Competence of Health Care Professionals from the Eyes of Patients Living with Hepatitis C and the caregivers in Karachi, Pakistan

Vol. 1 No. 4

Year: 2012

Issue: Nov-Jan

Title: Competence of Health Care Professionals from the Eyes of Patients Living with Hepatitis C and the caregivers in Karachi, Pakistan 

Author Name: Noureen Shehzad Jiwani, Raisa Begum Gul 

Synopsis: 

As a chronic disease, Hepatitis C impedes patients’ physical, psychosocial, financial, and emotional wellbeing throughout their illness. Competence of health care professional, especially their communication skills and attitude towards Hepatitis C may help to ease or add to the burden of this disease for patients and their families. Although few studies are available about the interactions of health care professionals with hepatitis C patients and their caregivers, little is known about this phenomenon in the developing countries including Pakistan. The aim of this study is to explore the experiences of hepatitis C patients’ and the caregivers with health care professionals in a Pakistani context. Using descriptive exploratory design, data were collected through in-depth interviews, from ten patients with hepatitis C and eight caregivers. Interviews were tape recorded and transcribed verbatim; manual content analysis was performed for extracting themes and categories. Findings of the study reveals that health care professionals for few patients were very supportive however, for majority of the participants lack competence in dealing with patients having hepatitis C and the caregivers. Study findings suggest that appropriate understanding of hepatitis C is critical for health care professionals of Pakistan, not only to alleviate patients and caregivers suffering but also to reduce the prevalence of hepatitis C. 

Awareness About Hepatitis Disease Among Youth In Coastal Areas Of Colachel And Muttom, Kanyakumari District, Tamil Nadu

Vol. 1 No. 4

Year: 2012

Issue: Nov-Jan

Title: Awareness About Hepatitis Disease Among Youth In Coastal Areas Of Colachel And Muttom, Kanyakumari District, Tamil Nadu 

Author Name: Mofanato S.K.Kala kumari, V. Jurist Lionial Kumar 

Synopsis: 

‘Health is Wealth’. Health is the fundamental human right. It is the duty of the community to provide a proper environment for helping each individual to be healthy. This will include the supply of safe drinking water, adequate measures for disposal of excreta, avoidance of air pollution and control of communicable diseases. Hepatitis is an inflammation of the liver caused by infection with virus or by drugs and alcohol. It causes ill health and severe liver damage and leads to cirrhosis of the liver and the liver cancer. Hepatitis disease spread through contaminated water, food, blood transfusions, organ transplantations, injection, drug use, children sharing the bed of the hepatitis affected children, contaminated syringes and needles. Hepatitis virus is severe than AIDS virus. Colachel and Muttom are situated near seashore, population in overcrowded; sanitation facilities are not well developed. So it is necessary to investigate whether the coastal people of Colachel  and Muttom have the knowledge about the dreadful hepatitis disease and its prevention. The investigators conducted the study “Awareness About Hepatitis Disease Among Youth in Coastal Areas with reference to Colachel and Muttom. The investigators recommended that Awareness Programmes about Hepatitis disease should be conducted in the Coastal areas of Colachel and Muttom”.

Whether a video awareness programme is effective in increasing the knowledge of primary school teachers regarding ADHD? An experimental study

Vol. 1 No. 4

Year: 2012

Issue: Nov-Jan

Title: Whether a video awareness programme is effective in increasing the knowledge of primary school teachers regarding ADHD? An experimental study 

Author Name: Renjulal Yesodharan, Asha K Nayak 

Synopsis: 

Attention-deficit hyperactivity disorder (ADHD) is the most commonly diagnosed behavioural disorder of childhood. For working effectively with students diagnosed with ADHD, teachers need to be knowledgeable not only about the etiology, diagnosis, and prognosis of the disorder; they also need to know how to implement educational interventions that have been shown to have positive outcomes for students with ADHD. The study aims to assess the existing knowledge and belief of primary school teachers regarding ADHD. Furthermore, the study evaluates the effectiveness of a video awareness programme in terms of gain in knowledge score regarding ADHD. This is a pre- experimental study that was conducted in Block Resource Centre, Udupi. Primary school teacher’s knowledge regarding ADHD was measured by using KADDS. A  Pre-test was conducted before giving awareness video program and a post-test was conducted after 7 days. The effectiveness of the video awareness was analysed by paired t test. The average knowledge of primary school teachers regarding ADHD was 14.78 ± 4.038  There was a significant improvement in the knowledge of primary school teachers regarding ADHD after viewing video awareness program (10.267 ± 4.290, t=18.538 p <0.001). The study finding suggests the primary school teachers had inadequate knowledge regarding ADHD and video awareness programme on ADHD is an effective method to improve knowledge on ADHD.

