipped with basic health knowledge and the ability to measure physical vital signs, including blood oxygen levels, blood pressure, and pulse and pain indices, for around 100 older adults when they visit them to deliver meals. The health data collected by the delivery workers will be uploaded to the mHealth monitoring platform developed by Dr Arkers WONG’s research team. Registered nurses (RNs) will be given access to the platform to evaluate the health status of the older adults. When needed, an RN will give in-depth personal care and interventions via the mHealth app to the older adults. Referrals to allied health professionals or social workers can also be made by the RNs for early interventions.

The team hope that this first-of-its-kind grassroots community health model, undertaken in combination with the Health-Social Partnership, will provide scientific research evidence for the Hong Kong government to consider introducing the mHealth app and the service model to the community as a way to strengthen primary healthcare.

The mHealth app is a pilot health management mobile app with an interactive nurse support function. The app enables nurses to monitor the health status of users and allow users to communicate with nurses when they have health concerns. Research findings released by the team in March 2023 showed that older adults’ use of the app for 3 to 6 months resulted in a significant increase in self-efficacy, a significant decrease in depression levels, a reduction in the use of medical services, and an improvement in quality of life.

In this project, a novel peer support virtual reality-based therapy will be developed for AD/HD carers to reduce their stress and increase their empathy in dealing with children with AD/HD. Under the impact of COVID-19, children with AD/HD and their parents felt lost and worried and experienced changes in mood and behaviour. During the closure of schools and childcare centres, parents became responsible for the daily personal care and education of their children with AD/HD. A peer support VR intervention can relieve stress and increase empathy by providing carers with a leisurely, memorable, and immersive experience. Furthermore, with better stress management, carers will experience an improvement in well-being and develop fewer chronic health conditions, leading to improved caregiver performance. Empathy contributes to helping behaviours that benefit interpersonal relationships. Therefore, the relationship between carers and children with AD/HD will also be enhanced by the therapy approach developed in the project. In addition, arrangements will be made for two participants to be in the same therapy session so that they can share their experiences of and feelings and knowledge about taking care of children with AD/HD. This can promote mutual assistance among peer carers. It is anticipated that the project will help families with children with AD/HD to become better able to adapt to a rapidly changing society.

Many studies have found that aerobic exercise can significantly reduce the frequency of migraine attacks and alleviate the intensity and duration of headaches. However, as exercise might also be a trigger, the type, frequency, intensity, and duration of exercise should be carefully determined for migraine prophylaxis. Tai Chi, a traditional Chinese martial art, can be easily and conveniently practised in daily life. Most prophylactic medications treat migraineurs merely through general biochemical mechanisms. As a traditional Chinese martial art and a complementary and alternative therapy, Tai Chi differs from conventional medication in that it can be considered a holistic approach to healthcare. We are interested in investigating the underlying mechanisms of how Tai Chi works to alleviate migraine attacks. The key issues that we want to address are whether Tai Chi is appropriate as a stand-alone preventive strategy that is comparable in treatment efficacy with standard prophylactic medications, or is at least not worse than these; and, if it is proven to be effective, what mechanism leads to such treatment efficacy.

Supported by the General Research Fund, Dr Grace XIE (Associate Professor) and her team are implementing a two-arm individual-level non-inferiority randomised controlled trial. A total of 220 local women aged from 18 to 65 who have been diagnosed with episodic migraine will be randomly assigned to one of two groups: (1) a Tai Chi training group receiving the 33-short form Yang-style of Tai Chi training; or (2) a standard prophylactic medication group receiving regular medication prescribed by a neurologist. The intervention period will be 24 weeks with another 24 weeks of follow-up. The frequency of migraine attacks, number of days with migraine, and intensity and duration of headaches will be recorded using a migraine diary at baseline, 24 weeks, and 48 weeks. MRI and a Transcranial Doppler will be used to measure white matter lesions and cerebral vasculature activity before and after the intervention, respectively. The clinical efficacy will be determined by comparing the differences in outcomes between the two groups from baseline to the end of the trial. The mechanism of the intervention effect will be explored by analysing the changes and associations of migraine features with the process of brain white matter and neurovascular changes after the Tai Chi training.