Cardiovascular, Metabolic and Stroke Care

Our mission is to generate new knowledge in cardiovascular, metabolic and stroke care through impactful research:

  • Research in cardiovascular care addresses the needs of individuals who have or are at risk of developing cerebro-cardiovascular diseases (CVD).
  • Research in metabolic care emphasises on the prevention of metabolic syndrome, non-pharmacological management and CVD risk reduction in individuals with metabolic syndrome, and lifestyle interventions for individuals with diabetes, with inter-disciplinary and innovative approaches being adopted in the studies to maximise client and nursing outcomes.
  • Research in stroke care focuses on empowering stroke survivors and their caregivers with knowledge, skills, and confidence to manage their conditions to promote health-related quality of life.

Signature Research Work

International Research Collaborations

• Translation of instrument in collaboration with Prof. Fadol from the MD Anderson Cancer Center, USA
- Chair, S.Y., Wang, Q., Yu, M., So, W.K.W., Tian, C., Sit, J.W.H., ... Fadol, A. (2016). A psychometric evaluation of the Chinese version of the M.D. Anderson Symptom Inventory-Heart Failure in Chinese cancer patients with concurrent heart failure. Rehabilitation Nursing, 0 , 1-9. doi:10.1002/rnj.259.

• Examining the association between nurse staffing levels, the practice environment and nurse-sensitive patient outcomes in hospitals in collaboration with faculty members from Center for Health Outcomes and Policy Research, University of Pennsylvania, USA

Selected Research Projects​

Research Highlights

A fight to a better cardiovascular health

Various factors could lead to the occurrence of cardiovascular diseases (CVD), and the factors vary across different populations. To reduce CVD risk and improve cardiovascular health, we have conducted a series of randomised clinical trials with a variety of strategies for different patient groups to achieve these goals. For example, we have used:

1) motivational interview, home-based cardiac rehabilitation model, and music-paced physical activity to facilitate patients’ compliance with cardiac rehabilitation or maintain the prescribed physical activity after cardiac rehabilitation;

2) lifestyle modification to reduce CVD risk for patients with metabolic syndrome;

3) educational intervention to improve the health of heart failure patients and post-menopausal women.

Findings from our studies support the use of these innovative strategies to improve cardiovascular health.

Related publications:

  • Wang, Q., Chair, S. Y., & Wong, E. M. L. (2017). The effects of a lifestyle intervention programme on physical outcomes, depression, and quality of life in adults with metabolic syndrome: A randomised clinical trial. International Journal of Cardiology, 230, 461- doi:10.1016/j.ijcard.2016.12.084
  • Lo, S. W. S., Chair, S. Y., & Lee, I. F. K. (2017). Effects of lifestyle intervention on physiological outcomes in Chinese adults with, or at high risk of metabolic syndrome. Journal of Cardiovascular Nursing, 32(6):514-521. doi: 10.1097/JCN.0000000000000386
  • Yu, M., Chair, S. Y., Chan, C. W., & Choi, K. C. (2015). A health education booklet and telephone follow-ups can improve medication adherence, health-related quality of life, and psychological status of patients with heart failure. Heart & Lung, 44(5), 400-407. doi: 10.1016/j.hrtlng.2015.05.004
  • Chair, S. Y., Chan, S. W. C., Thompson, D. R., Leung, K. P., Ng, S. K. C., & Choi, K. C. (2013). Long-term effect of motivational interviewing on clinical and psychological outcomes and health-related quality of life in cardiac rehabilitation patients with poor motivation in Hong Kong: A randomised controlled trial. Clinical Rehabilitation27(12), 1107-1117. doi: 10.1177/0269215513490527
  • Wang, W., Chair, S. Y., Thompson, D. R., & Twinn, S. F. (2012). Effects of home-based rehabilitation on health-related quality of life and psychological status in Chinese patients recovering from acute myocardial infarction. Heart & Lung41(1), 15-25. doi:10.1016/j.hrtlng.2011.05.005
  • Chan, K. M. C., Leung, K. C., & Chair, S. Y. (2012). The effect of cardiac health promotion programme among the general public in Hong Kong. Journal of the Hong Kong College of Cardiology, 20(1), 21-30.
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The health benefits of Tai Chi