Determination of nursing manpower requirement for hemodialysis unit of a referral hospital of north India: A holistic approach

Vol. 1 No. 4

Year: 2012

Issue: Nov-Jan

Title: Determination of nursing manpower requirement for hemodialysis unit of a referral hospital of north India: A holistic approach 

Author Name: Jogindra Vati, Sunita Sharma , H S Kohli 

Synopsis: 

Safety of patients has become the matter of prime importance. Safe staffing is required in order to render the quality patient care and to cope with expanding role of nurses. Despite its importance, empirical evidence related to optimal nursing staff requirement for hemodialysis (HD) unit is lacking in Indian scenario. Hence an attempt has been made to determine nursing manpower (bedside nurses) for this unit. After getting approved from Institute ethical committee and head of department, a total 525 patients (both routine and emergency) including patients on ventilator (n=30), who underwent HD and patients for Internal Jugular vein (IJV) Catheterization (n=47) were observed for 30 days in the month of August 2009 through pretested check list developed by Delphi method of three rounds. Thus work measurement and consultative approach was used to identify the type and frequency of nursing activities required in HD unit. Total 53 nursing activities including 27 HD related, 4 ventilators related, 13 IJV related, 6 ward-related and 3 week-end related activities were identified. Maximum 93.2% of time was spent on HD related activities. On the average 648 minutes are required to carry out all activities and 28138.3 minutes per week. After calculation and keeping in mind 30% nurses for leave reserve, the data revealed that 17 bedside nurses (without meal break) are required for HD unit with 10 HD stations and one table for patients undergoing IJV catheterization. Thus this study has highlighted the need for deploying more nurses; since at present two nurses in the morning and one nurse in the evening duty are posted. It has also provided the empirical evidence for framing practice standards for nursing care of patients undergoing HD and IJV catheterization and a base for calculating nursing manpower for this specialty unit.

Health and Human Development Nexus in Nepal

Vol. 1 No. 4

Year: 2012

Issue: Nov-Jan

Title: Health and Human Development Nexus in Nepal 

Author Name: Mukesh Kumar Mishra, Vinod Mishra , Farhat N.Siddiquie 

Synopsis: 

The dimensions of human development are quite broad. It does have association with many indicators. This study analyzes the links between health and human development in terms of human development indices and survival progress (i.e. life expectancy, infant mortality, under-five mortality). Secondary data from Nepal Demographic Health Survey and Human Development Reports in particular has been used for the analysis. The analysis reveals that one of the major development concerns is people, that is, healthy people. Good health is obviously an important determinant for optimal development. In general, the health status of the people is improving in Nepal. The survival progress indicators has gradually but positively changed between 1996 to 2006 but still there are many challenges as well to maintain optimum health and human development in Nepal. The millennium development goals can only be achieved if improvement in health facilities and human development indicators is given priority in Nepal. 

Do Schools Have an Ethical Responsibility to Provide Primary and/or Emergency Care?

Vol. 1 No. 4

Year: 2012

Issue: Nov-Jan

Title: Do Schools Have an Ethical Responsibility to Provide Primary and/or Emergency Care? 

Author Name: Ruth Rosenblum 

Synopsis: 

Schools and school nurses are frequently asked to care for medically fragile students who have complex medical needs including administration of emergency medications given by injection or per rectum. Since all children are entitled to a free and public education in the least restrictive environment, school personnel must be prepared to accept these students and deliver safe, appropriate care at school. This paper explores whether schools have an ethical responsibility to provide primary and/or emergency care at school. Legal precedent to date has supported children receiving necessary care; however school administration and school nurses sometimes question the ability to safely provide the care.  Additionally, in many cases nurses are mandated to train unlicensed personnel to perform these procedures.  If schools have an ethical responsibility to provide medical care, then does the legal liability override the ethical duty? The Lagana-Duderstadt Deontological-Ethical Model is used to explore this question.

