Advance Directives: A Policy required in the Asian Countries

Vol. 3 No. 3

Year: 2013

Issue: Aug-Oct

Title : Advance Directives: A Policy required in the Asian Countries

Author Name : Nasreen Panjwani

Synopsis :

Advancements in health care have resulted in elaborate treatments all over the world and contributed to problems at times for the terminally ill who need palliative care. Futile treatments have demonstrated to defuse the symptoms of the disease without curing. In such scenarios physicians only prolong life of patients, keeping them away from dying peacefully and depriving them from quality of life. In this context, families exhaust their financial and material resources for the treatment of their loved ones without any substantial results. Health care systems are passionate about prolonging life and are ignoring the component of caring by disregarding the patient's rights. There are no existing policies about Advance Directives (ADs) in Pakistan and many other Asian countries, which result in ethical dilemmas among nurses and physicians. Thus, the decisions to limit the treatments such as ADs are needed in this age of modern medical technology. In this paper the author walks the audience through a scenario where she felt a dire necessity for a policy of ADs in an Asian country like Pakistan. This position paper reveals the ethical dilemma that is encountered, the position taken, supported by the ethical principles, the arguments, counter arguments and the justification for having the policy of ADs. Lastly, the final position has been stated and recommendations to implement the policy have been elaborated.

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Perceptions of Leprosy and Its Attributes Among Health Care Workers in Karachi, Pakistan

Vol. 3 No. 3

Year: 2013

Issue: Aug-Oct

Title : Perceptions of Leprosy and Its Attributes Among Health Care Workers in Karachi, Pakistan

Author Name : Saleema, Jacoline Sommer, Muhammad Shahid, Yasmin Parpio, Noureen N Karamali

Synopsis :

Leprosy is one of the socially stigmatized diseases known today which affects the social status of an individual as much as the physical, eventually impacting one's status in society. Nerve destruction leads to weakness in the hand and feet resulting in deformity. According to World Health Organization (WHO, 2013) official reports depicted that the global registered prevalence of leprosy at the beginning of 2012 stood at 181,941 cases from 105 countries. A quantitative, analytical cross-sectional design was considered to compare the knowledge and perceptions about Leprosy among Health Care Providers (HCPs) who were directly and indirectly involved in taking care of Leprosy patients. Stratified random sampling was employed to recruit 65 HCPs from NGOs, government and private hospitals. The Result has shown significant difference between two groups directly and indirectly involved in Leprosy care patients. The HCPs directly involved in providing care and possess sound knowledge about Leprosy were 98% and hence involved in providing holistic care including psychological aspects. Whereas, 40% health care providers who were not involved in direct care were not equipped with updated information and thus having fear about contracting disease resulting in ineffective care provision. It is concluded from the findings of the study that there is a strong association between knowledge about Leprosy and its perception. The in-depth knowledge and positive perception about Leprosy will help patients to receive quality care from HCPs and this will eventually reduce the stigmatization effect in society.

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A Comparative Study to Assess Job Satisfaction among Married Staff Nurses and Nursing Faculty in selected Institutions of Udupi and Mangalore Taluks

Vol. 3 No. 3

Year: 2013

Issue: Aug-Oct

Title : A Comparative Study to Assess Job Satisfaction among Married Staff Nurses and Nursing Faculty in selected Institutions of Udupi and Mangalore Taluks

Author Name : Aradhana Viswam, Blessy Valsaraj, Tessy Treesa

Synopsis :

Married working women face many challenges in their life as career women and as a responsible family member. Inability to maintain a balance in this dual role makes them frustrated in various aspects which adversely affect their performance and quality of life. Work demands, night duties and poor wages made the staff nurses to shift from clinical side to the education field. Academic field is also facing the same burdens but for other reasons such as class preparation, assignment corrections, class coordination, student counselling and many more. Moreover recent strikes by nurses all over India also throw light to the difficult job adjustment situations (“Nurses go on”, 2013) All these show the importance of investigating more to throw light to this area. These entirely made to analyse job satisfaction among married staff nurses and nursing faculty. A descriptive survey was carried out. Simple random sampling was done for the selection of hospitals and purposive sampling for married staff nurses and nursing faculty. The criteria for sample selection include married staff nurses and nursing faculty whose age ranges from 22 to 55 years with 6 months or more of marriage life and work experience Data was collected using a standardized questionnaire. Data was analysed and interpreted using descriptive and inferential statistics. Findings revealed that majority 50% married staff nurses have average job satisfaction where as majority of married nursing faculty has high job satisfaction. It was also found that there was significant difference (t=4.25, p= 0.01) between the job satisfaction between married nursing faculty and staff nurses; hence it can be interpreted that job satisfaction is more among nursing faculty than staff nurses. The study suggest that there is a need to take necessary steps to improve job satisfaction among married staff nurses in order to promote wellbeing and to prevent mental illness for them as well as to enable them to deliver high quality care to the patients. It also suggests that it is high time to reframe the policies and to encourage coping enhancing programmes to improve quality of working life. The findings of present study pointed out the need of outcome driven research for examining the effectiveness, efficacy, and cost-benefit of specific strategies aimed at improving the nurses quality of working life and organizational productivity.