Physical inactivity is a major risk factor associated with cardiovascular diseases, while regular exercise contributes to a reduction in cardiovascular disease mortality. A 3-month Tai Chi programme was conducted in the community for people with cardiovascular risk factors including hypertension, diabetes, dyslipidaemia, overweight, physical inactivity and smoking. After acquiring Tai Chi skills, participants were advised to practise Tai Chi at home for at least 30 minutes per day and 5 days per week. Tai Chi exercise was then compared with brisk walking exercise. The results suggest that regular Tai Chi exercise is better than brisk walking in reducing blood pressure and blood glucose levels, and improving psychosocial well-being with long-term benefits.

Related publications:

  • Leung, L. Y. L., Chan, A. W. K., Sit, J. W. H., Liu, T., & Taylor-Piliae, R. E. (2019). Tai Chi in Chinese adults with metabolic syndrome: A pilot randomized controlled trial. Complementary Therapies in Medicine, 46, 54–61.
  • Chan, A. W. K. , Chair, S. Y., Lee, T. F. D., Leung, D. Y. P., Sit, J. W. H., Cheng, H. Y., & Taylor-Piliae, R. E. (2018). Tai Chi exercise is more effective than brisk walking in reducing cardiovascular disease risk factors among adults with hypertension: A randomised controlled trial. International Journal of Nursing Studies, 88, 44-52. doi: 10.1016/j.ijnurstu.2018.08.009.
  • Liu, T., Chan, A. W. K., Liu, Y. H., & Taylor-Piliae, R. E. (2018) Effects of Tai Chi-based cardiac rehabilitation on aerobic endurance, psychosocial well-being, and cardiovascular risk reduction among patients with coronary heart disease: A systematic review and meta-analysis. European Journal of Cardiovascular Nursing, 17(4), 368-383. doi: 10.1177/1474515117749592.
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Innovative approach to cardio-cerebrovascular care in hazardous or emergency conditions

A large majority of older adults suffer from cardiovascular and/or cerebrovascular conditions, of which stroke and acute cardiac syndrome constitute the leading causes of disability and mortality. The growing occurrence, intensity and duration of various hazardous or emergency conditions, such as extreme weather, worsen the situation, which urges for innovative solutions to build individual and institutional resilience to confront the challenges. Given the scarcity of related evidence at present, efforts have been made in both education and practice to identify and better understand innovative solutions in nursing for building individual and institutional resilience to confront extreme weather conditions, such as heatwave, and other challenges.

Related publications

  • Jin, S., Liu, Y., Hennessy, D. A., Sun, L., Zang, Y., Si, M., & Zhang, J. (2019). Physical illnesses and medically serious suicide attempts in rural China. Crisis - The Journal of Crisis Intervention and Suicide Prevention, 0(0), 000-000. doi:10.1027/0227-5910/a000597
  • Li, Q. & Zang, Y. L. (2019). Clinical symptoms of acute myocardial infarction. Contemporary Nurse, 0(0), 000-000. (In Chinese)
  • Ma, X., Yang, Y. Y., Wang, X., & Zang, Y. (2018). An integrative review: Developing and measuring creativity in nursing. Nurse Education Today, 62, 1-8. doi:10.1016/j.nedt.2017.12.011
  • Ma, H. J., Wang, L. Y. & Zang, Y. L. (2015) A study of nursing managers’ perception of hospital resilience to public emergency. Nursing Journal of Chinese People's Liberation Army, 32(2), 23-26. (In Chinese)
  • Zhong, S., Clark, M., Hou, X. Y., Zang, Y. L., & FitzGerald, G. (2015). Development of key indicators of hospital resilience: A modified Delphi study. Journal of Health Services Research & Policy, 20(2), 74-82. doi:10.1177/1355819614561537
  • Zhong, S., Hou, X. Y., Clark, M., Zang, Y. L., Wang, L., Xu, L. Z., & FitzGerald, G. (2014). Disaster resilience in tertiary hospitals: A cross-sectional survey in Shandong Province, China. BMC Health Services Research, 14. doi:10.1186/1472-6963-14-135
  • Liu, C. Y., Xu, L., & Zang, Y. L. (2014). Effectiveness of audiovisual interventions on stress responses in adolescents with ENT surgery in hospital: Randomised controlled trial protocol. Journal of Advanced Nursing, 70(6), 1414-1424. doi:10.1111/jan.12295
Nurse-led patient-centred care