Transitioning to practice: A nursing student peer mentoring leadership initiative

Vol. 1 No. 3

Year: 2011

Issue: Aug-Oct

Title: Transitioning to practice: A nursing student peer mentoring leadership initiative 

Author Name: Margaret Bagnardi 

Synopsis: 

The current changes and challenges for the future of our healthcare system necessitates a renewed look at what the Baccalaureate prepared Registered Nurse (RN) looks like for the 21st century. There is urgency as we face increasing healthcare costs, inconsistent utilization of services and a demand for better, less costly and better organized healthcare for the nation. Nurses need to be the leaders in all facets of care from the patient bedside to administrative settings, and these leadership traits need to be nurtured early on in Registered Nurses’ education.A national survey “Bridging the Preparation Gap” (The Advisory Board Company, 2008) indicated that new graduate nurses scored the lowest in the areas of delegation of tasks, ability to anticipate risk, ability to prioritize, conflict resolution, and ability to keep track of multiple responsibilities. Fostering these leadership skills can be accomplished by introducing concepts early in the students’ nursing education, empowering them to perceive themselves as future leaders, and defining and creating a safe environment for them to practice those skills.

Uterine Prolapse in Madhesh: Gender, Reproductive Rights and Development

Vol. 1 No. 3

Year: 2011

Issue: Aug-Oct

Title: Uterine Prolapse in Madhesh: Gender, Reproductive Rights and Development 

Author Name: Mukesh Kumar Mishra, Tej Prasada Adhikari 

Synopsis: 

Uterus prolapse (UP) is a severe public health concern among married women of Madhesh and is poorly addressed by the state. It has multiple effects in the lives of married women. Systematic studies evaluating the impacts of Uterine prolapse on Madheshi Women’s life is not carried out in Nepal. This study sheds light on the investigation of, whether gender beliefs and gender-skewed cultural practices have association with high prevalence of UP and what are the impacts and predictors of UP for Madheshi women?

Alcohol versus Sterile water cleaning for newborn umbilical cord care

Vol. 1 No. 3

Year: 2011

Issue: Aug-Oct

Title: Alcohol versus Sterile water cleaning for newborn umbilical cord care 

Author Name: Ranjani Palanisamy, Dr. Baby Sathish Nayak, Sonia R. B D’Souza , Maria Pais , P.Manjula 

Synopsis: 

Concern about the umbilical cord care arises when there is delay in the cord separation or cord infection. Greater percentage reduction in the cord separation time by using sterile water than alcohol has been reported. Randomized control trial was carried out at postnatal wards of medical college attached hospitals of Udupi district among 80 newborns. The analysis revealed, no significant difference in the cord separation time, and cord infection rate of newborn umbilical cord treated with alcohol and sterile water. The cost spent for the alcohol group is three times more than that of sterile water group. The birth weight, gender of newborn and parity of mother had no effect on the time of separation of the umbilical cord. Sterile water cleaning is safe and cost effective means of umbilical cord care in term infants.

A time study on measuring and recording of blood pressure in selected wards of a tertiary care hospital of North India

Vol. 1 No. 3

Year: 2011

Issue: Aug-Oct

Title: A time study on measuring and recording of blood pressure in selected wards of a tertiary care hospital of North India 

Author Name: Jogindra Vati, Masih Dayal 

Synopsis: 

The blood pressure (BP) measurement and recording is one of the many nursing activities performed by nurses. Mostly conventional non-invasive auscultatory method is used in measuring blood pressure that is an indirect measurement of arterial pressure. Nurses spend a large quantum of time of duty hours on this procedure. Despite the time spent by nurses for different nursing activities documented in the literature, but empirical evidence on time study specifically on blood pressure measurement is lacking in Indian scenario. Hence an attempt was made to estimate the time taken in measuring and recording the blood pressure. Fifty operational nurses were selected conveniently from 13 randomly selected wards of a tertiary care hospital. A total 250 observations (five on each subject) were made during morning, evening and night hours with the help of pretested electronic stopwatch. The data revealed that to carry out all steps of the procedure, the average time taken by a nurse was132.4 seconds (2.2 minutes). On the average they spent 6 seconds (range 5.4-6.45 seconds) to assemble the articles either from nursing station or from one patient to another and 1-2.1 seconds in explaining the procedure to the patient. Whereas in carrying out the actual procedure that comprised of fifteen steps, they took an average of 115.3 seconds and 9.73 seconds to record the readings in the nurses document sheet. The nurses working in special wards took more time than the nurses working in medical wards.