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Effectiveness of Teaching Module on Knowledge of Caregivers of the Elderly

Vol. 3 No. 3

Year: 2013

Issue: Aug-Oct

Title : Effectiveness of Teaching Module on Knowledge of Caregivers of the Elderly

Author Name : S.Sharmila

Synopsis :

Ageing is a normal, universal and inevitable change which takes place even with best of nutrition and healthcare (Contran, 1998). This study investigates the effectiveness of teaching module on knowledge of caregivers of the elderly. A sample of 100 caregivers of the elderly were selected by purposive sampling method. Among 16 old age homes in Kanyakumari District, the investigator selected 10 old age homes by lottery method. The tools used for the data collection included demographic variables, knowledge assessment tool for caregivers of the elderly. Data were collected through self administered questionnaire. The major findings shows that mean pre test knowledge score of caregivers of the elderly was 38.96, and mean post test knowledge score of caregivers of the elderly was 68.38. The overall knowledge gained by the caregivers was 29.42% , and it was found to be significant (t=12.62, p<0.001). The association between the various aspects of knowledge was found to be significant (F=10.57,p<0.01). From the findings it is concluded that there was a marked improvement found in overall knowledge of the caregivers of the elderly after the educational intervention.

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The Effects of a Rapid Response Team on Clinical Outcomes

Vol. 3 No. 3

Year: 2013

Issue: Aug-Oct

Title : The Effects of a Rapid Response Team on Clinical Outcomes

Author Name : Milton Evans

Synopsis :

One of the most startling US healthcare statistics is that somewhere between 44,000 and 98,000 hospital in-patient deaths each year are considered to be the result of medical error or oversight and thus, are arguably avoidable mortalities (Byrne, Delarose, et al. 2007). The purpose of this study was to explore the effects of a Rapid Response Team (RRT) implementation on rates of patient mortality, in-hospital cardiac arrests, ICU admissions, length of patient stay, code calls, and overall cost-effectiveness of a 300 bed, non-metropolitan hospital. The discharge rate was significantly higher post RRT, the mortality rate was significantly lower post RRT, and the number of deaths were significantly lower post RRT. The data also demonstrated that for each unit of RRT implementation, patient stay increased by 0.43 days and an average increase of 23 dollars of hospital cost per patient, per day. The evidence that the RRT implementation and integration had a significant impact on death, mortality rate, and discharge from the hospital is a potential argument in favor of RRT implementation.

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Effectiveness of Structured Activity Programe on Self Esteem Among Inmates of the Destitute Home

Vol. 3 No. 3

Year: 2013

Issue: Aug-Oct

Title : Effectiveness of Structured Activity Programe on Self Esteem Among Inmates of the Destitute Home

Author Name : Anjali K G, Asha K Nayak , Maxie Andrade

Synopsis :

Advances in health care practice resulted in increased cost of health care services. This emphasised on cost effective integrated approach of pharmacological and life style modification. This can help mentally ill individual and destitute to obtain the optimum level of functioning. This study aimed to determine the effectiveness of structured activity programme on cognitive function, self esteem and behaviour among mentally ill destitute home inmates. The Study was conceptualized based on Albert Bandura's Triadic reciprocity of determinism. An evaluative approach using pre test post test design was used for the study. The samples were selected based on the sampling criteria and a total of 50 samples were recruited for the study with the mean age of 41.98±13.13. This Study findings reveal that structured activity programme was effective in improving the self esteem of mentally ill destitute. This suggests that structured activities can be used in institutionalized or hospital setting to improve the self esteem of mentally ill clients.

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Nursing: A Profession in Need in Pakistan

Vol. 3 No. 3

Year: 2013

Issue: Aug-Oct

Title : Nursing: A Profession in Need in Pakistan

Author Name : Shaista Rajani Meghani, Salma Sajwani

Synopsis :

The objective of the literature review is to focus on the need of nursing profession and challenges faced by nurses in Pakistan while persuading nursing career as their profession. A systematic search of the literature is performed for the period of 1994 to 2009. The results of the literature review indicated that domain of nursing care has spread from patient care to the family centered care, community and public health nursing, education, and research. However, Pakistan being a developing country has underprivileged healthcare system and is still facing scarcity of nursing professionals contributing for nurses shortage. Factors contributing towards nursing shortage in Pakistan are low salary, lack of career development, migration, marriages, pregnancies, domestic problems, less educational opportunities, poor infrastructure of teaching and learning resources, lack of involvement in decision making at different level of healthcare system, and violence and so forth. Literature also highlights that nurses feel lack of appreciation for their work from their managers. Moreover, nursing is considered as female centered profession; professional training and job is submissive to medical practice. This difference has affected public image of nursing as low profile job. To gain respect, dignity and professionalism in nursing profession, nurses need a quality educational and professional regulatory body. This paper mainly focuses on the healthcare system of Pakistan, factors of nursing turnover, and the level of nursing education in Pakistan.


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