Since patients’ experience may affect their health management process, nurses are obligated to work with the patients and acknowledge their experience, values, beliefs, knowledge, preferences, and self-management ability in planning of care. There was a lack of studies incorporating patient-centred care concepts when designing the intervention for secondary prevention of coronary heart disease. A systematic review of 15 articles reporting 12 randomised controlled trials showed that this intervention could significantly improve coronary heart disease patients' smoking habits, adherence to physical activity advices, and total cholesterol level with medical regimen optimization in the short- to medium-term. This intervention also showed beneficial effect on improving the patients’ quality of life in several domains (36-Item Short Form Survey, SF-36).

Related publication:

  • Chiang, C. Y., Choi, K. C., Ho, K. M, & Yu, S. F. (2018). Effectiveness of nurse-led patient-centred care behavioural risk modification on secondary prevention of coronary heart disease: A systematic review. International Journal of Nursing Studies, 84, 28-39. doi:
Stroke caregiver: How to take care of yourself?

The overwhelming stress associated with caregiving hinders the ability of family caregivers to utilise their internal and external resources to cope with daily problems thereby placing their own health at risk. Our randomised controlled trial showed that family caregivers who received our strength-oriented psychoeducational programme improved their problem-solving coping abilities, caregiving competence and reduced caregiving burden. Caregivers joining the programme also have improved family functioning and social support. (Professor Ho Yu CHENG, Professor Sek Ying CHAIR and Professor Janita CHAU)

Related publications:

  • Cheng, H. Y., Chair, S. Y., & Chau, J.P. C. (2018). Effectiveness of a strength-oriented psychoeducation on caregiving competence, problem-solving abilities, psychosocial outcomes and physical health among family caregiver of stroke survivors: A randomized controlled trial. International Journal of Nursing Studies, 87, 84-93.
  • Cheng, H. Y., Chair, S. Y., & Chau, J. P. C. (2017). Psychometric evaluation of the Caregiving Competence Scale among Chinese family caregivers. Rehabilitation Nursing, 42(3), 157-163. Doi:10.1002/rnj.207.
  • Cheng, H. Y., Chair, S. Y., & Chau, J. P. C. (2014). The effectiveness of psychosocial interventions for stroke family caregivers and stroke survivors: A systematic review and meta-analysis. Patient Education and Counseling, 95(1), 30-44.

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Building self-management skills to enhance stroke survivors’ recovery

The physical and psychosocial challenges that stroke survivors face after discharge from hospitals are enormous. Professor Suzanne Lo and Professor Janita Chau conducted a research to look into the effectiveness of a self-efficacy and outcome-expectation enhancing self-management programme on community-dwelling stroke survivors’ recovery. The findings supported this innovative model of stroke self-management during transition back to home.

Related publications:

  • Lo, S. H. S., Chang, A. M., Chau, J. P. C., & Gardner, G. (2013). Theory-based self-management programs for promoting recovery in community-dwelling stroke survivors: A systematic review. The JBI Database of Systematic Reviews and Implementation Reports, 11(12), 157−215. doi: 10.11124/jbisrir-2013-1056
  • Lo, S. H. S., Chang, A. M., & Chau, J. P. C. (2018). Stroke self-management support improves survivors’ self-efficacy and outcome expectation of self-management behaviors. Stroke, 49(3), 758-760. doi: 10.1161/STROKEAHA.117.019437.

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