 

Using Lived Experiences of Adults to Understand Chronic Pain: Sickle Cell Disease, an Exemplar

Vol. 1 No. 3

Year: 2011

Issue: Aug-Oct

Title: Using Lived Experiences of Adults to Understand Chronic Pain: Sickle Cell Disease, an Exemplar 

Author Name: Maxine Adegbola 

Synopsis: 

 Healthcare provision pertaining to painful, chronic conditions can best be optimized by developing positive healthcare provider (HCP)-patient relationships that minimize fragmented care. Nurses, with their holistic, humanistic approach provide a multidimensional focus that fosters individualized and effective outcomes for chronic events. The chronic pain phenotype is subjective, difficult to assess, define and effectively manage. Individuals with one such chronic syndrome, sickle cell disease (SCD), are living longer with pain that is poorly defined and inadequately managed. In addition to using quantitative assessment, clinicians and researchers must use substantive qualitative inquiry to understand the pain from the individual’s perspective, define, and appropriately manage the pain. Combined quantitative and qualitative inquiry can help clinicians and researchers gain insights into pain experiences. This manuscript summarizes the importance of including a narrative (qualitative) inquiry, to offer a holistic, comprehensive and humanistic approach to understanding chronic pain from the individual’s perspective and subsequently positively impacting care delivery. All nurses in the academy-educators, clinicians and researchers need to include a qualitative approach to care delivery, investigation and evaluation of the phenomenon pain, and intentionally demonstrate care. The experiences of individuals with chronic sickle cell disease (SCD) pain are used as an exemplar.

 

Use of High Fidelity Simulation in Early Nursing Courses

Vol. 1 No. 2

Year: 2011

Issue: May-Jul

Title: Use of High Fidelity Simulation in Early Nursing Courses 

Author Name: 

Synopsis: 

Simulation is increasingly being used in nursing education, especially in upper level courses. A faculty member teaching a wellness course at the sophomore level was interested in integrating simulation into this level of the curriculum but found pre-packaged scenarios too complex, quick paced, and advanced for younger students. As a result, two scenarios were created using a high fidelity simulation manikin which incorporated content from health assessment, wellness, and nutrition coursework. Learning objectives focused on subjective and objective assessment skills, therapeutic relationships, safety and quality issues, SBAR (situation-background-assessment-recommendation) communication and primary and secondary nursing interventions to improve and promote health. Unlike the acute care settings where most upper level course scenarios occur, the setting for these scenarios was senior centers and adult day centers. Manikins were assembled to appear as well elderly, interacting with others in community settings. This experience allowed less experienced nursing students to engage in critical thinking and utilize new skills through use of technology. Experiences were well received by students and faculty alike, who had no previous interaction with simulation. Starting with slower, low-acuity scenarios can serve to increase the confidence of using simulation for both students and educators as well as prepare students for higher acuity encounters.

Does Ethnicity Matter in Family Planning Services? Evidence from Nepal Demography Health Survey (NDHS) 2006

Vol. 1 No. 2

Year: 2011

Issue: May-Jul

Title: Does Ethnicity Matter in Family Planning Services? Evidence from Nepal Demography Health Survey (NDHS) 2006 

Author Name: 

Synopsis: 

Regardless of three decades of implementation of family planning program in Nepal, need of family planning services is largely unmet. Systematic studies evaluating the impact of family program on several ethnic groups of Nepal has not been carried out in large scale. This study sheds light on the investigation of, whether the use of contraceptives varies among different ethnic groups in Nepal and what are the predictors of contraceptive variance in ethnic groups in Nepal. The study is based on data collected from Nepal Demographic Health Survey 2006. Multilevel logistic regression analyses of 10793 married women of reproductive age nested within 264 clusters from the surveys were considered as the sample size. Individual, household, and program variables were set and a multilevel logistic regression model was fitted to analyze the variables, using GLLAMM command in STATA-9. Multilevel logistic regression analysis indicated that Muslims, Dalits and Terai madheshi women were significantly less likely to use modern contraceptives compared to the Brahmins and Chhetries (Higher Castes). Women who were exposed to family planning information in radio were more likely to use modern contraceptives than women not exposed to radio information (OR=1.22, P> 0.01). An odd of using contraceptives by Newar was (OR 1.09, P>0.05), the highest among all ethnic groups. Exposure of women to family planning messages through health facilities, family planning workers, and means of communication, increased the odds of using modern contraceptives. However, impact of the family planning information on contraceptive use varied among ethnicity. Special attention need to be paid, in particular to the ethnicity ,  while formulating family planning policies in Nepal, for better success rate of family planning intervention programs.

