This active role of older people in their pain relief is likely to enhance the effect of education seminars and workshops aimed at novel, non-pharmacological pain relief strategies for older people with chronic pain.

Aim.  To review systematically the literature about barriers to diabetes self‐care from both patients’ and healthcare providers’ perspectives. Background.  Diabetes mellitus is a global health concern due to rapidly increasing prevalence. The healthcare costs for diabetes care and related complications are high. Tight glycaemic control achieved by intensive therapy has been shown to lower the risk of complications. Despite the provision of comprehensive management programmes, patients are often unable to achieve the desired outcomes. It is essential to understand the barriers to diabetes self‐care in order to promote successfully self‐care behaviours. Methods.  A search of OVID Medline (R), CINAHL, Cochrane Library and British Nursing Index was carried out during 1986–2007 using keywords: Type 2 Diabetes Mellitus, self care, patient compliance, patient adherence and barriers to diabetes self care. Manual searching of relevant nursing journals and sourcing of secondary research extended the search. Results.  A total of 16 original research papers using various methods including survey, descriptive correlational, sequential explanatory mixed‐method and qualitative exploratory design were reviewed. In total, over 8900 patients and 4550 healthcare providers were recruited from over 28 countries in these studies. Major barriers identified included psychosocial, socioeconomic, physical, environmental and cultural factors. Conclusions.  Healthcare providers can enhance patient empowerment and participation with family support to achieve feasible targets. Better health care delivery systems and reforms that improve affordability, accessibility, and efficiency of care are essential for helping both providers and patients to meet desirable standards of diabetes care. Relevance to clinical practice.  Understanding barriers to diabetes self‐care is the first step in facilitating providers to identify their role in enabling patients to overcome these barriers. Healthcare providers can develop strategies to clarify and individualise treatment guidelines, implement continuing education, improve communication skills, and help motivate patients to achieve desired behavioral changes.

Severe acute respiratory syndrome (SARS) has affected many areas of the world recently and is becoming a global problem. Hong Kong and China have been most severely affected by this new infectious disease. The elderly population is highly vulnerable, and mortality in those older than 65 years is more than 50%. In our study, 27 health care workers and 40 elderly residents in a nursing home were interviewed to investigate their level of knowledge of SARS and its prevention. Most of the elderly residents knew little regarding SARS and prevention strategies, despite access to outside news by TV, radio, and visitors. Also, the worry and fear of an outbreak of SARS among staff working in the nursing home was considered to be high. Tailored education programs to promote awareness and prevention of SARS for the elderly are needed. Also, more in-service training, support, and counseling are strongly indicated for staff to promote disease prevention and improve quality of care.

The Internet is becoming a preferred place to find information. Millions of people go online in the search of health and medical information. Likewise, the demand for Web-based courses grows. This article presents the development, utilization and evaluation of a web-based pharmacology course for nursing students. The course was developed based on 150 commonly used drugs. There were 110 year 1 nursing students took part in the course. After attending six hours face to face lecture of pharmacology over three weeks, students were invited to complete a questionnaire (pre-test) about learning pharmacology. The course materials were then uploaded to a WebCT for student's self-directed learning and attempts to pass two scheduled online quizzes. At the end of the semester, students were given the same questionnaire (post-test). There were a significant increase in the understanding compared with memorizing the subject content, the development of problem solving ability in learning pharmacology and becoming an independent learner (p ,0.05). Online quizzes yielded satisfactory results. In the focused group interview, students appreciated the time flexibility and convenience associated with web-based learning, also, they had made good suggestions in enhancing web-based learning. Web-based approach is promising for teaching and learning pharmacology for nurses and other health-care professionals.

With increasing life expectancy, the incidence of chronic illness and chronic pain also increase. Chronic pain robs older people of their quality of life, and limits functional mobility and ambulation, which leads to muscle atrophy. Older people are often reluctant to request pain relief, attempting to endure pain as a "normal" part of ageing. Innovative non-pharmacological interventions in pain management are appealing. In this study, affective images and pictures were used in 15 elderly patients (12 female and three male) in chronic pain who needed to perform stretching and standing exercises in their physiotherapy sessions. Pain scores were measured by the Visual Analogue Scale (VAS), and health-related quality of life was measured by the Medical Outcomes Study Short Form 36 (SF-36). VAS and SF-36 were administered in weeks 1 and in 6. Pain scores were measured during physiotherapy session in the following weeks. There was a significant decreased in VAS from week 1 to week 6 (t = 3.607; df = 14; p < 0.05). Also, a significant decrease in VAS occurred when the patients were watching affective pictures while performing the physiotherapy exercise in weeks 2 and 3, but not in weeks 4 and 5. SF-36 increased in week 6, which indicated an increase in health-related quality of life, though not statistically significant. Affective images and pictures appear to be an effective non-pharmacological intervention in pain management for the older person.