The Emotional Experience and Grades in Nursing School

Vol. 1 No. 2

Year: 2011

Issue: May-Jul

Title: The Emotional Experience and Grades in Nursing School 

Author Name: 

Synopsis: 

There has been much research to suggest that depression, anxiety, and stress exist among college students. However, there is limited research on how these emotional states may affect grade point average (GPA). The purpose of this study was to determine the effects of depression, anxiety, and stress among nursing students and to further analyze how those states influence GPA. The study was conducted during the spring 2010 semester at a mid-sized, rural university in the southern United States. The Depression Anxiety Stress Scale, a demographic survey, and academic records were used as instrumentation for this study. Kruskal-Wallis nonparametric tests and multiple regression analyses were used to explain and identify significant findings. These findings indicate that nursing students have a significant amount of self-reported anxiety during the first year of nursing. Level I nursing students have the lowest GPA among the three levels which indicates the higher level of anxiety may potentially lead to poor academic achievement. The multiple regression analyses indicated statistical significance in predicting end of semester grade point average among Level I and Level III students. This study provided insightful information related to emotional variables in nursing students. Future research studies may include further analyses of a larger, more diverse population to strengthen the ability to predict GPA.

Prevalence of Advance Directives in 18-65 Age Groups

Vol. 1 No. 2

Year: 2011

Issue: May-Jul

Title: Prevalence of Advance Directives in 18-65 Age Groups 

Author Name: 

Synopsis:

This study investigates the prevalence of Advance Directives (AD’s) in patients between 18-65 years old. AD’s evolved from legislation passed by California in 1976, the Natural Death Act which legalized living wills, hoping to maintain the patient’s voice in medical decision making.  While ample research has been published on the prevalence of AD’s in the elderly population, there are few studies that evaluate its use in the younger age group.  This research is among the first to retrospectively review AD’s in this population. Data was collected on 497 in-patient records to evaluate AD completion and admitting diagnosis. Overall prevalence of AD’s was 7.6% and female patients were more likely than male patients to complete an AD.  In the younger the age group (18-32), prevalence was as low as 5%. This research is groundbreaking as it demonstrates that the youthful age groups tend to have an even lower prevalence of AD completion than was documented in previous literature. Increasing AD completion rates for all age groups would improve patient autonomy, nursing management and healthcare delivery.  Further nursing research is needed on AD’s as well as nursing strategies to reduce barriers to AD completion.

Preparing the Future Nursing Workforce for Political Activism

Vol. 1 No. 2

Year: 2011

Issue: May-Jul

Title: Preparing the Future Nursing Workforce for Political Activism 

Author Name: 

Synopsis: 

Awareness of the importance of political advocacy for both the nursing profession and for patient outcomes is critical to the advancement of health related legislature at the state and federal level. The 2010 IOM report, The Future of Nursing: Leading Change, Advancing Health, recommends that nursing education prepares a workforce of nurses for key government leadership positions. This study evaluated the effectiveness of group participation in a health policy and legislative blog in increasing nursing student self-efficacy scores on political activism. The research design was an evaluative before-and-after design using each participant as his/her own control. The study utilized a convenience sample of 56 senior level nursing students enrolled in a leadership course. A paired-samples t test was conducted to compare the pre-test mean and the post-test mean of a 12 item political self-efficacy survey. The overall self-efficacy score and all three self-efficacy subscales were statistically significant (p<.05) demonstrating a noteworthy increase in self-efficacy for political activism. This study has identified an effective teaching strategy to improve the self-efficacy of nursing students in advocating for the nursing profession and patient outcomes. The outcome of this study was that graduating baccalaureate students enter the workforce with an established level of confidence in their ability to affect change in health policy promotion.

Hazards of Computer in Human – A Work Related Injury

Vol. 1 No. 2

Year: 2011

Issue: May-Jul

Title: Hazards of Computer in Human – A Work Related Injury 

Author Name: 

Synopsis: 

Computers are widely used in the office workplace, which provide efficiency, competitive advantages, and the ability to carry out work that would be impossible or less effective without their use. They also provide new methods for managing work and tracking the behaviour of employees. Computerized jobs are more sedentary, require more cognitive processing and mental attention, and require less physical expenditure of energy. Yet the production demands of these jobs are often high, with constant work pressure and little decision making possibilities. Many jobs that require heavy daily computer use have been found to be stressful. Recently, potential adverse health effects of long-term computer use have been attracted attention. Renewed concerns about radiation, combined with reports of newly recognized "repetitive stress injuries" such as carpal tunnel syndrome, have led some to call for regulation in the workplace and others to rearrange their offices and computer labs. A lot of people are spending more time doing more tasks with computers and faculty, students and staff at colleges and universities have some of the most computer-intensive work styles in the world. Computer related injuries which began to be reported in India five years ago are now developing into an epidemic among computer users. It is estimated that world-wide, 25% of computer users are already suffering from computer related injuries. The United States has to shell out more than 2 billion US dollars annually for having ignored these computer related problems. It is now proved that the duration of work and computer - related problems are positively correlated. It is not uncommon these days for people having to leave computer dependent careers or even be permanently disabled and unable to perform tasks such as driving or dressing themselves. Occupationally caused RSI rank first among the health problems, in the frequency with which they affect the quality of life. Thus with rampant and excessive use of computers we are now entering into a new era of computer related health problems

Charles Bonnet Syndrome: Visual Hallucination Impact in the Elderly

Vol. 1 No. 2

Year: 2011

Issue: May-Jul

Title: Charles Bonnet Syndrome: Visual Hallucination Impact in the Elderly 

Author Name: 

Synopsis: 

Charles Bonnet syndrome presents as visual hallucination affecting the elderly population visual perception.  The visual hallucination may present as abstract images or distinct clear small stature images know as Lilliputian, causing distress and affecting the elderly patient’s quality of life.  This syndrome has been mistaken and misdiagnosed as early onset dementia or psychosis, which furthers isolates the patient from the community.  Fear of prejudice or being labeled mentally incompetence becomes a barrier in seeking treatment.  There is not specific etiology to explain Charles Bonnet syndrome and this makes treatment a challenge for the clinician.  The difference between visual hallucination and illusion is the presence of insight and recognizing the visual image as not real.

The Impact of Culture on Faculty Retention in Nursing Education

Vol. 1 No. 2

Year: 2011

Issue: May-Jul

Title: The Impact of Culture on Faculty Retention in Nursing Education 

Author Name: 

Synopsis: 

There is a need to appreciate the impact of cultural dissonance on the transition of the experienced nurse clinician into the faculty role.  This factor is of utmost concern for nursing education administrators as they confront the current shortage of nursing faculty in programs throughout the United States. Nurses initially socialized into the culture of the profession may eventually transition into the culture of academia. The following paper explores how cultural similarities and differences influence that change. A review of the literature reveals that cultural dissonance exists for novice nursing faculty as they adjust to a faculty role and is related to the values transferred fromclinical practice. This role change creates conflict for the novice nurse educator and may negatively affect job satisfaction and retention, leading to the exodus of valuable future educators from the academic setting. Access to long term, formal mentoring programs for novice nurse educators, along with pairing of faculty mentors who are able to understand and address the issue of cultural dissonance, can facilitate successful socialization and transition into academia.  Implications for eliminating cultural dissonance involve specifying clear expectations for new nursing faculty, increasing the availability of mentoring programs in nursing education, and affording access to positive, expert faculty role models.

Meeting the social, emotional and psychological needs of patients in a cancer palliative care setting: Student Nurses’ experiences from Karachi, Pakistan

Vol. 1 No. 1

Year: 2011

Issue: Feb-Apr

Title: Meeting the social, emotional and psychological needs of patients in a cancer palliative care setting: Student Nurses’ experiences from Karachi, Pakistan 

Author Name: Nasreen Sulaiman Lalani, Shabana D. Lakhani , Muslim Shah 

Synopsis:

Palliative care is an urgent humanitarian need for people worldwide with cancer and other chronic fatal diseases as it provide comfort and ease suffering. Nearly 80 % of the cancer patients in Pakistan present late in stages 3 & 4 with terminal disease.  In Pakistan, the concept of palliative care is in its infancy stage and need to be strengthened.  In the early 1980s, the primary focus of palliative care was to provide pain and symptom relief. However, later the scope of palliative care was extended to take a holistic approach of care with a major emphasis on improving the quality of life of patients and their families or caregivers in general. This paper intent to share palliative care experiences where the student nurses from a teaching hospital under their faculty supervision utilized palliative care principles while giving holistic care to their patients in a hospice care setting. These patients were in their end stages of cancer and were suffering from various physiological as well as psychosocial issues. Pain was the major concern among these patients, therefore, other than the pharmacological support for the pain relief, various non pharmacologic measures such as therapeutic communication, guided imagery, relaxation exercises, religious and other diversional activities were used with the patients and their families in order to ease their suffering, emotional distress and provide optimal comfort and support during the terminal stages of their illnesses. The outcomes were measured as lowered pain scores, patients’ verbalization of having positive attitude towards life, increased motivation, strong nurse patient relationship and enhanced participation in activities of daily living.

  

Win the battle of loneliness: Nurses Role

Vol. 1 No. 1

Year: 2011

Issue: Feb-Apr

Title: Win the battle of loneliness: Nurses Role 

Author Name: Kiran Qaisar Ali 

Synopsis:

Introduction: Loneliness is an emotional state of emptiness and hollowness. It has a great impact on physical and mental health of a person. As a health care professional, it is important and essential to prevent, detect and treat loneliness appropriately and effectively in order to promote mental health and prevent mental illnesses. Case Presentation: A 40 year old lady admitted in a psychiatric hospital with the diagnosis of schizophrenia a year back. There was no past and family history of psychiatric illness. Before her illness, she was leading a glorious life with her husband and children. When she was diagnosed as schizophrenic patient she had lost everything. Her husband got separated and at the same time he took their children with him. She was left all alone with her illness. Initially, there were lots of hurdles in interaction with this patient as she was not talking with anyone and remain isolated in her room. Whenever she speaks, she talks about her children. It seems that she was missing her children. One day during conversation, she stated that I feel emptiness. I am all alone in this world. Conclusion: To win the battle of loneliness, there are many ways to detect loneliness, however, clinical manifestation and patient’s history including root cause of loneliness plays a significant part. In addition, effective strategies could be applied by health care professionals as well as patients to combat with loneliness effectively.

Sleeping pattern and factors contributing to sleep disturbances among elderly above 40 years residing in urban resettled colony of UT, Chandigarh

Vol. 1 No. 1

Year: 2011

Issue: Feb-Apr

Title: Sleeping pattern and factors contributing to sleep disturbances among elderly above 40 years residing in urban resettled colony of UT, Chandigarh 

Author Name: Jogindra Vati 

Synopsis:

Background: Efficient functioning of people especially of elderly depends upon quality and quantity of sleep as well as the pattern of their sleep. Sleep efficiency shows a sharp decline among them. There is variation in factors which make them sleep as well as there are various factors that disturb their sleep. The studies conducted in India lacks about the details of sleeping pattern of the population above the age of 40 years.Objectives: To determine sleep and wake pattern of adults above 40 years residing in urban resettled colony and to identify and analyze the factors affecting their sleepMethods: A descriptive study was carried out on convenience sample of 222 adults above 40 years after getting the ethical clearance from ethical committee of Institute. A pre-tested semi-structured interview schedule was used to collect the data. Results: The subjects took on an average 37.6±44.9 minutes (range=0-300) to get into sleep. About 52(23.4%) faced difficulty to fell asleep. On the average they slept for 6±1.56 hours during night and had naps for 33.8±56.1 minutes during day time. The quality of sleep ranges from light sleep to very deep sleep. More than half of subjects woke up once or twice during night while 2 subjects were awake for more than six times. But majority of them were either alert (n=75) or fairly clear-headed (n=52) in the morning. Duration of night sleep decreased and day naps increased with advancement of age. Females had higher sleep latency and slept for longer time for longer time during night. The day naps and frequent awakening during night was common among males. Psychological and financial problems were the main factors for the disruption of their sleep. Implications: The study provides evidence on sleep patterns and contributing factors affecting the sleep patterns among adults above 40 years. Further studies can be conducted on impact of various measures to reduce the factors affecting the general quality of sleep, sleep onset, and sleep duration.

  

Sleep in the Fibromyalgia Patient

Vol. 1 No. 1

Year: 2011

Issue: Feb-Apr

Title: Sleep in the Fibromyalgia Patient 

Author Name: Linda Carol Hughes 

Synopsis:

It is estimated that fibromyalgia, a chronic condition in which pain occurs in 98% of the patients, can be found in 3-to 6- million American adults with females as the majority of those suffering. The aim of this study was to describe the relationship between sleep-wake disturbance (i.e. daily and mean number of awakenings each night, daily and mean percentage of sleep each night) and the daily and mean morning/evening intensity of chronic pain in a subset of women with fibromyalgia, based on daily actigraph recordings over seventy-two hours. Actigraph testing was completed on a convenience sample of 85 female participants, as part of a larger research study of 107 fibromyalgia patients. Results indicated significant associations between the evening intensity of pain, measured by a visual analog scale, and the night awakenings. The progressive association between the number of awakenings and pain should prompt further attention given to the sleep-wake disturbance in the fibromyalgia patient in the form of improved interventions directed to effective sleep.

Trends/issues facing by Health Care Professionals While Discussing Sexual Issues with patient

Vol. 1 No. 1

Year: 2011

Issue: Feb-Apr

Title: Trends/issues facing by Health Care Professionals While Discussing Sexual Issues with patient 

Author Name: Nasreen Alwani, Anila Naveed , Erum Jewani , Saira Momin 

Synopsis:

Objective: The objective of the Literature Review Research is to investigate doctors and nurses’ perceptions on their roles and practices in meeting patients’ sexual health promotion needs. To identify the barriers of talking sexual health issues with patientsMethodology: A systematic search of the literature was performed for the period of January 1999 to 2009. A total 20 research articles were reviewed.Results: The literature review indicates that taking a sexual history is the first step towards appropriate diagnosis and therapeutic intervention for most patients, and is a fundamental part of holistic care. However, generally it is found from literatures that health care team members and patients feel hesitation in talking about sexual problems and concerns originated because of certain disease processes. The barriers identified included lack of time, lack of knowledge, personal attitudes about sexuality, and patient’s lack of readiness. Another barrier is the discomfort health care providers and patients may feel about discussing sexuality. Conclusion/recommendation: To accomplish the said objectives, the studies described attitudes and beliefs that might act as barriers to incorporating patient sexuality assessment and counseling into nursing / medical practice. The studies show that talking about sex-related topics is still repressed in patient—doctor encounters. It is an urgent matter to increase doctors/nurses awareness and clinical skills to deal with patients' sexual issues.

  

Physical activity risk factors for childhood overweight and obesity

Vol. 1 No. 1

Year: 2011

Issue: Feb-Apr

Title: Physical activity risk factors for childhood overweight and obesity 

Author Name: Dr. Baby Sathish Nayak, Vinod Bhat 

Synopsis:

 Introduction: Overweight and obesity and their health consequences have been recognized as major public health problems worldwide. A significant increasing trend in the prevalence of overweight and obesity among children and adolescents has been documented over the last few decades in developed and in developing countries.  The present study attempted to identify the most common physical factors of childhood overweight and obesity.Methodology: A case control study was carried out among 310 obese (cases) and 384 non obese (control) children from selected schools of Udupi district.  Based on the BMI children were classified as obese or non-obese.  A structured questionnaire was administered to assess the physical activity level of the children.Result: The physical activity risk factors associated with childhood obesity are Less than two hours of physical education per week, sedentary activity after school hours, spending more than two hours per day in videogames and watching television, spending more than two hours per day on sedentary activity, never participating in team sports, less than two hours of vigorous physical activity per week, less than 3 sessions/week of muscle training activity. Conclusion: Sedentary lifestyle is the most common factor for childhood obesity. Measures should be initiated at the early age to prevent and control childhood obesity.

Heart Failure Nurse Case Management System: A rising need in Pakistan

Vol. 1 No. 1

Year: 2011

Issue: Feb-Apr

Title: Heart Failure Nurse Case Management System: A rising need in Pakistan 

Author Name: Rozina Barolia 

Synopsis:

 Introduction: Heart failure is a complex and a debilitating syndrome (Driscoll, Worrall-Carte, Hare, Davidson, Riegel, Tonkin & Stewart, 2011) requiring complex management that places a significant burden on an individual, community and the health care system (McDonagh, 2005). However, cardiac patients in the third world including Pakistan, often suffer not only from the nature of their illness but also from the insufficiency of facilities available to treat them and to enhance their functional capabilities at work, home and in community than patients in more developed countries (Utriyaprasit & Moore, 2005). Therefore, concerted efforts are needed to manage heart failure patients in developing countries. Objective: This paper aims at elaborating the role of a nurse led case management program for heart failure patients in the light of literature within the context of Pakistan. Nurse led case management: Nursing case management is a dynamic and systematic collaborative approach to provide and coordinate health care services to a defined population (American Nurse Credentialing Centre). The nurse case manager is the coordinator of a multidisciplinary treatment plan which addresses a patient/ family’s continuum of care needs while ensuring clinical quality that is cost and time effective (White & Hall, 2006). As the complex nature of the disease requires holistic management, this approach provides patients with home visits, telephone calls, counseling sessions, support group and skills building. Conclusion: Nurse led case management should be introduced for the care of heart failure patients in Pakistan to improve quality and continuity of care, reducing length of hospital stay, improving pt satisfaction and assisting with the reduction in overall health care costs.

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Editorial Memebers - Journal on Nursing

 Editorial Board Members –Nursing (JNUR)

Sl. No.	Editorial Board Members	Designation
1	Dr. Lin Hughes	Director of Undergraduate Nursing Programs Nebraska Methodist College- Josie Harper Campus Omaha
2.	Dr. Jogindra Vati	Professor cum Principal SGHS, College of Nursing Mohali (Pb), Near Chandigarh.
3.	Dr. Baby S Nayak	Professor & HOD Department of child health nursing Manipal College of Nursing Manipal Manipal University, Manipal Udupi District
4	Dr. Sherri Melrose	Assistant Professor Centre for Nursing and Health Studies Athabasca University, Canada
5	Mr. John Thain	Senior Lecturer School of Health and Wellbeing University of Wolverhampton United Kingdom